HomeMy WebLinkAboutBLD9679 Mobile Home - BLD Permit / Conditions - 6/17/1980 Bouchey, Clare 0. #9679
6-17-80
1 1/8 mi. no. Belfair old Hwy E. on Newkirk Rd. , 6th house
on right
NE SE 20-23-1
Mobile Home
$12,950.00
_ e
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 7 —d r'
DATE ISSUED (�/� U
PERMIT NO. 96
OWNER NAME MAIL ADDRESS CITY 8 STATE J ZIP _ PHONE
C/a/-e O, orlcli -Ma,- /��c 3 ,Box -o C3e�i��r a �S".Z •Z ?5S
DIRECTIONS I / �p
TO JOB SITE f m/ /v �c'� A C?�d �w E, �n �r✓✓�i�� /)�• ��� ���SP, 0,9
!Y �i
LEGAL n /p (❑SEE ATTACHED SHEET)
DESCR. A/,41 2 01" � � SF'�. �� 7`w,, S 2-3 N, /l � W,/f
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: �" � �
� x �D O Z /e /7rJ/7? 10 9140
Valuation of work: $ /.✓' PLAN CHECK FEE PERMIT FEE
�Q
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS L TOTAL SQ. FT. GARAGE ❑;
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SC FT. FIREPLACE ❑ 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 11
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. I]
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
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 will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PER g4E& 7�
�op �' AP I TION P ED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner' Date.z - BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH