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Home My WebLink AboutBLD20828 Final Mobile Home - BLD Permit / Conditions - 10/2/1987 u1i1�1■Ilmo�r Shorelines: d le, Plumbing: Setback: iL Special Mechanica Condit l: Interior: FINAL: MDbile Smoke Detector: ooting Remarks: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: TYPE MOBILE HOME POrmit No. 20828 No. Floors Udd a er STOICAN, Jon Michael Add Tel 2 55-4909 Da 842ress P 0 Box 1005 A11 g_g7 n Co Zip Contractors Hills Address Allyn Legal Description Tr 12 SE NE 1p Direction to project site mi a out o turn right on Sherwood Lane o to end of rd. n on H 3 Plumbing Mechanical Sewer Fireplace Deck W-b Stove Basement Loft Garage Carport Other 1987 12x40 1 bdrm BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED t--7 PERMIT NO. OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE d IJ�� loo - L ►.1 W 2$sZ Z-7 s 2 o DIRECTIONS TO JOB SITE Mtt.-e— 15o0-Txt BFpL t-1 0 v W 2•J Rle,Wr-oN S+1f-g a e--- t 6 n To PARCEL LEGAL NUMBER Q/ei D SCR. /; /o� /► f J /� CO CONTRALTO N ME MAILADDRESS CITY&STAT LICENSE NO. ZIP PHONE USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK r DESCRIBE WORK O/�Y� X a�) BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES r BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWJNESAFFIDAVIT CONTRACTORS AFFIDAVIT I CETHAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGTION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQENTS 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 RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTG APPROVAL FROM THE BUILDI G DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. OR r DATE X BY DATE FOR OFFICE USE ONLY DE RTMENT Y APPROVED�O DEPARTMENT YES DEPARTMENTBUILDING VALUATION HEALTH - PUBLIC WORKS FEE PLANNING AA,07j FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE _7APPLICATION ACCEPTED BY PLAN E BY APPRO O ISSUANCE PERMIT VALIDATION '/ TOTAL Y �, 75 BY CASH CK MO -_or PLOT PLAN ADDRESS i5 1706 qW�j f W4 PERMIT NO. o s v LEGAL .1L fj� ! l �� DESCRIPTION LOT T�I 5 P BLK ADDITION SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS r9do Sq.Ft. INSTRUCTIONS TO APPLICANT 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.) 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. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"-20' � n o , ` .'• r i, I— 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. Too N\I,(-HAw�= S--o I c A NAMa:l1) OF OWNKR(S) OF SIT[ a STRUCT RI&M WRMT) N T R N 1a) OR AUTHORI O REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE PLOT PLAN ADDRESS 17o o 3 HW 7 -3 U.l PERMIT NO. 0 i w s LEGAL s DESCRIPTION LOT TQ S 63 BLK ADDITION SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS L/80 Sq.Ft. INSTRUCTIONS TO APPLICANT 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.) 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. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"-20' 02 ri I I �b 4� Q 9� Q � � z « � 3 � 1 � N I/We certify that the proposed construction will conform to the dimansioru and uses shown above and that no changes will be made without first obtaining approval. -,Tots Mi C t+-" 6-ro i c kO a14 ' k1111'_b NAME(S) Or OWNER(f) OF SITE STRUCTURE(f) (PRINT) N U NE lfl R AUTHORIZED RZIORKSENTATIV9 DO NOT WRITE BELOW THIS LINE �J APPROVED '�n� DISTRICT AS NOTED 'U` DATE �C i