HomeMy WebLinkAboutBLD7878 Mobile Home - BLD Permit / Conditions - 11/21/1977 Newkirk, M. W. #7878
11-21-77
N 1/2 W 1/2 W 1/2 NW 1/4 Sw 1/4 21-23-1
1/4 mile east on Newkirk road, south to creek
Mobile Home
321 --�Z C�UZD
BUILDING PERMIT APPLICATION
MASON COUNTY IZZzY
P.O. Box 186 Shelton, Washington g884 � �v v
DATE ISSUED I%a// 77
PERMIT NO.
OWNER NAME r IL ADD SS C &ST E p ZIP PHONE
M'W �Ne 12�r� • doX �S �e.� e,�T (�as1h - 5. ' a7S��a�l
DIRECTIONS O JOB S T E QY1e- Lk , te'V n,,I2 �'A�-f 6�r. f`IeilJ���r _ C1
LEGAL w� p p n n (❑ SEE ATTACHED SHEET)
DESCR. ti � a W �2- 0 � W 1/',- � N W �� O 1— S W' �� O 4' �ec- -)- T-WN 1-3 N RT W
CONTRACTOR NAME MAIL ADDRESS CITY&STATE crp 3 3 1 LICENSE NO. PHONE
f3 V te�.J o b, e 0130,E a 3 ' 0077
USE OF t0"�
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
&4 w a d t• �t t oh. 6,d' x a4' YKa bt le
�C'Lj e c
Valuation of work: $ q p � PLAN CHECK FEE PERMIT FEE o !�
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY, PLANS CHECK BY APP ED FOR IS A CE Type of (� 7 Occupancy Division
B 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. //
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 REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be injdnformance th reWlth. 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 ate �� n WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. M.O. CASH