HomeMy WebLinkAboutBLD10944 Mobile Home #36 - BLD Permit / Conditions - 7/7/1981 WHITE, Joseph R. #10944
E. 1702 Shelton Springs Rd. , Shelton 07-07-81
SW1/4 SW1/4 SW1/4, ex. tracts 3, space #36, 1 204
Hidden Haven Mobile Home Park
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Mobile Home Contractor - McMinvill Oregon
Home Sales
$26,640.00
y0?ao/- 33- vt of �
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED / 9(
PERMIT NO. ! O
OWNER NAME „ MAIL ADDRESS / CITY&STATE ZIP PHONE
DIRECTIONS I &/ �ry
TO JOB SITE
LEGAL J _ (C7 SEE ATTACHED SHEET)
DESCR. 1T! .S"k• ` Sk-1 i¢c%f —3 `Sf�C ��
NAME AIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
CONTRACTOR NAME
USE OF ra
BUILDING / f/ly
Class of work: 4NEW b ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ �'�, PLAN CHECK FEE PERMIT47 C
� '
SPECIAL CONDITIO S:
BEDROOMS (DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL S0. FT. GARAGE Lj
ATTACHED i� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [] OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ;� 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 ofWashington and I aware of the FOR OFFICE USE ONLY
ordinance requirements
the regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES
Firm SEASONAL [ ) FLOODPLAIN [I
E.D. NO. S.E.P.A. iI
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. IXl Vl
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 � MOT VEHICLE PERMIT
e j� Pp APPLIC 10 A PTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
w r Date- �'� D BY
AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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