HomeMy WebLinkAboutBLD9282 Mobile Home - BLD Permit / Conditions - 5/6/1976 Sharp, Paul #9282
5-6-76
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E. 165' Tract 16, SEµ, NW4, SE4, 9-23-1
Mobile Home
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� 30�
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO.
OWNER }NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS i
TO JOB SITE
LEGAL c7 (❑SEE ATTACHED SHEET)
DESCR.
CR NAME MAIL ADDRESS dITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
PLACE I40 ,Z�rLC-
Valuation of work: $ PLAN CHECK FEE PERMIT FW
.20 0
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY, PLANS CHECK BY APP9PVED FOR ISSUANCE Type of Occupancy Division
e-e-sc-ey 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.
Firm PUBLIC WORKS
By ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
kl--o is NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
� JSUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner + �1 Date WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH