HomeMy WebLinkAboutBLD5397 Addition - BLD Permit / Conditions - 6/15/1977 ?hillips, James #5397
6-15-77
E 3' Tr, _k all of Tr. 20
William J. Murphy Brookpoint Trs. ( /�
1/2 mile sawM1 of Casa De Canal
Addition
$3,900.00
OX 6-;2
7
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER T S / L Fl 7 -7 /v;E' . /3 IT« 9'
DIRECTIONS
TO JOB SITE �'� E �' _r 5e -
LEGAL � •3 (❑ SEE/�1�CHEq•,SH Fr..
ESCR
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICEN NO. PH SAE rM .
17,2�igus
o n/ S�• t� O, o / l o t�1' t�.� %� - - r"r' o .!� f 6 6
USE OF
BUILDING
Class of work: ❑ NEW )Z ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
� �•
r G t ' e `i C 4 C. t' C Gv r O I'� c K 11
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n
Valuation of work: $ PLAN CHECK FEIFk- PERMIT FEE
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SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
BY Const. Group 41 /
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 /Avj PV-S 0 VAj PUBLIC WORKS
BY -
ROAD DEPT.
Lic. No.7 cti Date iJu Ali. 117/
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 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 in conformance 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 Date. WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH