HomeMy WebLinkAboutBLD24820 Mobile Home - BLD Permit / Conditions - 11/22/1989 1a� . D _
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile
Smoke Detector:
<SE7 Remarks: -�-
Fee�•
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 24820 No. Floors Sq Ftg 1372
Owner PTAK, Edward R Tel 898-3550 Date 11 22-89
Address p 0 Box 156 Union Zip
Contractor' Olympic Mobile Homes
Address r ip
Legal Description Lae Li rick Div 4 Lot 192
Direction to project site Past Ist Lk Limerick entrance rt on
Olde Lyme Rd (at train trestle . follow about 000' to 190 Lw e Rd.
on ri t i lot no, at site,
Plumbing c anjcaSewer Wood Stove
Fireplace Deck Uarage —Carport
Basement Loft Other
1989 28x49 3 bdrm
I
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. 4 a a G
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
Ou/6&0 R. �T4 ,Q• Y30ic 14'6 UA&D A!
DIRECTIONS TO JOB SITE JU 1'!�
7 sr k.4k /m Ea /ck Al m 4&jC-49 ? A/
o N 01-D E Y/M E 2D Rr_T,2A/N 7R,,c-.5 ZLE- Fo 4,Lo u1 48c v /o 0 o FT f/6 o T
PARCEL LEGAL DESCR. �.D'j j Q/{/ 5'G'4 a• LTV' e_
NUMBER 34) t7s',30o 1Q2, II LAke C
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR �� ��� •�� r., 2-o tl RPFu9a2 /0 /fC 7axj
USE OF �f
BUILDING O�ll /tONILc
CLASS OF EW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE >
WORK
v
BEDROOMS 3 DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS 2 TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. 1203 FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT X �ORELINE
01
SEASONAL
OWNE/APVAL
CONTRACTORS AFFIDAVIT
I CERTIFEXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTR 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREICH 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 CONFREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
CBTAININOM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
G 4k /-/,
X OWN DATE X BY DATE
FOR OFFICE USE ONLY
APPROVED APPROVED
DEPARTMENT DEPARTMENT BUILDING VALUATION
YES NO YES NO i Q6
HEALTH PUBLIC WORKS FEE
PLANNING FIRE �a BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP - PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE Q
STATE SURCHARGE
APP TION ACCEPTED BY I PLANS CHEG1C`BY p APPROVED FOR IS NCE PERMIT VALIDATIONLl clv �'
/�G�..,-c/ I BY L CASH CK MO TOTAL 9
PLOT PLAN
ADDRESS I���-OL1%� ��� �� �S�f"�-T(ILl% /� PERMIT NO. ° o
R •
�,IlKC � llr/E/C�ce w \
LEGAL
1
DESCRIPTION LOT l y 1�-- D IV Af BLK ADDITION
6 y k C6F L, W- 7,,;0 P—
lt,
SITE AREA -� Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS I j yb Sq.Ft. �I
INSTRUCTIONS TO APPLICANT T`
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) CIA
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION AND SEWER SERVICE ELEVATION. SHr'W LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY' INS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
r
1 1
�f --- >
INDICATE NORTH IN CIRCLE GRAPH SQUARE ARE 5' X 5' OR 1"=20'
�n
Ole
1 i rl
a
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I/We certify that the proposed construct n will conform to the dlmansidns and uses shown above and that no c nges will be made without
first obtaining approval. <_- I y Vi
U
NAME(S) OF OWNER(!) OF SITE ! STRUCTURE(!) (PRINT) IGNATUR OF OWNER(!) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
II - --