HomeMy WebLinkAboutBLD92-00292 Cancelled Mobile Home - BLD Permit / Conditions - 9/24/1999 MASON COUNTY PERMIT
Mason County Bldg. 111 426 W, Cedar NUL VOID BY XPIRATION--
P.O. Box 186 Shelton, Washington 98584 DATE By �w
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date by
Foundation Walls date by Set Up
Ate 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
J
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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the
mason county
assessor
Darryl Cleveland
Dear
We have received a copy of' the tax certificate for movement of your
mobile home . In order that we may accurately value your mobile
home , please complete the questions below and return this form to
our office by
This information is imperative to prevent a possible double
assessment on your mobile home .
MOBILE HOME DATA LENGTH � � WIDTH z 8
/ MODEL
MAKE 1�VF-P,0c, tV - F , P,b.1 u0 MODEL L, Z - 3z `' YEAR
MOBILE HOME LOCATION INFORMATION SERIAL #
A . My privately owned land yes f. no
OR
B . If rented or leased land who from? NAME
ADDRESS / ZU -0 L D L Y M t CITY & STATE .yB 5-S't
C . Real Property Parcel # 34( 2,7 -,53 - 00183 ( from tax
statement of new location )
0 ., Mailing name and address for owner of mobile home
NAME ? KQkK x-> L" P,V 1 S
- -, 7 O M IDS v N L.kK E D .TO tr �/�j N . Cl
ADDRESS k D CITY & STATE
E . Location address of mobile home./ ZG1 C', o City S1AE1-T0H
F . Date mobile home was placed on present site
G . Purchase Price � ZO.Cgc —
DATE G - yZ x SIGNATURE 04V""-C�r (-
'i TYPE OR PRINT NAME i.t> s
TELEPHONE NUMBER '-� ?- 7 - 7Z-Lr 7
411 N. 5th P.O. Box J Shelton, Washington 98584 Phone 427-9670
BUILDING PERMIT APPLICATION 6C' 14Z - D2_9I_ R0
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER .� v ,Z3 7tJ p.'ou t� v+ _5 �+-Tc1� s 1-a� - z
DIRECTIONS i s
TO JOB SITE p ._L 2.�;- M% ` To -' E t.
1.YMED t��c.11 T �Jcw M1 /o
PARCEL LEGAL
NUMBER 320-7-53 -001183 DESCR. G-taKE I_(MERjCK LdT 1 8 3
NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO.
CONTRACTOR
USE OF
BUILDING 74Kc.,LE RV_5y
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE +N S rALL
WORK 5 upa?- C,,ce o CEN7S �_kouVF t15
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES I SHORELINE❑ CONDITIONING.
BASEMENT.---(D-- SgFt BEDROOMS 7- PRIMARY RES.Q«` THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
SOU S Ft BATHROOMS COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
DECKS q _L SEASONAL RES.❑ ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED
CARPORT 3 GO SgFt FIREPLACE$ IS CARPORT/GARAGE
GARAGE SgFt ATTACHED 0 DETACHED t,
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 �, DATE -6 -y Z X BY_ DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH MT PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT o
D.O.T. BUILDING PLAN CHECK
Sf,ESIAL CONDITIONS BUILDING GROUP 7 PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY PLANS CHECK BY P OVE OR IS CE PERMIT VALIDATION
G CASH Cl MO
TOTAL