HomeMy WebLinkAboutBLD2214 Modular Home Final - BLD Permit / Conditions - 10/1/1979 Smith, Robert L. #2214
6-27-79
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Modular Home Contractor
Evergreen Modular
$35,950.00
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BUILDING PERMIT APPLICATION
- r MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED e�—.2 /2 79
PERMIT NO. -U/ 1-6
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIISN 01
TO JOB SITE —
LEGAL (❑SEE A AC EET)
DESCR. cS�� —� 7-- T��.— �& i(/ N`
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE -,,:.,,LICENSE NO. PHONE
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7 �f2 —3 Yv3
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
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Valuation of work: $ PLAN CHECK FEE PERMIT FEE 7a
SPECIAL CONDITIONS: ,
BEDROOMS DECKS CARPORT Ll NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor In WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT)k SHORELINES []
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Firm ,/� -� E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No.Ey" �'�"" 4'� "'Date 7 ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPRO ED FOR ISSU<
Ow er Date . � -C:AC.♦-� B/¢ � '
G
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASI
' •y 1
Purchaser agrees to be soley Vrespbl, r and hereby warrants the following:
a. That he has good and legal title to the subject property, free and clear of all encumbrances.
b. That the boundary lines of the subject property are as represented by Purchaser to Contractor for the purpose of the project
contracted for.
c. That all requirements of the applicable zoning codes including set-back requirements are met by the location of the house on
the subject property as requested by Purchaser.
d. That suitable road access to the subject property is and will be availabie to the Contractor during the construction period.
e. That the geological and all other sub-surfance conditions of the subject property are suitable for the construction and use of
the home contracted for.
f. The establishment of appropriate structural site elevations related to fixed reference.
PLOT PLAN
THE HOUSE IS TO FACE DIRECTION INDICATED BY FRO14T DOOR ON DRAWING BELOW.
(INDICATE POWER, WATER, AND SEWER LOCATIONS)
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MAP TO SITE: -Ire r
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