HomeMy WebLinkAboutBLD13999 Final Mobile Home - BLD Permit / Conditions - 10/18/1983 Pope's Shopping Center #13999
275-2073, _,_; _ : 5/18/83
23
29-3t-1, Tract 16 of NW 1/4, SE 1/4
Behind north end of Belfair Thriftway
Mobile Home Contractor:
1,387 Sq. Ft. None
$25,659.50
i
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls.:—
Framing:
Fir a%lace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior :
Final:Q,�-j6
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �l ��
DATE ISSUED
��J
PERMIT NO. 1 /
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
- SAr ,V 0 /3GT`T u s"L✓ Z 7S
DIRECTIONS
TO JOB SITE &-r {VU
LEGAL Z T ` (❑ SEE ATTACHED SHEET)
DESCR. — _' Ti 'CIC /6 Of' /vGt� S� SGT
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR o
USE OF
BUILDING �T
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
&voO i-d i 9
Valuation of work: $ PLAN CHECK FEE PERMIT F
SPECIAL CONDITIONS:
BEDROOMS A DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE [I' 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 f
conformance therewith. PERMANENT SHORELINES� 9X/
SEASONAL ❑ FLOODPLAIN ❑
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. �j�f�� 6'L �
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 h. MOTOR VEHICLE PERMIT
~ 4 LIGATION CCI�PJfED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner _����Date. 17 rJJ �
BAH
PL CHECK VALIDATION CK.. M.O. CASH PERMIT VALIDATION
PV CK. M.O. CASH
PLOT PLAN
�ri (1
ADDRESS i i 0. /a Olt 39 '0�"6 Fallc,1 cu'y 7ZSSr'.� PERMIT NO. 0 o
= a
2 '3,LEGAL
% / iiJJ
DESCRIPTION7%tAG+. �(r� LOT 0'( �LiJ /a c3[: BILK ADDITION u
dd �
SITE AREA j A-- Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS �a Sq.Ft.
INSTRUCTIONS TO APPLICANT n
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.) 7
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 P"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.
L
, INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'�) V.,
11-5
I
1
� r1
A
-�
I
V
4.
d
changes will be made without
shown above and that no
I/We certify that the proposed construction will conform to the dimensicfis and uses
first obtaining approval.
'(3) OF OWNERS) OF SITE 6 STRUCTURE(S) (PRINT) IGNATURE OF OWNER(S) OR AU ORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED DATE
AS NOTED
.TINTING
^1HUI'STO d-IZASON HEALTH DISTRICT
x Division of Sanitation Receipt ,;'
5th and Birch Court House Annex
Shelton, 1dashington Olympia, vlashington
Fhone: 426-4407 Site Inspection';/ ' Fhone: 352-4851 Ex. 84
APPLICATIO1d TO CONSTRUCT OR ALTER Ail IZIVIDUAL SE1.1 AGE DISPOSAL SYSTLPI
(Application required for each installation and/or major repair )
Buyer or
Property Owner i Phone C Z3
hailing Address �� City State
i
Builder Address 'Lip
Location of rronerty, including: Lot J Block Other
Mailing Address of bite
r Detailed directions to- site: '
Property Commerc
Size .z .,� Residence - lof Bedrooms_� ,Basement_L_,Type u�
1 '.later Supply: Depth..of, ':ell Spring Other
\ Is well .or body of 'fresh..water within 100 feet of sewage system?
Is salt water supply within 50 feet of sewage system?
Septic Tank gals. Drainfield length ft. Trench width Z Wit.
(Refer to Table 9 of letzn)
And/or system other than above
(Refer to Table 2 of Bulletin
'`oIs garbage grinder being installed? Is contractor installing septic tank?
Drainfield?
i\fllame of Sewage Contractor ���r.�✓!Z � '/� �v
(Sewace Contractor must be licensed by Thur6ton•-11ason Health District
THE UIZEIi.SIG 3ED hereby applies for a permit to construct( ), alter( ) and/or
modify( ) a sewage system on above property in accordance with the Bulletin.
Applicant'd Signature
flailing Address Z'1')
Bulletin: i4ashzngton State Dept, of Health Bulletin E.S. ;,l entitle "A Septic
Tank system for your Home" for minimum requirements.
Not to be f it ed.d. in by Ap liccant
Permit;` <�� ,; �c> Fee�,l, Date Issued .� h
\ Area Sanitarian - pates Inspected
REMARKS:
Date Approved q el Approved by�i
v
1
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