HomeMy WebLinkAboutBLD10324 Mobile Home #1 - BLD Application - 4/1/1981 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED ~
PERMIT NO. �y3 '
OWNER NAME 1 MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE �, A 13L
LEGAL p (0 EE ATTACHED SHEET)
DESCR. L #� L pl�'rc, P/��' L F/; �1 —
NAME �� M A RESS ee OtTY 8 STATE LICENSE NO. PHONE
CONTRACTOR
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Class of work: Q NEW 171 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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Valuation of work: i 4 PLAN CHECK FEE - PERMIT FEE -5-
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SPECIAL CONDITIONS:
BEDROOMS DECKS— CARPORT-. NOTICE
BATHROOMS 9. „ TOTAL SO. F'. ♦LA20_ GARAGE ;
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i i OR AIR CONDITIONING.
TOTAL SO. FIREPLACE : i 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 -
SEASONAL '' FLOODPLAIN
Firm.—
E.Q. NO..... _ S.E.P.A. :
By Special Approvals IN OUT YES APPROVED NO
Lic. No.—_ Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT
_~
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 work done willTOACESS
be in conformance therewith. EHICLE PERMIT
ON AC BY PLANS CHECK BY A ROVED;FO,ISSUANCE
Owner Date.
'LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH