HomeMy WebLinkAboutBLD13536 Final Mobile Home - BLD Permit / Conditions - 8/2/1984 Yohn, Richard E. 913536,
426-7519 1/31/83
31-20-3, Tract 1 & lA of NW 1/4 of NW 1/4
South on W. Cloquallum Road to center of Mason County
Salvage then left 1/4 mile, W 250 Clark Road
Mobile home Contractor:
1968, 1Ox50 Owner
$6,250.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
ATechanica
Roof:
Exterior:
Interior:
j Final: 2 u6. �4 O ,C C
Stop tnbrk:
Mobile Home: - -Bv� 9 ¢ L
Smoke Detector: Z- ;0
Remarks:
r ,*
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 .� �_ k 3
11 DATE ISSUED
PERMIT NO. 13Jj4 -�
NAME MAIL ADDRESS t CITY 3 STATE ZIP P NE
OWNER ��c�.4K� £, 1�oNc1 w 2J� C Ii4LK 12c1. �h SS*by VZ 7S
DIRECTIONS y/
TO JOB SITE Sc, JCl v„L lv Ctc� c.��c., tv C¢.c -e �jcx�it Cc �� CZt+� �S�a•*eC{
LEGAL ?? / p (❑ SEE ATTACHED SHEET)
DESCR. J� o�� ' 3 l Q 1A NA) y &Wy4
NAME J MAIL ADDRESS CI 6 STATE LICENSE NO. PHONE
CONTRACTOR ti N G 2
USE OF
BUILDING /2L 1 ,
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR XMOVE ❑ REMOVE
Describe work:
-.4-�- �,f 6_-j
Valuation of work: $ / PLAN CHECK FEE PERMIT FEW(,3/ a -
SPECIAL CONDITIONS: (v
BEDROOMS {DECKS CARPORT Ll NOTICE
BATHROOMS I TOTAL SO. FT. GARAGE I;
ATTACHED i I SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING i
NO. OF STORIES BASEMENT '' OR AIR CONDITIONING.
TOTAL SO. FT." FIREPLACE f DETACHED L]
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 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 SHORELINES
01
SEASONAL I � FLOODPLAIN Ll
Firm E.D. NO. S.E.P.A. [I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
WORKS
I certify that I am exempt from the requirements of the EIREAR
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for
which this permit is issued and that II work done will be ' nfor anc herewit PERMIT
PTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date ,
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
1
PILOT PIAN
ADDRESS PERMIT NO. f o
= o
n >
a c
LEGAL a
n
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"ID 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. > //) -f-
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
1
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.
NAME(S) OF OWNER(S) OF 31TE S STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3