HomeMy WebLinkAboutBLD18656 Mobile Home - BLD Permit / Conditions - 5/21/1986 TYPE MOBILE
Permit No. 18656 ND: Floors 1 Sq Ftg 1,152
Owner- LaHU , Mar-r yn 1y Tel 476-7067 Date 5-21-86
Address P.O. Box 32, Gorst, A Zip= 7`-'
lContractoigUNT MOBILE
Address - --ZIP
Legal Description 16-2 - o
Direction-to project site SEE ATTACHED
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �6p
DATE ISSUED r✓jam
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 3 STATE ZIP PHONE
G. Nue BAR 6 , T w n 9�s3 y1G ✓Ia(
DIRECTIONS j"'P"� 6ats� Zur./QiCt� t3e/Fa.�-C,CraS /Yi.45on/ !?� . �iivB- 7cc��✓ K/GN�' /fir«j�2MEscsve�
TO JOB SITE 5/Cn/- a.Bnl , N' A ass L66 y,9LPz aev sS Rye TiPacK+%AKC Se--�D AC'fd;#r Fua•d
LEGAL , (❑ SEE ATTACHED SHEET)
DESCR. S,LUG OF It�� /`� 7a� /��• ,/� GC/�
CONTRACTOR
NAME MAIL ADDRESS CITY,&STATE LICENSE NO. PHONE
USE OF
BUILDING ;Pe-'S l.�D eAhC e_
Class of work: VNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: � �
/ gllg IVD/ A4AMv'1_ "
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
I�L v oo
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT NOTICE
BATHROOMS_ TOTAL SO. FT. GARAGE ❑
?I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED r OR AIR CONDITIONING.
TOTAL SO. FT/Zr�. 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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
V Ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES J
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A.
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT �L, ✓
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
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVE FOR ISSUANCE
Owner Date '
PLAN CHECK VALIDATION CK. M.O. CASH U PERMIT VALIDATION CK. M.O. SH
CHRISTMASTOWN PRINTING
PLOT PLAN
ADDRESS C �f0 4 OeJD �1}f� IJ PERMIT NO. o
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LEGAL OF o
/� ' r / ��J
DESCRIPTION .--- LOT BILK ADDITION
SITE AREA U �l , fi4-F . 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 .4"D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF E H UILDING AND MAJOR POR-
TION THEREOF. Ale 6�
�h �V0
INDICATE NORTH IN CIRCLE GRAPH SOUARES ARE 5' X 5' OR V-20'
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I/We certify that the proposed construction will conform to the dimerai&w and uses shown above and that no changes will be mide without
first obtaining approval.
NAMIM OVI OWNER(S) OF SITR 6 STRUCTUREM IPRINTJ �ICN TURI OW NIRIaJ OR AU TNORI D R V IL3 ENTA7IVH
DO NOT WRITE BELOW THIS LINE `!
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTnWN PRINTING