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HomeMy WebLinkAboutBLD9540 Mobile Home - BLD Permit / Conditions - 6/15/1976 Lee, David #9540 6-15-76 NE4j NW4 NW4, 28-23-1 Mobile Home IZ,32Y 2,z ��y M BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 96%4/'� DATE ISSUED 6 f«" 76 PERMIT NO. 9-5-4 b OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE � � DIRECTIONS TO JOB SITE ) ,,—i LEGAL pp (❑SEE ATTACHED SHEET) DESCR. N ,Y hi 'em irr Wit A — - CONTRACTOR NAME MAIL ADDRESS CITY d STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: APPLICATION ACCEPTED BY, PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division /-1 BYO Conat. 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 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 Owner Date. WORK IS COMMENCED. PJ�AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH