HomeMy WebLinkAboutBLD9830 Mobile Home - BLD Permit / Conditions - 8/5/1976 Kuhn, Frank W. #9830
8-5-76
Old Belfair Hwy
SZ of All NW4 of SE4 17-23N-1W
Mobile Home
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F B UI Ir IN1G PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED '?/-S
PERMIT NO. `V 3U
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS
TO JOB SITE e
VIV
LEGAL A (❑ SEE ATTACHED SHEET)
DESCR. J Q v !
NAM MAIL AD RESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR G
USE OF
BUILDING e
lass of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
escribe work:
L ! -5
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
APPLICATION ACEPTED BY PLANS CHECK APTROVED I§SUANCE�S Type of Occupancy Division
i Const. 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 2.vvare 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
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR 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
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
Xer Date —� WORK IS COMMENCED.
CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH