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HomeMy WebLinkAboutBLD83-14036 - BLD Permit / Conditions - 5/27/1983 Blucher, Mr. & Mrs. W. F. #14036 , No Phone Listed 5/27/83 W.1/Z, NE 1/4, SW 1/4, 3-20-4 Next door & behind Victs Auto Wrecking, 1.5 miles down Dayton Airport Road at W 1583. Mobile Home Contractor: 1,848, 19&j None Listed $34,188.00 (D p 0 rt H. p >4 O (D O H. 11 0 (D O 'd m P- p O o' O O rr rt O n o O H w o rr 0 (D ct O w pV H.•ti w (D (D I-h :::r P_ (D EI v rt i (D N I- "i 1-1 .. w 'C a !)., H. r• w (D £ •• r• r. O r• Cn H O w` 0 0 w 0 F, rn d O O O r• rt w va rt P'oq r- .. (D x H n ( O rt O T W C (D H. C� (D n N (n (D p O N A rrt H. O v 1. y BUILDING PERMIT APPLICATION MASOn COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 ry DATE ISSUED PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE s i Ad c . �. DIRECTIONS TO JOB SITE LEGAL �1 ' SEE ATTACHED SH T) DESCR. Z 5 7 Sv --Z0 - CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF BUILDING 10 ME /N/106/4E r Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: / J Valuation of work: $ �t/' ` (1 PLAN CHECK FEE PERMIT FEE V Y / 7 SPECIAL CONDITIONS: BEDROOMS_ ` I DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT./Q-YS— GARAGE ❑ SEPARATE RE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT Ll ATTACHED El OR AIR CONDITION CONDITIONING. TOTAL SQ. FT. FIREPLACE C' 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 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 N LY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES [I SEASONAL CI FLOODPLAIN Firm E.D. NO. S.E.P.A. ❑ 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 BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT T LIGATION ACCEPTED,BY PLANS CHECK BY A ROVED FOR IS ANC Owner Date . PLV CHECK VALIDATION CK. M.O. CASH v PERMIT VALIDATION (CK.) M.O. CASH PLOT PLAN i ADDRESS l,C/_ 24tr PERMIT NO. o °o LEGAL DESCRIPTION LOT BILK ADDITION _ u SITE AREA— _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 PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION A"'D 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. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' O n� 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. NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) &IGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE GHELTON PRINTINu Building Design ( _ rf FLOOR PLAN - i -�-- - �--�- ---r-- r-- r I � f I i �l110 1 E ' r Ly 1 Id r 111 i i i F ( I I i f Pq cti i 10 Ix r P SE CHECK:! I i l,E� -ZRoof-Pi 0 — —,— — r E VIIMV- ayes-kleigh#iinirr urn CI' ar noes ! ( M 'SO B ` !. � IN -- _ - - -- - — A�16 #t81T O VA + Ir i i I n%meIL 1 -` — — - —i - -- -- - -- - 14 T17, 122 r t r 11 + I ' F- -. I FR34 7/89 •� =,1 oNN Count ® Suite B • 16521 99 • Lynnwood, WA 98037-3161 S T EEL BUILDINGS Everett Line:(206) 258-4171 Toll Free: 1-800-824-9552 _ Administrative Headquarters: (206) 743-1555 DIVISION OF Contractor's Lic. #: PERMABI 179JR Quality: Our Future Depends On Its" Site Plan PLL,EEASE CHECK: V19 roperty dimensions Cl]�Septic and drainfield fZJAL.,o ccess to proposed building (N xlsting buildings ❑�Sewer linesf size oroposed building Wsetbacks of proposed and ZElevation of property ❑Easements pAsting buildings ❑Bodies of water MMain road with name ❑Floorplan Job name: BILL B Ue-f+�;-IR Job Site Address: b. 1ST 3 "Tuo Legal Description 14 --5 C)F ICU 11,2 SLG WA �- phyTON R IRfbRT I t I i ! j E ' l I _ ; -} i � I , r t . i ' I ' P"I : I � t yc i ►)tLL tie DS I , t FRot GAIkA a F I - - i L_ t o - - - -- -- t Owner has verified and approved the location of accessories,orientation of the building to the north,a verifies that all item 'specified in paragraph B of the contract are shown on this drawing and vice versa. Customer signature: _�� � �r _ r ©1989 PermaBilt Industries 719q