HomeMy WebLinkAboutBLD350 Final Mobile Home - BLD Permit / Conditions - 10/19/1979 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. °�-�-� �✓
OWNER NAME. MAIL ADDRESS 1 _ CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE7?-�a_,3
LEGAL t � t' '
DESCR. / � (❑ SEE ATTA HED SHEET)
CAI 3CONTRACTOR NA E MAIL ADDRESS C 8 STATE J
LICENSE NO. PHONE
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
PValuationof work: $ � PLAN CHECK FEE
PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑
BATHROOMS__ TOTAL SQ. FT. GARAGE ❑ NOTICE
NO. OF STORIES_L_ BASEMENT ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
TOTAL SQ. FT. C FIREPLACE ❑ DETACHED ❑ OR AIR CONDITIONING.
CONTRACTOR AFFIDAVIT THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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 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 USE ONLY
the permit is issued and all work done will be in I -
conformance therewith. PERMANENT SHORELINES [
Firm
SEASONAL [] FLOODPLAIN
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. r1 z ?n
PUBLIC WORKS
I certify that I am exempt from the requirements of the
contract or registration law RCW 18.27, and am aware FIRE MARSHAL
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 MOTOR VEHICLE PERMI r
Ct,�t� i'` Date,� �tl '" ICATION ACCEPTED BY PLANS CHECK BY AP OVED R ISSUANCE
Owner ,� tal :
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION %LK. M.O. CASH
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#350
9-10-79
_�icCowan� Maxiel
side of rd.
on ov tnext to Belf air
shore BElf of B andi s C
3 1/10 North end
G. L• 3 31 o2or to E1mar Beard.
Hwy next d
Mobile Home
$20 51000,00