HomeMy WebLinkAboutBLD14910 Mobile Home - BLD Permit / Conditions - 11/8/1983r
LaHUE, Marilyn G. #14910
11-8-83
16-23-1, SW!4,NE14
From Gorst, take Hwy. 3 toward Belfair, cross Mason Co.
line. At Weyerhauser Timber sign turn right, at "Y"
keep right, cross RR tracks, 2nd right, follow signs
Contractor
Self 876-0636
Mobile Home
$2,100.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
fkoof
Exterior :
Interior :
Final:
Stop Work:
Mobile Home:
Smoke Detector :
Remarks:
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584 `
426-5593
DATE ISSUED L—
PERMIT NO. ` 1
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
DIRECTIONS fwoi„ 6oC5r 1�wjv s 7.1dAgo i3e,LFn�rz�C',eaSS /nA-SOA/ d-0. Wr l�erG�Ndcc.ic.0 7ini
TO JOB SITE 76e/ 7' Rtv , " 'ela'q Se D I s(,'
LEGAL //-- (❑ SEE ATTACHED SHEET)
DESCR. �, Cc)
CONTRACTOR NAM MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
USE OF
BUILDING { j q/y\ C r,-�
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:, OV3{ t 1 ( ,�L 1(
Valuation of work: $ 1 PLAN CHECK FEE PERMIT FEE
_r
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT Ll NOTICE
BATHROOMS _ TOTAL SO. FT. GARAGE !_!
ATTACHED i_; SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L] OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE l ! DETACHED Ll
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 the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
Conformance therewith. PERMANENT ! SHORELINES
SEASONAL FLOODPLAIN IL
Firm
E.D. NO. S.E.P.A. L
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
HEALTH DEPT.
r% OWNERS AFFIDAVIT
PUBLIC WORKS
I ce ify that I am exempt from the requirements of the FIRE MARSHAL
co6tract or registration law RCW 18.27, and am aware
f the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith.
MOTOR VEHICLE PERMIT
., I ATION CCE PLANS CHECK BY APPROVED FOR ISSUANCE
Owner '� uL Date BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
1
PLOT PLAN
ADDRESS PERMIT NO. 14q V✓ f o
r '
LEGAL .S it)/`I OF /V��y L i IO Twsp I?A►v(o p u/• A n
DESCRIPTION LOT BLK ADDITION u
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 A"ID 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. /
T INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
A\
vb► �
Jo Ft
D F,
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
1hr9 R)Ly1,V fr, f-A Hr u.t-_
NAME(S) OF OWNER(3) OF 31TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE ( '
APPROVED I yc
DISTRICT AS NOTED DATE C,
6H ELT ON PniN TINu