HomeMy WebLinkAboutBLD14342 Final Mobile Home - BLD Permit / Conditions - 8/8/1983 Thaves, Terry #14342
275-6151 7/8/83
Beard's Cove, #5, Lot 16
Sand Hill Road, left onto Larson Lake Blvd, right on
Schooner Loop, right on Schooner Place
Mobile Home Contractor:
24'x56' , 1983 None Listed
$24,864.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior :
Stop Work:
Mobile Home:
Smoke Detector:
Remarks: 6---j
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 _Q 2
DATE ISSUED ` UJ�
PERMIT NO. / 113[1
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER ,/`r r r S IV1 r -Zfj— Z 1SL
DIRECTIONS
TO JOB SITE Q I R L
LEGAL / (❑ SEE TTA ED HEET)
DESCR. 3
AME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ p/ PLAN CHECK FEE PERMIT FEWyS,, �
SPECIAL CONDITIONS:
BEDROOMS_NJ — DECKS---- CARPORT [, NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE I I
ATTACHED l_' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L; OR AIR CONDITIONING.
TOTAL SO. FT. 3 FIREPLACE C] 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 7
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conformance therewith. PERMANENT SHORELINES
SEASONAL [ ! FLOODPLAIN ! l
Firm E.D. NO. _ S.E.P.A. L I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT
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 in conformance therewith. MOTOR VEHICLE PERMIT
LICATION ACC PTED BY PLANS CHECK BY APPROVED OR ISSUANCE
Owner Datej— k - L3
PL CHECK VALIDATION CK. M.O. CASH PER VT VALIDATION CV. M.O. CASH
1 -
PLOT PLAN
ADDRESS PERMIT NO. F o
ICI D
2 O
LEGAL a
DESCRIPTION LOT BILK ADDITION u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILGS�c 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 GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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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 & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3