HomeMy WebLinkAboutBLD1695 Final Mobile Home - BLD Permit / Conditions - 8/10/1975 Whitman, Dann F. #1695
4-9-75
NEµ of NEµ, 20-23-1
Old Belfair Highway 11 miles North of Shopping Center
Mobile Home
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BUILDING PERMIT APPLICATION
MASON COUNTY
P. O. Box 400 Shelton, Washinqton 985844.E
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PERMIT NO.� 9 A
Applicant to complete numbered spaces only. .
JOB ADDR ESS N
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C�L I EZ— A v % /. NOR T4 0 I Pin/( Ce*?e-N, aC
LEGAL.
( SEE ATTACHED SHEET)
OWNER MAIL ADDRESS ZIP PHONE I
2 U Cie S `l
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. •
3ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS BRANCH
6
USE OF BUILDING
L� E
8 Class of work: ❑ NEW ❑ADDITION ❑ALTERATION ❑ REPAIR N MOVE ❑ REMOVE
9 Describe work: PL C
10 Change of use from
Change of use to
11 Valuation of work: $ J T o-Q �-
PLAN CHECK FEE — PERMIT FEE � 0
SPECIAL CONDITIONS: Type of Occupancy
Const. Group Division
Size of Bldg. No.of Max.
(Total) Sq. Ft. Stories Occ. Load
Fire Use Fire Sprinklers
APPLICATION ACCEPT PLANS CHECKED BY APPROVED FOR ISSUANCE BY. Zone Zone Required []Yes ❑No
0 df - OFFSTREET PARKING SPACES:
Dwelling Units Covered Uncovered
N O T I C E Special Approvals Required Received Not Required
ZONINC.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, P-
HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. b 4 4- s i L
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION FIRE DEPT.
AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUC- OTHER (Specify)
TION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF
120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
hereby certify that I have read and examined this application and
know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other state or
local law regulating construction or the performance of construction.
4NA E OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
-7S
SIGNATURE OF OWNER IF OWN R DU ILDE R) DATE)
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
�H�LTG�.N PRiNT11;G CO.
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PLOT PLAN
ADDRESS P0.
O. /(��rT� �.4// 61-7 I3C4;:- to PERMIT NO. /62 6 o
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LEGAL
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DESCRIPTION TrAt 1`7 170? BLK ADDITION '
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SITE AREA lt. S Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS __ Sq. Ft. J
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.) C9
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 Al"D 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 5' X 5' OR 1"=20' (�
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I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
N AMEI I��0Rn OF'SITE & ST)A, �(5) (PRINT SIGNATURE OF OWNER(5) O AUTHORIZED aL V/w'�""
RE9EN TA TIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
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DESCRIPTION: Q-54950
That part of the Northeast quarter of the Northeast quarter of Section
20 , Township 23 North, Range 1 West, 1.9.1M. , in _`Mason County, Washington,
described as follows :
BEGINNING at the Northeast corner of said Section 20 ; thence along
the North line of the Northeast quarter of the Northeast quarter of
said Section 20, North 87' 36 ' 30" Ilest 690 .33 feet to the true point
of beginning; thence continuing along said North line, North 870 36 ' 30"
West 332. 16 feet; thence South 0° 29 ' 39" East 660 . 69 feet; thence
South 881 12 ' 25" East 332.00 feet; thence North 00 29 ' 39" West
657 . 22 feet to the true point of beginning;
SUBJECT TO and TOGETHER WITH an easement for ingress and egress over
and across a strip of land 40 feet in width extending Northerly from
the Old Belfair Highway across the Southeast quarter of the Northeast
quarter and the Northeast quarter of the Northeast quarter of said
Section 20 to terminate in a cul-de-sac having a radius of 50 feet
near the Southwest corner of the above described parcel. The location
of said easement is yet to be determined.