HomeMy WebLinkAboutBLD9591 Mobile Home - BLD Permit / Conditions - 4/24/1978 Cummings, Jack R. #9591
4-24-78
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Lake Limerick Div. 5 Lot 44
Left on Clonakilty to second lot on right.
Mobile Home
1
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED001
PERMIT NO. /.✓ ��
OWNER NAME V MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS N0AT-H bN IYl/iSbW W • AC (), -rui6) A1L,HT /} t:mf rs-r N- A-A - UNDE12PItS
TO JOB SITE LEFT 0 e 6 et7
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. L L = C
NAME DRESS CITY& TAT LICE SE NO. PHONE
CONTRACTOR Q
USE OF
BUILDING a
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR )(MOVE ❑ REMOVE
Describe work:
1
Valuation of work: $ ��O rp PLAN CHECK FEE PERMIT FEE y4 i,..
SPECIAL CONDITIONS: of
APPLICATION ACCEPfED BY PLANS rkECK BY AP ROVED FOR ISSUANCE Type of Occupancy Division
B Const. 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 O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
` IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
72 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
OW er ate. `" 7 WORK IS COMMENCED.
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PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 11