HomeMy WebLinkAboutBLD15155 MOBILE HOME - BLD Permit / Conditions - 2/6/1984 DYCUS, Richard J. #15155
2-6-84
Timber Tides Tract 10
510 Arnold
Pt. Orchard, Wash. 98366 876-9192
Contractor
Self
South Shore Road to Timber Tides Lot 10 - top of ridge
Mobile Home
$10,360.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior :
Final:
Stop Work:
Mobile Home:
Smoke Detector :
Remarks:
FROM THE DESK OF
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 G
DATE ISSUED
l.5 PERMIT NO.�S�.�
OWNER NAM MAIL ADDRESS CITY 8 STAB ZIP PHONE
DIRECTIONS _
TO JOB SITE s
LEGAL. (❑ SEE ATTACHED SHEET) 00,
DESCR
NAM MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR I
USE OF
BUILDING `
Class of work: �S NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
725
lq&
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE I
ATTACHED L SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ IDETACHED L
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 FOR A PERIOD OF 180 DAYS AT ANY TIME 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 U S ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES i^/
SEASONAL I 1 FLOODPLAIN Li
Firm
E.D. NO. S.E.P.A. L
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 Gpnform nc� t erewith. MOTOR VEHICLE PERMIT
AP LICAT N ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date . � _ 1 BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS `j/q (,c/srC PERMIT NO.
f o
z
a
n >
o
LEGAL
DESCRIPTION/�i�X� ) C�LOTr � // W Oi ELK ADDITION i iv Fu
SITE AREA L L Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS �� `> Sq.Ft.
INSTRUCTIONS TO APPLICANT \
v
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 Al"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. `•
- INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
14-1
X /
.I
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.
� � 1
NAME(3) OF OWNER(3) OF 31TE 6 STRUCTURE(3) MRINT) I ATURE OF OWN I R AU ORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED / fl
DISTRICT AS NOTED DATE
SHELTON PWNTIN^