HomeMy WebLinkAboutBLD10371 Final Mobile Home - BLD Permit / Conditions - 5/5/1981 LITTLE II, Clifton ,A. #10371
04-09-81
Turn right on Sand Hill Rd. off No. Shore Rd. , make
1st left, turn lst right on Bowden St. , then left on
Durant Ct.
Beards Cove, Lot 38 Tract 3
Mobile Home
$16,576.00
f '
BUILDING PERMIT APPLICATION
MASON COUNTY.
• P.O. Box 186 Shelton, Washington 98584
' 426-5593
DATE•ISSUED
. PERMIT NO. /0 3
OWNER a NAME MAIL ADDRESS CITY eSTATE ZIP PHONE
C.Li FtO N L.1TPLG LIi SEAE01I0 CARCLe &WMkv VAsb,rrsrar r 9'8.S/0 377-36
DIRECTIONS It m 't b-A Sa.,o( f • S • f
TO JOB SITE (7.n 8q VAd� f5f-- -f4,P'A 6h C-f •
LEGAL Ir-O-cf _-3 (� (O SEE ATTACHED SHEET) r
DESCR. f*10bILE MU-• PhX�0 PACkFIC.4 I q 74 JG�1dl�
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING Resiaeiv4-vaz `' e'rv►na.Ae*'j-
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Pho L& hovwk,
Valuation of work: $ 00 PLAN CHECK FEE PERMIT E
/,GIs
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT L NOTICE
BATHROOMS__— TOTAL SQ. FTj242__ GARAGE L
ATTACHED L SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
N OF STORIES__ BASEMENT [] OR AIR CONDITIONING.
L SO. FT. FIREPLACE LJ DETACHED Li
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 11
SEASONAL ❑ 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.
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
be in conforman a therewith MOTOR VEHICLE PERMIT
A CAT N 4ACCTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date ��� ' L BYE
CASH
LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
—J
t PLOT PLAN
3 7 1 .16 ctI
ADDRESS 1'24 CA -ae +Q1QN,►M � w�Stj '1 0 PERMITNO. 0 ra
LEGAL �Q�,�ti p p ) Cc F
DESCRIPTION Ili+ryi LOT [? Vi r /QT ��� 5 BLK ADDITION `ww
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. Z-,?
INSTRUCTIONS TO APPLICANT D C
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE r LU
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. I
f►1
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
I
Lt
r�
A ,
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) IGNATU OF OWNER(S) O THOR ED REPRESENTATIVE
DO NOT WRITE BELOW THIS NE
APPROVED
DISTRICT AS NOTED DATE
GHELTON PRINTING