HomeMy WebLinkAboutBLD2808 Mobile Home - BLD Permit / Conditions - 8/6/1978 BUILDING, PERMIT APPLICATIONyo-�¢
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER A V16C
, MAIL DRESS 18 ' CITY S HT TE ZIP 1O ONE il
TDO JOB SITE RD, , O M O DIRr 1VJ AT 00AMSOA S16
LEGAL S z S 2 w ^ OL3 — (❑SEE ATTACHED SHEET) S
DESCR. T u
CTOR CONTRA NAME MAIL ADDRESS CITY✓t<STATE LICENSE NO. PHONE
05 S. 13r w .35ig-
USE OF Q� t223-D1.. 016-Et-
BUILDING MO BUE t't�'4�'� at225L I!
Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: l A� MlJ[�U G RORE 64-'Y(7t�) o 1 'm P1ePPV-rY
Valuation of work: $ 12 100
00 PLAN CHECK FEE PERMIT FEE�P?O• e-0
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT-0— GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT 0 OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
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 1 am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES ❑
SEASONAL❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. Elgy Special Approvals IN OUT YES APPROVED NO
-�Imz
2
ZONING
Llc. No. (- — � a eT
(O i Z q PLANNING DEPT,
OWNERS AFFIDAVIT HEALTH DEPT. ,f
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 conformance therewith. MOTOR VEHICLE PERMIT
O ner
Date, —�✓� APPLICATION ACCEPTED BY PLANS CHECK BY ROVED FOR ISSUANCE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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���LER - µo8s
�C. — IORS
J"nson, Randall A. #2808
8-9-78
S 1/2 S 1/2 NE 1/4 NW 1/4 30-23-1
1 mile up Sandhill Road, turn left on dirt road at
Johnson sign and follow signs.
Mobile Home
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