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Home My WebLink AboutBLD96-0854 Mobile Home #34 BLD0064 Mobile Home #28 - BLD Permit / Conditions - 6/10/1996 Permit No.�— MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-8800-562-5628 -LEASE PRINT -ri JYI /� Phone # �_ #1 ner D S tt�(f Fire District# ite Address X�� nn APE St� ZIP 1� — City � / Directions to Job Site �� w Owner Mail... Address St _Zip715r_� City Lien/Title Holder Address St ZiP City i/ / /tirti /. Contractor Reg #2 Contractor Name a' r5 Expiration Date 7 / Address St Zip 5}13,3 7 Phone# c� - City � #3 If septic is located on pro ect site, include records. Well Connect to Septic? Public Water SupPly�_ 1�k Connect to Sewer System? Name of System "� Zar idential, proof of potable water is required) l No./ F Legal Description #5 Building Square Foote: (existing/proposed) 1st FI_ � • 2nd F 3rd FI / —Loft / Basement Deck #bedrooms bathrooms Carport / (Circle:Attached or etached?) Garage / Zr Other sq. ft. �✓�.� a Describe work #6 Use of building " / L , � #7 Type of Job: New Add Alt Repair.Other ,�� #g MOBILE/MANUFACTUREDHO E7 1NF�ov1ATI,ON � �jec��t)0� Model Year �>q Make /��'" M '� Length_ (p_Serial No. �� f £s/ # Bedrooms # Bathrooms �- Type of Heat �� C Purchase Price$ 2 � Z� #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Septic Systems Wel �ry ls Proposed Improvements Easemerrts Name of Flanking Street [=: :7Name of Fronting Street APPLICANT TO DRAW SITE PLAN BELOW n 5' APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW F ` c�� --..�� c�.w,,.es (�50 each) Plu_bim ct a roc to p each) CIRCLE FUEL TYPE: Gas, Electric, No.a Toilets Bath Basins Heatpump,Other 5ln" EM 8'Bath Tubs BTU Fum _LShowers Heatpumps Hot Water Htr Vent Systems Laundry Washer — Spot Vent Fans Sinks Floor Drains Boale HP —Laundry Basins �, Air H na dlinc Units —Dishwasher _ cfm �_ —Disposal � Urinals 50.00 -- Auto. Fire Alarm Sys Other. _ Fixed_ xed Fire Supp. Sys 16.25 Auto Fire Sprink Sys 35.00 Permit Basic Fee —" TOTAL PLUMBING $ MIX _ Gas Outlets Wood, Gas, Pellet Stove rNoTnICE: THIS—PER MIT BECOMES NULL AND VOID IF _ 18 25 R CONSTRUCTION AUTHORIZED IS NOT COM- Permit Basic Fee D WITHIN 180 DAYS OR If CONSTRUCTION OR TOTAL MECHANICALS SUSPENDED OR ABANDONED FOR A PERIOD DAYS AT ANY TIME AFTER WORK IS COM- D. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. CONTRACTORS AFFIDAVIT OWNERS AFFIDAVIT T I AM A CURRENTLY REGISTERED I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- CONTRACTORI CERTIFY pIN T STATE OF WASHINGTON AND I MENTS OF THE CONTRACTORS REGISTRATION LAW gMAWAREOFHEORDINANCEREQUIREMENTSREGU- RCW 18.27, AND AM AWARE OF THE MASON COUNTYIT IS ISSUED MIDIS ISSUED AND THAT ALL WORK DONE WILL BE N AND ALL EMENTS F WORK DONE WILL BE N CONFOR WHICH THIS PER- LATINGTHEWORKIFORWHICH THE PERM ORMANCE THEREWITH.NO CHANGES SHALL BE CONFORMANCE THEREWITH.NO CHANGES SHALL BE FIRST OBTAINING APPROVAL FROM THEBUILDING LY REGISTERED MADE WITHOUT FIRST OBTAINING APPROVAL FROM DEPARTMENT. THE BUI DIN PART ENT. X BY X OWNER ✓f — �� DATE DATE DEPARTMENTAL REVIEW FOR OFFICE USE ONLY ,{{yy Approved Cond, Hold Planning: :HIO E_ cn Approval Environmental Health: V If Building Plan Review Occupancy Group: 12-3 Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit o /So O Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Lt Other Other Building Valuation: TOTALFEE GOLDEN BELL MOBILE HOME PARK N.E. 20 ROESSEL RD. BELFAIR, WA 98528 PHONE#(360)275-4623 DEPT OF GENERAL P.O. BOX#186 SHELTON, WA 98584 As required,we are sending you a 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. Legal Discrepton: Lot 20 Sam B thelers- home garden tracts. Volume 4 page 20 RECORDS MASON COUNTY. PARCEL NO-112��33250--00050 New Tenant Name: lL�CCs„ 7� o P�J New Tenant Lot:-. THANK YOU, Dede Schattenkerk Mgr. BUILDING PERMIT APPLICATION2 MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED__2/��_ _ PERMIT NO. _(_17- 06 OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE F �. Lt > 73 S '� DIRECTIONS TO JOB SITE LEGAL (C SEE ATTACHED SHEET) DESCR. —L f � G t.,f. �i -i u�_di�. - �.i -y l NAME MAIL ADDRESS CITY&STATE •LICENSE NO. wPHONE CONTRACTOR I g � n _� So.T lL� E49� USE OF BUILDING Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR G MOVE ❑ REMOVE Describe work: Valuation of work: PLAN CHECK FEE PERMIT FEE _y c. SPECIAL CONDITIONS: BEDROOMS __ (DECKS_ -_ — CARPORT NOTICE BATHROOMS__ TOTAL SO, FT. GARAGE ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE DETACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT (ZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER I certify that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the 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. I-- By Special Approvals IN OUT YES APPROVED NO Lic. No, Date 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. — r/� which t is permit is issued and that all work done will ROAD ACCESS ' ;,yeti nrc7rIT a t�C� MOTOR VEHICLE PERMIT L/� (r` ' Date APPLICATION ACCEPTED BY PLAN HECK BY APPROVED OR ISSUANCE Owner _ PLA CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION CK. M.O. CASH