HomeMy WebLinkAboutBLD8872 Mobile Home - BLD Application - 2/20/1976 • P BUILDING PLI RMI T APPLI CAT I N
MASON COUNTY
P. O. Box. 400 Shelton, Washinqton 98584
f' - DATE ISSUED —2p5=2�
PERMIT NO.
OWNER
MAIL ADDRESS60
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DIRECT /; /� /J
TO JOB S E
1_____ of_
MAIL ADDRESS SIP
� (OS[L ATTACHLD SN[LT)
DLSCR[ LE"
_-- --_-- �-',r���-� .MAIL A ORlS -' PN ONE --
-CONTRACTOR � �.4� /�
(ILK
USE OF MAIL ADORE S PHONE LICENSE NO.
BUILDING
Class of work: 0 NEW A ❑ADDITION 0 ALT R ION 'ClREPAIR O MOVE 0 REMOVE
Describe work:
Valuation of work:$ PLAN CHECK FEE PERMIT FEE crT
cX. �—
r SPECIAL CONDITIONS:
APP CATION ACCEPTED BY PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
Type of A• Occupancy
�— - Const. Al 1-191 Group I Division
64lize of Bldg. No.of Max.
(Total)Sq.Ft.I.?X,0 Stories Occ.Load Id
CONTRACTOR AFFIDAVIT Special Approvals Required Received Not Required
I Certify that I am a currently registered contractor in the State
of Washington and the County of Mason and I am aware of the HEALTH DEPT. ,7- ,
ordinance requirements regulating the work for which the permit P0130C WORRIB
Is Issued and all work done wi;l be in conformance therewith. 045AD DEPT.
Firm
By —
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the contrast
or registration law RCW 18.27, and am aware of the Mason N 0 T I C E
County ordinance requirements for which this permit is issued
and that all work done will be in conformance therewith. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING,
HEATING. VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC-
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
�
Owner C Date'a
/ t 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SHELTON PRINTING CO.