HomeMy WebLinkAboutBLD16114 Mobile Home - BLD Permit / Conditions - 9/13/1984 THOMAS, Eunee _ #16114
" 9-13-84
Beard's Cove Lot 51
P.O.Box 1145
Belfair, Wash 98528 275-4110 (Seattle 859-1088-)
NE 380 Schooner Loop
Belfair, Wash. Contractor
None listed
Mobile Home 1984 14x45 8x12
$12,395.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426 5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL AD ESS CITY 11 STATE ZIP PHONE
DIRECTIO p �8-
TO J O 8 SNTT E �O y�2/ L-UtJ �a g 0�7 0�� 76
-44/ /
LEGAL. X ' (❑ SEE ATTACHED SHEET)
DESCR �� �A/ D�4 �m-u-� � -y�J .
NAME MAIL ADDRESS CITY&STATE j LICENSE NO. PH N
CONTRACTOR
USE OF
BUILDING
Class of work: Q N,€14l=- ❑ ALTERATION El REPAIR El MOVE ❑ REMOVE
Describe w,fk-
r�
Valuation of work: $ •)/ 9.JL"Y PLAN CHECK FEE PERMIT FEW Id5^
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE LJ
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED Li
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
informance
permit is issued and all work done will be in
therewith. PERMANENT [ SHORELINES l: AJM
SEASONAL ❑ FLOODPLAIN Ll
Firm E.D. NO. S.E.P.A. I I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. Q
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
r Date
be conformance therewith. MOTOR VEHICLE PERMIT
.
3 APPLICATION ACCEPTED BY PLANS CHECK BY "ROVEDANCE
Owne
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION Q.K. M.O. CASH
P - PLOT PLAN
ADDRESS PERMIT NO. f a
A D
D O
O
LEGAL
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"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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
O
D
r
a
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 S STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
GHELTON PFUNTING
r �
w A'
SITE Ii:3SPECTION CHECK LIST NO
Chec.. every acceptable feature. Lcave every questionable or unacceptable
feature blank. Explain every blank in the space for remarks.
Ttem Applicable Regulations
�1. Soil in holes-describe layers & depth Art. VI Sec. 3.5 (a) VII 3.3, 3.7, 10.2
t✓ 2. Existing sewage systems /Vj
x/ 3. Existing structures - check usw b VI 3.5 VII 4.1, 4.2
='✓ 4. Existing wells - check construction w0 VI 2.1 (b) VII 4.1
✓ 5. Presence of fill VI 1.8 VII 3.6
t76. Has soil been removed VI 2.1 (c) , 2.4, 3.5(f) VII4.1
__`47. Salt water it
Lake "
✓ 9. Piv,2r
✓10. Crock
vll. Stream "
✓ 12. Pond 10
13. Swamp
n
V*�'14. 'Tisc. Surface water
v 15. Property VI 3.5 (f) VII 4.1
✓ 16. Banks or cuts VI 3.5 VII 4.1, 3.7
L17. Distance to public sewer VI 3.5 (g), 9.2, 10.2, 10.3 &
10.4
18. I•later table - P.ecord depth VI 3.5 (d) VII 1.4
19. Slopes VI 3.5 (e) VII 3.7,4.1
✓ 20. Driveways and roads VTI 4.2
✓ 21. Drainage patterns 171 3.5 (e) VII 4.1
r/22. Interceptor drains VIZ 3.8
r/23. Culverts
r/24. Water lines VII 2.6, 4.1
-�"25. Flood control zones VII 4.4
4�26. Roof drains VII 3.2
27. Vegetation VII 3.2
RAT VIRI:S