HomeMy WebLinkAboutBLD0128 Final Mobile Home - BLD Permit / Conditions - 3/22/1984 JOHNSON, Steve #0128
• 3-6-84
Beard's Cove Div. 5 Lot 38
N. E. 701 Mission Rd.
Belfair, Wash. 275-6734
Beard's Cove - Schooner Crt. Contractor
Self
Mobile Home 14 x 70 1983
$18,130.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing: ,
Fireplace:
Wood Stove: _
Plumbing: '
Mechanical:
Roof:
Exterior :
Interior :
Final: X4,1
Stop Work:
Mobile Home:
Smoke Detector :
Remarks:
BUILDING PERMIT-APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 /
DATEISSUED C
PERMIT NO.
AME MAIL ADDR€SS CITY&STATE / SIP/ PHONE
OWNER
DIRECTI S
TO JOB SITE
LEGAL (❑ SEE ATTACH E T)
DESCR. � — 3
N CONTRACTOR MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OFF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ (:!i PLAN CHECK FEE PERMIT FEE �2_5"
W__/3 C11 /lam
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT Ll NOTICE
BATHROOMS TOTAL SO. FT. GARAGE []
ATTACHED L] LSEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L; CONDITIONING.
TOTAL SO. FT.2&P FIREPLACE IDETACHED 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
/the
rtify that I am a currently registered contractor in WORK IS COMMENCED.
State of Washington and I the
aware of the FOR OFFICE USE ONLY
nance requirements regulating the work for which
permit is issued and all work done will be in
ormance therewith. PERMANENT SHORELINESSEASONALi1 FLOODPLAIN LI
E.D. NO. S.E.P.A. L'
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 C ordinance requirements for
whWi�n �for
per is is ed and that all work done will ROAD ACCESS
ance t rewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CK BY APPROVED FOR ISSUANCE
Owner Date, ,� /� Bv�,�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS 7C� GI�i S�( �. �d ��.L' PERMIT NO O/ � o
= a
n D
A O
LEGAL
c" N
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"'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'
r
�.
i
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.
NAMES) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3