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Home My WebLink AboutBLD13861 Mobile Home - BLD Permit / Conditions - 4/20/1983 Refsnider, Patricia & Robert #13861 275-5463 4/20/83 Beard's Cove, A, Lot 5 NE Capt. Kidds Ct. Mobile Home Contractor: 12'x60' , 1966 Self $9,000.00 r Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Vraming: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: Stop Work: Mobile Home: Smoke Detector: Remarks: PERMIT BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 � DATE ISSUED H I Ct 2.FSn '�P� Gr PERMIT NO. OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE E 9H/ .oar "' qj Y_ 2 7_3 yd3 DIRECTIONS �+ TO JOB SITE /IE Ga f' �'��s C�, �eart�S 6o✓4f LEGAL (❑ SEE ATTACHED SHEET) DESCR. gQQrC�S ✓� �i✓ y 4,1 S CONTRACTOR NAME MAIL ADDRESS CITY 3 STATE LICENSE NO. PHONE �� '/O/r- '17"y Ar USE OF BUILDING IlprWe Class of work: W NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: /Vove � .y . Ap /o7L � ! Valuation of work: $ Q PLAN CHECK FEE PERMIT FjE 7� s" r u SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS A TOTAL SO. FT. GARAGE ❑ ATI%CHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El OR AIR CONDITIONING. TOTAL SO. FT. 720 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 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. 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 will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT JPLI.CATION Owner Date ACCEPTED BY PLANS ECK BY APPROVED FO ISSUANCE v"" 8 PLWN CHECK VALIDATION CK. M.O. CASH P .RMIT VALIDATION CK. M.O. CASH %PLOT PLAN ADDRESS I�[s gea/'dy CG V - PERMIT NO. F LEGAL rs DESCRIPTIONDi ✓ LOT �5 BLK ADDITION ( ". SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS / I Z Sq. Ft. INSTRUCTIONS TO APPLICANT U� THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE C 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 f� 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 USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' O G � s LL it S I/We certify that the proposed construction will conform to the dimensidns and uses shown above and that no changes will be made without first obtaining approval. r -tr/a ��.�s'�' `/ rrtct , ep -1 NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) IGNATURE OF OWNERS OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTING PLOT PLAN ADDRESS PERMIT NO. f s � > LEGAL S6a'-e6 DESCRIPTION LOT S BEM✓ y ADDITION ��u r!'✓� Cv v u SITE AREA geyo gPrA`Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS 7� p 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. eINDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' 1pV 3 / c b,% Ag f o 'l:'{ I/We certify that the proposed construction will conform to the dimensions and uses sho above and that no changes will be made without first obtaining approval. NAME(S) OF OWNER(S) OF SITE 6 STRUCTUREl3) (PRINT) I NATURE OF O ER(S) O.. AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTIN3