HomeMy WebLinkAboutBLD13276 Mobile Home - BLD Application - 11/15/1982' 1
BUILDING PERii WAPPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED i
330 AW PERMIT NO. / 3a? l0
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
I'/Z� /Lf 44,j firZd 67101 //-/C,fliv.4 /D�o C/<'t/i0�✓ /� % �?�20 d
DIRECTIONS
TO JOB SITE E SPi2uCC 577e4t+ 4W/D.V 6t;4
LEGAL 7,eA §EE ED SHEF,T)
DESCR. 407-6 aV I� aZ a{ =3j 4`f -L lc: &LOCK "?O / /G CtT�
NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF BUILDING 144t,O� 64- fe, /C�� P".)-noT
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: 0?
i
Valuation of work: $ 9 v PLAN CHECK FEE PERMIT FE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT❑ NOTICE
BATHROOMS TOTAL SO. FTI-S-42 GARAGE []
ATTACHED _' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLAC DETACHED L'
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
SEASONAL ❑ FLOODPLAIN Lj
Firm E.D. NO. S.E.P.A. ❑
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. ,f g2
00,
which this permit is issued and that all work done will ROAD ACCESS
e In conformance th rewlt p MOTOR VEHICLE PERMIT
s/J /(-/J i V� PLICATION ACC PIED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own -- LG Date. a
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
l
100
I
. APPROVED
I,1'ASM WU(LDINO INSPECT01
UBIECT TO AFPROVAV
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