HomeMy WebLinkAboutBLD9475 Change Carport to Garage - BLD Application - 6/7/1976PPPPP
BUILDING PERMIT APPLICATION
MASON COUNT'
aa3a5 • 5�' P.O. Box 1cb :>nelton, Washington .,sSJc
�Ja DATE ISSUED 7_ 7-4
t JJ O�V(,Y , PERMIT NO. !9 7_5'
ER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE may„
LEGAL 4/ (Ci SEE AT SHEET)
DESCR. 91
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF E
BUILDING
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ /a Q PLAN CHECK FEE / PERMIT F fa
SPECIAL CONDITIONS:
02 e fe
APPLICATION ACCEPTED BY1 PLANS CHECK BY APPROVE[ FOR ISSUANCE; Type of Occupancy Division
Const. 3L
Group
Size of Bldg. No. of / Max.
(Total) Sq. Ft. Stories / Occ. Load
CONTRACTOR AFF;DAV17 V 9y 66
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State Of Washington and I am av,are 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.
irm___ PUBLIC WORKS
Fay
ROAD DEFT.
------
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 REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
whicf this permit is issued and that all work done will
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
L _- ---Date WORK IS COMMENCED.
Pi Aar' HEC{ VALIDATION Cti M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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