HomeMy WebLinkAboutBLD0161 Final Mobile Home - BLD Permit / Conditions - 5/22/1984 SMITH, David L. #0161
5-15-84
Haven Lake Tracks, Lot 398
NE 2080 Haven Way
Tahuya, Wash 98588 275-3114
Contractor
none listed
Mobile Home 1Ox50 1963
$2,600.00
�o ra 66t '>,ah ct
La k�
Shorelines:
Setback:
Special Conditions :----
Foot i ng:
Setback:
Foundation Walls:—
Fr am i ng:
Fireplace:
Wood Stove•
Plumbing:
Mechanical :
Roof :
Exterior•
Interior:
Final (n
Stop Work:
Mobile Home:
Smoke Detector •
Remarks•
--Jli
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED �
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
'an 985E 75- 11
DIRECTIONS
TO JOB SITE
LEGAL hh (❑ SEE ATTACHED SHEET)
DESCR. L-dt J9g v� �<*z s
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF Y�
BUILDING
Class of wor : ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
'S d
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT [, NOTICE
BATHROOMS_ _. I TOTAL SO. FT. GARAGE I; ,n '
ATTACHED ',: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El OR AIR CONDITIONING.
TOTAL SO. FT.GD_0 FIREPLACE ❑ DETACHED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
t
he State of Washington and I the
aware of the FOR OFFICE USE ONLY
nance requirements regulating the work for which
permit is issued and all work done will be in /formance therewith. PERMANENT to SHORELINES f�6
SEASONAL I i FLOODPLAIN
Firm
E.D. NO. S.E.P.A. L'
By Special Approvals IN OUT YES APPROVED NO
Lic. No.— Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
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 BUILDING DEPT. o
of the Mason County ordinance requirements for fS �—
which this permit is issued and that all work done will ROAD ACCESS
be l nformance t rewith. MOTOR VEHICLE PERMIT
I _Dy riL APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED F R ISSUANCE
Owner � '`� Date BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH