HomeMy WebLinkAboutBLD5452 Deck - BLD Application - 6/23/1977 T
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 7 7
Jb vl PERMIT NO.
NAME f MAIL ADDRESS , // JJ CI STATE ZIP PHONE
OWNER AID J Ii-XITST A) 1624 vakCti14 pme4y,, Wvx -hvodzi-,659-3
DIRECTIONS II
TO JOB SITE /Vt� Share Dy"llille -, � 5 Crt41ka',
LEGAL ,/` �/�7 (❑ SEE ATTACHED SHEET)
DESCR. a N h 1 Q ®2c. 7 v- 7"
CONTRACTOR
NAI MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
a.
USE OF r.--- c D ( /
BUILDING F--
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work, ,.
X
Valuation of work: $ jf �-V PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
LICATION ACCEPTED BY PLANS CHECK BY APP 11VED FOR ISSUANCE Type of Occupancy Division
BY 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
I certify that I am exempt from the requirements of the N O T I C E
contr or registration law RCW 18.27, and am aware
of t e Mason County Ordinance requirements for SEPARATE PERMITS ARE REQUIRED NG. FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
wh. h is p r it is issued and that all work done will
n conf r i c th 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
Date. WORK IS COMMENCED.
M.O. CASH PERMIT VALIDATION K. M.O. CASH