HomeMy WebLinkAboutBLD10401 Final Mobile Home - BLD Permit / Conditions - 4/28/1981 DAWSON, Donald K. #10401
04-16-81
Beards Cove, Div. 5 lot 53
Lot 53 Div 5, Beards Cove
Contractor
Yoest Homes, Inc.
Mobile Home
MR$11,500.00
�" ®� ��C �
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
,�a vlat Gl�Sa N S7 R7L �2, I3,-r 2 �/ 'i"p-5,29
DIRECTIONS L TO JOB SITE &—,GL 5 COV e �j p, S SOT S_3
LEGAL // (❑ SEE ATTACHED SHEET)
DESCR. LOT 5_3 �.r/� S- �ea{rds CDU to
A E MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
3S�PS� _ oes
USE OF vv11//II / r ,CL 373
BUILDING /��O6i< P `j V 'e" 'e
Class of work: �(NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
7LQ l /�o 4
x S6
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:vQ r;g n C -a<o r `QG1�5 — Yt07� 7�l C�,t'CC�C� -rCro�L _T > �n
BEDROOMS I DECKS / CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT.-_;!�_ GARAGE ❑
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIESBASEMENT ❑ ATTACHED ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ IDETACHED ❑
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 ❑
SEASONAL ❑ 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.
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
emu , ✓� �/ L ATION ACCEPTED BY PLANS CHECK BY AP VED F RO R 1 UANCE
Owner Date.
LC.�L
P AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. G o
= v
n s
LEGAL
n
DESCRIPTION LOT 53 BILK ADDITION
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft.
INSTRUCTIONS TO APPLICANT
-V ?t"
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 +�v
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POW
TION THEREOF.
1�
n
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
Q
F(21/
1
no changes ill be made without
' n ill conform to the dimensions and uses shown above and that cha g w
I/We certify that the proposed construction w
Y P p�
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED L
DISTRICT AS NOTED DATE /,L S�
r/
`v
6HELTON PRTNTIN3