HomeMy WebLinkAboutMobile Home Final - BLD Permit / Conditions - 10/9/1984 ply PMff APPLICATIOW
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 3 /� ��
DATE ISSUED / —
PERMIT NO.
OWNER NAME MAIL ADDRESS /, C17Y&STATE P PHONE
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DIRECTIONS rr
TO JOB SITE
LEGAL y (❑S E ATTACHED SHEET)
DESCR. /1 740 Ino B lk g 7tV 111 T /� /V Yi7 SW
NAME MAIL ADDRESS CITY A STATE LICENSE NO. PHONE
CONTRACTOR
O
USE OF 6 �
BUILDING. LIN
Class of Work: r NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
oAl e 4o,6
Describe wank:
x 7-0
Valuation of work: S / OJ PLAN CHECK FEE PERMIT FEE
7.
SPECIAL CONDITIONS:
BEDROOM DECKS CARPORT❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FIM FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR-CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZEDISNOTCOtAMENCEDWITHIN 180 DAYS,OR IF CONSTRUMON OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I 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 US ONLY
the permit is issued and all work done will be in
co ormance therewith. PERMANENT SHORELINES
SEASONAL❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No Date ZONING
PLANNING DEPT. MAW it Won--
OWNERS AFFIDAVIT HEALTH DEPT. / S,
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
conformance therewith. MOTOR VEHICLE PERMIT
rCAyyO�ACCEPTED PLANS CHECK BY APPROVED F RISSUANCE
Date: p BY
Own —
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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Shorelines:
Setback:
Special Conditions:
Footing:
Setback: --_�
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: nl /D 9 -
Stop Work:
Mobile Home:
Smoke Detector:
Remarks: