HomeMy WebLinkAboutBLD93-0883 SFR - BLD Application - 12/31/1993 Permit No. &Q 13- OV3
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
.EASE PRINT
Owner Larry e/Brooke Healy Phone# 275-6322
Site Address NE Mountain Lake Drive Fire District#
City Bremerton, Wa 98312 St Zip
Directions to Job Site Old Belfair Hwy, Left onto Dewatto, Right onto Tiger/Mission Rd. Left onto
Mountain Lake Drive
Owner Mailing Address None
City St Zip
Lien/Title Holder None
Address
Clty St Zip
Contractor Name Walter S. Galitzki, dba Sun Path Energy Contractor Reg# SUNPAE*166LA
Address 3460 N Mission Rd W. Expiration Date_/ 1 94
City Bremerton, Wa St Zip 98312 Phone # 275-0774
3 If septic is located on project site, include records.
Connect to Septic? yes Public Water Supply Well yes
Connect to Sewer System? Name of System
(if residential, proof of potable water is required)
I Parcel No. -1*5e ' - 11-1 - '�fltj30'
Legal Description The South 110 feet of the North 200 ft of the South 1178.50 feet of that
portion of Government Lot 1, Section 5, Township 23 North, Range 1 West, W.M. ; in Mason County,
Washington, lying Westerly of the Ti er Lake Branch Road as constructed around the North end of
a Building S 3re Footage: (existing/proposed Tiger Lake.
1st FI 12 / 2nd FI / 3rd FI / Loft
Basement / Deck / #bedrooms 1 / #bathrooms 1 /
Garage / Carport / 4(Circle:Attached or Detached?)
Other Mechanical sq.ft.
e 2
3 Use of bu' Ing Single family residential Describe work See plans
7 Type of Job: New xx Add Alt Repair Other
3 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No.
-
#Bedrooms # Bathrooms Type of Heat
Purchase Price $
9 Indicate by circling the applicable source ji-wy water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake)Marsh Saltwater Seasonal Runoff Other