HomeMy WebLinkAboutBLD13705 Mobile Home - BLD Permit / Conditions - 3/11/1983 Collum, Barry L. #13705
426-8640 3/11/83
SE 1/4, SE 1/4, 17-20-4
6 miles towards Matlock, brown house on left side of
road with brown wooden fence, W 6091 Shelton Matlock
Road, between brown house & white & yellow house.
Mobile Home (Replacement) Contractor:
24'x52' , 1983 Robin Hood
$23,088.00
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:
PERMIT
DATE '- L yl BY ��'�
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED L
PERMIT NO. —To S
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
r L , loo c, o. fl �S&
TDIRECTIONS IO JOB SITE o h i' SSq f $ �. (1Y1 o D W an Xo vnce ro l;f-WeF brow►ri L
LEGAL Yam- , • ' (❑ SEE ATTACHED SHEET)
DESCR. S y S `r 1 W
NAME U MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR o b' (,) U
USE OF
BUILDING
Class of work: XNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
493
Valuation of work: $ PLAN CHECK FEE PERMITE
S
SPECIAL CONDITIONS:
BEDROOMS 6L,
I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE Li
ATTACHED G SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE a DETACHED 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES
SEASONAL Lj FLOODPLAIN L
Firm E.D. NO. S.E.P.A. i l
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
1 certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. TOR VEHICLE PERMIT
Own Date.�'1 AP LIGATION A P ED BY PLANS CHECK BY APPROVED FOR ISSUANCE
e4:' ��l�t 1 �•
CHECK VALIDATION CK. M.O. CASH RMIT VALIDATION CK M.O. CASH
PLOT PLAN
ADDRESS fV Vr lI/ O-1 I V ��- I � ' �I rI�C I�- I�('� PERMIT NO. o
S h y s �4 S � ►7 � ao'r� R �-I �v' o
, o
LEGAL
DESCRIPTION LOT BLK ADDITION u
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 A"'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'
1/ 100
I/We certify that the proposed construction will conform to the dimensions and uses show ve and that no changes will be made without
first obtaining approval.
v
C( r ((..I L , t ILk b l-1
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6NELTON PRINTIN3