HomeMy WebLinkAboutBLD18653 Mobile Home - BLD Permit / Conditions - 5/22/1986 TYPE MOBILE HOME
Permit No. 18653 No. Floors Sq Ftg 720
Owner FASSIO Joe P. Tel Date
Address P.O. Box 53, Union, WA Zips
Contractor
Address Zip
Legal Description UbCtX Grays Hrbr UnCtyRR Add Slk 19 ,
Direction to project site Lots 11-12 5th. St in Union
- - iln Pnrr Townsend to Spruse Street
PlLmbing Nbchanical Seer Wood Stove
(Fireplace Deck Garage Z`arport
Basement Loft Other
Shorelines: A/A plumbing:
Setback: Mechanic
cial Interior:
Conditions: FINAL: �r
Mobile Home:
Smoke I
Fbotin
Remarks:
Setbackg.
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT NO.
OWNER NAME MA DDR S CITY&STATE ZIP PHONE /V�
UQ
DIRECTIONS -
TO JOB SITE T� l id k L& j /,
W't 44 / /
LEGAL
DESCR.
CONTRACTOR NAME MAILADDRE S CIT &STATE LICENS ZIP PHONE
USE OF
BUILDING j
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓ I
DESCRIBE .670
C�
WORK /
BEDROOMS DECKS CARPORT n NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.F . 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 ANYTIME 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
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OB INING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE L j&6 XBY DATE
61 FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO �-
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPL ATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
BY CASH CK MO
PLOT PLAN
�•
ADDRESS �(� 'Eck
S3 two"I t t)o, PERMIT NO. 0
i o
LEGAL
n D
a O
O
a
DESCRIPTION ('��Cj� LOT /ram/ BLK f 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.
4__1NNDICATE NORTH IN CIRCLE / I GRAPH SQUARES ARE 5' X 5' OR 1"=20'
17nll
FV
I
I/We certify that the proposed construction will conform to the dimensions and uses shown ab ve and t no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTING