HomeMy WebLinkAboutBLD2198 Mobile Home - BLD Permit / Conditions - 6/25/1979 13onvilie, Foster B. #2198
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• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 _
DATEISSUED _ S - 7 l
PERMIT NO. .2117
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS tI LOGO-
TO JOB SITE _ G Z
LEGAL (❑ SEE ATTA ED SHEET)
DESCR. / ? 9 Ma `L
CONTRACTOR MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING d -rn e,
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
3f S ® �'o rAlev, -,n-,o aj/-'L o.
Valuation of work: $ o•�i p � r—q PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:: O
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ LSEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑
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 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 SHORELINES 11
SEASONAL [l FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. [J
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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all done will ROAD ACCESS
be i onfo an h ith. MOTOR VEHICLE PERMIT I V6 .S
� APPLICATION ACCEPTED 8Y PLANS CHECK BY APPROVED FOR ISSUANCE
Owne e.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION . CK. M.O. CAS