HomeMy WebLinkAboutBLD7257 Mobile Home - BLD Permit / Conditions - 8/27/1980 McDonald, ,Wayne #7257
8-27-80
Lot 39 - #2 Pine Tree Place - Collins Lake
Pinetree Place, Collins Lake - Lot 39, Div. 2
Mobile Home
$14,800.00
BUILDING PERMIT APPLICATION �
MASON COUNTY -
P.O. Box 186 Shelton, Washington 98584
426.5593 p
DATE ISSUED r7 "�' 7-l��
PERMIT NO.
OWNER nNAME MAIL ADDRESS TY 3 STATE 5 ZIP PHONE
r7 LI e
c r
DIRECTIONS
TO JOB SITE 3� I (�jQ
LEGAL 44, 1 (O SEE ATTACHED SHEET)
DESCRIL
� l V �P 0, G 5
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
Dic-CONTRACTOR ` 5 / PP
USE OF
BUILDING
Class of work: El NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work
i � v
Valuation of work: $ /A O Q PLAN CHECK FEE PERMIT FEE - �S-
SPECIAL CONDITIONS: l Q <<
.c� S'v
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS I TOTAL SQ. FT.-,)?CV-_ GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ElOR 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 SHORELINES ❑
SEASONAL ❑ 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
/be
tify that I am exempt from the requirements of the FIRE MARSHAL
ract or registration law RCW 18.27, and am aware
he Mason County ordinance requirements for BUILDING DEPT.
h this permit is issued and that all work done will ROAD ACCESS
c nformance ther with. , MOTOR VEHICLE PERMIT
LIGATION ACCEPTED BY PLANS CHECK BY P
Owner Date ROVED FOR ISSUANCE
� .
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH