HomeMy WebLinkAboutBLD0286 Final Mobile Home - BLD Permit / Conditions - 5/23/1985 SORENSEN, Steve #0286
4-23-85
Por NW-1/4, SW-1/4, NE-1/4 16-23-1
517 S. Hartford Bremerton 98312 377-9776
2 miles from Fire St 'on Old Belfair Hwy.,
Contractor
None listed
Mobile Home 44x28 1985 3 bdrm.
$22,792.00
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Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: A's 3 9-s `
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED _
PERMIT NO.
OWNER NAME ADDRESS CITY& TA ZIP PHONE
DIRECTIONSc--
TO JOB SITE
LEGAL -- (❑ SEE A HIED SHEET)
DESCR. fQ I'. 1
NAME AIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: El NEW El ADDITION U,.AI1ERATI_ O___- Q-REPAIR ❑ MOVE ❑ REMOVE
Describe work:
m 013/ �1Nf
Valuation of work: $ _ � n�j� PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS — CARPORT LI NOTICE
BATHROOMS (TOTAL SQ. FT. GARAGE I_;
ATTACHED I_ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED IJ
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 am aware of the O R F F I C E USE N LY
ordi ance requirements regulating the work for which
the permit is issued and all work done will be in
co 0rmance therewith. PERMANENT SHORELINES Ji4�7 U ' r
SEASONAL FLOODPLAIN
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-
- ACCEPTED BYLA BY APPROVED F ISSUANCE
Owner Date 6
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PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. f o
= o
LEGAL
n >
a o
DESCRIPTION €� JLOT,r BLK ADDITION u
SITE AREA --, ��OUd Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS 31 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 All 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.
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INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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I/We certify th 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 0 STRUCTURE(S) IPRIN TI I ATURE OF OWNER(S) R AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED DATE
DISTRICT AS NOTED
SHELTON PRINTIN^u
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