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Home My WebLink AboutBLD9155 Final Mobile Home - BLD Permit / Conditions - 4/2/1981 McCorkle, James F. #9155 12-4-80 Proceed on Roy Board rd. off of Old Belfair Hwy across from N. Shore Rd. 4/10 mi, see mail box on left side Rt. 3, Box 8 N. 135' of the E 323' of N. 270' of So. 1/2 of SE NE 23-23-1, excepting public rds. , if any Mobile Home (Variance for blocks) 1980 (24 X 52) $25,063.50 I /�/�i �J -BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATEISSUED I� PERMIT NO. OWNER NAME MAIL ADDRESS .f'e. CITY 8 STATE� ` ZIP AV. PHONE FA/R 6-�W, ` _\l DIRECTIONS PROEtE,t7 oN �'ey cA1I1F�oA7/ (nr ,per Q�p ,B.�.CFdq/,p t/ a,�/l'y{�+,�oss Fipby N TO JOB SITE yam V` 0 4 a D 6: = L� S LEGAL TotE.��/E T /ems �tFJ�y��ST Z3�Ot= TN�� L`/QT Z� DESCR. AtiST ��'CT�R G'f'>rs�fF Nb�'7y' 1�T T OF PC` Q TuJt1a� /t,*2. NAME WAILADMES—S' ` LI SE PHONE CONTRACTOR N 0 Ado K USE OF BUILDING Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE ,R Describe work: 6 rc� Ll 3 -5-0 Valuation of work: $ _ Q PLAN CHECK FEE PERMIT FEE i SPECIAL ONDITIONS: BEDROOMS I D CKS CARPORT ❑ NOTICE BATHROOMS Z TOTAL SO. FT/A6L-2 GARAGE [A SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIESBASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING. TOTAL SQ. FTA` .�t� 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. PERMANENT l i SHORELINES ❑ �w� � SEASONAL L� FLOODPLAIN '+�� Vh, E.D. NO. S.E.P.A. Ll By Special Approvals IN OUT YES APPROVED NO Lic. No. Date 2 ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. 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 RO ACCESS be in conformance therewith. Mgkpfi VEHICLE PXT VN Own A P ATION PLANS CHECK BY I AP BY P E FOR ANCE Y a PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATI N CK. M.O. CASH FORM 100 ,.O.R OaCo of Washington RETAIL Gig Harbor 898.7718—Tacoma 272-3778—Bremerton 377.1436 BUYFr�S ORDER 9215-54th Avenue N.W. GIG HARBOR,WASHINGTON 98335 UCC 4 2-201 SOLD TO rAC., fr;Rt�:E.: s AU�E=`'S t-'' �� ..... ``�_n DATA_ _. I DDRESS yv7 , � S F?s� > y !0� ��f 1� f'Stj ' SALESMI N SUIIJECT TO THE TERMS AND CONOITIONS STATED ON BOTH 11DES OF THIS AOREFOAEPT SELLER AGREES TO SELL A40 T4E RURCHASER AGREES TO PURCMW THE FOLLOIYINO .'[SCRIBED PROPERTY; f MA•cam M,J ROCMS I APPRC%. STOCK,NUMBERS I ji�; jf� •.:..C:T 4.1,.\ S.,-�"T-'re I iti;V .5 -� '>> _ �,:,,?i-. - i err- SERIALNUMnr _rI COLOR i KEY NUM9ER5 yW DklldtRY DATE —~ CUSTOMER MAY CHOOSE PERSON FROM WHICH INSURA CE 15 OBTAINED. I PRICE OF UNIT $ a a 5_ s — INSURANCE COVERAGE NUMBER OPTIONAL EQUIPMENT NO VERAGES EXCEPT kS SHOWN BELO OF MONTHS $ COST OF SET-UP PARTS FIRE AN EFT - CAC FIRE AND TH T-COMPREHEN E SUB-TOTAL a ❑ PERSONAL EFFE S _ ❑ F NOT 3 MOBILE HOMEOW 'S INCLUDED LBELOW ES TAX IIN(4o) I ❑ Other insurance(Descrlb NON-TAXABLE ITEMS TOTAL PREMIUM foncmonr lco severeyoh on ,.„.....ee a $ FEES IF NOT INCLUDED BELOW IN(,f) Q U commodity if obtained from or Ifoul holler......... ..... ............................ t ❑Please purchase the coverages checked above. I.CASH PRICE p $ �rs� �d ALLOWANCE IN $ 4 0 SIGNED X SIGNEDX LESS:BAL.DUE O N A VE ❑ NET ALLOWANCE Purchaser has purchased required insurance through: CASH DOWN PAYMENT (AGENT'SNAME) CASH AS AGREED SEE"REMARKS" $ (AGENT'S ADDRESS) 2.LESS TOTAL CREDITS y �O 3.UNPAID BALANCE OF CASH SALE PRICE $ / SO NAME OFINsuRANCECOMPANY) . THIS IS NOT A TRUTH-IN-LENDING-ACT DISCLOSURE FORM INSURANCE AGAINST LIABILITY FOR BODILY INJURY OR PROPERTY 4.OTHER C�HAROES DAMAGE TO OTHERS IS NOT INCLUDED IN THIS TRANSACTION. a.Official Fees ISpecifyl . . $ OPTIONAL EQUIPMENT,LABOR AND ACCESSORIES VSI $ b.Insurance on Commodity. , . . $ 1 0 A QA c.Credit Life Insurance. . . . . . $ u d.Credit Accident 6 Health. . . . $ o r-S ^ . . e e.maces INot Incl,abowl• $ 1 it, f. Liceme Fees$ RogbL Fees $ (Total) Certif.of $ $ Tltle Fees ee s & ax es Will e removed upon TOTAL OTHER CHARGES(a+•b+c+d+e+11 . . $ delivery for recycling purposes. S.UNPAID BAL.—AMOUNT FINANCED (3+4) , ,$ S.FINANCE CHARGE . . . . r $ Gelling: erg ass n. c , 7.ANNUAL PERCENTAGE RATE % Walls: 1 @rg asS 1nethick, R a.TOTAL OF PAYMENTS IS+ 6) . . . . . . . . . . $ Floor: 1 erg ass 1n. 1C 9.TOTAL DEFERRED PAYMENT PRICE(1+4+6) ....... $ REMARKS: Payable in monthly installments of $ _.- .--- chi The to the within described unit passers and one final installment of$ all payable the like e 1 as of the date of signing of the retail installment or security agreement by of each successive month commencing 19-- the purchasers even though physical delivery may net be made until a later dote. IT IS MUTUALLY UNDERSTOOD THAT THIS AGREEMENT IS SUBJECT TO NECES- BALANCE CARRIED TO OPTIONAL EQUIPMENT j$ SARY CORRECTIONS, AND ADJUSTMENTS CONCERNING CHANGES IN NET PAYOFF ON TRADE-IN TO BE MADE AT THE TIME OF SETTLEMENT. DESCRIPTION OF TRADE-IN �`�� / 's"G 6 "aa`L s`oaaaM SOCIAL SECURITY TITLE MO sEAiAL NO. COLOR AMOUNT OWING TO w"OMM oN�. — SOCIAL SECURITY TRADE-IN DEBT TO BE PAID BY = DEALER = CUSTOMER The undersigned certif that the matter printed on the back hereof is agreed to as a part of this a reement the same as if it were rinted above the si na- tures; t at un ersigne is o statutory age or a� een ega y emancipat ; t oft a pure ase o t e a eve escri a trailer,mo i e ome or vehicle;the op- tional equipment and accessories thereon,the insurance as described has been voluntary; that the property being traded in is free from all encumbrances whatsoever,except as noted herein.The undersigned agrees each paragraph cnd provision of this contract is severable;If one portion thereof is invalid the re- maining portion shall,nevertheless,remain in full force and effect. I, OR WE, HE Y N WLED CEIP F A COPY OF THIS ORDER Chaco of Washington DEALER SIGNED PURCHASER Not Valid Unless Signed and Accepted by on Officer of the Company 1�12SIGNED X--=CL%ZJ I � HASER I By Approved,Sublacf to acceptance of financing by bonk or finance company. _ lenbms Mobilerhome/rioters, - Pr:^led,n U 5 A c �6FORM 100.3 Moscoutah.Ill, k ht 1978 �. PLOT PLAN Y (ESS PERMIT NO. 0 c _2A �3 1 4 GAL L�� ,,�Qi� kv o 0 SCRIPTION jr&//, T /2�� OB ADDITION u fE 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. INDICATE NORTH IN CIRCLE Z-7 / GR PH SQUARES ARE 5' X 5' OR 1"=20' G e � A/c^1 E i I/We certify that the proposed construction will conform to the dimensions and uses sho n above an that no changes will be made without first obtaining approval. ME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED TRICT AS NOTED DATE 4CLT ON PRINTING