HomeMy WebLinkAboutBLD21907 Mobile Home - BLD Permit / Conditions - 5/4/1988 Shorelines: Plunbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile
Smoke Detector:
Remarks:
oo ing:
Setback: �4019 A,
Foundation VOID 5YIV.
Walls: r1Ul.L &
Framing: '
.J
Fireplace: l
Wood Stove:
TYPE MOBILE HOME
Permit No. 21907 No. Floors Sq Ftg
Owner LANCER MARKETING Tel 857-5552 Date 5-4-88
Address p. O. Box 1821 Gig Harbor Zip 98335
Contractor
Address Zip
Legal Description Beard's Cove Div 3 Lot 36
Direction to proje si e
ing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED !
PERMIT NO. `` V
OWNER IN E MAJLADDRESS,4 CITY&STATE ZIP PHONE
a1c� U t�� �, w-�2 i
DIRECTIONS
TO JOB SITE ,��t e- k-z,,ee—
PARCEL LEGAL /n
NUMBER :!136 S76-000.36 DESCR.
CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE OF /
BUILDING
CLASS OF WORK NEW ADDITION ALTERATION FREAIR MOVE REMOVE
✓
DESCRIBE
WORK
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SO.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 SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT '✓ SHORELINE
SEASONAL
C}IINERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
EMENTS 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
SIN CO ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI G APPROV ROM THE LDING EPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
O N 1tc DATE �- '�� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENTBUILDING VALUATION d0
HEALTH y- PUBLIC WORKS FEE
PLANNING 17 L FIRE BUILDING PERMIT ��I 15-
D.O.T. BUILDING ! PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE r�
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR SUANCE PERMIT VALIDATION
,� .t� BY �I CASH CK MO TOTAL
PLOT PLAN
ADDRESS �� �`—^�—�� ( PERMIT NO. i o
= s
n s
a o
0
LEGAL DESCRIPTION LOT BLK e S ADDITION
��
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 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'
NV
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