HomeMy WebLinkAboutBLD14860 Mobile Home - BLD Permit / Conditions - 10/25/1983 (2) COMMONS, Roger #14860
10-25-83
30-23-1, Beards Cove, Division 4, Lot 17
From No. Shore Rd. take Sandhill Road, left on Larson Blvd
then right on Galley Way, last lot on right
Contractor
Self - no phone listed
Mobile Home
$17.760.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior :
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remar k s
PERMIT
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DATE fly h
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED — —
PERMIT NO.
MAIL ADDRES CITY&STATE ZIP PHONE
OWNER AME � �• f%
�'� 0�4ix C S NE,7D CESSEL �-f' f�
N LE TON. , A2.St�J L- 'T
DIRECTIONS
TO JOB SITE bt-S 6AUZY WA l � 2 0-0',YL 2
' ! /� I `') (❑ SEE ATTACHED SHEET)
LEGAL D�U "T I ` 1 O � 5 C LV '���
DESCR.
NAME
MAIL ADDRESS CITY&STATE LICENSE NO, PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW )L ADDITION ❑ ALTERATION ❑ REPAIR K MOVE ❑ REMOVE
Describe work: fy�OL `� i J I 4a
�-' t 3 y Amz'�
Q -�y
9bo
I�Valuation of work: $ r PLAN CHECK FEE PERMIT FEE C`•7
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT i t NOTICE
BATHROOMS 1► TOTAL SO. F - GARAGE C l
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i 1 ATTACHED OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACEA DETACHED L
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
WORK IS COMMENCED.
I certify that I am a currently registered contractor in
the State of Washington and I am 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 PERMANENT L7 SHORELINES
conformance therewith.
SEASONAL [ I FLOODPLAIN l
F/No.
E.D. NO. S.E.P.A. L
APPROVED
Special Approvals IN OUT YES NO
B
L
Date ZONING
PLANNING DEPT.
HEALTH DEPT. Q
OWNERS AFFIDAVIT 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. O �S S
of the Mason County ordinance requirements for
'whic this permit is issued and that all work done will ROAD ACCESS
be i conformance h ith. MOTOR VEHICLE PERMIT
[L=
PLANS CHECK BY APPROVED FOR ISSUANCE
Owner ate. 7 /� L�
C !.
PLAN CHECK VALIDATION CK. M.O. CASH
PERMIT VALIDATION CK. M.O. CASH
1
PLOT PLAN
ADDRESS N E 140 C ALLFY WM PERMIT NO.
n D
LEGAL
D O
� � s
DESCRIPTION 6N. LOT OF ►-�JEARDS l_3VCBLK 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.
h�
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
V
C„
I/We certify that the posed construction will conform to the dimensions and us h�ownve and at no hinges will be made without
first obtaining appr
To
NAME(3) OF OWNER(3) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE V �J
6HELTON PRINTINi