HomeMy WebLinkAboutBLD20823 Mobile home - BLD Permit / Conditions - 8/27/1987 Shorelines: /,q Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile Hame-
Smoke Detector:
Remarks:
Doting
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit NC). 20823 No. Floors Sq Ftg 1560
Owner OWEN, EvedTel 7�86 Date 8-27-87
Address P 0 Box 641 Belfair Zip
Contractor Self
Address Zip
Legal Description Por, g,SE -22-1
Direction to project site g.Yj:582 jh=.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1987 26x60 3 bdrm
m JAB BUILDING PERMIT APPLICATION
rI MASON COUNTY
DEPARTMENT of GENERAL SERVICES
/�
P.O. BOX 186 SHELTON, WASHINGTON 98584
(2Z W-�141 - IC b I ! 426-5593 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY 8.STATE ZIP PHONE
OWNER CX) ES ec_ - `I&SZ Se-:b'
DIRECTIONS
TO JOB SITE _ SQL-
PARCEL LEGAL
NUMBER DESCR. /Q/✓
C-EyME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR C 7=
USE OF
BUILDING ��1 .`, � {Z_
CLASS OF NEW ADDITION ALTERATION RE R MOVE TMOVE
WORK ✓
DESCRIBE
WORK �` i�.✓E7 CZ'_ /� � L! .6� 6" C
f r �
GJ .-
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 WITHIN 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.
PERMANENT SHORELINES —�
SEASONAL
OWNERSAFFIDAVIT 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
OBTAINING APPROVAL FROM T UILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
O NER DATE ,— 7 �• J X BY DATE
FOR OFFICE USE ONLY
APPROVED APPROVED
DEP RTMENT YES No DEPARTMENT YES NO BUILDING VALUATION _
HEALTH }1 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 j
STATE SURCHARGE
APPLICATION ACCEPTED PLA HEC PRO OR PERMIT VALIDATION
TOTAL
1 B CASH CK MO
PLOT PLA
ADDRESS �' Z PERMIT NO. i 0
a s
n s
a c
LEGAL
DESCRIPTION LOT BLK ADDITION N
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 AND 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.
��-- INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
01
-C' I Q 1
n, L.
C t^
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.
/E(al OF OWNER(S) OF SITE s STRUCTURE(!)-(PRINT) IGNATURE OF OW ( AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW TN/S LINE
APPROVED
'CT AS NOTED DATE