HomeMy WebLinkAboutBLD21138 Mobile Home - BLD Permit / Conditions - 1/9/1991 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:`
Mobile 36e:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove: j Zvi Gdiy /.3Y
TYPE MOBILE HOME
Permit No. 21138 No. Floors Sq Ftg 924
Owner BEARDS COVE COMM. CLUB Tel 275-4750 Date 10-30-87
Address P 0 Box 338 Belfair Zip
Contractor None
Address Zip
Legal Description Beards Cove Div 5, Lot 2
Direction to project site Larson Blvd & Capt. Kidd ('t.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1982 14x66 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. "
NAME n MAILADDRESS CITY&STATE ZIP PHONE
OWNER - ' CO✓ Q� d 80x
DIRECTIONS // �^ ��/ v7�sfs�s
TO JOB SITE G�,�SOi✓ $L fly. �/ �� / Anl ,a2) C/
PARCEL LEGAL]
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TDESCR
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NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK '�D C / V
e
BEDROOMS_ DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANE T SHORELINE
SEASON IL
OWNE7S AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI MENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CO FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
O N E R 7, ATE X BY DATE
FOR OFFICE USE ONLY
AD D� RTMENT YESPPROVENo DEPARTMENT YES No
BUILDING VALUATION
HEALTH ; PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 6 - o
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
�) ) -�' rpyti0i1-,0-6 PLUMBING
yp l rTAC44 7 MECHANICAL
STATE BUILDING FEE e d t
STATESURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY APPROVE I�ORZANCE I PERMIT VALIDATION
IBY CASH CK MO TOTAL
PLOT PLAN
y�
�
ADDRESS ybc 2D 00yCAOMM1111VI PERMIT NO. 0 o
= s
n >
LEGAL
DESCRIPTION LOT BLK ADDITION
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 AND 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'
a ti
C: a
1
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.
- 0,01
NAMEW OF OWNER(a) OF SITE & STRUCTURE(S) (PRINT) S IG E
URE OF OW ER(S) OR AUTHORIZD REP ESENTATIVE
pDO NOT WRITE BEL THIS LINE (�
APPROVED I DATE
DISTRICT AS NOTED