HomeMy WebLinkAboutBLD6177 Modular Home - BLD Permit / Conditions - 4/9/1980 Valley, Patrick #6177
4-9-80
Portion S 1/2 NW 1/2 NE 1/4 20-23-1
1 mile north of Belfair down old Highway. River
side of road just past Union River bridge on right.
209 feet south of first drive past bridge
fffi�U2 n (4-1- Contractor
Modular Home Evergreen Modular
$39,500.00
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BUIL...NG PERMIT APPLIC, 'ION
' MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED '$e Q—
PERMIT NO. 61ZZ
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NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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[DESCAL (❑ SE SHEET)
E ATTACHED SH
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CONTRACTOR NAME MAIL ADDRES CITY&STATE LICENSE NO. PHONE
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USE OF
BUILDING � �`
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ DO PLAN CHECK FEE PERMIT FEE//,;F Co
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE []
ATTACHED C] 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 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 am aware of the
ordinance requirements regulating the work for which FOR OFFICE USE ONLY
the permit is issued and all work done will be in
conformance therewith..(/) �,� �► PERMANENT ❑ SHORELINES ❑
Firm�����«�/ ��0�"'A�• /1�i�9<f' •.wit, SEASONAL Li FLOODPLAIN ❑
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. 'Z ' O� Date > ZONING
y.Z�3C'7 PL
OWNERS AFFIDAVIT HEALTH DEPT. �p
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
APPLICATION ACCEPTED BY PLANS CHECK BY APPR05fD FOR ISSUANCE
BY
Owner Date. �(��
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH