HomeMy WebLinkAboutBLD28523 Mobile Home - BLD Permit / Conditions - 7/8/1991 (3c)
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobilehome:
Smoke Detector:
Remarks:
ooting:
Setback �-
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE Mobile Home
Permit No. 28523 No. Floors Sq Ftg 1203
Owner Ted ason Tel Date 8 91
Address 4220 S 154 th St Apt 15 Seattle 981g8 Zip
Contractor OlVwic Mobile Homes
Address Zip
Legal Description Lake Limerick Div 4 Lot 1
Direction to project site Dartmoor Dr to rriga
(South side of road)
Plumbing x c anica x ewer Wood Stove
Fireplace Deck =arage —Carport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED' r
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER 10A 9-�;/�� -/
DIRECTIONS
TO JOB SITE
PARCEL LEGAL /
NUMBER DESCR. F- /� c'/2 1c/ /_ �G
ME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE NO.
CONTRACTOR c YG 0/ _ �r 7 SZ,d
USE OF a
BUILDING J — G 6�;-
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK L C / 1 O 9
99
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE 126 3SgFt STORIES SHORELINE 0 CONDITIONING.
BASEMENT ----S Ft BEDROOMS PRIMARY RES.❑
g y'c THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS - S Ft BATHROOMS A / COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
g SEASONAL RES.❑ /Y Q ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE — SgFt ATTACHED O DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM T E BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT,
X OWNER DATE G X BY_ __ DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVE ry
AD NO BUILDING VALUATION
HEALTH 1�1 - J PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT -217
D.O.T. BUILDING y PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
Aiy Z> i- SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
Af PLICATION ACCEPTED BY PLANS CHECK SY APP VED ISSUANCE PERMIT VALIDATION
IC.7 "� 1 B CASH CK MO TOTAL
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER 4 M
DIRECTIONS
TO JOB SITE
PARCEL LEGAL / o Al
NUMBER DESCR. •.. O z
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
O Location of proposed construction on property.
O Building& septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.
O Attach copy of septic system"as built" or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
1414 Z.C.4=1�e ty),
N
- - - N
0
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval.
SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE