HomeMy WebLinkAboutBLD21154 Mobile Home Space 19 - BLD Inspections - 11/4/1987 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls: pi:RMiT
Framing: NULL _VOID RY FXPIRAT10N
Fireplace:
Wood Stove: DATE
TYPE MOBILE HOME
Permit No. 21154 No. Floors Sq Ftg 52 -
Owner MC LEAN: Jack M Tel 275-6767 Date 11-4-87
Address P 0 Box 671 Allyn Zip
Contractor None
Address Zip
Legal Description Town of A11 n Lot 9
Direction to projectsite he wnnd Hills D V Park
Space 19
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basenent --Loft Other
1987 12x44 1 bdrm
1
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 188 SHELTON, WASHINGTON 98584 //
426-5593 DATE ISSUED
PERMIT NO. C=9
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER C c = ,J 0• Bax LL 985-24 "-G74
DIRECTIONS //
TO JOB SITE 14 a P-uj00 � t 1 L, •V. ^,e
moot
PARCEL
NUMBER 4 Q a�� DESCR.
�
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE
WORK
axe
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSO.FT. GARAGE CONDITIONING.
NO.OF STORI ES _ BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALSO.FT. FIREPLACE DETACHED ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMAN NT SHORELINE
SEASO L
OWN SAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST TION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR MENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
CO ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
O TAIN G APPROVAL FROM THEBUILDINNGG�DEPARTMENT. y APPROVAL FROM THE BUILDING DEPARTMENT.
X O ERC "' DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED
YES NO BUILDING VALUATION �c/�
YES NO / W •al
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT Q�a
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP -.3 PRE-INSPECTION
Q 'ffilkit c SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE I
APPLICATION ACCEPTED BY PLAN CHj�K B� BY ROVEDFO8 ISM NCE PERMIT VALIDATION /
f! ef/� �J�'�/ CASH CK MO TOTAL �3'