HomeMy WebLinkAboutBLD10872 Mobile Home - BLD Permit / Conditions - 6/24/1981 IT APPLICATION
MASON COUNTY
P•0• BOx 186 Shelton, Washington 98584
426-5593
DATE ISSUED
OWNER NA E aS
MAIL AD Ess PERMIT NO. 7a--
DIRE CTIONS � CITY TATE
TO JOB SITE PHONE
LEGAL
DESCR.
(❑SEE ATTACHED SH CONTRACTOR NAME p MAIL ADDRESS 4p EET)
cp-
CITY&STATE (�T
USE OF LICENSE NO. PHONE��
BUILDING
Class of work: NEW
❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: S
d OQ PLAN CHECK FEE 9
SPECIAL C NDITIONS: /(/ PERMIT FED
BEDROOMS DECKS
BATHROOMS ------ CARPORT❑
TOTAL SO. FT.
NO. OF STORIES MIT
GARAGE ❑ NOTICE
TOTAL SQ. FT BASEMENT El ATTACHED El SEPARATE PE
FIREPLACE ElCONNDITNI DETACHED ❑ OR AIR ROK�NING.ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
CONTRACTOR AFFIDAVIT THIS PERMIT BED
OMES IZED IS NOT NULL AND VOID IF WORK OR
1 certify that 1 am a currently registered contractor in SUSPENDED OORRA ENCED WITHIN iS0 DAYS,OR IF �NST�CTION AUTHOR.
the State f WORK IS BAMIDONED FOR A PERIOD OF 180 DAYS AT Neya) Oy THEWORKIS
AFTER
o Washington and I am aware of COMMENCED.
ordinance requirements regulating the work for which
the permit is issued and all work done will be in FO O "'�'�
Conformance therewith. C'E USE L Q
PERMANE `"'^y
Firm NT SHORELINES
SEASONAL ❑ FLOODPLAIN❑
Iy E.D. NO.
S.E.P.A. ❑
.1c. NO. Special Approvals IN
Date ZONING OUT YES A
D NO
PLANNING DEPT. �rX�
OWNERS AFFIDAVIT
HEALTH DEPT.
I certify that I am exempt from the requlrements;of the PUBLIC WORKS
Contract or registration law RCW 18.27, and am aware
Of the Mason FIRE MARSHAL
which this County ordinance requirements for permit is issued and that all work done Will
BUILDING DEPT.
be in Conformance therewith. ROAD ACCESS
er MOTOR VEHICLE PERMIT
Date ION A p
BY PLANS CHECK BY APPROV F
CE
BY
W CHECK VALIDATION CK, M.O. CASH
'PERMIT VALIDATIO
CK. M.O. CASH
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Z riemeth D.
S k 81 Pine Lake Blvd. , Olall 0 -
06-2424-81
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Panarama Park #E3, 2-22-2, Tr. 8 of Gov't Lot 2 b 3 b TL
Mobile Home
Contractor - Self
$6,500.00
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