HomeMy WebLinkAboutBLD1647 Mobile Home - BLD Permit / Conditions - 3/26/1975 Fassio, Marcel P. - #1647
3-26-75
Lots 13, 14, 15, 16, Plat of Grays Harbor and
Union City Railroad Addition to Union
From 5th St. at Union turn South on Port Townsend.
Go up hill , turn left at top of hill .
Install Mobile Home.
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
3- a� -�� D
DATE __—_ — _
PERMIT N0. � 5� a
Applicant to complete numbered spaces only. a
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JOB ADDR ESS
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LEGAL / / (J/ 1 EE ATT CHED SH E'ETI W`
1 DESCR.
MAIL ADDRESS 4�� P
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
3
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6
USE
,
8 Class of work: ❑ NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
9 Describe work:
I
10 Change of use from
Change of use to
o_
11 Valuation of work:$ h co, �e CIS
PLAN CHECK FEE PERMIT FEE �
SPECIAL CONDITIONS:
Type of f, Occupancy
Const. /��7 Group Division
Size of Bldg. iyh No.of Max.
(Total)Sq. Ft. 4J Stories Occ. Load
Fire Use Fire Sprinklers
APPL CATION ACCEPTED$Y: PLANS CHECKED BY. APP OVED FOR ISSUANCE BY: Zone Zone Required ElYe5 ❑NO
No.of OFFSTREET PARKING SPACES:
Dwelling Units Covered Uncovered
N 0 T I C E Special Approvals Required Received Not Required
ZONING'.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEALTH DEPT. f
HEATING, VENTILATING OR AIR CONDITIONING. v7
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- OTHER (Soecify)
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
I hereby certify that I have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regulating construction or the performance of construction.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
.0 � - .9— a V/—
E BUILDER) (DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHELTON PRINTING CO.