HomeMy WebLinkAboutBLD22111 Mobile Home #22 - BLD Permit / Conditions - 6/8/1988 C)C)C)
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TYPE MOBILE HOME
Permit No. 22111 1 pl 33
Sa-50
der BACKU No. Floors
Address O BoXo9 T �� Sq Ftg 720
—
9 Tel 45 341 Date 6—g Contra'
Bellevue
Address None Zip-~-�
Legal De Zip Sam Theler
birection to Home Zxp
Project site & Garden Tr,
Golden Bell T 2r- 0
Mobile Home pardE
Plum bin e 2
place Mechanical
Fire . Deck Sealer Wood Stove
Basement �, Garage ^� Carport
Loft �^ ether ~�
1972 12,
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 ppG
427-9670 DATE ISSUED
OWNER NAME MAILAD PERMIT NO.
DRESS CITY 8 STATE
ZIP PHONE
DIRECTIONS K/ �� Ge✓de
TO JOB SITE
PARCEL LEGAL
NUMBER DESCR.
CONTRACTOR NAME MAIIADDRESS ~
CITY 3 STATE LICENSE NO. ZIP
PHONE
USE OF
BUILDING F SiOtA/T/i¢L
CLASS OF
WORK r NEW ADDITION ALTERATION REPAIR MOVE
DESCRIBE REMOVE
WORK
Ix
BEDROOMS 2' _ DECKS CARPORT NOTICE
BATHROOMS l TOTAL SQ.FT. GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING. VENTILATING OR AIR
NO.OF STORIES BASEMENT CONDITIONING.
ATTACHED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
TOTAL SO. FIREPLACE DETACHED COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT
CONTRACTORS AFFIDAVIT
I CERTIFY THAT 1 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 REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE REGULATING THE
PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN C NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
O4XN
T FOR
APPROVAL FROM THE BUILDING DEPARTMENT.
APPROVAL FROM THE BUILDING DEPARTMENT.
E DATE
X BY_ DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED
YES NO YES NO BUILDING VALUATION
HEALTH �_ PUBLIC WORKS
PLANNING FEE
I�b FIRE BUILDING PERMIT
D.O.T. BUILDING
d�t " PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
` STATE BUILDING FEE s--
PPLICATION ACCE PTED BY PLANjp
cCHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION STATE SURCHARGE
4 i c BY 14A CASH CK Mo TOTAL _
Golden Bell 1,Sobile 11ome Park
N.F',. 20 Poessel Rd. ;z20
Belfair, ashington 98528
1;11ason County
Dept. of General Services
Sanitation Div.
'Phis ::ill verify that John T. Backus has been given perminision
tO place four mobile homes in this park on lots 14o. 16,18,22and
29. -
This park is set up to accommdate 40 unitslwft- .four persons
per unit. !.t the present it is at only 50;'o of capacity.
The sanitation Facility was designed handle this load.
7 hope this is the information that you require, if any more
is needed please call me at tel 275-4623 or write me at the above
address.
respectfully
filbert Ti. Sanders,L'anager