HomeMy WebLinkAboutBLD5440 Porch - BLD Application - 6/22/1977 BUILDING PERMIT APPLICATION
MASON COUNTY 0232S 3-D 6 qa�-
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED �%Z 2.Z7 7
PERMIT NO.
OWNER NAME MAI A DR S CITY TATE ZIP PHONE
DIRECTIONS TO JOB SITE t er r /U
LEGAL U (❑ A ACHED SHEET) _1
DESCR. Q /OCG D O C? 0 lV"t
NAME MAIL ADDRESS LITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW e ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Porch 160 sq. ft.
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
$640.00 $7.00
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY PLANS CHECK BY APP O ED FOR IS#JANCE Type of Occupancy Division
B CCU L<—U 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
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR 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
AA r//�// IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
Owner G �v Date, a �,WORK NS COMMENCE DO SUSPEDED OR NED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
PJ(AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH