HomeMy WebLinkAboutBLD9024 MFG Home - BLD Permit / Conditions - 11/10/1980 Ally, Pearl #9024
11-10-80
Hwy. 300 - 8/10 mi. from•Thriftway - Belfair
Exhibit A - SW SE 20-23-1
Modular Homes Contractor
Evergreen Modular Homes
$44,950.00
BUIVING PERMIT APPLIGSTION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98684
DATE ISSUED
PERMIT NO. � �
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
'4-11 e,4i S q 2 -13e z ",7/3.6
DIRECTIONS
TO JOB SITE
LEGAL /� ii' �/ i - (❑ SEE ATTACHED SHEET)
DESCR. X'yi,61 � S u1� cFT�` 5,r y� ScQc, z� T�'�.z 3�—
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR �4H4`
E'�' Z c'otiAsr�
USE OF „ ZS�•��T
BUILDINGG-��
Class of work: Pr-NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
�l y,G►���� s�vy c
Describe work:
Valuation of work`. $ PLAN CHECK FEE PERMIT FEE _
SPECIAL CONDITIONS: 3 3
APPLI N ACCEP7E:(IBY PLANS CHECK BY APPROVE FOR tISS )IE Type of Occupancy Division
BY; Const. Group
r
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 �i�'�e�iu Mt�s'li,c f1l.' y� i-9e�s «r• PUBLIC WORKS
By ROAD DEPT.
Lic. No.EN 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
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
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
V 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 WORK IS COMMENCED.
PL N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIOk CK�./ M.O. CASH