HomeMy WebLinkAboutBLD15686 Mobile Home - BLD Application - 6/18/1984 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED —/ �/
PERMIT NO. x5 Ce2
OWNER NAME MAILADDR SS 1,DA 34,Cl-CITYSSTAT ZIP � PHONE
-71
DIRECTIONS
TO JOB SITE S fd I& h,3
LEGAL i (O SEE ATTACHED SHEET)
DESCR.
NAME M CI STATE LICENSE NO. PHONE
CONTRACTOR
USE OF ��
BUILDING /
Class of work: N ❑ ADDITION ❑ ALTERATION ❑ REPA ❑ MOVE ❑ REMOVE
Describe work:
Xa ztee-)—e'l
Valuation of work: $� O� PLAN CHECK FEE PERMIT FEED 7b
i
SPECIAL CONDITIONS:
BEDROOMS--Iq I DECKS CARPORT i; NOTICE
BATHROOMS_d TOTAL SO. FTAWW GARAGE
i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES I BASEMENT ❑ ATTACHED I OR AIR CONDITIONING.
TOTAL SO. FTZj It FIREPLACE G DETACHED L-1
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FO OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES
SEASONAL [ FLOODPLAIN
Firm
E.D. NO. S.E.P.A. I :
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT. G
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance t erewith. MOTOR VEHICLE PERMIT
��P C LIC�I N ACCEPTED 8Y ) PLANS CHECK BY APPRO�VM FOR ISSUANCE
"---\ � Date . D . ��t'_�� �.�-�,C
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CA