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HomeMy WebLinkAboutBLD7043 Final Mobile Home - BLD Permit / Conditions - 8/26/1980 Burrows, George E. #7043 8-25-80 Collins Lake, Lot 80, Div. 3 Mobile Home $4,750.00 Final Inspection BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 _ U DATE ISSUED PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE Rawe W;-� S1� �e �x I�0 oh',(j jq It/d.5 A 795 X, DIRECTIONS / TO JOB SITE K /, ' U LEGAL (❑ SEE ATTACHED SHEET) DESCR. NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF ` BUILDING 1 Ole Class of work: ❑ NEW ❑ ADDITIO ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Ci vvt7d 'D Valuation of work: $ v PLAN CHECK FEE PERMIT FEEaS��r 4 / v SPECIAL CONDITIONS: 0 II t! 7 AD BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS__ TOTAL SO. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES�j ,� BASEMENT I_1 OR AIR CONDITIONING. TOTAL SO. FT-742 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 I 1 SEASONAL ❑ FLOODPLAIN I Firm E.D. NO. S.E.P.A. Cl By Special Approvals IN OUT YES APPROVED NO Lic. No.— Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS /be ertify that I am exempt from the requirements of the FIRE MARSHAL ntract or registration law RCW 18.27, and am aware the Mason County ordinance requirements for BUILDING DEPT. hich this permit is issued and that all work done will ROAD ACCESS i conformance th rewith. MOTOR VEHICLE PERMIT s, J LIGATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owner Date_ �o C BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH