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HomeMy WebLinkAboutBLD0101 Cancelled Mobile Home - BLD Permit / Conditions - 11/15/1983 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. ©` NAME MAIL A ESS CITY&STATE ZIP PHONE OWNER29 8 .14e 5 y i DIRECTIONS /ll11Q ae.,t d-1 o- 4c.'�i Q! 3M+'�• /(-+�r.�L. �.�MG d- ?at >}iPllt-t`i I TO JOB SITE c+ E'sR -j�C-R C.e J2G C.o?2o�2dt rIV lrr.H7 e. ti a 7l O (❑SElf ATTACHED SHEET) � LEGAL DESCR. PHONE �N,A+ME MAIL ADDRESS CITY 3 STATE LICENSE NO. CONTRACTOR Tl j__l j[ Al ��, �� 4i/ 7S +' USE OF /� r BUILDING ztje-�41 '{ Class of work: ❑ NE ElADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: �y k 4 Valuation of work: $© d PLAN CHECK FEE PERMIT FEE�s'� / S SPECIAL CONDITIONS: BEDROOMS 1 DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT 1-1ATTACHED ❑ OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I certify that I am a currently registered contractor in the State of Washington and I am aware of the F p R OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in PERMANENT ❑ SHORELINES ❑ conformance therewith. SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. ❑ Special Approvals IN OUT YES APPROVED NO By ZONING Lic. No. Date PLANNING DEPT. HEALTH DEPT. D OWNERS AFFIDAVIT 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. l� /� ✓ 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 APPLICATION ACCEPTED BY PLAN E�CK_BY� BYPROVED ISSUANCE Owne4�����Date PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION CK. M.O. CASH 5 r �w V191=, Bruce 1. #0101 11-15-83 32-22-1, N;j of Tract 22 of Sam B. Theler's Home & Garden Tracts same as legal Contractor Hunt Mobile Homes Mobile Home $161576.00 a Nwzm O NHMZ b � VA cn �NNNWN m g o r► wp w o m ro P. H q m o m cr .{ or � o r► o m r* Fr 1-4 r-.oIImm �n � ga. m pwct mcr9 ti K .. m � b am w ww m ar m V w w p 1-4 w ;j W 0 w m r w Cl 0 � °s p o0o rp o 0) OQ rt oa c ar p .. .. rt K rr IYJ w 'a i