HomeMy WebLinkAboutBLD9645 Mobile Home - BLD Permit / Conditions - 3/24/1978 Douglas, Danny J. #9645
3-24-78
S 1/2 N 1/2 NE 1/4 SW 1/4 21-23-1
Newkirk road to dead end & bear right on private
dirt road 500'
Mobile Home
1232.1 -3 �� z-
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED 1�7
/�/� C� ( ✓ / !�c/J PERMIT NO. 9�O'K5---
OWNER LD44
ME MAILADD SS CI &S T � ll ZIP PHONE
X 7 G/ Q //z GC/ / � .2 - �-Sr�3
DIRECTIONS {�c,4� �r/o�te / p.,✓ d� /ljp` dii( ywiC� t� `its, Z �i,C.-r/ ,( T �-
TO JOB SITE �cc�i�/�/CEycl �a.d�C /Q ivsiT .litJ� Ses7 T
LEGAL e I.' SEE ATTACHED SHEET)
DESCR. S�� Al -/Z Al tG�V � Gu
NAME AIL ADDRES CITY&STAT LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
�M ll e
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
l9, hU ��•
SPECIAL CONDITIONS:
0,-
APPLICATTON ACCEPTEib BY PLANS CHECK BY PROVED FOR ISSUANCE Type of Occupancy Division
r 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 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. log
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 i confoyce erewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
__�� "7� SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
0 er Date. / WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH