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HomeMy WebLinkAboutBLD25929 Mobile Home - BLD Permit / Conditions - 6/14/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUE / PERMIT NO. NAME MAILADDRESS CITY BSTATE ZIP PHONE OWNER 0 (Z a L.L - 4-1 ' - !a >>~A C A 7�5 DIRECTIONS TO JOB SITE ' L Ke nV ck _1 Ax ° 0 rl -r y I e i.L v n PARCEL LEGAL NUMBER Z3Z - f5c-5 -53�x� DESCR. ��u1s vl, 04,3 4 t �AM©4 tttitP, co B T"4 NAME MAILADDRESS CITY BSTATE LICENSE NO, ZIP PHONE CONTRACTOR USE OF 70cj BUILDING b\A(J- %L T CLASS OF NEW ADDITION ALTERATION REPAIR MOVE ,� REMOVE WORK ✓ DESCRIBE _ WORK M ti , ,4lr4vyi 0 6601 S BEDROOMS DECKS YORN CARPORT NOTICE TOTAL SQ.FT. SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SO.FT. ODECK TAGSO.FT. CONDITIONING. NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT I FIREPLACE IATTACHED SEASONAL SHORELINE DETACHED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. 1 _ XOWNER DATE c7 4 XBY Jt7t t7 ----DATE J�3/�y 4 FOR OFFICE U6ff ON LY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION i YES NO YES NO HEALTH r PUBLIC WORKS FEE PLANNING Aa FIRE BUILDING PERMIT µa D.O.T. BUILDING 4- 6 .3 PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP R-3 PRE-INSPECTION !' ✓ SHORELINE ' WOODSTOVE 4/'. " 5-op 7 PLUMBING MECHANICAL STATE BUILDING FEE STATESURCHARGE APPLICATION ACCEPTED BY P NS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION 6/3-yv 6/3 'yo TOTAL y 1'� BY O,- CASH CK MO PLOT PLAN ADDRESS PERMIT NO. a° c : • i o LEGAL x DESCRIPTION LOT BLK 53 ADDITION 14004 (�Otiol kayr'9f- = Y Y 11t .'is iile,+"i- R: SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. r L0- S 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. r s JV J INDICATE NORTH_IN CIRCLE _ _ � i i Le C -- f i r Ro F Ai I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made Withouj first obtaining approval. Ce. iiY�% NAME(a) OF OWNER(a) OF SITE 6 STRUCTURE(S) (PRINT) IGNATUR OF OWNERIS) OR AUTHORIZED "PRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED '2 DISTRICT AS NOTED ( �jtc�j--ti DATE Shorelines:Setback: Plumbing: Special Mechanica Conditions: Interior: FINAL: Mobile ome: Smoke Detector: noting: Remarks: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: TYPE MnR i I F HnMF Permit No. 25929 No. Floors �_ Sq Ftg Owner REED. ORVT► IF H Tel Address BOX OR Paci ��h-a7�R Date ��� Contractor A AR��L Zip QR5z1 Union Address E. 5080 Hwy Ina Union Legal Description ip P Un7on�Hcod Canal I and R imn rn hllr 5� 1n Direction to project site t Tac,nma St turn 1 Aft �., n+ti Ctroo+ 7 turn UUIU ing Mechanic Sewer W00a Stove Fireplace Deck Garage Carport Basement Loft Other x_