HomeMy WebLinkAboutBLD76512 Alteration #316 - BLD Permit / Conditions - 3/18/1998 MAR-22-1990 14:34 WA HOME CTR SHELTON 360 426 9493 P.02
bCpsrIIutrt[OE Labor&Industncs," 4Y ALTERATION PERMIT
Facaay Assembled Smscrums Section. Do nor rnmplem shaded artas
INST►}tUCTIONS: ,c .;' -9
1.`C�mplete all sluaer�� trding the 51gnatur�bc�Ctmet red w►th an%}.
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2. raw a map on revvv side or WHITE copy ody.
3. Forward completed permit and fee to the nearest L&I oNfke. See Ilst on reverse. a°
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4. Contact and achadule the lospectlon alth the same L&I oMce within 15 days. Y a
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Owner IMAu me -�� ` �' .•. first name DAy time phone Dare
Address 2
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hurallerlCorarwrar jj rho"
/, Coy s regisaaom r tuber.
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Adam. st,te Z�+a
Check the appropriate bows in section A and section B. ; '• :.':" ., ��
A h t„r $ Alteration Inspection(check appropriate 13 :e be10W) $75.00
Air Conditigning/I�eat Pum ;
Scrarfl . � Eiectncal ,:�
;hr•x. Y,i;. r�s.,Y, "I•' •R. 1 .:y.._.u......•..A.
Elocnical Appliances
Mobile Home Fire Safety
Gas Fum=
Gas Piping
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Trans`I>a" 985,58611
I :° : S�vt�icboua 03/19/19%;10:n
Recrrational Vehicle ae Park Trailer :, WoodlPellet Stove—
c a Plan RcviCW.
1�rtx! Ytsr� sxr leery 3`" ��zi " o _——— — — — g70.00
A �:a�. AY Inspection . . .-•-- -- -- - - 570.00
fin} iiryr G+4wsi5iiw.iass++ww{.,id+b �l - ,
Reinspection--- 550,00
. `#§4 Tezhtti®l Inspecion --- _ - - - -- $50.00/hr,
5igruraae of applicant of authorized cntati - ,.- Maker chock payable to: Dept.of Labor&Industrics '
'FEEC�D °
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