Loading...
HomeMy WebLinkAboutBLD27380 Mobile Home #10 - BLD Permit / Conditions - 1/18/1991 (2) BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 I 427-9670 DATE ISSUED I _� PERMIT NO. �� OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE d e DIRECTIONS TOJOBSITE O PARCEL /-� LEGAL -7- NUMBER �GY Q©� DESCR. L�j�I Ci C. I✓[ t7,- C !�� r{.�1 '�/- / r C CONTRACTOR � NAME MAILADDRESS CITY B STATE LICENSE NO. ZIP PHONE -6- � G P Z USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE / WORK XlqG, U714 E' (� L i -'� 1921 BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS Z TOTAL SO.FT. GARAGE CONDITIONING. NO.OFSTORIES 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.Ilzo FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERSAFFI AVIT CONTRACTORS AFFIDAVIT I CERTIFY THA I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION AW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENT 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 CONFOR ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING PROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. C 'lt DATE Z -,/��- �/� X BY _. DATE FOR OFFICE USE ONLY DEPARTMENT YES NO NO DEPARTMENT YES APPROVED o BUILDING VALUATION HEALTH < _ PUBLICWORKS FEE PLANNING - � FIRE BUILDING PERMIT ` D.O.T. BUILDING L PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP hLf`. PRE-INSPECTION sIc.— .^,f- ��1� }.,L.c !ii 1. SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANSCCHHECKBY PP "EEDD/91SSUANCE PERMIT VALIDATION �J B ``1�--- CASH CK MO TOTAL / Ldi Ct y�c� - ---sub ? C� BUILDINGl O PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED NAME MAIL DDRESS PERMIT NO. _ PIONS R CITY&STATE ZIP q)6 PHONE x SITE 91J PARCEL LEGAL � lJ NUMBER DESCR Indicate below. O Property lines and dimensions. I L O Easements and roads. O Septic, drainfield and reserve area, or sewer. O 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 lindicate topography profile of property and structure on reverse side. .0 I t 7� 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 DISTRICT APPROVED AS NOTED DATE � �s" � 099..2.-