HomeMy WebLinkAboutBLD87-21203 MOBILE - BLD Permit / Conditions - 11/16/1987 Shorelines: Plumbing:
Setback: Mechanical:
S cial
Conditions: FINtAAL:
Mobile Home:
Smoke Detector:
Remarks
Footing: l'7/4
Setback: _
Foundation
Walls: +.,
Framing: 1.L
Fireplace: I -q-yf UT
Wood Stove:
TYPE MOBILE HOME
Permit No. 21203 No. Floors Sq Ftg 896
Owner _GREEN, Lorrie M Tel Date 11-16-87
Address w 3380 Dayton Airport Rd Shelton Zip
Contractor None
Address lip
Legal Description Tr 6 SE,NE 8-20-4 (Lot 1 S/P 1307)
Direction to project site 1/2 mile past corrections
center.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1973 14x64 3 bdrm
I
c� BUILDING PERMIT APPLICATION
MASON COUNTY
I �0-o-* DEPARTMENT of GENERAL ERVICES
1 P.O. BOX 186 SHELTON, WASHING ON 98584
k 427-9670 DATE ISSUED
`\,/ ��ejdcvp�- <�®® e--q PERMIT NO. / }
NAME o MAILADDRESS I STATE �� Z P PHONE
OWNER Gr �� Lr
ev ► e M . , 3390 �� c
DIRECTIONS -D( � E)tr C7-(�. � f lA,l e. W
TO JOB SITE
Grv�e:: i 0vL6 G vV4ev1 .7-1--- 6 �
MBER ( ESCR � 61? C/`
CONTRACTOR '' CITYBSTA E LICE SE NO. ZP PHONE
rG i-t� zoo 8�
USE OF
BUILDING e ✓ I ��VC
CLASS OF NEW ADDITION ALTERATION REP IR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
BEDROOMS DECKS CARPORT b NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING,,HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE C CONDITIONING.
NO.OF STORI ESQ BASEMENT C: ATTACHED THIS PERMIT BEC MES NULL AND VOID IF WORK OR CO STRUCTION AUTHORIZED IS NOT
COMMENCED WI HIN 180 DAYS, OR IF CONSTRUCTI N OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE 0 DETACHED ABANDONEDFO A PERIOD OF180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT J SHORELINE
SEASONAL
OWNERSFFIDAVIT 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
REGISTR ION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AN D I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQ IRE ENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WH CH THE PERMIT IS ISSUED AND LL WORK DONE WILL BE IN
IN ON ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE HEREWITH.NO CHANGES SHALL BE ADE WITHOUT FIRST OBTAINING
OBT IN G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM HE BUILDING DEPARTMENT.
X OWN ER �� 1 . ATE �' �3 � 7 XBY DA E
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPRO ED BUILDING VALUATI N
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
r
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY AP O ISS PERMIT VALIDATI N
Y CASH CK MO TOTAL, `�
PLOT PLAN
ADDRESS PERMIT NO. c
LEGAL
LOT
DESCRIPTION 7 BLK AiDDITION ��
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"=2 ' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN rHE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUI DING,SITE,AND SETBACKDIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST Ft OOR ELEVATION, STREET E LEVA.
TION AND SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE O EACH BUILDING AND MAJO I POR-
TION THEREOF.
5
INDICATE NORTH IN CIRCLE 1 RAPH SQUARES ARE 5' 5' OR 01 '=20'
rt
Fj
► '
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Q �
O
I/We certify that the proposed construction will conform to the di"wnsims and uses shown bove and that no changes't ill be mna4e without
first obtaining approval. \
N AMR( OF OWNER(a) F S4+Rir►ST RUC TUREIt) (PR I T1 IG A7URE OF O NERISI OR AUTHORIZED REP EaEN 'A,TIVE
NOT WRITE L HT
LINE
PROVE )
DISTRICT S NOTE E 1 Ci — 3'