HomeMy WebLinkAboutBLD15257 Cancelled Mobile Home - BLD Permit / Conditions - 1/9/1991 SMITH, David Kelly - #15257
3-14-84
Beard's Cove Div 5 Lot 11
Located 2-1/2 miles east of Belfair on Sand Hill Rd. ,
then about 2 blocks straight to Harpoon Ct.
25112 132nd Ave SE
Kent, Wash. 98031 Contractor
Self
Mobile Home 1979 14x52 (must stay back at least
5' from all property lines)
$9,100.90
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:
.T ._
n�I=p- ?/ BY/ — -- -
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 —
DATEISSUED
PERMIT NO.
OWNER ��N✓EJ 'fe/ ` AIL DDRESS �� �CCITY eTT ��' ZIP PHONE
.YY�u K 1—` YO 3 CP 30•Y1139
DIRECTIONS E'G S�-1 ,I �^ 1'!1�✓ 4_e
TO JOB SITE cat c �i r+t(tt t, �+0 �[. v�J JO.K) r LL G S Qitth
LEGAL / (❑ SEE ATTACHED SHEET)
DESCR. I/
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR S M4►11� Q pd✓
USE OF
BUILDING Lr V 1"0
Class of work: ❑ EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: ,
c i,v 2a Gtr o-n Lot, o%in✓ u L c✓4 fi'i` EC�,
z/ )( j4 ?711
Valuation of work: $ nl �D� B p PLAN CHECK FEE PERMIT FEE
'7 � Y
SPECIAL CONDITIONS: al
L41-
BEDROOMS {DECKS CARPORT [] NOTICE
BATHROOMS__ (TOTAL SO. FT. GARAGE Ll
ATTACHED 1 1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT G OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE L. DETACHED L;
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
conformar{Ce therewith. PERMANENT SHORELINES
i SEASONAL I FLOODPLAIN i
Firm
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.
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
Owner /�Date 4 APPLICATION ACCEPTED Y PLANS CHECK BY Y ROVED FOR ISSUANCE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH
PLOT PLAN
ADDRESS S I Q � & C PERMIT NO. °
F °
z �
n s
a o
LEGAL o
DESCRIPTION LOT BLK ADDITION
u
SITE AREA ax 'O Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS , � r f
v , 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.
INDICATE NORTH IN CIRCLE 0 ' GRAPH SQUARES ARE 5' X 5' OR 1"=20'
v d
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.
IE(S) OF OWNER(3) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
CT AS NOTED
DATE
N PRINTINi
LOIS SCOTT
ASSESSOR
THE MASON COUNTY ASSESSOR DARRYLCLEVELAND
CHIEF DEPUTY
PLEASE SUPPLY THE FOLLOWING INFORMATION
REGARDING YOUR MOBILE HOME
Owners Name: 4 i2r."Z & Tele #
6 . sue
Mailing Address /.7s;- l/
Previous Owners Name & Address
3 - S --
Description of Mobile Home: ( Information is on your registration certificate)
Make Size (y � '5 4� l
Year ) 7,01 Serial # oq LV41oL_nA
Year Purchased c�i Price (Less furniture & sales tax) $
If in Mobile Home Park:
Name of Park: Space #
If NOT in Mobile Home Park: /
Do you own the land on which the home is placed? YES / NO
s
Real Property description go X 9 LI
Owner of Land if you are NOT the Owner: r
Brief direction to location: �� w(iG-eS �SfOr ��— �~✓� aN
u,c� ��tC.0 tw sAnd ,L �l Scponle�
Date Mobile Home Entered Mason County:
Date you anticipate moving Mobile Home to another location:
If moved from a Mobile Home Park give:
Name of Park: �(J. (trn obi ip, pace # /�—
Your home will be placed on the rolls of Mason County. We would appreciate a
prompt reply. Please feel free to contact this office if you have any questions
at all .
Very truly yours,
Helen Glaser
Personal Property Department
__ Owne Signature Date