HomeMy WebLinkAboutBLD1760 Mobile Home - BLD Permit / Conditions - 4/22/1975 Taylor, Lee Inez #1760
4-22-75
Tract 10 of Govt. Lot 2 & T.L., 34-22-3
Install Mobile Home
$16,598.95
3 X23q-y300ioo
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 98584
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DATE 2-- 10
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Applicant to complete numbered spaces only. PERMIT N0. /7ro m
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,JOB ADDRESS
LEGAL 1 DESCR. (C:]9EE ATTACHED SHEET)
OWNER > Y MAIL ADDRESS ,D ZIP PHONE
2 c�S w �/ ;Qe�J /c�.2i / ,6� a 4 0? z��u-d�J � •
CONTRACTOR MAIL ADDRESS PH E LICENSE NO. ,, A
ved
ARCHIT T OR DE31#AER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6
USE OF BUILDING
7
8 Class of work: B NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑MOVE ❑ REMOVE
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $ 16, 59PI?,96_
PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: Type of Occupancy
Const. M//y Group Division
Size of Bldg. No.of Max.
(Total)Sq. Ft. Stories Occ. Load
Fire �j Use Fire Sprinklers
APPLICATION ACCEPTED BY: PLANS CHECKED BY. APP OVED FOR ISSUANCE BY. Zone J Zone Required Oyes ❑NO
No. of OFFSTREET PARKING SPACES:
Dwelling Units Covered Uncovered
N O T I C E Special Approvals Required Received Not Required
ZONINC,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEALTH DEPT. /
HEATING, VENTILATING OR AIR CONDITIONING.
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.
SIGNATU OF CONTRACTORIOR AUTH IZ D AGENT (DATE)
SIGNATURE_OF OWNER IF OWNER BUILDER (DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
_V/ SHELTOl PRINTING CO. D