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Home My WebLink AboutBLD N/A Mobile Home - BLD Application - 9/14/1987 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE DIRECTIONS « �� TO JOB SITE G - O AJ PAR EL // LEGAL 2�0 ES f rEL(tXrJ C.J/ LYe' NUMBER � �L C, `Y DG �/r DESCR. _ NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR USE OF BUILDING CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK DESCRIBE _ WORK S L S ` OfC L) � x p e-7/-)_-yz� 7 x /-!� jy BEDROOMS DECKS �4-r CARPORTZ NOTICE mil- 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./_0� FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT 1 AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. p APPROVAL FROM THE BUILDING DEPARTMENT. X OWNE -^ DATE 7 X BY FOR OFFICE USE ONLY APPROVED APPROVED l DEPARTMENT YES No DEPARTMENT YES No z of BUILDING VALUATION l HEALTH ' jr PUBLIC WORKS FEE PLANNING FIRE 1 FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP ll PRE-INSPECTION �LkS_ 0. 6 PtkaftQ-, SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY =BY &�, PERMIT VALIDATIONTOTALCASH CK MO PLOT PLAN ADDRESS ), A c—L� 1,9 jyca2< PERMIT NO. °s o �� = s T'R ��tJ4) SE q-� i -�� ' �� DESCRIPTION LOT a—!LEGAL Cp0/< ��QQ��QBLK ADDITION 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 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. TINDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' ID ti� i S k K � F' q 1/We certify that the proposed construction will conform to the dimonsidns and uses shown above and that no changes will be made without first obtaining approval. N AMfiI OF O ER(!) OF SITE 6 lTRUC TUR l!) (PRINT) GNAT-RE O OWNERISI AUT OR ZED REP ESENTATIVE DO NOT WRITE LOW THIS LINEF APPROVED DISTRICT AS NOTED DATE t;0R1)0..i CnAir, QS�ESSOR THE " ASO !; COUNITY ; SSESSOR Pf)'JrLAS .JONtES C�iiEF r:�R��TY PLEASE SUPPLY THE rOLLOVIVO I TOTI1TIn'r R Er-AFT I v r- VOIJI !'Or I LE f'OPT: Owners Name: " � �' /o Tele # Nailing Address Ifl, 4E. W 8 Previous ! obile Hone Owners P!ame & Address - Description of Mobile Home: (Inforration is on your registration certificate) ,,ake IDMFT,LC _ - _Size /�X 2O c, 1 7eU0 EP4 M Year / C ' �D Serial # p 702 -Al Year Purchased_L24OPrice (Less furniture & sales tax) $ If 1 ocati ng in Mobile horse Park: Name of Park: A/ 1A Space If :lOT in i'lobile Home Park: Do you ovm the land on which the home is laced? Yes NO Y p - Real Property description 1 Owner of Land if you are NOT the Owner: Brief direction to location: / &dc& 7AyA),jAD rWEW�J� /1✓�f�PT dy DC� CF�fi/' .;�yY � DRi✓�wf� T14� DEi Cam= Date Mobile Home Entered t'ason County: Date you anticipate moving Mobile Horse to another location: If roved from a Mobile Horse Park rive: Name of Park: Snace # Your home will be placed on the rolls of r1ason County. Ile would appreciate a prompt reply. Please feel free to contact this office if you have any questions at all . Very truly yours, Helen Claser Personal Property Department (�;�Owners Sionat re -- - a- - MASON COUNTY _- DEPARTMENT of GENERAL SERVICES Courthouse Annex 2 N. Fourth & W. Cedar P.O. Box 186 Shelton, Washington 98584 (206)426-5593 building environmental health maintenance parks&recreation planning sewer&water January 14, 1988 James Torpey NE 3281 Old Belfair Hwy. Belfair, Washington 98528 Re: Mobile Home Permit Dear Mr. Torpey: Some time ago you made application through this-office to obtain a building permit. Please be advised the permit is ready to be issued and can be called for at this time. If you are unable to call in person, a check in the amount of $ 52.75 can be sent to us and we will return your permit by mail. This permit becomes null- and void if not called for within 180 days of the date of application. We hope to hear from you soon. Sincerely, f.. Evelyn Fuller ' Receptionist f