HomeMy WebLinkAboutBLD92-0279 MOBILE - BLD Permit / Conditions - 6/15/1992 w
o Cnr J v
Q N Z
_ CQ
0o Q
4 0 Q
00
a:
r
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date --/7 z by r G G� Gas Piping date b
Foundation Waj s date by Set Up
date - by INSULATION date ' by
BG/s'_AB Insulation Floors Final
datee by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
3roundwork Attic
d date by
ate by
D.W.V. WALLBOARD NAILING
date by date by
Water Line "FINAL INSPECTION
date by date by date by
%4X V�'S �k ��e►-�E _ ,s iL i � ? ` rCw c ��Y►, T�Q
BUILDING PERMIT APPLICATION 6t-F/)qj--j-L7q
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. (� \�
OWNER
NAME MAIL ADDRESS CI Y&STATE ZIP PHONE
S'Qp,�,�.
DIRECTIONS
TO JOB SITE ( e-br 6,0- i1;1z'Aa1zi-,PAY A., .4" fo Lecr qro use to••� S'j � Mn6r�T,n�{
PARCEL LEGAL
NUMBER ;z 60 fp U66t'7 DESCR.
NAME MAILADDRESS CITY BSTATE ZIP PHONE LICENSE NO.
CONTRACTOR ffe;ac Cc.�T�✓� CHAoU�`"S7:t� eTrn�/1ti,�,rt /Zp r a%.4TCA " YPr`a? f7/�'!6�% c.
USE OF
BUILDING 72c- t c<
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK M I D 11 a .HD/he- �(L')'2trc'-Jor� r o
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERM IS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE j %2 2 SgFt STORIES I SHORELINE❑ CONDITIONING.
BASEMENT �- SgFt BEDROOMS PRIMARY RES.4 THIS PERMIT BEC IMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS /* $ Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
g ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS'COMMENCED.
CARPORT fA SgFt FIREPLACE L%A IS CARPORT/GARAGE
GARAGE x A SgFt ATTACHED❑DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT 1 AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE X BY DATE Z ��
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPRov D BUILDING VALUATION
YES NO YES I NO
HEALTH r'1 j PUBLIC WORKS FEE
PLANNING �' FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP �Q PRE.INSPECTION
L QjjTSHORELINE
L? tpL=L O � WOODSTOVE
PLUMBING
4� 1'�C rF[OP�S MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL !
BY CASH CK MO