HomeMy WebLinkAboutBLD7621 Garage - BLD Permit / Conditions - 9/28/1977 1
Peterson, Orville 0. #7621
9-28-77
497 Mason Lake Drive, Grapeview
Madings Sunny •S±vpe Lot 75
3tiohc-s
Garage
$4,368.00
2 33 Z OCO
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ar
BUILDING PERMIT APPLICATION
MASON COUNTY �� jeo C;��1J�
P.O. Box 186 Shelton, Washington 98584
222 DATE ISSUED I
PERMIT NO. 7r� �
OWNER �� NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE o V :TU�-jl e1!Rhr- /m,I 4L b"CAf1 D 1c
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �� Mal e] un n1 51.
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
S
USE OF
BUILDING
Class of work: �NE ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK F zti. — PERMIT FEE ciLr'
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED 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
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
X/� be In conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
Ow r ® ��{ IS NOT COMMENCED WITHIN OR DAYS, OR F CONSTRUCTION OR WORK IS
L, SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
rye YQ � p� WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. ` M.O. CASH