HomeMy WebLinkAboutBLD16649 Mobile Home #34 - BLD Permit / Conditions - 4/5/1985 MICHELSEN, Kevin & Kathy #16649
4-5-85
Sam B. Theler's Home & Garden Tracts Tr. 20 32-23-1
Golden Bell Mobile Home Park #34
NE 20 Roessel Rd. Belfair
Contractor
Mobile Home 1984 52x24 3 bdrm, None
$23,088.00
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED _
PERMIT NO.
OWNER NAME MAIL ADDRE S CITY d STATE 5/74 C P ZIP PHONE
DIRECTIO
TO JOB SIJTE 23
FDLE &GA � (=i SEE ATTACHED SHEET)
Sc •3,- /
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF C
BUILDING LLy {rn��
Class of work: [I TIEW C ADDITION ❑ ALTERATION E. REPAIR X MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS_ _.... I DECKS CARPORT :.; NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ; '
ATTACHED i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE F: IDETACHED f'.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FORA PERIOD OF 180 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 .: FLOOOPLAIN
Firm E.D. NO. S.E.P.A.
By Special Approvals IN OUT YES APPROVED NO
Li o. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.`f'Yfp i/ ,-y) -
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
A
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Ow r F_ Date .
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. C SH