HomeMy WebLinkAboutBLD7073 Mobile Home #22 - BLD Permit / Conditions - 8/7/1980 Bayview Mobile Homes #7073
2 8-7-80
St. Rt. 1, Box 15 - Belfair 69Z
Tract 20, Sam Theler's Home & Garden Tracts - Belfair
Mobile Home (comply w/ Trailer Park Set-backs)
$219250.00
BUILDING PERMIT APPLICATION
MASON COUNTY
P,O. Box 186 Shelton, Washington 98584 7
DATE ISSUED
PERMIT NO.
_ PHONE ? '�
— ADD S CITY�STATE �7e �� J C,�
INNER ' ✓ice O >T , s1X Y - _C
IRECTIONS / {, 'a --
D JOB SITE L' 1)� T �t" p� r, ' /-(�SEE ATTACHED SHEET}
GAL
ESCR. �.T- C `-Nk LICENSE NO.EGAL PHONE
Ti A CITY a STATE
NAME MAIL ADDRESS y(-
ONTRACTOR fA t 7
y
SE OF � L !-JCIcI
UILDING I /c ri l+tl ( c�
n RATION ❑ REPAIR )� MOVE O REMOVE
:lass of work: Lsl NEWT ❑ A/� DIT/IION ATE _
)ascribe work:
.. `� ` � 'r'ail I l c � ��•�."� A p 'w..
K'�n� �.Wr.? h2 tc'l(:'L ; �� F<':�rc �f a •..� a •L
PLAN CHECK FEE J PERMIT PEE ��
Valuation of work: S
SPECIAL CONDITIONS: L.���I_�--s, ��:!� �` /�/�^- , , •r��' ' ` - _ - - - - -
Occupancy Division
PP ,ATION D BY PLANS CHECK BY APP VED FOR ISSU CE CoType n st f Group
Size of Bldg. No. of Max.Stories Occ. Load
(Total) Sq. Ft. `—
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
E
N
ESIDEC
I Certify that I am a currently registered contractor in RESIDENCE
C
the State of Washington and I am aware of the HOME Received Not Required
ordinance requirements regulating the work for which Special Approvals Required
the permit is issued and all work done will be in ZONING
conformance therewith. HEALTH DEP -
�.' , �.�,<<� % <: PUBLIC WORKS
Firm ` - �• `
ROAD DEFT.
By
Lic. No.'
2-13:"r - ' l _ .j lI DN Date -
OWNERS AFFIDAVIT
C E
certify that I am exempt from the requirements of the
NOT 1
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 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
be in ponform nce therewith. + �: !(� / IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
/� / f/ "' SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
' c' WORK IS COMMENCED.
Owner.
+-/il !;• :� -.Date .
PERMIT VALIDATION CK. M.O. � CASH
... ..� nuct^u vAl IDATtON CK. M.O. CASH