HomeMy WebLinkAboutBLD2623 Mobile Home - BLD Permit / Conditions - 7/13/1978 Dameron, Steven R. #2623
7-13-78
Collins Lake Div. 1 Lot 64
Mobile Home
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 � p�
DATE ISSUED ��'./O
PERMIT NO. "���✓
OWNER NAME MAI ADDRESS CITY 8 STATE ��ZIP PHONE
J
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DIRECTIONS, ,d IL41
TO JOB SITE "7'44,
LEGAL 1pti(/! A (91 SEE ATTACHED SHEET) '^
DESCR.
NAM
MALL ADDRESS CITY LICENSE NO. PHONE
CONTRACTOR '
USE OF
BUILDING
Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ �iO PLAN CHECK FEE PERMIT FEEV6.
oC /
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT [] NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE C]
ATTACHED [� SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT C OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ 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 fJ SHORELINES
SEASONA FLOODPLAIN
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.
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—
b Cinformance therewith. MOTOR VEHICLE PERMIT -��3
�i
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. / BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH