HomeMy WebLinkAboutBLD14815 SFR - BLD Permit / Conditions - 10/17/1983 MASON COUNTY DEPARTMENT, OF GENERAL SERVICES
Legal Description: Section 18 Township 20 North, Range 4 West , W.M. : NE4,NE4SW4
Project: Mobile Home 10x55 1965 2 bdrm Date Received 10-17-83
Address of Project:
Owners Name: STITES, Bradley J. Address : 1403 Dickenson, Shelton, Wa. _98584 Phone: 426-4583
Directions to Project Site: Dayton, left on Highland Road, 4 mile on left across from Mobile
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HEALTH Fee Paid 7`J'0 Receipt No. 0-74S Date Received —/3-83
Plot Plan Type of Septic System
Tank Size Gallons; Drainfield Length Feet; Approved for System Site
Bedrooms; Septic Syst
Approved Final Approval ; Contractor Phone
Inspected By ; Completion Date ; Water Supply Approved
PLANNING Fee Paid Receipt No. Date Received
Residence Commercial Plat
SEPA Final Declaration EIS Required
Shoreline Exempt Shoreline Permit Local Decision
Appeal Final Decision
Preliminary Plat Date Final Plat Date
Phone Project Engineer Phone
Contractor ,
By
BUILDING Fee Paid 1,5 Receipt No. 1+00 1 J Date Received /O-/7 � 8-3
Plan Check: Approved Denied with the following corrections
Conditions
3y
Approved: Property Line Setback Footings Foundation Walls Framing Fireplace Wood Stove
Plumbing Mechanical Roof Exterior Interior Final Stop Work
Mobile Home Smoke Detector
Iemarks
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 10`t
DATE ISSUED I 1
PERMIT NO. 4-9 I
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
.S �Stli'>=.5 a3 c. 'Ns W SH�L-Tc w,4 '6-y5s3
DIRECTIONS u n
TO JOB SITE DA ON L Ert Gj HI C"IyLAN+(� /Cio 1�6 m LC- 4-,-r'T Ac << K' , - 1-nJIS1L1
LEGAL (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING RJ-S ( Al\e E,
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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S• O c
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Valuation of work: $ O c) PLAN CHECK FEE PERMIT FEE
r e
SPECIAL CONDITIONS:
BEDROOMS — I DECKS—r CARPORT G NOTICE
BATHROOMS___ TOTAL SQ. FT.1840 GARAGE
ATTACHED i_' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L_' OR AIR CONDITIONING.
TOTAL SO, FT_QrQ FIREPLACE 1_1 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 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 USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT i J SHORELINES 1
SEASONAL !' FLOODPLAIN L'
Firm
E.D. NO. S.E.P.A. ;
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. V f Y1(� 0_74
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contr ct or registration law RCW 18.27, and am aware BUILDING DEPT.
of a Mason County ordinance requirements for
w ich this permit is issued and that all work done will ROAD ACCESS
e in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date , BY
f
PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION K. M.O. CASH
+ PLOT PLAN
ADDRESS• PERMIT NO. Q00
f o
= o
LEGAL Nt 7 -
DESCRIPTION/'R -NUJLOT BLK ADDITION u
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS "S U
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'
F/
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n I Ift,
*
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/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.
NAME(S) OF OWNER(S) OF SITE R STRUCTURE(S) (PRINT) I URE OF Ow E (S OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED `1
DISTRICT AS NOTED DATE
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GHCLTON PRINTING