HomeMy WebLinkAboutBLD14379 Mobile Home Replacement #35 - BLD Application - 7/14/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 ;Shelto. ashi ton 98584
DATEISSUED
PERMIT NO. / z
OWNER NAME MAIL ADDRESS C &STATE ZIP PHONE
/� oo . .3s _ -i
DIRECTIONS :3/l���� IflO 9r ex—
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
�/
DESCR. 'v? �' `S Gil 14, SW y S Glf
NAME MAIL ADDRESS / CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR _S / Wr , '
USE OF
BUILDING
Class of work: A NEW ADDITION ❑ ALTERATION ❑ REPAIR ; MOVE ❑ REMOVE
Describe work: .,
Valuation of work: $ r� „"� PLAN CHECK FEE PERMIT FE C
SPECIAL CONDITIONS: •7 (� J
BEDROOMS DECKS— CARPORT Ci NOTICE
BATHROOMS TOTAL SQ. FT./P_�/t GARAGE I i
NO. OF STORIES__ BASEMENT L ATTACHED L. OR AIR ATE PERMITS CONDITIONING.RE REQUIRED FOR PLUMBING, HEATING, VENTILATING
TOTAL SO. FT FIREPLACE Li DETACHED L:
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 F O 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 n
� �^,AA 1 SEASONAL !_; FLOODPLAIN i
Firm ✓� o b l� e/rt P _S
E.D. NO. S.E.P.A. I
By l o� Special Approvals IN OUT YES APPROVED NO
I, 1 r Lic. No. "[ 4t Date —� �� �J 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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
7 �Y^ O p� �AVLICATION A CEP ED BY PLANS CHECK BY APPROVED F R ISSUANCE
Owner Date . BY
P CHECK VALIDATION CK. M.O. CASH PERW VALIDATION CK. M.O. CASH