The URL can be used to link to this page

Home My WebLink AboutBLD19181 Mobile Home - BLD Application - 8/21/1986 TYPE MOBILE HOME Permit No. 19181 No. Floors �_ Sq Ftg 550 Owner FERNANDEZ. Jose W. Tel340=0751 Date 8-21-86 Address P. 0. Box 19412 Seattle Zip Contractor Self Address Zip Legal Description Tr 23-A 35-22-3 Tr 2 S P 1562 Direction to project site (Timber Tides) Timber Tides drive off Hwv 106 (1st rd past ('asa d CA all to top & turn left Qo 1/2mi Right side. Red gibbons Plumbing Mechanical Sewer Wood Stove Fireplace Deck Garage Carport Basement Loft Other 1968 1Ox55 1 bdrm. Shorelines: Plumbing: Setb4ic : Mechanics . Specia Interior: Conditions: FINAL: Mobile Home: Smoke Detect Footi Remarks: n SetbaT Foundation Walls: Framing: Fireplace: PERMIT Wood Stove: ► it L R VOID DATE BY t� BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 426-5593 DATE ISSUED - ` �j/ PERMIT NO. /57��I / OWNER NAME ao <-- MAILADDRESS CITY BSTATE ZIP PHONE 1 Se 9s�'/v 3 -o IS( DIRECTIONS TO JOB SITE ee 'I�P-f dnl , w t o ) vC W 1Q6 )Q aTfer r-ai;:A' / Cd hc) /) c rc u f -Kr- ti l — a 14 1"y- '/Z - dvl J""\j e S LEGAL DESCR. r 3-A o• Survey Vol P •s. to 13 T� a f s is,(,2 tl/1�dr/� fdetr NAME MAILADDRESS CITY BSTATE LICENSE No. ZIP PHON CONTRACTOR_, S e I _ -Z Z USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK r DESCRIBE lw L<: /ls 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 SQ.FT. l�i�i FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS ATANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS FIDAVIT 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 REGISTRA ON LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIRE 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 CON RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAIN G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. } / / i X ERA�_�DATE " � X BY __ DATE ___-- - FOR OFFICE USE ONLY DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENO BUILDING VALUATION HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT 6 D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE PLANNING PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION TOTAL BY CASH CK MO PLOT PLAN ADDRESS PERMIT NO. 0 a f o �� o SI. v-ve y V 0 l ��S .210— 13 Z o LEGAL X / ✓VI �e� Ides �(�t y� DESCRIPTION LOT BILK ADDITION �L r SITE AREA 33Lf X t" Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft, a 1 INSTRUCTIONS TO APPLICANT -t THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE R— Ili FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) h 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 Q/ SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. Q_ �. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' l3 � la I i 0 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 h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTIN^.!