HomeMy WebLinkAboutBLD24719 Mobile Home - BLD Permit / Conditions - 11/3/1989 TYPE MOBILE HOKE
Permit No. 24719 No. Floors Sq Ftg 980
Owner JENSEN, William Tel Date 11 -3-89
Address 140 Blevins Rd N # 06 shelton Zip
Contractor Professional Mobile Movers
Address Bremerton Zip
Legal Description Tr 4 S2.NW 17-20-4
Direction to project site Little Egypt Rd. 2nd driveway on left.
1200' from Davtnn Matlock Rd- Catp i ml o(-ked
Plunbing Mechanical Sewer Wood St7v-e
Fireplace Deck Garage Carport
Basement Loft Other
1979 1470 3 bdrm
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL: 3.�p
MobileHome:
Smoke Detector: kr?
Remarks: e4ov
Doting: 7
Setback:
Foundation
ion
Walls:
Framing:
Fireplace:
Wood Stove:
I`
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.C�
OWNER NA E MAILADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS .
TO JOB SITEL G 1_{-
L e- an Lo ,kA 12W .�
PARCEL Z L ALJ e s /ucf f pF r� Alott' ac!;t" QU/+RtCd` t
S'e4 "on.J'l "luiv5h p
NUMBER �j 3- DESCR. -- 0-) 00ttv
CONTRACTOR NAME MAILADDfjESS CI STATE LIiEjJSENO. / �O PHONE
USE OF /'em-5� r 70
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK r I i a, I SZ' iv
/ x 70
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS._ TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES J-- BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, 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 A [DAVIT CONTRACTORS AFFIDAVIT
I CERTIFY T AT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATI LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREM TS 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 CONF MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X NER� DATE � 0 X87 X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT Y SPPROVEDJO DEPARTMENT YESPPROVED10 BUILDING VALUATION
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 �r O
STATE SURCHARGE
APPLICATION ACCEPTED BY APPROVED FOR ISSUANCE PERMIT VALIDATION
A TOTAL j
BY f�J• CASH CK MO
PLOT PLAN
ADDRESS / �C ' �'�� ' PERMIT NO. o
ni w' S T /} e l m f'G'),,L
�1+4I1� O# �C veo UCiI See- / s o
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LEGAL
DESCRIPTIt W IV4�"� T°I Xe.5r V�J, �Vi f /r �f�LK ADDITION
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SITE AREA42) 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 Ir
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
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_r�:�A� �
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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V
If 1�
T
I/We certify that the proposed construction will conform to the dlrtwnsidns and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNERl81 OF SITE a STRUCTURE(S) (PRINT) IGNA TUBE F O (!) OR AU TMORI ED REP ESEN TA TIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
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