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HomeMy WebLinkAboutBLD92-00084 Cancelled Mobile Home - BLD Application - 2/23/2000 BUILDING PERMIT APPLICATION "9-004E4. MASON COUNTY DEPARTMENT of GENERAL SERVICES 426 W.CEDAR/P.O. BOX 186 SHELTON, WASHINGTON 98584 rr 427-9670 DATE ISSUED -1-V ' 71' ERMIT NO. OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE DIRECTIONS TO JOB SITE ,/, /2O / ,�Y!/L (y 10? TjO eO4P O , OL ie l T Si az✓�v yaws nr4/>'7/ ,D'Pfr�W'4 PARCEL LEGAL I e4774FAI OF //r OF jl/ NUMBER d- Z DESCR. 7/j/9Cj O� / 72 7 4/ 23 NAME MAIL ADDRESS CITY&STATE ZIP ,2! �y/ LICENSE NO. CONTRACTOR USE OF BUILDING CLASS OF NEW t/ ADDITION ALTERATION REPAIR MOVE REMOVE WORK r V DESCRIBE WORK AREA: NUMBER OF: PLEASE INDICATE: NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR RESIDENCE 700 SgFt STORIES SHORELINE❑ CONDITIONING. BASEMENT SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT DECKS SgFt BATHROOMS SEASONAL RES.0 COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. CARPORT SgFt FIREPLACE IS CARPORT/GARAGE GARAGE SgFt ATTACHED❑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, HALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM BUILDINC,DE ENT. / APPROVAL FROM THE BUILDING DEPARTMENT. XOWNER DATE /� �� XBY_ DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YES NO HEALTH PUBLIC WORKS FEE PLANNING FIRE MARSHAL BUILDING PERMIT D.O.T. BUILDING PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION `�'l� 'rz BY CASH CK MO TOTAL .t the k; mason county assessor Darryl Cleveland Dear We have received a copy of` the tax certificate for movement of your mobile home . In order that we may accurately value your mobile home , please complete the questions below and return this form to our office by This information is imperative to prevent a possible double assessment on your mobile home . MOBILE HOME DATA LENGTH G / WIDTH MODEL MAKE �LrfT��1©u! MODEL YEAR � �f7 MOBILE HOME LOCATION INFORMATION SERIAL # A . My privately owned land yes no OR B . If rented or leased land who from? NAME ADDRESS CITY & STATE C . Real Property Parcel # 2� Z— _220t 5C / 7Z ( from tax statement of new location ) 11 D . Mailing name and address for owner of mobile home N A M E W,%� eAl�P�17 ADDRESS 32DE 4IAA4- CITY & STATE E . Location address of mobile home AtW 77� -- Z/9� City F . Date mobile home was placed on present site G . Purchase Price c' Lam( DATE ' ? '- %� SIGNATURE TYPE OR PRINT NAME A /- TELEPHONE NUMBER S_> 77" ���' � 411 N. 5th P.O. Box J Shelton, Washington 98584 Phone 427-9670 BUILDING PERMIT PLOT PLAN MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. Box 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. NAME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER :�ZG(n ' - '� '�D DIRECTIONS TO JOB SITE �rL Lt�T 5i rR sT Boo L� ,�c/ �� �b1,✓�r�1ru Gtr/T ��iYE� PARCEL LEGAL, 2 DESCR. j` T Z U� 17Z NUMBER Indicate below. O Property lines and dimensions. O Easements and roads. O Septic, drainfield and reserve area, or sewer. O Septic tank and drainfield setback distances from foundations. 0 O Location of proposed construction on property. O Building & septic system setback distances from all property lines & easements. Indicate North O Well and water line. In Circle O Saltwater, lakes, rivers, streams, wetlands, drainage. O Attach copy of septic system"as built' or septic permit approval. O Indicate topography profile of property and structure on reverse side. 17 qr d I/We certify that the proposed construction will conform to the dimensions and uses shown ve n that changes will be m de witho first obtaining approval. L SIGNATURE F OWNER(S)Oh AU `Z6 R PRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED nATF I TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE c v MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W.Cedar P.O. Box 186 Shelton, Washington 98584 (206) 427-9670 building environmental health maintenance landfill parks&recreation fair/convention center planning sewer&water April 24, 1992 Ralph Knight 3206 Pine #C-8 Bremerton, WA 98310 RE: Permit application Dear Mr. Knight, After a brief plan review, it was determined that an on-site inspection must be done by Building Inspector, Don Fawver, prior to the issuance of the building permit. It will be necessary for you to stake out the proposed placement of the mobile home and contact Mr. Fawver once this has been done. Normal procedure would be to hold this permit in the building department until this had been completed however, I will pass it on to the Environmental Health Department for their review while awaiting your response. Mr. Fawver can be contacted from 8 : 00am to 9 :00am Monday through Friday at (206) 427-9670 ext 285 . jamiTh You,tCGriffey Building Department