HomeMy WebLinkAboutBLD23613 Mobile Home - BLD Permit / Conditions - 4/26/1989 Shorelines:
Setback: _�� h Plunbin
Special Mechanicca :
Conditions: Interior:
FINAL:
Mobile Home:
Smoke Detector:
ootin Remarks: - %�,- �
g: �Sr� ar c
Setback:
Foundation
Walls:
Framing;
Fireplace.
Wood Stove:
TYPE MOBILE HOME
Permit No. 23613 No. Floors
Owner RENNER Mark A Tel—
I Ftg 80
Address P 0 Box 1948 87=6724 Date
Contractor ame of Mobile Homes
Orchard Zip _
Address 9 Pacific HwyE
Legal Description Tr 8 SE NW 21 -2311e' Zip
Direction to project site T TrD '
hill . lst left at "Asso.Sand" sign. Left at "T '
rac<s. y s�gh� Over RR
um in c anica ewer
Fireplace Deck Gara e o Stove
Basement Loft g Carport
Other
1984 14x70 2 bdrm /2��
BUILDING PERMIT APPLICATION b` 'r-Y
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 Q
427-9670 DATE ISSUED / �
PERMIT NO. 26 03&J
ZIP
OWNER �E I� A Ru M��MAILADDpo &) I qe I O-rCITY& T ►ATE� c k w� a-wo PHONE_ L .
DIRECTIONS `V'
TO JOB SITE Gra TLC OELFA) T-65 ON �PJ y 3 UP ILL. . Flg—. T L ��EFT T A.51
11
wt> G 9AV V - 3l 060 LEf I f gf- RAe,' .Sc i00 YZI S a 9 6 1.
PARCEL NUMBER IZ3� qoaffo DESCL p - �,�a 3
9pkl fLr) 6 Rr4vv * #36 /.3
NAME MAILADDRESS �C TYSST TE ttermsE" e. ZIP PHONE
CONTRACTOR C cLdT a6LL 140 LS (0113 VAeik 4wY Z, f/fr- wA lYyy 9i-Ilit
USE DI �* To Ll VE / � l -3 q ` /W
BUILDING NO ME ���£�S�
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK `
CCV ,
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. 7f. 7 FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE ---
SEASONAL
OWN S AFFIDAVIT CONTRACTORS AFFIDAVIT
I CER THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIS ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI EMENTS 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 C FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTA ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XO NER 61*jFBATE XBY DATE
FOR OFFICE USE ONLY
DEPARTMENT Y SPPROVEDJO DEPARTMENT YEAPPROVED1O BUILDING VALUATION
HEALTH 9PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 7
D.O.T. BUILDING &lot PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP `— PRE-INSPECTION
j '.e,,oj17 SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE JL"
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION �y
- TOTAL
-- BY a/C C//j E�rf ' �Q.
CASH CK MO
PLOT PLAN
'TRACT "b" <S 1NDR) R,(7* 6 2-5 -
DORESS k:S rSSa9S 4- 3(00 3; PERMIT NO. `os
n >
s o
0
LEGAL
DESCRIPTION LOT BLK ADDITION N
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS ZY 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 AND 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' 0 1"=20'
S
J r`
VEY
PM
D9 A INFIf I I
si P is
1
M05
LE
WAR
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.
A�'k-, A yEtjdEk_ A L(
NAME(S) OF OWNER(S) OF SITE s STRUCTURE(S) (PRINT) SIGNAT RE OF O ER 3) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
1