HomeMy WebLinkAboutBLD18796 Mobile Home - BLD Permit / Conditions - 6/16/1986 ' TYPE MOBILE HOME
Permit No. 18796 No. Floors 1 Sq Ftg 1344
Owner TAYLOR, James A. Tel 275-5489 Date 6-16 86
Address P, 0, Box 304 Belfair Zip
Contractor Sun Mobile
Address Shelton Zip
Legal Description Tr, 3 Lakewood Plat L
Direction to project site 2,g mi. on S.Shore Rd. ,left
turn, 200 yds. uD hill (gravel rd.) , right turn, 2nd
rt, in drivewaX
PlLubing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement ---Iqft Other
28x48 1986 2 bdrm, 1 study
Shorelines: A1,4 , pltunbin
Setback: Mechanic .
Special Interior:
Conditions: FIl AL:,r
Mobile Home:
Smoke Detect .
Remarks:
Footing
Setback:
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 MAILA DRESS CTY&ST TE ZIP PHONE
�� Ba o l �J y s�� 2-7-5
DIRECTIONS po
TO JOB SITE 2, l �, - V
lv� "Z�w) - A�4 AM�CL)�?-4
LEGAL
/ `
D SCR. !Z �WZ 2- Z
NAME MAIL ADDR S // CITY 8 STATE LICENSE NO. / ZIP , PHONE
CONTRACTOR �' E C� Gbh 10 �i/" /'
USEOF
BUILDING �/n� l �n
CLASS OF NEW ADDITIO N REPAIR MOVE REMOVE
WORK ✓
DESCRIBE ( 'D 'z i
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. 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 SO.FT. FIREPLACE DETACHED ABANDONED FORA PERIODOF180 DAYS AT ANYTIME AFTER WORK ISCOMMENCED.
PERMANENT 0�' SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTR ION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS 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 C FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
8V,
T ING APPROVAL FROM THE BUILDING D ARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
OWNE �• DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
ENo DEPARTMENT YESPPROVENO BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT l
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE , 61
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY RO RR�SSUANC PERMIT VALIDATION
Y r�L�1l CASH CK MO TOTAL
PLOT PLAN
ADDRESS PERMIT NO. o 0
f u
z
n >
LEGAL : a
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
J
J v
i
G �
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($) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING