HomeMy WebLinkAboutBLD9418 Mobile Home - BLD Permit / Conditions - 10/15/1979 Gallinger, Darwin #9418
10-15-79
Tr. 8 NE 1/4 NE 1/4 18-20-4
Dayton Nimrod Hall
Mobile Home
BUILDING PERMIT APPLICATION
' MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED ze `�799
PERMIT NO.
OWNER NAME MA A DRESS CITY STATE ZIP - PHONE
. �tJJ� 7G r 7
DIRECTIONS
TO JOB SITE
LEGAL L (❑ SEE ATTACHED SHEET)
DESCR. 7
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
'� '.s o mod. .-a
1
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORTh NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE [1
ATTACHED I I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT iJ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I ? DETACHED Li
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT 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
I certify that I am a currently registered contractor In WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANEN1 SHORELINES
SEASONAL h FLOODPLAIN i i
Firm E.D. NO. S.E.P.A. I]
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issue and that all work done will ROAD ACCESS
in c formance ther i MOTOR VEHICLE PERMIT
�( ,/ _ ICATION ACCEPTED BY PLANS CHECK BY PROVED FO ISSUANCE
Oarner Date. B �
AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH