HomeMy WebLinkAboutBLD10807 Final Mobile Home - BLD Inspections - 6/23/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
40 2 ,d
DIRECTIONS
TO JOB SITE 4_0f of di
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. E �# ,�, f► N M >�
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR P S -
�.
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
27
Valuation of work: $ PLAN CHECK FEE VZA PERMIT F
SPECIAL CONDITIONS:
BEDROOMS 2 DECKS CARPORT ❑ NOTICE
BATHROOMS R TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 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. PERMANENT SHORELINE 0400
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. 3
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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in confo manse there i h, MOW R VEHICLE PERMIT
PLI T1 N EPTED Y PLANS CHECK BY APPROV D F R S ANCE
Owner l�f Date. BY
P AN CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
i
CHISHOLM Jr. , William #10807
Rt. 4, Box 272A, Shelton 06-17-81
Take Hartstine Island North - South Rd. to dirt access
road at corner of NS Rd 7 Bergundy
Lot #3, Port of Sec. 30, Twp 20 N, Rge 1 W
Mobile Home Contractor - All Seasons Mobile
Home Sales, Inc.
I
Rochester
$15,666
a