HomeMy WebLinkAboutBLD13955 Final Modular Home - BLD Permit / Conditions - 7/12/1983 Brucker, George A. #13955
746-6899, Union, Bellevue 5/11/83
Portion of lots 8 & 9 of Pebble Beach Park
E 10210 Highway 106, Union
Modular Home Contractor:
1,173 Sq. Ft. Kentwood Homes, Inc.
Decks 528 Sq. Ft.
$31,187.00 Plumbing Permit
U
Shorelines:
Setback:
Special Conditions:
Footing: G
Setback:
Foundation Walls:
Framing.-
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:C1A`7 is �3
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 // ��jj
DATE ISSUED__'S—__� ,22
PERMIT NO. IS 1 S5-
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
A Rrurker P O Rnx G 11ninn- W 8592 -- 746-6$99
DIRECTIONS
TO JOB SITE f= 10210 HY_-10h_ Union WA (Pphhlp Reach Estates)
LEGAL SEE ATTACHED SHEET)
DESCR. at portion f lots 8 & 9 of Pebble Beach Park as rpcordpd in Volump 4 Of Plats ,
CONTRACTOR NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PH NE
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR MOVE REMOVE
Describe work:
homes.Modular home by Kentwood Inc. , WA 98002
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS i2 DECKS _—�.,—pp CARPORT ElNOTICE
BATHROOMS (TOTAL SQ. FTC GARAGE
ATTACHED L: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT OR AIR CONDITIONING.
TOTAL SQ. FT.[�73 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 i_,
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS _
be conformance therewith. MOTOR VEHICLE PERMIT
(CATIO7A /PTE BY PLANS CHECK BY ROVED FOR SSUANCE
Owrk, Date . B
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS E 1 n?j n Niwaw jn6 ilnionr WQ -9RF92 PERMIT NO. 4 0�
A >
a o
LEGAL a
DESCRIPTION p^'"tl Bn e jjLOT 8 & g BLK ADDITION pebbl Q Reach park 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.
r'/ INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
6� �
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 6 STRUCTUREM (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHCLTON PRTNTIN3
r -
MASON COUNTY PLANNING DEPARTMENT
P.O. BOX 186 Shelton,Washington 98584
PLUMBING PERMIT APPLICATION
IMPORTANT— Complete ALL items. Mark boxes where applicable.
Name Mailing address—Number,street,city,and State Zip code Tel No.
George A. Brucker P 0 Box G. Union WA 98592 98592 74 -6899
2.
Contractor
The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and State of Washington
Signature of applicant Address Application date
LEGAL DESCRIPTION
Location
Of
Building That portion of lots 8 9 of Pebble Beach Park as rpcordpd in Volume 4 of
NO. PLUMBING FIXTURES FEE
WATER CLOSETS
BASINS D-C)
BATH TUBS
SHOWERS ,
WATER HEATERS d'D
AUTO.WASHERS
SINKS
FLOOR DRAINS
DRINKING FOUNTAINS
LAUNDRY TRAYS
Connect to City Sewer
1 DISH WASHER
DISPOSAL
URINAL
(Show Street Names & Property Lines)
INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER.
PERMIT SKETCH IN SEPTIC TANK & DRAIN FIELD LOCATION OR SUBMIT
ON OTHER SKETCH.
DO NOT WRITE IN THIS SPACE — FOR OFFICE USE
Appro by �/j Permit fee Date pemit'ssued Permit number / Receipt No.