HomeMy WebLinkAboutBLD12312 Mobile Home - BLD Permit / Conditions - 4/22/1982 #12312
Arndt, Emil G. 4/22/82
426-8371
South 238' of West 208' of SE 1/4, NE 1/4, SW 1/4,
29-20-2.
Arcadia to Arcadia Point, take right on Lynch Road,
first drive on right.
Contractor:
Mobile Home None Listed
1967 121x55'
$5,000.00
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
OWNER �C �s3-/S" 4 11CIk e �� dlv <37/
DIRECTIONS wcL(cAz, PCI,1'f- 1 `i �.�
T`k�- f}Y-CCLdre.., --ta � can Y I
TO JOB SITE 1,1P
LEGAL (❑ SEE ATTACHED SHEET) Rq�•�<L�
DESCR. S �3p a�' W � o� SCY d� & 0j StJ T ,ScCIL 2.9 1o�"1 20 c,l+ti e }
NAME
MAIL ADDRESS CITY 8 STATE LICENSE NO. PHON
CONTRACTOR
USE OF
BUILDING I Fyn oti��
Class of work: E3'N W ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ Oo PLAN CHECK FEE PERMIT FIE
SPECIAL CONDITIONS:
BEDROOMS—. (DECKS— CARPORT [- NOTICE
BATH ROOMS--/-_.— TOTAL SO. FT._ GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES_ BASEMENT I ATTACHED I. OR AIR CONDITIONING.
TOTAL SO. FL FIREPLACE i DETACHED i_I
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 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED.
I certify that I am a currently registered contractor in
the State of Washington and I am aware of the FO OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit 15 i and all work done will be in PERMANENT L SHORELINES
conformance therewith.
SEASONAL II FLOODPLAIN L]
Firm E.D. NO. S.E.P.A. C;
Special Approvals IN OUT YES APPROVEDNO
By
Date ZONING
Lic. No.— PLANNING DEPT.
HEALTH EP . --?I-
OWNERS AFFIDAVIT P KS
I certify that I am exempt from the requirements of the FIRE M HAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROA
be in conformance therewith. MOTOR VEHICLE PERMIT
�7 D 2 A LIGATION ACCEPTE BY PLANS HECK BY APPROVED FOR ISSUANCE
�U
Owner :�1L. G —Date . - _ II
o CHECK VALIDATION CK. M.O. CASH PE IT VALIDATION CK. M.O CASH
.
PLOT PLAN
ADDRESS E S PE RM IT NO. i
ll /
1.iP 20 /(/or
>
�S�a.3� a� �W,6L0�$ cS• �SE"'/4�6(:�i�E/'+Jo-�(SW�}� o� Section �2� Tows s � )
DESCRIPTION/ WfLEGAL C (2�OT SILK ADDITION R
SITE AREA 'L/ a' Sq.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
PROPDIMEN-
SIONS.SHOW EASEMENTS. FINISH CONTOURS OR DRAINAGE, FIRST FED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOWILOOR ELEVATION,S STREET ELEVA-
TION A-ID 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.
OINDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
cl�
„Y
I Q CIA
V t 7
i
I/We cartify that the Pro nstruction will conform to the dimensidrS end uses shown above and that no changes will be made withoyC
first obtaining approval.
1
6"
AUTHORIZED
NAME(a) OF OWNER(!I OP SITE 6 bTRUC TU REfl1 IPRIN TI IGN♦TUR OF OW NER(EI OR R P EEE TATIVE
00 NOT WRITE BELOW THIS LINE
APPROVED DATE
DISTRICT AS NOTED
eNCLTON PRINTING