HomeMy WebLinkAboutBLD5907 Mobile Home - BLD Permit / Conditions - 2/27/1980 Mark Brown #5907
2-27-80
N.E. 1/4, N.E. 1/4, S.W. 1/4, 18-20-4
8 miles outside of Shelton towards Dayton,
first left past Dayton Store (Highland Rd)
right on Highland Road
MOBILE HOME 1979 24 X 52
$25,000.00
- bop00
crt-&
BOILDING PERMIT APPLICATION
(A MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 a—o2 f-�v
426 5593
DATE ISSUED PERMIT NO. 5/C�
O
OWNER NA E MAIL ADDRESS CITY&STATE ZIP PHONE
i ?- E`TOA/ kv 9
DIRECTIONS
TO JOB SITE O I� ��ES OLt7S:�E U� S11EC71J!✓ TI�Le!f�iP[SS dAyT�:✓ P/RS% L£f7' pAs
LEGAL / F (❑ SEE ATTACHED SHEET)
DESCR. /Vt.I At Al SLc) SoRF (tf/6tIL/4N,6 R0) ft 1RsT RT Od HIM �
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING /L E S i DtN (f C
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
1
Describe work:
Valuation of work: $ Od PLAN CHECK FEE PER IT EE n
�� C��)C) / Q V
SPECIAL CONDITIONS:
BEDROOMS DECKS. CARPORT [ i NOTICE
BATHROOMS TOTAL SO. FT GARAGE L]
ATTACHED i i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT Li ATTACHED AIR CONDITIONING.
TOTAL SQ. FT./ S Z FIREPLACEly DETACHED I
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor In WORK IS COMMENCED.
the State of Washington and I 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 lk
conformance therewith. PERMANENT SHORELINES
SEASONAL i I FLOODPLAIN I 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. Q
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. MOTOR VEHICLE PERMIT
��� O A LIGATION CEP ED BY LA S C ECK BY AP
Owner Date ROVED FOR SUANCE
PLAN CHECK VALIDATION C M.O. CASH PERMIT VALIDATION CK. M.O. CASH