HomeMy WebLinkAboutBLD20096 Mobile Home - BLD Permit / Conditions - 4/14/1987 Shorelines: PlLrnbing:
Setback: Mechanic
Special Interior:
Conditions: FINAL:
Mobile Home:
Spoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove: L & VOID BY MR ATInR )
DATE L y"t BY
TYPE MOBILE HOME
Permit No. 20096 No. Floors Sq Ftg 1344
Owner RAYMOND, Floyd Tel 863-8027 Date 4-14-87
Address 7220 191st Ave E Sumner Zip
Contractor None
Address Zip
Legal Description Shorec_rest Terrace Div. 2,B1.2,Lot 16
Direction to project site Crestview Dr. to Parkway. Left
to Wood Lane. Left 1 block to Ashwood Lane. Lot is 2nd
on right.
PiLrbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Zarport
Basement Loft Other
28x48 1987 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT NO.�
NAME 1L ADDRESS CITY,&STATE ZIP H
OWNER
DIRECTIONS
TO JOB SITE
PARCEL LEGAL NUMBER _ DESCRjfy)C,, U�ertq
�
NAME MAIL ADDRESS CITY&STAlt LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF L
BUILDING , e
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE
WORK j
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_ TOTAL SQ. FT. GARAGE CONDITIONING.
NO.OF STORI ES 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
OWNERSAFF AVIT CONTRACTORS AFFIDAVIT
I CERTIFY TH I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATI LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREM TS 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 CO
MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
O TAINI APPROVAL FROM THE
BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X NER� y°1J,1' � 4ATE Y1'�I-,`(� XBY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION QG
YES NO YES NO i
HEALTH PUBLIC WORKS FEE
PLANNING / !�( FIRE BUILDING PERMIT ��
D.O.T. BUILDING l PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP - PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS C K BY APPROVED FOR I ANCE PERMIT VALIDATION
BY zMf I CASH CK MO TOTAL �� �5
PLOT PLAN
ADDRESS PERMIT NO.
0
= a
n >
LEGAL L, y^ ' a
DESCRIPTION LOT ��- BLK ADDITION�( .f4 tGc-� , u
Vic x /�.'Sj
SITE AREA 73"12CIS.. Ft. AREA OF SITE OCCUPIED BY BUILDINGS- I�''� 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 AND 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'
Tj
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.
ti VD y VA4
NAME(ST Ojr OWNER(S) OF SITE a STRUCTURE(S) (PRINT(PRINTY 3I1.NATfRK OF OWN (a) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE