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Home My WebLink AboutBLD23900 and BLD15119 Mobile Home #27 - BLD Permit / Conditions - 6/16/1989 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 / r' ISSUED DATE ISSU 427-9670 n PERMIT N00 _�3 166 NAME MAIL ADDRE55 / CITY TE Zlp no9 OWNER Q%I / V l �DIRECTIONS / y EJ / y�+,y)�r /2Q/- J aTO JOB SITETPARCEL LEGAL f � , / 7;" NUMB ERA23 c7� v"O4 22'� �"A DESC NAME MAIL ADDR5 CITY dSTATE L E SE NO. I ZIP\ PHONE CONTRACTOR O �� Cho__I ` , = T ILA "mil l S USEOF L I V I BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE sLT U e I L•u I-{ o r'1� � � yv 06 Lv 4< �. r.` ✓' �A2 K WORK e� N � O � cl< S o rL I Rl— Merl (.�, I5 IOri `li v %'rH ?�ao I BEDROOMS a DECKS� CARPORT NOTICE 3l0 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS I TOTAL SO.FT. — GARAGE CONDITIONING. ATTACHED U ��-- THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT ND.OF STORIES, �1 BASEM ENT fY-- 1� COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTALSO.FT. *4/L FIREPLACE 0 /A DETACHED L ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT e- SHORELINE tj A SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I AM A CURRENTLY EGISTERED OR IN THE STATE OF FROM HE EMENTS OF THE CONTRACTORS I CERTIFY THAT IR CERTIFY THAT I EGISTRATIOtF! LAWARCW 102PT AND AMTAWAREOO FRTHE MASON COUNTY ORDINANCE WASHINGTON AND II AM AWARE OF THERORDINANCE REOOUIPEMTENTS REGULATING THE REGISRATION FOR RCW WHICH THIS PERMIT A ISSUED AND THAT ALLWORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN IN CONFO.MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST APPROVALAROM THE BUILDINDEPARTMENT NCE THEREWITIL NO ES HALL BE MADE WITHOUT FIRST OBTAINING O BTAININ APPROVAL FROM THE BUILDING DEPARTMENT. XOW R ��..., ti.._.___ DATE S O 1 X BY fI __ _DATE_ 4 FOR OFFICE USE ONLY APPROVED APPROVED BUILDING VALUATION i DEPARTMENT YES NO DEPARTMENT Yes NO FEE HEALTH PUBLIC WORKS r FIRE BUILDING PERMIT PLANNING D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTEDBV PLANS CHECK BY APPRO Dt�FOR SUANCE PERMIT VALIDATION TOTAL �-.0 BY 11 I CASH CK MID r J: _ � »ASec : ter . If 7. oessA , 20 w ash a ?eQ 275«§> _o :ho: this MLly eelice—; 2n e is :e : I t esle7 submitted« >w w » : L De tenancy in . s« e z have y1yU_ 27. 'Pbere r 6 = a� »#Il o: wa \ »SIG =: O tea ee <e� �1w q1O theTp: :� I= -e e s m e rl eta/ J wse m sewer system in to a sa« ,,:as :I,e4 -to m:o s,<me »�,e .2tt four 1:�_. \:e j ,at the ym:,r « e there o-2 7 homes in tb�e_ 2 r, s S E an e>aF.e of t'a --)ersors Per » m 1« a eJ z z,m information rlease feel free t, call solden .i »AGe > e22 .yeG «2 «20 \el\ r, +.<35 a >eG:S :: «T)e:t± :25er� G <.deve ae Golden Bell Mobile Home Park N.E. 20 Roessel Rd. Belfair,Wa 98528 Phone#(206) 2754623 Deede Schattenkerk, Manager Dept Of General Services P.O. Box# 186 Shelton, Wa 98584 As required, we are sending you notification of a new lease agreement with the following new tenant. Lease agreement will commence when their Mobile Home arrives on our pre-existing lot. If you have any questions please call during normal business hours. New Tenant Name: New Tenant Lot # Thank You, Duck Se46tMra" Mgr. MASON COUNTY DEPARTMENT OF HEALTH SERVICES POST OFFICE BOX 1666 SHELTON) WA 98584 � 120#)f 197a APPLICATION FOR DETERMINATION OF AD',�},^w�,�'{1 Revised 09/01/92 U u FFB o 6 1995 INSTRUCTIONS /V��/ 1. Complete Part 1. No determination can be made until Part e u ilizeES 2. Complete only the portion of Part 2 applying to the type o 3. Submit completed application, with attachments to the health department for review. PART 1: APPLICANT/PARCEL IDENTIFICATION cc �1 T DATE OF APPLICANT Rev9 C 'rn 0S()Yam n MAILING ADDRESS C- cot3 \ (1\l�� PY- C ��A TELEPHONE (90(D) 1 3� ma ,�c� Te r9\ ireA-n�r • S Q — ti,1 1-IOrne r city state zip �il-11P Y1 ��f 1\ C S P l3 c.'f aC' �Ces•,e\ ?a t (�3c\cc3r) ASSESSOR'S PARCEL NUMBER OL L S L SUBDIVISION (If Applicable) LOT TYPE OF WATER SYSTEM (Check One) REASON FOR .'APPLICATION (Check One) 14 Public/Community Water System Building Permit, Single Family Res Individual System, Drilled Well Building Permit, Commercial • Individual System, Dug Well Building Permit, Replace/Remodel • Individual System, Spring Land Use Application Name Individual System, Surface Water Type r1 Individual System, Other U Other PART 2-A: PUBLIC WATER SYSTEM €------_---- €€€s €--------- .-- NAME OF WATER SYSTEM �G\<Q Ar \QTe r � � 1-T r(L L WFI ID O�3 SLR The water purveyor for this system has previously filed a certificate of water adequacy with the health district. ❑ service I an manager of the above referenced water system. The water system has DOA approval for �/ L connections presently in use. The applicant has approval to connect to this water connections, with is consistent with both the water system system. Service of water to the applicant for domestic purposes plan and the water right permit presently in effect. Water lines are available to the applicant'- property line, or the applicant has made a is actory arrangements to extendA the lines. J, �.,.._ ��, .u.y � �C✓�. DATE SIGNATURE OF SYSTEM MANAGER .f `' —7 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 /—� G� DATE ISSUED O PERMIT NO. 151 �? OWNER ME MAIL ADDRESS nl CITY&STATE 21P PHONE Vsp a '4�f �� S�•�p I f 3-% 6 DIRECTIONS TO JOB SITE n M , - �' J'oZ-o�3- DESCR. - �\ ATrncHEDSHEETI LEGAL CONTRACTOR ME MAIL ADDRESS CITY&STATE ICEN*NO PHO E So-m -rk t C7arc�s�J USE OF I_ `r --5 BUILDING M O" � e Class of work: EI NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR MMLOVEO ❑ REMOVE Describ work: C 7 Ca o a l -t- t e is/x '70 Valuation of work: $ PLAN CHECK FEE PERMIT FEE /a, a 50 5 SPECIAL CONDITIONS: BEDROOMS_ IDEfCkS-1 CARPORT L, NOTICE BATHROOMS _L_ TOTAL 80. FLjM GARAGE '.'. NO OF STORIES BASEMENT ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING. VENTILATING . OR AIR CONDITIONING. TOTAL SQ. FT._. FIREPLACE DETACHED ;.-. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 1R0 DAYS AT ANYTIME AFTER I certify that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I am aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT .. SHORELINES SEASONAL , FLOODPLAIN Firm E.D. NO. S.E.P.A. BY Special Approvals IN OUT YES APPROVED NO Lic. ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18,27, and am aware of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith, fk n o ,Vr'iy` Y,'z '.h yOv.n u �'1}..P- y,Q f MOTOR VEHICLE PERMIT AP LICATI ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owner Date L3 ev PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH HYLAND, Michael #15119 1-24-84 Sam Theler's Home & Garden Tracts 32-23-1 Golden Bell Trailer Court 243-1161 Space 27 Contractor Self Mobile Home $12,250.00 c .. 0 Ol U O N > .. ..O O bO U .-L O C •• •• +a .• H H H 5 N .01 ,Ci C M M •. 3 w Ciy O u y O u O ro H 0 7 U O L N cc p O A 0 vim] vO] En W La) W W W 3 ow �" p4 W H W V] y