HomeMy WebLinkAboutBLD9855 Mobile Home - BLD Permit / Conditions - 7/30/1976 Watso o, Mary Beth #9855
7-30-76
St. Rt. 3 Box 430, �Belfair
S16-Twn23N-Rng1W-W.M.
Mobile Home
A 2 F� c
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington e8o"84
DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY'&STATE 21P PHONE
Al'lk-y Re-OWNER tie , v V � .+���✓r 3b'-'
DIRECTIONS
TO JOB SITE
LEGAL. / (C SEE ATTACHE SHEETY
J
DESCR - /" y
NAME MAIL At$DRtS§ LIC f 6E NO. PHONE
CONTRACTOR
S.
USE OF
BUILDINGlla�P
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE a REMOVE
Describe work: _
1e, ,Lau (t2�. 060��)
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l
Valuation of work: $ PLAN CHECK FEE PERMIT FEE �I C
SPECIAL CONDITIONS:
APP4ICATION ACCEPTED BYi PLANS CHECK BY APPRO\'EO O I SUANCE Type of Occupancy Division
Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories 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
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. c E
=irm PUBLIC WORKS
ROAD DEPT.
"y
Lic. No. __.--. Date
OWNERS AFFIDAVIT
I certify*t-at I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance there Ith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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
Owner WORK IS COMMENCED.
Pl AN ECK VALIDATION CK M.O. CASH PERMIT VALIDATION K. M.O. CASH