HomeMy WebLinkAboutBLD9594 ReRoof - BLD Permit / Conditions - 6/21/1976 Richardson, Charles E. #9594
6-21-76
Union, Tract #4, Blks 81-83
Re-roof Residence
$1 ,000.00
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C. E . k) e,�0- soy
_ . . BUI ING PERMIT APP►�ICATION
MASON COUNTY 2 s��lC
P.O. Box 186 Shelton, Washington 98584��
DATE ISSUED
PERMIT NO. gsgS�
OWNER N E MAIL ESS CITY 3 STATE ZI PHONE
DIRECTIONS
TO JOB SITE
LEGAL 0�/t�� .1/ (0 SEE ATTACHED SHEET)
DESCR. 7�"
ems• 'el -Id
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE _ ❑ REMOVE
Describe work:
YL
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Valuation of work: $ PLAN CHECK FEE ` PERMIT FEE
—
SPECIAL-CONDITIO S:
APPLICATION ACCEPTED BY PLANS CHECK BY ABYPRq!(ED FOR SSUANCE Type of Occupancy Division
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 1 am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit Is Issued and all work done will be in Speclal Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT `.
Firm PUBLIC WORKS
By— ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
which this permit is issued an thatjall work done will VENTILATING OR AIR CONDITIONING.
be in conformance ther It THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
Owne — -- �j SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
to. WORK IS COMMENCED.
PLAN CF11ECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK. M.O. CASH