HomeMy WebLinkAboutBLD14778 Final Mobile Home - BLD Permit / Conditions - 4/24/1984 WANALISTA, John #14778
10-10-83
Beards Cove, Division 5, Lot 36
Approx. 2 miles out on No. Shore Rd. , take right on
Sand Hill Rd. , go 3/4 mile, turn left, go 3/4 mile
to Scooner Loop
Contractor
Self 275-3033
Mobile Home
$13,320.00
Shorelines: 114
Setback: C/L
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof :
Exterior:
Interior :
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY ' - .
P.O. Box 186 Shelton, Washington 98584
426-5593 0
DATE ISSUED 1 _ —t O
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
ljoh u L s Z 0 W i L c 1441 RD. 04 N / 2 17S=-3
DIRECTIONS (� m �p /' T / do Aw
TO JOB SITE V RDS l d V Div APT 3 fo 4 PRO X d/%1 4eS 007
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. AMC C e 16A.7 0A1 MAP X1110, 6o `YY Ili le-Al 670 3 /YI le 1U SCa lNP
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF JJ L f -T
BUILDING c�j )Cp /O ST®RE- `� ReRolk V oea GnmFS'
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR KMOVE ❑ REMOVE
Describe work:
ePLO9 CE t QAJ COI C(ZeT'60 GLOCk r0 Grp T o,v 19FRW tit o VE
EOM 333o NWY -00 Wbel!?,4? Mobil U-SED AS BUSim S
/ aoo� la x /v0
`�. 41 ((;S) I9:1. .So
Valuation of work: $ i 0
0 PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS::
BEDROOMS DECKS _ CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES ATTACHED [_]_L BASEMENT L] OR AIR CONDITIONING.
TOTAL SO. FT.-72-0— FIREPLACE L1 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 FORA PERIOD OF 180 DAYS AT ANYTIME 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 1 1 SHORELINES
SEASONAL i I FLOODPLAIN
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. Q Q
PUBLIC WORKS
I certXtor
hat I am exempt from the requirements of the FIRE MARSHAL
contr registration law RCW 18.27, and am aware
of a Mason County ordinance requirements for BUILDING DEPT. Q io
ich this permit is issued and that all work done will ROAD ACCESS
e in conformance therewith. MOTOR•VEHICLE PERMIT
A LICATIO CC T D Y PLANS CHECK BY APPROVED OR ISSUANCE
Xwn r —Date . D
1 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. I ° `
4 °
i a
n `>
LEGAL n
DESCRIPTION LOT BLK ADDITION u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. Q
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"ID 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.
f
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' V
i
W
W A r R
1110
PA RK i rul er- L
A PC7 �.
P -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.
i
r
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIG URE OF OWNER(S) OR AUTHORIZEDREPRESENTATIVE
DO NOT WRITE BELO HIS LINE
APPROVED
DISTRICT AS NOTED DATE t �>
SHELTON PRINTIN3