HomeMy WebLinkAboutBLD94-0292 Cancelled Conditional Installation - BLD Permit / Conditions - 11/12/1997 MASON COUNTY PERMIT
BULL & VOID BY EXPIRATION
Mason County Bldg. III 426 W. Cedar DATE BY
P.O. Box 186 Shelton, Washington 98584
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by
date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
II -- --- ----- -
MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Department of Labor&Industries y W ALT -I4N PERMIT
Factory Assembled Structures Section C6rrmt Do not complete shaded areas' t
INSTRUCTIONS: � �� J 29711
1. Complete all spaces to and including the box with the signature X in it.
Invoice
2. Draw map on reverse side of WHITE copy only. #
3. Submit completed permit and fee to the nearest office listed on the back.
4. Contact and schedule the inspection with the office in which you submitted the permit Insignia#
within 15 days.
Owner last name first name Day time phone Date
r 1 ,;� f � , ,,;
................................�.......•.... .................9..�,,;.�.P.::". - -..... t-3 f ....... 1�............. '.i!v.......
Address � City State ZIP
Installer/Contractor/Dealer Phone Contractor's registration number
........................................................................•-----------..........................................--........................ ....................................... .............................................................
Address City State ZIP+4
Check the appropriate boxes in section A and section B. FEES
A B ❑ Alteration Inspection(check appropriate boxes below) $75
❑ Commercial Coach Air Conditioning/Heat Pump
Serial No. Electrical
Electrical Appliances
+ Mobile Home Fire Safety
Serial No: . /✓ Gas Furnace
Gas Piping 27 "1409f.,1510
HUD No. Plumbing
Structural
Serial No.
Recreational Vehicle or Park Trailer Wood/Pellet Stove — —
— — — — — — —
Serial No. Plan Review — — — — — — — — — — — $70.00
RV Inspection — — — — — — — — $70.00
Model No.or Plan Approval No. Re-Inspection— — — — — gmaermn
No $50.00
Technical Inspection — — — — — — — — — — — — — — — $50.00/hr
Signature of applicant or authorized representative Make check payable to: Dept.of Labor&Industries
X - FEES DUE $ 2
De artment use only
T Request approved or ❑ Request denied because of specific violations of Washington rules and regulations. Violations
must be corrected and reinspection requested within 10 days for recreational vehicles and 20 days for mobile homes and
commercial coaches of the notice of violation date. (This does not apply to technical inspections). It is unlawful to offer for sale,
rent,or lease any non-complying mobile hptne,commercial coach or recreational vehicle.
- - - - - - - - - - - - - -- - - - - -- - - -- - - - - -- - - •-- -'- -. - . _ ._
❑ Included are forms required which must be completed and fees submitted before reinspection.
Date Area office Inspect�t ' Total pages
F622-01Y000 t ration rmit 12-92 White-Olympia Green-Contractor Canary-Inspector Pink-Purchaser Goldenrod-Purchaser
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Draw map givingdirections to location on the WHITE COPY ONLY.
Address
City State ZIP
N
W E
S
Department of Labor&Industries Offlees
ABERDEEN EVERETT OKANOGAN TACOMA
415 W Wishkah Evergreen Way Business Center 1234 2nd Ave S 1305 Tacoma Ave S Ste 305
PO Box 66 8625 Evergreen Way Ste 250 PO Box 632 Tacoma WA 98402-1988
Aberdeen WA 98520-0013 Everett WA 98208-2620 Okanogan WA 98840-0632 (206)596-3814
(206)533-9300 (206)290-1346/1347 (509)826-7345
TUKWILA
BELLEVUE KELSO OLYMPIA 12806 Gateway Dr
616 120th Ave NE Ste C201 711 Vine St PO Box 44430 Seattle WA 98168-3346
Bellevue WA 98005-3037 Kelso WA 98626-2621 Olympia WA 98504-4430 (206)248-8240
(206)453-7048RO74 (206)577-2200 (206)956-5799
BELLINGHAM Effective Feb 1,1993 PORT ANGELES V 401 NE Fourth
Rd
2500 Elm St Ste F 900 Ocean Beach Hwy 1026 E 1 st St Ste 1 Vancouver
ve Fourth Plain 63
Vancouver WA 98662-6302
Bellingham WA 98225-2732 Longview WA 98632-4013 Port Angeles WA 98362-4020 (206)696-6295
(206)676-2083 (206)577-2200 (206)457-2572
1-800-544-1509 WALLA WALLA
SEATTLE 1815 Portland Ave Ste 2
BREMERTON KENNEWICK 300 W Harrison St Walla Walla WA 99362,2246
4841 Auto Center Way Ste 201 500 N Morain Ste I I10A Seattle WA 98119-4081 (509)527-4437
Bremerton WA 98312-4379 Kennewick WA'99336-2607 (206)281-5400
(206)478-4926 (509)735-0100 WENATCHEE
SPOKANE 123 Ohme Gardens Rd Ste 203
EPHRATA MOUNT VERNON 901 N Monroe St Ste 100 Wenatchee WA 98801-9634
21 C Street SW 525 E College Way Spokane WA 99201-2111 (509)663-1713
Ephrata WA 98823-1895 Mt Vernon WA 98273-5500 (509)324-2568
(509)574-4608 (206)428-1350 YAKIMA
(509)574-2291 1716 S 16th Ave
!1 Yakima WA 98902-5789
(509)454-3769
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