HomeMy WebLinkAboutBLD13209 Mobile Home - BLD Permit / Conditions - 10/27/1982 Stanford, Eldon #13209
426-9536 10/27/82
18-20-4, Tract 2 of SE, SE
W 860 Little Egypt Road
Mobile Home Contractor:
14'x52' , 1981 Robin Hood Trailer
$13,468.00
�(26(� q 61 OUD�O
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:
PERM-1
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 /O -a
DATE ISSUED
PERMIT NO.
OWNER ME MAIL AD RES CITY&STATE ZIP PHONE
tR W'es 9S 3 f
DIRECTIONS
OF 17
TO JOB SITE
LEGAL (❑SEE ATTACHED SHEET)
DESCR.
CONTRACTOR
NAME` kiAIL ADDRESS V CITY&STATE LICENSE NO. PHONE
USE OF �4•`�-�
BUILDING ,t,vlt
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE./
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT [] NOTICE
BATHROOMS TOTAL SO. FT. GARAGE Ci
ATTACHED L1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [ ] OR AIR CONDITIONING.
TOTAL SO. FT.7 FIREPLACE DETACHED Li
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 Li SHORELINES
SEASONAL I FLOODPLAIN i_7
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. a';, a
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
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. MOTOR VEHICLE PERMIT
PLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
wner DatV —Z n O Y
N CHECK VALIDATION CK. M.O. CASH MIT VALIDATION CK. M.O. CASH
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PLOT PLAN
ADDRESS L1i� G� 0 �✓'-"� L �- PERMIT NO. o
a o
0
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 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.
0 INDICATE NORTH IN CIRCLE i GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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.
NAME(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTINi