The URL can be used to link to this page

Home My WebLink AboutBLD29897 Mobile Home - BLD Application - 2/4/1992 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 427-9670 DATE ISSUE ` PERMIT NO. ra M MAIL ADDRESS &STAT yP PHONE OWNER 1 - c DIRECTIONS ' TO JOB SITE ( _ r nl In LaAstm . R* La) " -6p, NUMBER a-loot ESCR. L NAME MAILADDRESS CITY&STATE ZIP PHONE LICENSE NO. CONTRACTOR USE BUILDING DING _T CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK AREA: NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE qFt STORIES SHORELINE Cl CONDITIONING. BASEMENT �- SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR DECKS / SgFt BATHROOMS _ SEASONAL RES.0 ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. CARPORT SgFt FIREPLACE IS CARPORT/GARAGE GARAGE ScIFt ATTACHED 0 DETACHED❑ OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER ATE�C��1 � X BY - DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YES NO / HEALTH -5/Z PUBLIC WORKS FEE PLANNING '�1 FIRE MARSHAL BUILDING PERMIT �c D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCEPTED BY PLANS CHECK BY APPRO&ED FOR ISSUANCE PERMIT VALIDATION 177 BY ,�?-`/' 7 CASH CK MO TOTAL - 1 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER E M A I L A SS TIATE ZIP PHONE &xqU &jRjCS-�9 " DIRECTIONS TO JOB SITE 3 ` W E g le o v,% F hA I fN O Ll 12 ✓\ In Y el L le cl, P a2 'ly b cT h� - PARCELNUMBER /2�3/ ?3 OD LEGAL �V#1 OF DESCR. NAME NMIL ADDRESS CITY 8 STATE LICENSE NO. ZIP PHONE CONTRACTOR USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK `y7 BEDROOMS_ DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES 000' BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT �y COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. FIREPLACE d DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING A L FROM THE BUILDING DEPARTMENT. APPROVAL APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER PPRO jq BY DATE _ �CkAla —4 FOR OFFICE USE ONLY DEPARTMENT YES PPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDINGGROUP IrYLQ j Le PRE.INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY I PLANS CHECK BY [APP=EDISSUL�;'A RMIT VALIDATIONTOTAL BYSH CK MO TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE rn S. Csardcn Craig .�; the M IS012 comfy .. asses Dea r We have recently received a copy of tax certificate for mobile home movemanc on your mobile homes- In order that we may accurately value you mobile hoaa, please coeplete the questions below and return this foes to our office by It is imperative chit this information be provi"d cc prevent a possible double assassmonc- Moa n-- HCME DATA Waim W.,=U ( &AXZ 4 =Az '7 MOBIL-_ 14aNT LCCATIDM nfFCRt1ATIQa gMIAL A- My privacaly owned Land- 3- If tented or leased land wbe from? OAISEI/4�/� �Lj,a�L�l '—T ADDRESS 01 -HX 13 _0 Cr:r & era= C- Roal P:a¢erCy Parcel D_ dailing name and address for owner of mobile bone YYl► c InaFI w'1�� Sa �I� C�o� Crrr a SUTE-jVM A i E_ Laeac ion address of mobile h.. ME 4-al�RSOn/ �d Cr3mc — Ir- Dace mobile home was placed on present sire C. Pucchase Price DATE: _ S ICNA=E TYPE 03 P9 VfT NAME CJltrt 1CUSd Sheiten, Wasningtcn 9&SSt Phone 427-3670