HomeMy WebLinkAboutBLD86-19520 MOBILE - BLD Application - 10/27/1986 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHING ON 98584
426-5593 DATE ISSUED
PERMIT NO. ,z!
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL
DESCR. � c 6) .-
CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR NAME MAILADDRESS ...,
USE OF
BUILDING \\-0 vv-\,e-
CLASS OF WORK NEW ADDITION ALTERATION RE 'AIR MOVE +/'� REMOVE✓
DESCRIBE
WORK
3C C fP�
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR lk PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERSAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATIpN LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREM NTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONF R=CE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI G APPROVAL F THE BUILDING DEPARTMENT. APPROVAL FROM HE BUILDING DEPARTMENT.
O DATE =�`�- (� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT PPROVENo DEPARTMENT YESPPROV N
YES O BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
TION ACCEPTED BY PLANS CHECK BY APPR ED FOR IS UA / PERMIT VALIDATIOIN
BY b CASH CK MO TOTAL � ``-3 7 `5
TypF MOBILE HOME
Floors Date 10-27-86
195'L0 Tel 26-0 6 Ziperm J
it 140- Shelton �—
PpWner ROSE, �,wasedngton
Zip �—
pcldress None
contractor NE SE
Address ion 4-20-4
Ie9al Descript site
Mason Count Landfill
D to project
Direction Wood Stove
Sewr
icalport
unbing chakn garage
Plt Fireplace Dec --der
FireP -soft
Basement
2 bdrm.
Shorelines:
�tback: �
Social Pl bin .
Conditions: �chani�.
Interior; '
.- FINAL; -----
Nbbile Home: � �G
Footing; '�Oke �tector;
Setback: ��'ks
Foundation
Walls:
Framin
Fire g'
Place;
Wood Stove: