HomeMy WebLinkAboutBLD5507 Alterations - BLD Permit / Conditions - 7/6/1977 Ellis, Ronald H. #5507
7-6-77
Lot 13 Springwood 12-20-4
2nd Cul-de-sac, grey house on corner
Alteration
$3,000.00
BUILDING PERMIT APPLICATION
' MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 17
7
PERMIT NO. 6�6 7
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS I _
TO JOB SITE Viet
n -, ' ^d -de c re Cogyle-rt
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. EC. I� Totv.►Sl►:p O AJC2tN IPav� C �rS� �oT 13 a'c'r's
NAME MAIL ADDRESS CITY&STATE LI ENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION "LTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
�A .�� t � ECE p" �✓
!)Bash�47 X'/
l ) e e1 4r1?1K£ e Inc. �d
r/E2T i D� ree Wrt E,e �i Sourl�tJ
(1) W r TH• mt?,A e✓l4o-once
Lrl /Y
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BYl PLANS CHECK BY Type of Occupancy Division
B Const. Group
Size of Bldg. No. of Max,
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
F-
I certify that I am exempt from the requirements of the NO T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be ' con rmance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner DateZ5Z 77 WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH