HomeMy WebLinkAboutBLD13871 Final Mobile Home - BLD Permit / Conditions - 5/17/1983 Amborn, Michael D. #13871
275-5012 4/29/83
Beard's Cove #3, Lot 29
See Attached
Mobile Home Contractor:
1680 Sq. Ft. Sun Mobile
$31,080.00 Wood Stove Permit
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Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: / '�
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
1 -
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 'a 9�3
DATE ISSUED
PERMIT NO. / .2143
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
6,?P .�s & 93 r a -
DIRECTIONS /p�
TO JOB SITE `c,Q ro('s,
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. Y�!'S
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
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USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
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Describe work:
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Valuation of work: $ PLAN CHECK FEE PERMIT F
SPECIAL CONDITIONS/-
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BEDROOMS DECKS CARPORT [I NOTICE
BATHROOMS_ TOTAL SO. FT._ GARAGE I I
ATTACHED i_' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES, BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT./W FIREPLACE t] 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 SHORELINES V)i Qi
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. Al;2 _f33
RKS
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.
of z
which this permit is issued and that all work done will ROAD ACCESS
be in conforms ith. MOTOR VEHICLE PERMIT
_ / AP (CATION Owner Date . TE ACCEP BY PLANS CHECK BY APPROVED FOR ISSUANCE
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A CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS �. _ O� 1 o �, t,�, � eJ PERMIT NO. o
Reg0'�s C,) ✓ ,P-
LEGAL -0 ` n
DESCRIPTION LOT o2 BILK 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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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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(SI OF OWNER(S) OF SITE d STRUCTUREIS) (PRINT) SIGN"ATURIE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6HELT ON PWNTIN i