HomeMy WebLinkAboutBLD13348 Mobile Home #14 - BLD Application - 12/8/1982r
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
� DATE ISSUED
(W
O l— 33— VDD G0 � 14 PERMIT NO. 1,3 �O
OWNER NA E L` MAIL ADDRES CITY&STAT ZIP PHONE
L
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET) /'/
DESCR. . I W ,
CONTRACTOR NAME MAIL ADD RE CITY&STATE LICENSE N . PHO
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ D g y do PLAN CHECK FEE PERMIT FEE .2 6—
SPECIAL CONDITIONS:
BEDROOMS DECKS — CARPORT LJ NOTICE
BATHROOMS_ TOTAL SQ. FT. GARAGE CJ
ATTACHED C SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES �1 / BASEMENT L; OR AIR CONDITIONING.
TOTAL SQ. FT.% `t FIREPLACE 11 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 I
SEASONAL 1 1 FLOODPLAIN I I
Firm
E.D. NO. S.E.P.A. I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT 0
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.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
ICATION AC PTE BY PLANS CHECK BY ROVED F ISSUANCE
O erg-- Date. d�G Y
P N ECK ALIDATION CK. M.O. CASH V PERMIT VALIDATION CK. M.O. CASH