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Home My WebLink AboutBLD0321 Mobile Home - BLD Permit / Conditions - 11/6/1990 PLOT PLAN ADDRESS Ale v(�7 / ef //W y _1q PERMIT NO. o �E 3 D ) LoC) Shorelines: Plumbing: Setback: Mechanical: Special Interior: Conditions: FINAL: Mobile Hcme: Smoke Detector: Ranarks: Weht Doting: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: TYPE MOgTI F HOMF Permit No. 0321 No. Floors 1 Sq Ftg 72A Owner CT VTNCFNTpF pAui Tel 275_61gq Date 11-6-q(1 Address p0 gox 1103 gelfair Zip Contractor nnnp Address Zip Legal Descrip ion 2o_ _Tr 16 SI,I cE Direction to project site Gd f-e -Plumbing Mechanical Sewer Wood Stove Fireplace Deck gage arport Basement Loft Other x _ MASON COUNTY DEPARTMENT OF GENERAL SERVICES Le Description: Section T o shi rth, Range / West , W.M. Project: Date Received Address of Project Owners NamEsT. Address - Phone ILA Directions to Prerfect Site- HEALTH Fee Paid r��_ Receipt No� r� Date Received '/0 Plot Plan Type of Septic System >a r ✓6f. Tank Size fib— gallons; Drainfield Length feet; Approved for bedrooms; Septic System Site Approved Final Approval Contractor7X ail n'`dwt Cif ' Phone Inspected By -n, d w Completion Date Water Supply Approved ' PLANNING Fee Paid Receipt No. Date Received Residence Commercial Plat SEPA Final Declaration EIS Required r�. Shoreline Exempt Shoreline Permit Local Decision Appeal Final Decision Preliminary Plat Date Final Plat Date Contractor Phone Proje t Engineer Phone By r :1 U—(l- �� BUILDING Fee Paid Receipt No. Date Received Plan Check: Approved Denied with the following corrections - 1�Vp VY Conditions By �- Approved: Property Line Setback Footings Foundation Walls Framing Fireplace Wood Stove Plumbing Mechanical Roof Exterior Interior Final Stop Work Mobile Home Smoke Detector Remarks ------------------------------------------------------------------------------ Additional Comments BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 X 427-9670 DATE ISSUED PERMIT NO. AME;/�,�``NT 2)ri7 L LMAIL ADDRESS CITY 6 STATE ZIP PHONE OWNER T Y j EA_CI �,,✓r }'c!�c'X 11,03 ��l I elf, DIRECTIONS TO JOB SITE .Fe' a2 - PARCEL LEGAL NUMBER DESCR. �/� �� S'✓-s`C /f O F S� f��/ CONTRACTOR NAME f MAIL ADDRESS CITY 8 STATE CENSE NO. ZIP ONE USE OF BUILDING EMEIF'�'�it/(' ec�sjA,'V CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK /N574, 1-L /2%t'6 d J4I6.6 I G -- 0 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 SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CE TIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGI TRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE RE IR1.=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 ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING AINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.I . X OWNE �"TE � 1� X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YES NO HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING yZ�_ PLAN CHECK SPECIAL CONDITIONS BUILDINGGROUPg PRE-INSPECTION it t �I U —(Q O� SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE L , STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY ` V FOR ISSUANCE PIERMITVALIDATION �J �}- BY CASH CK MO TOTAL / S. Gordon Craig the mason county ,. assessor Dea r We have recently received a copy of tax certificate for mobile home movement on your mobile home. In order that we may accurately value you mobile home , please complete the questions below and return this form to our office by It is imperative that this information be provided to prevent a possible double assessment . MOBILE HOME DATA LENCH WIDTH Z MODEL MAKE �'LTMGo2c' MODEL YEAR MOBILE HOME LOCATION INFORPIATION SERIAL # A. My privately owned land. YES NO B. If rented or leased land who from? NAME ADDRESS CITY & STATE C. Real Property Parcel # (tax statement #) _q y D. Mailing n me and address for owner of mobile home S7 ✓/ii�e.EN 7 1,0H v 1— NAME 1%,Vr-e aC- Pr,90,E 0,00C6ROJe6 ADDRESS ,� d 80)C 'Ile CITY & STATE,e3Ee/CPVW; k/191 E. Location address of mobile home CITY F. Date mobile home was placed on present site _ C. Purchase Price 96a,4147/DAJ DATE: SICNATUR TYPE OR PRINT N E �/V)C'S �•, UL�LTEM�S TELEPHONE NUMBER Courthouse Shelton, Washington 98584 Phone 427-9670 PLOT PLAN ADDRESS /Y r `�J e� PERMIT NO. 0 o LEGAL DESCRIPTION LOT BLK ADDITION °. SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Z2d 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 AND 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 1"=20' J lreo" 1 II 1 l I/We certify that the proposed con, on will conform to the dimensions and uses sh77' and that no changes will be made withou fiat obtaining approval. .�G"�L Jr y. NAME($) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) IGN� RE OF OWNER(!) OR AUTHORIZED REP ESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED IDISTRICT AS NOTED DATE