HomeMy WebLinkAboutBLD0224 Mobile Home - BLD Application - 9/25/1984 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED—
PERMIT NO.
z NAME MAIL ADDRESS CITY&STATE ZIP P E
OWNER
U&� r ay1S a `c1\ SZ c vc r �31�,
DIRECTIONS
TO JOB SITE 0 , oT
LEGAL / � /I r� /'�� (E] SEE TTACHED SHEET)
DESCR. J c� 1—O '� S C-` `
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR A, b r
USE OF
BUILDING 11 l�
Class of work: X NEW ❑ ADDITI - - ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
0 _S_N_ Vf ryl e X 15—
Valuation of work: $ d PLAN CHECK FEE PERMIT FEE
. / All,
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT Ll NOTICE
BATHROOMS ITOTAL SO. FT. GARAGE ❑
ATTACHED Ll SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT Ll OR AIR CONDITIONING.
TOTAL SQ. FT qV I FIREPLACE ❑ DETACHED L
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 FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit,,is issued and all work done will be in
conformance therewith. PERMANENT i i SHORELINES
SEASONAL ❑ FLOODPLAIN [ I
Firm ff`
E.D. NO. S.E.P.A. L7
By Special Approvals IN OUT YES APPROVED NO
Lic. N Date ZONING
PLANNING DEPT.
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. 7
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
�../ APPLICATION ACCEPTED BY PLANS MLCK BY� APPROV D, SSUANCE
Owner �� �- Date. / "v ^ BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH