HomeMy WebLinkAboutBLD0064 Mobile Home #28 - BLD Permit / Conditions - 7/26/1982 BUILDING PERMIT APPLICATION `
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
2 3Z —50 LL 000aD PERMIT NO. ZI 1(>f- _
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
SE i> t r
DIRECTIONS / R
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. C C} rykG Ij Rc P A P,
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
��� 41 C �O,T 0
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ C� L PLAN CHECK FEE PERMIT FEE .yaG
-5 .G,
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT7, NOTICE
BATHROOMS I TOTAL SQ. FT. GARAGE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES I BASEMENT C ATTACHED OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE F i 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
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES
SEASONAL L5 FLOODPLAIN i
Firm 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. C-
which this permit is issued and that all work done will ROAD ACCESS
i R4myn e 6 'th MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLAN HECK BY APPROVED OR ISSUANCE
Owner
_
'' ✓ Date
PLA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH