HomeMy WebLinkAboutBLD0588 Cancelled Mobile Home - BLD Permit / Conditions - 12/22/1987 Shorelines: Plumbing:
Setback: Mechanics .
Special Interior:
Conditions: FINAL:
Mob i 1 e Hume;
Smoke Detector:
noting: Remarks:
Setback:
Foundation
Walls:
Framing:
Fireplace: N L —
Wood Stove:
TYPE MOBILE HOME
Permit No. 0588 No. Floors Sq Ftg _1232
Owner ROBINSON, Barbara Te1275-2411 Date 12-22-87
Address NE 653 Gladwin Dr it 7 Bel fair zip
-
Address American Mobile Homes
Address Zip
Legal Description Tr 13-A G.L.2 31-23-1 (Tr 2 S/P 1579)
Direction to project site 2.5 mi. West from Belfair on St.Rt. #300. Turn rt. onto NE Larson Lk.Rd. for .04 mi.
Rt. on Bonanza NE 60 Bonanza Rd.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1988 28x44 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE IS UED1?/'?2*/
PERMIT NO. 05
OWNER NAME MAILADDRESS CITY&STATE ZIP PHON 57r�
Bar ty. S r'I 5- Y
DIRECTIONS
TOJOBSITE 2e5 Mi, we5Y- FRovr, .1ZCLF)4)9 vni ST. ier. *s'3cx� utc ✓� R�yI-Ir
pno-n 1 r,
lowyo NE zRk!iLnA LK. kd. Ft)R X4 MI `TkRv R,,-)vAr e,w-k L3o 1%r z w t�ole3ry
PARCEL
LEGAL '7�E' J ?,AA OF �O i,1 L "' Z
NU
3l 23 9v i 31 DESCR. 2 S /
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING �.cn,�,Q
CLASS OF NEW DDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE i
WORK
V
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEkTING, VENTILATING OR AIR
BATHROOMS TOTALSO.FT. GARAGE CONDITIONING.
NO.OFSTORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONS RUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALSO.FT. _ FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTEI I WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWN SAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERT THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CON RACTOR IN THE STATE OF
RED IS TION LAW RCW 18,27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REOUI MENTS FORWHICHTHIS PERMIT IS ISSUED AND THAT ALL WORK DONEWILLSE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CO FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MACE WITHOUT FIRST OBTAINING
OBTAI ING APPROVAL FROM THE BUILDING DEPARTMENT, APPROVAL FROM THE BUILDING DEPARTMENT.
X O ER ATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES NO
NO DEPARTMENT YES APPROVED NOBUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT a
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
1 j 'SIC 1'1 Ae4cQ1.)e- "-4'iA SHORELINE
WAto lik -p kj „ WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE �CQ
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS HEC BY I APPROVEFORtARSUANCE I PERMIT VALIDATION BY CASH CK MO TOTAL 6 a y, /
PLOT PLAN
ADDRESS PERMIT NO. i
nCciUP
LEGAL TI� C7 .S/ -.i'7y i
DESCRIPTION LOT BILK ADDITION
SITE AREA >CY0 Su. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 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 Q
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DI MEW
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION AND SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTR CAL .0
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJORPOR-
TION THEREOF.
OINDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X ' OR 1"=20'
1
s
h -
Ids �
I/We catt fV that the proposed construction will conform to the dimensions and uses Mown above and that no changes will be me It without
first obtaining approval.
NAM[lal OF OWNER(SI OF eITE a STRUCTURE(!) (PRINT) 1 N UR F OWNERS) OR AUTHORIZED R P N IV
DO NOT WRITE BELOW THIS LINE
DISTRICT AS NO EDD IN, 1 6 1 DATE � 2�� �97