HomeMy WebLinkAboutBLD9944 Mobile Home - BLD Application - 8/17/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
I,� 3o - 1;� - V 1 1 CQ V PERMIT NO.
OWNER NAME MAIL ADDRESS CITY STATE ZIP PHONE
a t� U)AI
DIRECTIONS
TO JOB SITE ME, 0Lb ',BPLEAjR gVal,
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. ^/eZ 0 5X 0 W 7RA6111, O
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF I /
BUILDING `
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ;<MOVE ❑ REMOVE
Describe work: 0 1
MoRit ornE
Valuation of work: $ ��U(?��f PLAN CHECK FEE PERMILfE6 3—
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT [I NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE [i
ATTACHED L' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
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 ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the F O OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT 1 SHORELINES I;
SEASONAL ❑ FLOODPLAIN Ll
Firm E.D. NO. S.E.P.A. ❑
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
b Inc for an therewith. MOTOR VEHICLE PERMIT
� — APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FO ISSUANCE
Owner Date. Bp
P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH