HomeMy WebLinkAboutBLD9569 Managers Quarters - BLD Application - 6/18/1976 CJ_4_��t�&
BUILDING PERMIT APPLICATIO
MASON COUNTY
P.O. Box 186 Shelton, Washingtor, 98584
DATE ISSUED 1
PERMIT NO. ��9
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
Blue Heron Owners Association Star Route 1 - Box 59N Union WA 98592 898-3123
DIRECTIONS
TO JOB SITE One mile east of Union, Washington, on State Highway #106
LEGAL IN SEE ATTACHED SHEET)
DESCR. See attached sheet
NAME MAIL ADDRESS CITY d STATE LICENSE NO. PHONE
CONTRACTOR provident Realty, Inc. P.O. Box 12098 San Diego, CA
USE OF
BUILDING Manager's Unit
Class of work: X) NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Addition of mobile home on propertysite required to serve as Manager's
living quarters.
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
16,000
SPECIAL CONDITIONS:
FA'PI�ICATIO ACCEPTED BY, PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
e �f ' Y Const. ti Group
CL t2��4.�CJ
Size of Bldg. No. of Max.
(Total) Sq. Ft. 1 344 Stories 1 Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor in RESIDENCE
the State of Washington and I am aware of the MOBILE HOME XX Yes
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT. ✓ 1ev rn cD
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that 1 am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE of the Mason County ordinance requirements for VENTILATING PERMITS FOR ELECTRICAL, PLUMBING, HEATING,
AT NG OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conforma Ce therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
�� June 8, 1976 SUSPENDED
WORK IS COOR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner 4 Date.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K J M.O. CASH