HomeMy WebLinkAboutBLD5584 Mobile Home - BLD Permit / Conditions - 2/15/1978 Skelton, John R. #5584
2-15-78
Collins Lake Plat 1 Lot 51
Mobile Home
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED � `�17
PERMIT NO.
OWNER NAME MAIL ADDRES CITY 8 STAT ZIP PHONE
/ W S`
DIRECTI NS
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
AM/,4 A j,/ e T Af s
USE OF 41 J /
BUILDING 0 L e mQ e j / Q/ (, /1 +-/ A L—
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe w
fit �Q {�L Q 2 AA
Valuation of work: $ l/ ,/O ` PLAN CHECK FEE PERMIT FEES /Z
l 'Y
SPECIAL CONDITIONS:
DL
IGATION ACCEPTED BY PLANS CHECK BY APP ED FOR NUANCE Type of Occupancy Division
BY .(X-4-� Const. / Group
Gee tfi I \
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories ` Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor In RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N 0 T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
whic this permit is issued a at all work done will
be ' confo anc erewi THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
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
Owner Date. WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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