HomeMy WebLinkAboutBLD9081 Final Mobile Home - BLD Permit / Conditions - 6/26/1981 Sande, Carl L. #9081
11-19-80 =
Lot 6, Beard's Cove - Beards Drive
Beard's Cove, Lot 6, Div. 5
Mobile Home (Variance for blocks)
$31,500.00
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER 6 NAM§ M IL ADDRESS CITY 8 STATE ZIP PHONE
�Rc < - �4. �y e k 44. 0 7 Y=,� /3
DIRECTIONS
TO JOB SITE 6 '
LEGAL f �] / (❑ SEE ATTACHE SHEET)
DESCR. `ck C6 � 1Vr'(/. � ge<.. � C O✓�
CONTRACTOR
NAME MAIL ADDRESS CITY d STATE LICENSE NO. PHONE
USE OF h'
BUILDING PC- --1 r
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE d I,
3 ; s'oo.civ
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS 3 TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT �6 FIREPLACE ❑ 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
conformance therewith. PERMANENT SHORELINES I
SEASONAL [', FLOODPLAIN LI
Firm
E.D. NO. S.E.P.A. ❑
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be i of rman therewith. MO R VEHICLE PERMIT
� � JAP�lQATION ACC E Y PLANS CHECK BY APP D FOR I A
Owner Date. q—
'LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH
'PLOT PLAN
ADDRESS PERMIT NO. f o
i o
n s
a c
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 r\
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 ARID 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'
L
7)
sv
I/We t:ertify 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 6 STRUCTURE(S) (PRINT) GNATURE OF OWNER(SI OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVEDA-0
DISTRICT AS NOTED DATE `
SHELTON PRTNTIN3