HomeMy WebLinkAboutBLD9409 Final Mobile Home - BLD Permit / Conditions - 8/17/1976 Moore, James L. #9409
6-30-76
N. 2451 SEr,, 20-23-1
Mobile Home
• ° BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 _
DATEISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
LiZ �va cam.. 27, -
DIRECTIONS /
TO JOB SITE / 7` '
LEGAL // m (O SEE ATTACHED SHEET)
DESCR. Thor l'/it T �� `" L d /U �f / �E y -�?Q--Z51—1
CONTRACTOR NAME MAIL ADDRESS CITY d STATE LICENSE NO. PHONE
s"/ ,
USE OF
BUILDING �L�
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE �_ PERMIT FE .��
SPECIAL CONDITIONS:
APPLICATION E BY, PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
7 BY Const. ! f� 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 SEPARATE PERMITS
of the Mason County ordinance requirements for VENTIILATING OR A R CONDITIONING.
FOR ELECTRICAL, PLUMBING, HEATING,
ONING
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
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
Owner Date. 2k, 7AC WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH