HomeMy WebLinkAboutBLD14411 Mobile Home - BLD Permit / Conditions - 7/20/1983 Vaughn, Betty #14411
275-2094 7/20/83
29-23-1, Tract 3 of NU 1/4, NE 1/4
NE 345 Old Belfair Highway
Mobile Home Contractor:
14'x6O' , 1978 None Listed
$10,500.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing-
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior :
Final:
Stop Work:
Mobile Home:
Smoke Detector :
Remarks:
PERMIT
DATS BY
r
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 %20 43
DATE ISSUED
PERMIT NO. /41///
OWNER NA MAIL AD ESS ITY& ATE ZIP� PHONE
DIRECTIONS
TO JOB SITE E, f/
(❑ SEE ATTACHED SHEET)
LEGAL
DESCR. 3
NAME MAIL AD RESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTS
L
USE OF ^��
BUILDING raw)
Class of work: ❑ NEW ElITION ❑ ALTERATION ❑ REPAIR El
❑ REMOVE
Describe work:
Valuation of work: $ Soo, vv PLAN CHECK FEE PERMIT�rE�/��,�'y �
SPECIAL CONDITIONS:
BEDROOMS DECKS _ CARPORT [; NOTICE
BATHROOMS__—_ TOTAL SQ. FT. GARAGE [ 1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIE BASEMENT L: ATTACHED IJ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE L; 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
WORK IS COMMENCED.
I certify that I am a currently registered contractor in
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 SHORELINES
conformance therewith. PERMANENT
SEASONAL [] FLOODPLAIN i_,
Firm E.D. NO. S.E.P.A. I 1
By Special Approvals IN OUT
YES APPROVED NO
ZONING
Lic. No.—
Date
PLANNING DEPT.
HEALTH DEPT. :.2.� G "�
OWNERS AFFIDAVIT PUBLIC WORKS
1 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
L CATION C PTED BY PLANS CHECK BY APPROVE FOR ISSUANCE
Owner �Date .
P CHECK VALIDATION CK. M.O. CASH PER IT VALIDATION CK CASH
M.O.
r
PLOT PLAN
ADDRESS PERMIT NO. f o
D O
LEGAL
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"'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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
d
1
l
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.
NAME(S) OF OWNER(!! OF SITE 6 STRUCTURE(S) (PRINT) AiGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3