HomeMy WebLinkAboutBLD23656 Final Mobile Home - BLD Permit / Conditions - 5/30/1989 t7
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Shorelines: ,U/J Plumbing:
Setback: Mechanics .--
Special
Conditions: FINAL:
Mobile ome:
Smoke Detector:
Remarks-
Footing: T�pt,._....o
Setback: �/ �
Foundation
Walls:
Framing:
Fireplace:
Woad Stove:
TYPE MOBILE HOME
Permit No. 23656 No. Floors Sq Ftg 1232
Owner THOMP ON, John Tel 2 55-6230 Date 5-5-89
Address P 0 Box e fair Zip
Contractor None
Address Zip
Legal Description Tr 11 NW NW 16-23-1 Lot B S/P 1854
Direction to project site 2-3 4 miles North of Belfair
on Old Belfair Hwy. (Ponderosa Rd. ) NE 51 Ponderosa Rd
Plumbing Ke-clian-ical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement soft Other
1989 28x44 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES Ia-j It, -0-u -cjQl
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED 5 n
PERMIT NO.c::V"56 '�2
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER GXn Iw 9/
DIRECTIONS 2,9- 430
TO JOB SITE L /, (�/� L�� J l� /e G(� G✓l��ieOS/Q led,
PARCEL LEGAL
NUMBER DESCR. (hl '1 ,Yr .� o� S A,e➢"
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE OF
@.UILDING /7
CLASS OF NEW X ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
'bESCRIBE
WORK
BEDROOMS -3 DECKS CARPORT NOTICE
w! SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT GARAGE 'y CONDITIONING.
NO.OF STORIES BASEMENT IVIiIIP ATTACHED J4 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
w COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. !3-44 FIREPLACE vm DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT _ X SHORELINE
SEASONAL
OWNE SAFFIDAVIT CONTRACTORS AFFIDAVIT
I CER FY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGI RATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REO EMENTS 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 NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT INING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X NE DATE Zs X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO �
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING l PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP '— PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CH K BY APPROVED FOR IS ANCE PERMIT VALIDATION
TOTAL
BY CASH CK MO j
PLOT PLAN
ADDRESS /VL � �jt°�Sr9 , PERMIT NO. e
� s
s o
LEGAL
DESCRIPTION LOT e5zSr BLK ADDITION !,
SITE AREA �t-+T 00-Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS /� -� 4 4 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.
v`
INDICATE NORTH IN CIRCLE APH SQUARES ARE 5' X 5' OR 1"=20'
�I
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I/We certify that the proposed construction will conform to the dimensidns and uses shown above and that no changes will be m W1. P
first obtaining approval.
NAME(SI OF OWNER(S) OF S1TE 6 STRUCTUREW (PRINT) T IONA UR OF OWNER I O AUTHORI ED RE ESENTA VE
DO NOT WRITE BELOW THIS E
APPROVED
DISTRICT AS NOTED DATE