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HomeMy WebLinkAboutBLD15729 Final Mobile Home - BLD Permit / Conditions - 7/31/1984 SHRIVER, Jack & Gladys #15729 6-25-84 Beard's Cove, Div. 4, Lot 2 P. 0. Box 25 Bremerton, Wash 98310 275-3063 Contractor Self Mobile Home 1973 12x 60 2 bdrm $9,000.00 i Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: ek 7 3i e'[/ Stop Work: Mobile Home: Smoke Detector: Remarks: BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED �' PERMIT NO. OWNER NAME MAIL ADDRESS CITY STATE ZIP PHONE d 5� rl v P6. Ba 0 5 t r.me H6A 9'S3/t) a75 3063 DIRECTIONS I 1 TO JOB SITE rdsCo ue. D J• L.O 1' o'� �C, g1 C2a/1T�/dWST— LEGAL / t (❑ SEE ATTACHED SHEET) DESCR. S4 yh e- !Z 1-- /� ( L-1 f NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR USE OF y BUILDING �� • r` Q.�/ /� -Z1/7-2e/ Class of work: ZNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: r I c Sj, Ell f / 40 Valuation of work: $9�Q� PLAN CHECK FEE PERMIT FEE ? SPECIAL CONDITIONS: '7 , BEDROOMS I DECKS CARPORT G NOTICE BATHROOMS TOTAL SQ. FT. GARAGE ['. ATTACHED I : SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [i OR AIR CONDITIONING. TOTAL SQ. FT.7Z© FIREPLACE I ; DETACHED C 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 cer fy that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the CO F F 1 C E USE ONLY or finance requirements regulating the work for which 1 t e permit is issued and all work done will be in onformance therewith. PERMANENT SHORELINES , SEASONAL [ ] FLOODPLAIN Fir E.D. NO. S.E.P.A. i By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. it �.3 (3�/' S 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 conformance therewith. MOTOR VEHICLE PERMIT A LICAT N ACCEPTED 1p PLANS CHECK BY APPROVED FOR ISSUANCE Owner Date. _l_g` - I PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH IPLOT PLAN ADDRESS PERMIT NO. f o z � ICI D D O O LEGAL DESCRIPTION LOT $tif— 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"ID 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. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' t V-VIf ilM I I 1 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 h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTIN3