HomeMy WebLinkAboutBLD11185 Final Mobile Home - BLD Inspections - 12/31/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �—��.—�/
DATE ISSUED /
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
t U t u� '< 5
DIRECTIONS ,
TO JOB SITE y Sf — S
LEGAL p SEE ATTAC D SHEET)
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NAME U MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING �,
Class of work: ;k NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: b C S e o-
Valuation of work: $ PLAN/CHECK FEE PERMIT FEE
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SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS_— TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
S ElNO. OF STORIES BASEMENT OR AIR CONDITIONING.
TOTAL SQ. FT.-910V 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. PERMANEN SHORELINES
SEASONAL ❑ FLOODPLAI ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
/be
ntract or registration law RCW 18.27, and am aware BUILDING DEPT.
the Mason County ordinance requirements for
ich this permit is issued and that all work done will ROAD ACCESS
in colnfoo mance therewith. M R VEHICLE PERMIT
Cif Date. '/� PPLI AT N EPTED Y PLANS CHECK BY APPROVED FOR IS UA CE
Own BY
PA LA VALIDATION CK.. M.O. CASH PERMIT VALIDATION CK. M.O. tASH
AROLA, Walter L. #11185
3516 Old Lewis,.Uver D. , Woodland 08-10-81
Left at Grapeview Store - 5th right - follow signs,
5th driveway from Grapeview store
W 340' Govt Lot 3, 5-21-1
Mobile Home Contractor - Deans Mfg. Homes
$17,760.00
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