HomeMy WebLinkAboutBLD5904 Final Mobile Home - BLD Permit / Conditions - 4/8/1980 Kirkham, Lecel S. #5904
• 2-26-80
Division 4, Lot 215
Lake Limerick - turn right on Olde Lime
Road
Mobile Home
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• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED �/U
PERMIT NO. c7 'i d y
OWNER NAME AIL ADDRESS CITY&STATE ZIP PHONE
R
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. `r .2 j
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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0 9 �
Valuation of work: $ PLAN CHECK FEE PERMIT FEE _ n
SPECIAL CONDITIONS:
BEDROOMS t)e— DECKS CARPORT [] NOTICE
BATHROOMS__ TOTAL SO. FT. GARAGE []
ATTACHED [] SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i_I OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE U DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 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 [-, SHORELINES LI
SEASONAL FLOODPLAIN I i
Firm E.D. NO. S.E.P.A. I I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. 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
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
� ICATION AC EPTED BY PLANS CHECK BY AP OVE OR ISSUANCE
Owne —4-4�1�Date .
PLAN CHECK VALIDATI CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH