HomeMy WebLinkAboutBLD12105 Mobile Home - BLD Permit / Conditions - 3/23/1982 Burfitt, R. B. #12105
(283-4700) " 3/23/82
Lot 4, Block 1, Shorecrest Terrace, Third Addition
Agate road to Crestview Drive, Turn right to Ponaramo
Drive.
L 6'/*� �Li hGt rtt vid �/
Mobile home Contractor:
Burfitt Const. Co.
$3,198.00
Shorelines: lA /y
Setback:
Special Conditions:
Footing: ^_
Setback:
Foundation Walls:
Framing:
Fireplace: _
Wood Stove:
Plumbing:
Mechanical:
Roof: _
Exterior:
Interior:_
Final: !r ,-
Stop Work:
Mobile Home
Remarks:
f-3 -5f z
BUILDING PERMIT APPLICATION kk
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 3, ? Q
DATE ISSUED
t�. PERMIT NO. �« O
?0jVV1 r 0 A"It a
OWNER NAM MAIL ADDRESS CITY&STAT ' \ ZIP PHONE
1J1,� � J " ' � � f�v 1 3- 4 2
DIRECTIONS /Vllo-� �,� r, - r Q� S --ef ��
TO JOB SITE L�1.c.c,( `W '""`��ti
LEGAL 1 b �c� �l0 C nACHEDSHE
DESCR. 'j r (J GiL ejS e C � e.b S d
CONTRACTOR
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE r
-O i I3`' Y '�3` `t
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
Describe work:
o ►�.
,�s 9
Valuation of work: $ PLAN CHECK FEE PERMIT F E
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT ❑ NOTICE
BATHROOMS I TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES 1 BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FTAo011 FIREPLACE ❑ DETACHED ❑
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 _ SHORELINES
SEASONAL ❑ FLOODPLAIN Lj
u CGw�b F Li( c
Firm ew E.D. NO. S.E.P.A. ��
gy Special Approvals IN OUT YES APPROVED NO
�1 Q� L�ate �' ZONING
Lic. No.��'' _ ^ jU` F
ll u No PLAN G DEPT.
OWNERS AFFIDAVIT EALTH DEPT.•
P WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEP
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
LICATION AC EP ED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date. BY
lla'
Pk4N CHECK VALIDATION CK.. M.O. CASH P RMIT VALIDATION CK. M.O. CASH
PLOT PLAN`
ADORESS PERMIT NO. 4 0
i o
LEGAL
n >
D O
DESCRIPTION STe LOT BILKl ADDITION 3 C(^G�lif 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"ID 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.
FY
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
NN
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.
/� 1\
NAMES) OF OWNER(S) OF SITE h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR UTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED&/J)
DISTRICT AS NOTED 2���� DATE
GHELT ON PRINTING