HomeMy WebLinkAboutBLD0511 Mobile Home - BLD Permit / Conditions - 4/7/1987 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
emarks:
Setback:
Foundation
Walls:
Framing: �L & VOIR BY V ,
Fireplace:
Wood Stove: �- BY
TYPE MOBILE HOME
Permit No. 0511 No. Floors
Sq Ftg 1344
Owner PETERSON, Wallace C. Tel Date 4-7-87
Address NE 371 Davis Farm Rd Belfair Zip
Contractor American Mobile Homes
Address Zip
legal Description NW,SW,NE 29-23-1 - r
Direction to project site Old Belfair Hwy across from
firehall & down Davis Farm Rd
P umbing Mechanical Sever Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1986 28x48 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED-Yb
�a y �3 90DgD PERMIT NO.
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
DIRECTIONS 1�/ �f
TO JOB SITE Q�CJ ��� //- T✓ul ��r�S� /�/�'7
_• •_ �ocu� �av/•s arm
LEGAL
DESCR. l(f/ —�L(f/ /y�•L - �3�_ A
NAMIE MAILADDR S ITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR �'' �� >o
USE OF
BUILDING
CLASS OF WORK NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE
WORK
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 SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE LWd
SEASONAL
OWNERS FIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTR ION LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS 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 CO ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTA ING APPROVAL FROM THE BU GG DEPATRLTM APPROVAL FROM THE BUILDING DEPARTMENT.
NE14 �I DATE o ,3-�� XBY DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVENo 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
STATE SURCHARGE
APPLICATION ACCEPTED BY PLAN C K/BY APPR3p F R IS NCE PERMIT VALIDATION ��, L _ ,1
/�+c� BY �/�C CASH CK MO TOTAL 7`�ll
Al
PLOT PLAN
ADDRESS NE. 371 UM I �) FARill R,1J_ PERMIT NO. f o
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 Al"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.
_
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR t"=20'
47
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P)
2.S emu'
2w
Mo Rlll-
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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($) OF OWNER(S) OF 31TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING