HomeMy WebLinkAboutBLD2586 Mobile Home - BLD Permit / Conditions - 7/10/1978 Dameron, Albert R. #2586
7-10-78
Div. 1 Lot 67 Collins Lake
Entrance go right and continue on to the Y in the
road go right and go until you find a street named
Creek View Road, turn right on Creek View Look for
signs "Dameron"
Mobile Home
r BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 ` G
DATE ISSUED
PERMIT NO.
OWNER NAM MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS ' jZ
TO JOB SITE /tc1�
LEGAL i (❑SEE ATTACH D SHEET)
DESCR.
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: ;9 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE D DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES Li
SEASONAL ❑ FLOODPLAIN Ll
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. 7 J�J J
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
//'-�� APPLICATION ACCEPTED BY PLANS CHECK BY PROVED FOR ISSUANCE
07(1 fi? ,a �i n Date.7` I r g��
PLAN CHECK VALIDATION CK. M.O. CASH v PERMIT VALIDATION CK. M.O. CAS