HomeMy WebLinkAboutBLD7781 Final Mobile Home - BLD Permit / Conditions - 12/7/1990 Buda, Tcr,r_y #7781
10=31-80
Frmm Belfair, no. Shore Rd. of Hood Canal - right on
Sand Hill Road, then 1st left, then 1st right, brown
mobile on left
Beard's Cove, Lot 943, Div. 3
Mobile Home (variance for blocks)
$17,760.00
i 2/,7/g0
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 �6j
DATE ISSUED ��7
r PERMIT NO. �2: i
OWNER �f ME / MAIL ADDRESS CITY 3 STATE ZIP PHONE
S IJGi'/� 3�c�S4E
DIRECTIONS C70 10'
TO JOB SITE ��e� z--
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. o i 3
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR YOz5S'7- enT
USE OF
BUILDING fjE/T �FSicfFi+(CE
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ 17 PLAN CHECK FE PERMIT F E
/ `��� r+` ICL
SPECIAL CONDITIONS:
BEDROOMS DEC A PORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
S ❑ ATTACHED ❑
NO. OF STORIES BASEMENT OR AIR CONDITIONING.
TOTAL SO. FT._?ZL0 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 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 LI
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. ,C
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 will4RADACCESbe i conformance therewith. R VEHI L PERMIT
G� rATIQ&A C TED BY PLANS CHECK BY PPROV �FORANC
Owner Date. O Y
FLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. ��� z f o
n D
LEGAL
a o
DESCRIPTION LOT `y /<% ' � BLK ADDITION �iPiP�S
SITE AREA III � d — l Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS � Sq.Ft.
/ilP 711i.S
INSTRUCTIONS TO APPLICANT r ��y,� r aP,oC x7—'0 \�*�
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 Al"D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE S/E OF EACH BUILDING AND MAJOR POR-
TION THEREOF. f 1/,9 T .�h7E �P,{I f��ljaE , ,y�iriP7c�
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
C 'BSI
TI 7$Nr 41 6
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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.
NA (S) OF OWNERS) OF SITE s STRUCTURE(S) (PRINT) IIGNATURE OF OWN (S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED DATE J S7�
DISTRICT AS NOTED
6HELTON PRINTIN3