HomeMy WebLinkAboutBLD0592 Mobile Home - BLD Permit / Conditions - 1/12/1988 BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED 2 a
PERMIT NO. (1 S 7--
OWNER NAME MAILADDRESS CITYSSTATE ZIP PHONE
;17
DIRECTIONS
TO JOB SITE
PARCEL - �! LEGAL f
CONTRACTOR ,
NUMBER DESCR. �. I.
NAME MAIL ADDRESS CITY S STATE LICENSE NO. ZIP rPHO E
USE OF
BUILDING l iw l k
CLASS OF NEW ADDITION [ALTERATION REPAIR MOVE REMOVE
WORK r i
DESCRIBE
WORK
V� �vG�
BEDROOMS _ DECKS CARPORT !^' NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_ TOTAL SQ.FT. GARAGE ti CONDITIONING.
NO.OF STORIES �_ BASEMENT 4 ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT.:.` FIREPLACE fa DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT " SHORELINE
SEASONAL
IRE
NERSAFFIDAVIT CONTRACTORS AFFIDAVIT
RTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
STRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
UIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT 1S ISSUED AND ALL WORK DONE WILL BE IN
ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
AINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
WNER - ' / ATE Z, X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH .pol-1 PUBLIC WORKS FEE
PLANNING P FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP — PRE-INSPECTION
SHORELINE
fa - WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE ,
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY PIFIS PERMIT VALIDATION
rBY7. A;2� CASH Cl MO TOTAL `,�'�
PLOT PLAN
ADDRESS PERMIT NO. A
>>, r Ile �� ^Fur% 1 ✓ - !, F"l�,l� !- 3 �J/ '' a o
LEGAL n1�C .1'/UI'!N 'LSk �� r�I ` l PA) '% %/V
DESCRIPTION LOT I ,�CI BLK / ADDITION ). / I 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 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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE. OR 1"=20'
Al
II,
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1/We certify'that the pro ~ion will conform to the dlrtwnsiot+s and uses shown above and that no changes will be mode without
first fttngta OyaI.
ti. / i_
NAMES) OF OWNER(S) OF SITE a STRUCTURE(.) ( RIN ) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
D O WRITE BELOW THIS LINE
APPROVE
l DISTRICT AS NOTE
DATE'6—?j 4-f-
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MASON COUNTY '
DEPARTMENT of GENERAL SERVICES
Courthouse Annex 2 N. Fourth & W. Cedar
P.O. Box 186 Shelton, Washington 98584
44
(206) 426-5593
building environmental health maintenance parks&recreation planning sewer&water
I
Dear Mr. Bell:
: Lot 1 , 9-23-1
�I
Your site inspection is being held because:'
1. Holes not deep enough (4 feet required).
2. Public water system not approved.
3. Need to install own well. I
X 4. Could not find. Directions not clear. See Below.
5. Lot size.
6. Insufficent information on water system. !
7. Insufficient lot size for private well and septic system.
8. Distance from drinking water suplly is inadequate. II
9. Other.
If you have any questions concerning further action on this matter, please
telephone this office at 426-5561.
Need added directions. Box 545 does
not agree with current mail box Ps. Sincerely,
This appears to be an old mailing !
address prior to # change. In
any event, present Vs jump from v
531 to 581 at the Knight Rd. & Sanitarian
D. Getty. !S11
.
nothing was marked on the Knight Rd.
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