HomeMy WebLinkAboutBLD84-18557 MOBILE - BLD Permit / Conditions - 4/28/1986 TYPE MOBILE HOME
Permit No. 18557
No. Floors Sq Ftg 1680
Owner BARROW2. Charles Tel 426-7866 Date 4-28-86
Address Airport Rd. Shelton Zip
Contractor Factor Homes
Address 5 5 W St. Hwy16 Gorst Zip
Legal Description S P 1307 Lot 3 Por SE-1/4,NE-1/4
Direction to project site
8-20-4
'1-1 Miles
Hw 1 2 1 2 mile past Correction
p ing Mechanical SevVUr Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1985 28x60 3 bdrm.
Shorelines:
Setback: Plumbing:
Special Mechanic
Conditions: Interior:
FINAL: � � !
Mobile Home:
Smoke Detector:
Footing Remarks:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL 9 ERVICES
P.O. BOX 186 SHELTON, WASHING rON 98584
426-5593 DATE ISSUED ��P
PERMiIT NO._ �
OWNER NAME MAILADDRESS TY&STATE ZP PHONE
r O w, I j9 _ q '7,Y�°y
DIRECTIONS
TO JOB SITE 3 13 EVIL 45 Ll
I r 1 x F on 'LEGAL
DESCR. ��307 ae �J /
NAME MAILADDRESS CITY&STATE LICENSENO. ZIP PHONE
CONTRACTOR c +_� 5/d , t
r t 3 7
USE OF �/
BUILDING /1c
CLASS OF NEW MOVE
WORK ✓ O REMOVE
DESCRIBE
WORK iK) Ct_ !
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PER TS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. J�o GARAGE CONDITIONING.
NO.OF STORI ES BASEMENT ATTACHED THIS PERMIT BE MES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WI FHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE ^�n_ DETACHED ABANDONED FOF A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTOI IS 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 AIN D 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 WH CH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE HEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
,
,OWNE �J `� DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
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
PLANNING
/ PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY AP rVR ISSUA CE PERMIT VALIDATI N
CASH CK MO TOTAL
i PLOT PLAN
ADDRESS G iq`J .^j 4IL�j, c� PERMIT NO.
_ ,moo
LEGAL � � i All
@�
-�
DESCRIPTION �) lLOT -3 BLK ADDITION f u
SITE AREA /N A "������ Sd-filC AREA OF SITE OCCUPIED BY BUILDINGS-1 ��' Sq. Ft. � h,
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE f.
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- 17"
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. i+J
i�
t1
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' I
/gy
r
\ n
a
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(S1 OF SITE 6 STRUCTURE(S) (PRINT) `� IGNA OF WNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3