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HomeMy WebLinkAboutBLD15954 Final Mobile Home - BLD Permit / Conditions - 10/3/1984 ENGLISH, William H. #15954 8-7-84 Beard's Cove A, Lot 3 4411 SW 100th St Seattle, Wash. 98146 932-7345 Go West from Belfair to Sand Hill Rd, right to Larson Blvd. left to Cap Kidd Ct. Contractor None listed Mobile Home 1966 12x55 2 bdrm. $3,300.00 Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: e7 1Z 5 �,L/ 17 Stop Work: Mobile Home: Smoke Detector: Remarks: 14 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 S ^0 7 4 DATE ISSUED ✓. i c��j�//5 ll.>id PERMIT NO. 1 I �J OWNER NA E MAI A RESS 7 CI &STATE ZIP PHONE u a �ZZ G � f DIRECTIONS TO JOB SITE 2t L sk. LEGAL �L--- ( EE A ACHED 6 at DESCR. �- ( 3 L. + CONTRACTOR NAME MAIL ADDRESS CITY S STATE LICENSE NO. PHONE USE OF BUILDING f/' .CI C/ h Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: !/ ` 2G"�121' s'L til-� c.•e .cE-C.cJ-�=f�C 1 (3 Xiss = C0(00 0 0� � VV\ Valuation of work: $ 3 :5 O© Q Q PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT G NOTICE BATHROOMS ITOTAL SQ. FT. GARAGE LJ ATTACHED � SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT I OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE i i 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 cert' y that I am a currently registered contractor in WORK IS COMMENCED. the fate of Washington and I the aware of the FO OFFICE USE ONLY ordi nce requirements regulating the work for which the ermit is issued and all work done will be in co ormance therewith. PERMANENT SHORELINES SEASONALI FLOODPLAIN Firm E.D. NO. S.E.P.A. i i By Special Approvals IN OUT YES APPROVED NO Lic. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. Z rIM\ OJ 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 i conformance therewith. MOTO VEHICLE PERMIT r _ LICATI AC P D BY PLANS CHECK BY APPROVED FOR ISSUANCE Own 777/// ti ate . __E BY PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS PERMIT NO, s o z � n s a o a LEGAL n DESCRIPTION LOT BLK 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. t I DICATE NORTH IN CIRCL ` GRAPH SQUARES ARE 5' X 5' OR 1"=20' C- ILA IF- 1717, t t 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(3) OF OWNER(3) OF 31TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DATE DISTRICT AS NOTED GHELTON PRINTIN3