HomeMy WebLinkAboutBLD7932 Swimming Pool Enclosure - BLD Application - 12/7/1977 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED /7 7
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
IWIS INIj VAj v J WIt
DIRECTIONS
TO JOB SITE
jLEGALFj. Q ,,, (❑ SEE ATTACHED SHEET)
DESCR. �S `� �lI nl tv'T� - AE*� A �O CV .
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR Q b t�l / ,r "Q. Q ,
USE OF P�� F�CL'O C0/,_C /V4 2 �21"3
BUILDING v U
Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Cow J c: At cl'v 11_ ISO 19 v 1
Valuation of work: $ 60 PLAN CHECK FEE / S�-- PERMIT FEE,O 7
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY1 PLANS CHECK BY APP ED FOR I VANCE Type of Occupancy Division
BY QlC Const. Group
U-
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 � �(D_� 11OAD DEPT.
Lic. No. F � — Date
3
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 REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
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