HomeMy WebLinkAboutBLD90-27169 MOBILE - BLD Permit / Conditions - 11/21/1990 Plumbing:
Shorelines: Mechanica
Setback: Interior:
Special FINAL:
Conditions:---- mobile�e�
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls: r7.77
Fr awning: ,rrJ1 �
Fireplace: ��11J—& _
Wood Stove:
TYPE MOBILE HOME
No. Floors �— Sq Ftg 60_=
Permit No. 216 TelaZti Date
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Owner Zip
Address
Contractor none ip
Address
Legal Description Tr 1 Surve 5 7
Direction to p ec
rojt site From Haay 101 L�J on Dayton Airport
4 i 1otIsonL
Mec anica Sewer Wo Stove
P un ing Deck arage arport
Fireplace Basement Loft Other
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BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHING!TON 98584
427-9670 DATE ISSUED_U /2J A
PERMIT NO. ..
OWNEF3,>
NAME MAILADDRE CITY 8 STATE ZIP PHONE
DIRECTIONS
TO JOB SITE , f d/ Q Q f}�j A/-'
1p 1.ES _ 14!%T 5 '0 L
PARCEL LEGAL NUMBER ' - `66 DESCR.
NAME MAIL ADDRESS CITY&STATE CENSE O. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE �n - !
WORK f f Yl 6 1 .`t :
BEDROOMS_? DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_ TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WETHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
;eRM*NfW- SHORELINE
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
J
AINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER ATE 170 XBY 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
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
gy -w_..._- CASH CK ON
APPLICATION ACCEPTED BY PLANS CHECK BY APPR FOR ISSUANCE PERMIT VALIDATION
MO TOTAL
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES,
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAI DD SS CITY&STATE ZIP PHONE
OWNER Z L7 l� 3 J` ELT 2 9
DIRECTIONS
TO JOB SITE
PARCEL LEGAL p � p
NUMBER - �' / DESCR. S - Zn" n
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
O Location of proposed construction on property.
1 O Building&septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.
O Attach copy of septic system "as built" or septic permit approval.
O Indicate topography profile of propert „ ` d structure on reverse side.
7 14
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It,OAPS
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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.
CLt,4.
SIGNATURE OF WNER(S)OR AUTH RIZED RURESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE