HomeMy WebLinkAboutBLD12867 Final Mobile Home - BLD Permit / Conditions - 3/1/1983 Kincaid, Robert & Vera #12867
935-3765, Seattle 8/13/82
30-23-1, Tract 1 of Govt. Lot 4, EX. R/W
1 mile down Mission Creek Road on right.
Mobile Home Contractor:
24'x56' Heritage Homes
$24,346.00
Shorel_. -L
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior: _
Final,te 7
Stop Work:_
Mobile Home:
Remarks:
I
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATEISSUED
PERMIT NO.
OWNER AM AIL ADDRESS CITY&STATE 21P PHONE
DIRECTIONS T
TO JOB SITE
LEGAL /�-�� F� �(O SEE ATTACHED SHEET)
DESCR. 30��3— 1 / ,* � `�!� . �J
N ME MAIL AD RESS ITY&STATE LICENSE NO. PHONE
CONTRACTOR .�5.� 'Jr
USE OF
BUILDING
Class of work: rX NEW ❑ ADDITION ❑ ALTERATIONU ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Co-
LT a-
Valuation of work: $ o? , / 31/' .O O PLAN CHECK FEE PERMIT WEF
SPECIAL CONDITIONS:
BEDROOMS DECKS _ CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE L]
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIE 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 ANYTIME AFTER
I certify that I am a Currently registered Contractor In WORK IS COMMENCED.
the State of Washington and 1 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 le
conformance therewith. PERMANENT SHORELINES Vt CIL
SEASONAL El FLOODPLAIN Ll
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. r36- 1
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be i c of rmanc erewith. MOTOR VEHICLE PERMIT
< - r
P ICATI e�/�� (�� ON ACCEPT D BY PLANS CHECK BY APPROV FOR ISSUANCE
jS O Y
Owner Date. Vt4d m4 / T_ I
PL CHECK VALIDATION CK. M.O. CASH PEIRMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. f o
n >
D O
O i
LEGAL a
n
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 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.
N a-
INDICATE NORTH IN CIRCLE C/( GRAPH SQUARES ARE 5' X 5' OR 1"=20'
- C ,
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(S) OF OWNER(S) OF SITE & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINT INS