HomeMy WebLinkAboutBLD28192 Final Mobile Home - BLD Permit / Conditions - 7/8/1991 Shorelines: Pltmbing:
Setback: Mechanica
Special Interior:
Conditions: FINALq/--1"7' 77
MobileHome:
Smoke Detector
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Remarks:,,-or, art 1 _51M,
Footing:
Setback: -i yi D:7
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 28192 No. Floors 1 Sq Ftg 720
Owner LA HUE, MARILYN Tel 275-5314 Date 5-24-91
Address P.O. Box 47, Gorst Zip 98317
Contractor Self
Address Zip
Legal Description 16-23-1
Direction to project site
cross RR Tracks right at sarnnr rnarl (' Dt-iniio
um ing c anica ewer t ve
Fireplace Deck garage arport
Basement Loft Other
OWNERS SIGNED FOR FAMILY MEMBER ONLY STATEMENT
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. I /
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNERarz,L N �d� .r A
DIRECTIONS ,,6y.4e-p -0,,oD 10*si L.bb,V,4)e 9, F7 ,Q - d4e."' ,r;R "T94C4S- R/(sNT f}T
TO J O B SITE q,�, Qp/} A G' e
/l-,t e-
PARCEL LEGAL , ,,/
NUMBER j(,, - IS- evoou DESCR. w �y/I/ %y SE G I 7All
CONTRACTOR
NAME MAILADDRESS CITY&STATE ZIP PHONE LICENSE NO.
USE OF
BUILDING ,r>
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE/)ISq Ft STORIES a SHORELINE❑ CONDITIONING.
BASEMENT..&A SgFt BEDROOMS / PRIMARY RES THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS SgFt BATHROOMS �_ SEASONAL RES.❑ COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORTNR SgFt FIREPLACE rt IS CARPORT/GARAGE
GARAGE_4ZSgFt ATTACHED O DETACHED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I 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. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVEDJO DEPARTMENT YESPPROVEDIO BUILDING VALUATION � V
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT O� J�
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
This mobile permit is conditioned that it not be used SHORELINE
for a rental unit at any time and it shall only be WOODSTOVE
occupied by immediate family members. Any other use of PLUMBING
this mobile will require a change of use permit and also MECHANICAL
will need to be permitted as a mobile home park if occupie STATE BUILDING FEE 5
by any non-related persons. X
APPLICATION ACCEPTED BY I PUNS CHECK BY APP E R IS CE PERMIT VALIDATION BY CASH CK MO TOTAL a� �S