HomeMy WebLinkAboutBLD6126 Final Mobile Home - BLD Permit / Conditions - 4/8/1980 Yorke, Don #6126
3/28/80
Division 4, Lot 214, Lake Limerick
MOBILE HOME
1972 14' X 60"
$6,500.00
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. _lam/)fk
�Q
OWNER NAME or MA ��VVDR�,SS I CITY&STATE / /� ZIP /—„� �PHONE �
DIRECTIONS r ,�fi[ v✓o �SXfJ
TO JOB SITE
LEGAL 1 (O SEE ATTACHED SHEET)
DESCR.
It /�
WAME/—. MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF BUILDING I -Mob I '
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE
Describe work: P �
ew'c_
lo�az
b 9 72 I K X 4 0 = 9 Yo s
Valuation of work: $ P� LAN CHECK FEE PERMIT F
SPECIAL CONDITION :
BEDROOMS +— DECKS CARPORT l i NOTICE
BATHROOMS TOTAL SQ. FT.-PR GARAGE []
1 r� ATTACHED Li SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ J OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE (i r DETACHED I_]
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 1 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
SEASONAL ( i FLOODPLAIN
Firm E.D. NO. S.E.P.A.
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH tE121
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. p'
which this permit is issued and that all work done will ROAD ACCESS
b94;7
nce therewith. (�/ MOTOR VEHICLE PERMIT
( (j APPLICATION ACCEPTED BY ANS CHECK BY APPROVED FOR ISSUANCE
Owner —Date.- tt77 U BY
PLAN CHECK VALIDATION M.O. CASH PERMIT VALIDATION CK. M.O. CASH