HomeMy WebLinkAboutBLD0222 Final Mobile Home - BLD Permit / Conditions - 9/25/1984 Im
BUILDING PERMIT APPLICATION -
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 _
DATE ISSUED---9�-�z S
PERMIT NO.
PBUILDING
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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(❑ SEE ATTACHED SHEET)
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NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
Class of work: D' NEW ❑ ADDITION__.. TION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work:�($ a d PLAN CHECK FEE PERMIT FEE
o, A �s
SPECIAL CONDITIONS:
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BEDROOMS `DECKS CARPORT❑
BATHROOMS ITOTAL SQ. FT. GARAGE ❑ NOTICE
NO. OF STORIES I BASEMENT ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
TOTAL SQ. FT14g10 FIREPLACE ❑ DETACHED LiOR AIR CONDITIONING.
CONTRACTOR AFFIDAVIT THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR.
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 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
conformance therewith. PERMANENT ❑ SHORELINES ❑
Firm
SEASONAL ElFLOODPLAIN ❑
E.D. NO. S.E.P.A. ❑
By—U
Special Approvals IN OUT YES APPROVED NO
Lic. N 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. 6 `�
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith.
MOTOR VEHICLE PERMIT
Owner, 4 APPLICATION ACCEPTED BY � SS CHECK BY
i��'
R ISSUANCE
ate-_9'�.S�fs'�,/
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
BROOKING, Gary R. #0222
9-25-84
Tracts 20 & 21 9-23-1 SW-1/4, SE-1/4
NE 122 Pederson Drive
Belfair, Wash 98312 275-2756
1/8 mile down Pederson Drive
Contractor
Hunt Mobile Homes
Mobile Home 28x60
$30,240.00
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