HomeMy WebLinkAboutBLD10692 Final Modular Home - BLD Permit / Conditions - 4/7/1982 BUILDING PERMIT APPLICATION
�. .,. , MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME p MAIL ADDRESS CITY&STATE ZIP PHONE
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DIRECTIONS �—
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. SeC'— ' 7'Gv�.�3 / �� T���`> 70r'S� /y'-eg '4 �
NAM MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR .v-
O GA1�S, r�'O.�s�v lti/ EI'�/Y- -+'I/�S�3G72�3iR•��
USE OF
BUILDING
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
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Describe work:
Valuation of work: $ 7�o Ba PLAN CHECK FEE PERMIT FEX ,•,/��
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SPECIAL CONDITIONS:
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BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑
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. PERMANEN SHORELINES
�/ SEASONAL ❑ FLOODPLAIN ❑
Firm 'C�t°'E=Rcc',v Mi0✓.c..vc��7�iW�s ..Z.Ua'
E.D. NO. S.E.P.A. ❑
By �iD � Special Approvals IN OUT YES APPROVED NO
Lic. Norte✓ /f akf-�'/Z 44 3<z Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. VS7
PUBLIC WORKS
I 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
AP IC TION ACQFTED BY j PLANS CHECK BY APPROV D FQR ISSUANCE
Owner Date. BY �W/
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P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH
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t,
'aser agrees to be complete onsible for and hereby warrants the
a , he has good and legal title to the subject property, free and clear of all encumbrances.
b. That the boundary lines of the subject property are as represented by Purchaser to Contractor for the purpose of
the project contracted for.
c. That all requirements of the applicable zoning codes including set-back requirements are met by the location of the
house on the subject property as requested by Purchaser.
d. That suitable road access to the subject property is and will be available to the Contractor during the construction
period.
e. That the geological and all other sub-surface conditions of the subject property are suitable for the construction
and use of the home contracted for.
f. The establishment of appropriate structural site elevations related to fixed reference.
PLOT PLAN
THE HOUSE IS TO FACE DIRECTION INDICATED BY FRONT DOOR ON DRAWING BELOW.
(INDICATE POWER, WATER, AND SEWER LOCATIONS)
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Date:
I (we) hereby approve the above drawn Plot Plan as correct and I (we) agree not to make any substantial changes in the
location of the house without written and advance notification to the contractor.
Purcha Evergreen Modula H s, Inc.: r
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EMH-80
ROSENAU, Beatrice #10692
06-02-81
Sec 29, Twp 23, Rgd 1, E1/2 Tract 7 of SW1/4 NE1/4
Corner of North shore road & and Old Belfair Hwy.
Coming from Belfair, go down Old Belfair Hwy 1 block
on left just past old block bldg. on corner and just
before old house.
Modular
$39,750.00
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