HomeMy WebLinkAboutBLD5746 Final Mobile Home - BLD Permit / Conditions - 9/19/1977 Hradon, John F. #5746
8-12-7T
Lake Limerick Div. 5 Lot 17
Mobile Home
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED .2177
PERMIT NO. S7 yrD
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL , (O SEE ATTACHED SHEET)
DESCR. �
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR / y�D % D �S• �Q�// C C d
USE OF
BUILDING ff 15 Piv d �L—
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
24Y t°�V• s D h of �.
Valuation of work: $ r-d PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
itPR�
(CATION ACCEPTED BY PLANS CHECK BY APP V IS ANCE Type of Occupancy Division
g Const. AP7 Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor In RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N Q r I C E
contract or registration law RCW 18.27, and am aware
of the Mason Count ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
y q VENTILATING OR AIR CO"WrtONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID" w RK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN ,2o DAYS, OR W c,AgTRUGTION OR WORK IS
x SUSPENDED OR ABANDONED FOR A PERIQD OF 120 DAYS w� ANY TIME AFTER
Owner w Date. WORK IS COMMENCED.
P N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH