HomeMy WebLinkAboutBLD12020 Mobile Home - BLD Permit / Conditions - 2/16/1982 I�eideffer, Hugh F. #12020 "
(939-0395) 2/16/82
35-22-3.
Highway 106 to Belfair, turn right at mile marker 9,
to Timber tides Lot 28A.
Mobile dome Contractor:
None Listed
$2,500.00
3 �235 - 7S- 0[ oZ� ►
Shorelines: ,y;# I,
Setback:
Sneci.al Conditions: '
Footing:
SPthack:
Foundation Walls:
Framing:
Fireplace:
wood Stove:
Pliunhinq:
Mechanical:
Roof:
Exterior:
Interior:
Final: 3 y t?2.
Stoz) work:
Mobile Home
Remarks:
i
BUILDING PERMIT T 1APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. �o2C�o7 d
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER 3L riff 6w"K 3ov z
DIRECTIONS _ e 7-0 Tr►'k b e.-I-I' e.S
TO JOB SITE 0 W../d" B@/�o_ t / /� �i£. rn�le �4+ke/ ci
/ D
LEGAL (❑ SEE ATTACHED SHEET)
DESCRY S SetCl'or+ 33` u7++S�i/� �1N RkK e 3 w•
NAME MAIL ADDR CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING ifec I&y.a--c1'0 0
Class of work: )K NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
v.- In o
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE -
1911
i> J
SPECIAL CONDITIONS:
BEDROOMS I DECKS— CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT.l7y GARAGE L]
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
_
TOTAL SQ. FT. Vo 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 1 1 SHORELINES I I
SEASONAL FLOODPLAIN I 1
Firm
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No.— Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC 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 DEPT.
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
( -4 �4& Date 12- ~ Z APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner
P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. 0 o
f
A >
a o
0
LEGAL
DESCRIPTION 7 LOT BLK ADDITION
SITE AREA -571 97 5 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS '1 � Sq.Ft.
INSTRUCTIONS TO APPLICANT
,r.
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 AIID 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'
10
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1/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.
/ d f
h °r,.._! car �, L
NAM OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) IGNA RE OF OWN ERIS) OR AU-rHgFRIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINT INS
I(
LOIS SCOTT
ASSESSOR
T H E M A S 0 N C O U N T Y A S S E S S O R
DARRYL CLEVELAND
CHIEF DEPUTY
PLEASE SUPPLY THE FOLLOWING INFORMATION
REGARDING YOUR MOBILE HOME
Owners Name: llk Gt C0. de er TeIe # 93 l' o 395r
Mai I ing Address
Previous Owners Name & Address L , C �- �• Ile. eke
- X r. 13uX / vvds/:2or- 4 k) #_S4
Description of Mobile Home: ( Information is on your registration certificate)
Make h, C' Size /4 A 5 O G S1- 11 Y90
Year f ff.,5—? Serial # Sid- S-0 //D
o
Year Purchased rice (Less furniture & sales tax) $
-T
If in Mobile Home Park:
Name of Park: Space #
If NOT in Mobile Home Park:
Do you own the land on which the home is placed? YES _NO
Real Property descriptio H , ►+�
Owner of Land if you are NOT the Owner:
Brief direction to location:,toe-
r /406 70'W.' � 8e1���"r Tv /�Iilelytur/tey
I X-;N T ted h,' ll ro Tf' ,,6,2r'r c'c1 eJ [c 71
Date Mobile Home Entered Mason County:
Date you anticipate moving Mobile Home to another location:
If moved from a Mobile Home Park give:
Name of Park:. Space #
Your home will be placed on the rolls of Mason County. We would appreciate a
prompt reply. Please feel free to contact this office if you have any questions
at all .
Very truly yours,
Helen Glaser
Personal Property Department
Owners Signat Date