HomeMy WebLinkAboutBLD16759 Final Modular Home - BLD Permit / Conditions - 9/24/1985 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER D NAME E MAIL ADDRESS CITY 3 STATE ZIP PHONE
E 'Cip r -4219
DIRECTIONS
TO JOB SITE AMP I
LEGAL 4 � OP A Pa ' ,W &.0 -VeC, t, � 2p a Al (❑SEE ATTACHED SHEET)
DESCR. .bT r-T�.l ,� Y4 R-4146er /W o.0
PHONE
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO.
CONTRACTOR -� p
USE OF
BUILDING ��GGE' •� kkss
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS_ � DECKS CARPORT ❑ NOTICE
BATHROOMS_ TOTAL SO. FT. GARAGE ❑
NO. OF STORIES ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT FIREPLACE ElDETACHED ❑
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 ertify that I am a currently registered contractor in WORK IS COMMENCED.
t e State of Washington and I am aware of the
o dinance requirements regulating the work for which FO FFICE USE ONLY
t e permit is issued and all work done will be in
nformance therewith. PERMANENT SHORELINES
F
SEASONAL ❑ FLOODPLAIN Elirm
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.
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 issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
Owner Date APPL ATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
WISE,David #E16759
4-30-85
Lot 1 of Por of SE-1/4, SW-1/4 5-23-1
NE 2151 Bear Creek Rd. Bremerton 98312 275-4218
MAP ATTACHED
Contractor
Evergreen
Modular Homes
Modular Home 1456 Sq.Ft— 2 bdrm.
void SrQrn� �'�
$48,776.00
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