HomeMy WebLinkAboutBLD2211 Mobile Home - BLD Permit / Conditions - 6/13/1978 Woodforo,Judy G. #2211
6-13-78
SE 1/4 SE 1/4 20-23-1
1/2 mile North of BElfair (Old Belfair Hwy) right do
McKnight Road.
Mobile Home
$8,000.00
SITE NO. O�41� NAME
Date Initials SITE NOT APPROVED BECAUSE:
Directions not clear
Holes not sufficiently marked
Soil holes needed to
Holes needed in a different area
Short plat not approved
Insufficient lot size for set back
requirements
High Ground Wat6P Evidence
Need plot plan
Need information on Water System
Water System not approved
Hold for Hold Harmless agreement
Other
FINAL NOT APPROVED BECAUSE
Red Tagged
' �U. Hold for As-Built
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED
PERMIT NO. 02�/
NAME MAIL ADDRESS �+ CITY&STATE ZIP PHONE
OWNER 'r JZIZ Q 3REM �b3 i() �7J� ' z
DIRECTIONS kc'or 00 A*ttiN
TO JOB SITE y
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ILEGAL , f (❑ SEE ATTACHED SHEET)
DESCR. 'SECTIDN Z� �u1N5a1 VJeS1 �
NAME MAIL.ADDRESS CITY&STATE , LICENSE NO. PHONE
CONTRACTOR n e �
USE OF
BUILDING TAM ILy pF pweLUlr aLy'p, Ltd
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE LT REMOVE
Describe work:
S c S s�rtiM WNTM V41EEZED<1
Valuation of work: $ p �-0 i c� PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS: Q
3� O
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Type of Occupancy Division
Const. 1,7 Bl . �fry3 Group
T
Size ota)fSq Sq. �°�X pJr Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor In RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
By
ROAD DEPT.
Lic. No. Date
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIREDFOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be in Conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
Q SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Own Date_S' V WORK IS COMMENCED.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH
PLOT PLAN
ADDRESS jlCV4I&H'� TlJ L�A11� PERMIT NO. 4
o
z �
n s
LEGAL a
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"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATE , SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE 0 EACH BUILDING AND MAJOR POR-
TION THEREOF.
INDICATE NORTH IN CIRCLE RAPH SQUARES ARE 5')C �' OR 1"=20'
zU3
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t/f o z
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I/We certify that the proposed construction will conform to the dimensiclns and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNERS) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING