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Home My WebLink AboutBLD27238 Mobile Home #312 - BLD Application - 12/10/1990 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 q 427-9670 DATE ISSUED PERMIT NO. OWNER NAME / MAILADDRESS CITY BSTAT ZIP PHONE Al a o S a yv., DIRECTIONS / J TO JOB SITE �cJtk LL P rN rr r �r 3do'+' S PARCEL LEGAL ��aJ r ca.._ Inc NUMBER ��o� !'L✓3oao (� IDESCR. J NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR , rc USE OF BUILDING C CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK r DESCRIBE WORK / BEDROOMS Z DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS 2 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 `� SHORELINE SEASONAL 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 REGI TRATION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE RE IREMENTS 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 ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING JAIN ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. WNER; .OVAL DATE -2 1 /';ZZ YC/ X BY DATE FOR OFFICE USE ONLY / DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVENQ BUILDING VALUATION S d, HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION v, S SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY AP VEfF ISSUANCE PERMIT VALIDATION 2- 0`9 BY CASH CK MO TOTAL �jf� L BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SH ELTON, WASH I NGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME AIL ADDRESS CITY&STATE ZIP PHONE OWNER ? 7v I3 3 / �/ Q7 DIRECTIONS TO JOB SITE 4L 3 �t1e� y�QQ /e fQ5 tE7,po 1:2/,e il y S PARCEL LEGAL NUMBER DESCR. 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. 0 O Location of proposed construction on property. 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 property and structure on reverse side. 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. SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE EVERGREEN MOBILE ESTATES 201 E.80 BLEVINS RD.N. SHELTON,WA 98584 PH.( 426-2015 tA ze- r Elf — Ego 'r ENO rfo/ Soi J 3°s 350 102 JI ro3 I/OVIyoY i 3/0 dog Sob i 5V �fi10 So s G ILI .I 3� Wz- so 9 S/D 3�6 4ts Everyr:cfv, MoW,- Est4t,,z I lascn Co. , WA G 1J tiJ 60 No AAA ,. /6- t //- '--�o