HomeMy WebLinkAboutBLD13077 Mobile Home - BLD Application - 9/28/1982 BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED _
PERMIT N0. l 0
OWNER NAME MAIL ADDFJESS CITY STATE ZIP PHONE
S�7
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
ME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR 7
USE OF
BUILDING
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
7
Valuation of work: $ l 3 PLAN CHECK FEE PERMIT FEV t
SPECIAL CONDITIONS:
BEDROOMS_ DECKS �( �� CARPORT NOTICE
BATHROOMS__ TOTAL SO. FT.A.___ GARAGE
', SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIESBASEMENT :, ATTACHED OR AIR CONDITIONING.
TOTAL SO, FT.jd_:l) FIREPLACE DETACHED 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 t 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 - SHORELINES V
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO.__ S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No.—__ Date ZONING
PLANNING DEPT. qlE
C h �fi' Tr
OWNERS AFFIDAVIT HEALTH DEPT. f',3 �--
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
PLICATION ACC PT D BY PLANS CHECK BY APPRO R ISSUANCE
Owner ,�(/l �� � �''-f"gti Date . d d
�LV'�� L
M.O. CASH
PL CHECK VALIDATION CK. M.O. CASH PE MIT VALIDATION
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