HomeMy WebLinkAboutBLD9141 Mobile Home - BLD Permit / Conditions - 4/13/1976 Bookout, John 0. #9141
4-13-76
W. 545' of NW4j NW4 17-20-4
Mobile Home
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• ► UILDING PERMIT APPLICA ICON
MASON COUNTY
P. O. Box 400 Shelton, Washington 98584 '/
DATE ISSUED `/3,7 _
PERMIT NO.
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MAIL ADDRESS 2Q1P PHONE
OWNER I � I�0/t�1 IJf�A . 9
DIRECTIONS �L
TO 10B SITE u_ t3f c p�(� _qQe a( �'I !e-U er-A n1 a L
LEGAL MAIL ADDRESS
DfSCR. N.
—L.l^�lwl Fes'/.
•MAIL DDR Ess PHONE-
CONTRACTOR
USE OF MAIL ADDRESS PHONE LICENSE NO.
BUILDING 14S' le--
Class of work: �l NEW ❑ADDITION ❑ALTERATION `❑ REPAIR ❑MOVE O REMOVE
Describe work:
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Valuation of work:$ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
AP► (CATION ACCEPTED BY PLANS CHECKED BY AP PR VEO FOR)ISSUANCE BY
Type of 7 I_� Occupancy —
Const. T� Group L-_ Division
-- Size of Bldg. itX No.of Max.
(Total)Sq.Ft. � Stories Occ. Load
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Require
I Certify that I am a currently registered contractor In the State MNINO
of Washington and the County of Mason and I am aware cf the HEALTH DEPT.
ordinance requirements regulating the work for which the permitWORKS
Is issued and all work done wi:i be in conformance therewith. AbAD DEPT,
Firm
By -
Llc. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contract.
or registration law RCW 18.27, and am aware of the Mason N O T I C E
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
Owner 3 `G �120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH