HomeMy WebLinkAboutBLD13994 Mobile Home #38 - BLD Application - 5/18/1983 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5
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/ d � DATE ISSUED a (�
4W 0/_93- 06)06U �;30 PERMIT NO. �3 /
OWNER NAME MAIL ADDRES CITY ATE ZIP PHONE
A n(�= cJ I N // E -3
DIRECTIONS `
TO JOB SITE (J 1_/V, , b A; �A� �� Z✓l70'�
LEGAL [ c (4X
(❑ SEE ATTACHED SHEET)
DESCR. �- 07 L
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Sr_=% U to d ; l � 0X
Valuation of work: $ PLAN CHECK FEE PERMIT
-0.00 C�
SPECIAL CONDITIONS:
BEDROOMS 23 DECKS / CARPORT V" NOTICE
BATHROOMS -L- (TOTAL SQ. FT. GARAGE C �� Ivv
/ ATTACHED I-1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT G OR AIR CONDITIONING.
TOTAL SO. FTZ3-0-0— FIREPLACE f_: DETACHED L7
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 V SHORELINES I
SEASONAL ' I FLOODPLAIN 1 1
Firm E.D. NO. S.E.P.A. [ i
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date 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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in nformance therewith. ? MOTOR VEHICLE PERMIT
(/ AP (CATION AC E T D BY PLANS CHECK BY APPROVED FOR ISSUANCE;
Own /// YYY c "Date. 3 �O V 9� BY
PL N CHECK VALIDATION CK. M.O. CASH RMIT VALIDATION CK. M.O. CASH