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HomeMy WebLinkAboutBLD13800 Final Mobile Home - BLD Permit / Conditions - 6/9/1983 Ballew, Robert A. #13800 692-1019, Bremerton 4/4/83 Beards Cove, Lot 34 #3 (Duane M. Brown) North Shore up Sand Dune Hill Road, left, on Davey Jones. Mobile Home Contractor: 14'x66' , 1982 Westlin Mobile Home: $16,835.00 Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Pinal: C�(� Stop Work: Mobile Home: Smoke Detector: Remarks:,f7v �^�- BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. 13 9 D v OWNER NAME MAIL ADDRESS CITY&STAT / ZIP PHONE 1, 7 / . 7 .� 4 93:rs 6 Z2 4-0 11 DIRECTIONS _ TO JOB SITEIA6a Lo f- 6/ 5i4 ,dAvre LEGAL (❑ SEE ATTACHED SHEET) DESCR. /_©7 j L40 ULC NAME MAIL ADD7S CITY&STATE LICENSE NO PHONE CONTRACTOR /d�ES USE OF BUILDING Poe"ZIA" Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ PLAN CHECK FEE PERMIT FEE / (J SPECIAL CONDITIONS: BEDROOMS I DECKS CARPORT ❑ NOTICE BATHROOMS___ TOTAL SQ. FT. GARAGE [] � ATTACHED _' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [ . OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE I 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 Conformance therewith. PERMANENT SHORELINES SEASONAL [_i FLOODPLAIN L; Firm E.D. NO. S.E.P.A. f_] By Special Approvals IN OUT YES APPROVED NO Lic. No.— Date 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 ROAD ACCESS conformanc therewith. M TOR VEHICLE PERMIT �i ^�' P LIGATION A CEPTEQ BY PLANS CHECK BY APPROVED OR ISSUANCE Owner _ Date PL N CHECK VALIDATION CK. M.O. CASH RMIT VALIDATION CK. M.O. CASH r PLOT PLAN ADDRESS PERMIT NO. 0 o z A O LEGAL DESCRIPTION LOT 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"'D 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' 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 6 STRUCTURE(S) (PRINT) IGNATURE OF OWN S) R HORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE GHELTON PFUNTINi