HomeMy WebLinkAboutBLD0538 Final Mobile Home - BLD Permit / Conditions - 6/9/1987 Shorelines: A/k Plumbing:
Setback: Mechanical :
Special Interior:
Conditions: FINAL: G 7
MobileHome:
Smoke Detector:
Remarks:
Footing :
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 0538 No. Floors Sq Ftg 1680
Owner POTTS, Robert D Tel 275-8167 Date 6-2-87
Address NE 510 River hill Dr #2�e7Tailip
Contractor Belfair Quality Homes
Address Belfair Zip
Legal Description NW,NE 2 —23-1 Lot I S P 1627�
Direction to project site From Belfair, North on Old Bel.
Hwy to Davis Farm Rd. West on farm rd. 200' . North side
of
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1987 28x60 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 f)
426-5593 DATE ISSUED l� �
PERMIT NO. d S 3 75
NAME G 1 ILADDRESS CITY&STATE ZIP PHONE 7
OWNER B�RT �. SmA .10 •E.S 0 R�v� LfQI
DIRECTIONS
TO JOB SITE �MtA 5-:L a- NOKT dfJ OLD IR To UAV
4 s 'F rr Ro o MOP,-rjA :SjZF Of ROAD
LEGAL `DESCR. S C CAP �• c� J '4 �- ,71�'- /� v P /�
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR 5Ea At UALIT" OR AUSE OF
BUILDING ENT AL. V�J E W 1J
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
WORK DESCRIBE aU L OKN -LAP
TRlP PA' X )e ��.
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES I BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
�� c� COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. l� FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT _ SHORELINE
SEASONAL
OWNERSAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI�Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST 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 CORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTA .FIN'APPROVAL FROM THE aWLE4NG DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
N E R L 416ZT U,�K DATE S-/1-0 7 X BY DATE
FOR OFFICE USE ONLY
APPROVED APPROVED O!✓
DEPARTMENT YES NO DEPARTMENT YES No BUILDING VALUATION /
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP _3 PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY I PLANS CHKIK BY APPROVED FOR IS UANCE PERMIT VALIDATION
fl� /� r TOTAL /' Q
2' !�>c O BY CASH CK MO CJ '
t
PLOT PLAN
ADDRESS Lam/, E (oO DAMS �P►RM kb • BEL MA (p_PT 6UDWERMIT NO f o
= o
n >
� o
LEGAL =
n
DESCRIPTION LOT BLK ADDITION
SITE AREA (001305-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 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.
1' INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
T �
b
9 LIT,
I D o r
4 It NES93LE
i
I
I
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. Pats
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER($) OR AUTFI ED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
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