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HomeMy WebLinkAboutBLD25870 Mobile Home - BLD Permit / Conditions - 6/8/1990 6�a Shorelines: Plumbing: Setback: Mechanica Special Interior: Conditions: FINAL: Mobile cme: Smoke Detector: Foot i Remarks: � ,; Setback:Foundation Walls: Framing: Fireplace: Wood Stove: TYPE MOBILE HOME Permit No. 25870 No. Floors 1 Sq Ftg 720 Owner T� �� R�ERT L Tel Date Address - 42�=�a88� 111 nrrhaCd RQArh nr -- rAn yPlw Zip g8�1L6 Contractor Address zip Legal Description Madinas Orchard Beach Bl B lot 2 Direction to project site North on Hwy 3 to Island View Rd to Orchard Beach left o E. 311 Plumbing Mech—anical 6ewer Wbod Stove Fireplace Deck Garage Carport Basement Loft Other XX S. Gordon Craig the mason county assessor Dea r We have recently received a copy of tax certificate for mobile home movement on your mobile home. In order that we may accurately value you mobile home , please complete the questions below and return this form to our office by It is imperative that this information be provided to prevent a possible double assessment. MOBILE HOME DATA LENCH WIDTH _ MODEL MAKE f MODEL (3 D YEAR MOBILE HOME LOCATION INFORMATION SERIAL # 6 2 �Z A. My privately owned land. YES' NO B. If rented or leased land/who from?? NAME ADDRESS )7ad &4bITY & STATE C. Real Property Parcel # (tax statement #) I - L, L) © Zoo 2- D. Mailing name and address for owner of mobile home NAME ADDRESS CITY 6 STATE E. Location address of mobile home A /j CITY_ F. Date mobile home was placed on present site C. Purchase Price- DATE: Ey 4 SIGNATURE �� t� TYPE OR PRINT NAME ZL O a k't TELEPHONE NUMBER 40 N'F_ Courthouse Y Shelton, Washington 98584 Phone 427-9670 65 U INVESTIGATION REPORT FORM Revised 10/6/94 Part A: Nature of Complaint • Initiator's Name: • Address: e N • Telephone: • Owner Name: • Address: • Telephone: • Department of Concern ❑ Clerical ❑ Building ❑ Health ❑ Comm Development ❑ Fire • Area of Concern: ❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other Refer to Director • Location of Concern: • Natur of Concern: t ' ( U7 a, y � t Part B: Con Zaallneut Intake and Referral Q\ Rprewed By: Referred To: Response Date: Name Date Name Date Date Part C: Findings / 1j l � F Referral Forwarded to: T. ❑N/A Name Date Findings: i 4,j _ Part D: Resolution i ,. /, W ame _ Date