HomeMy WebLinkAboutBLD0159 Mobile Home - BLD Permit / Conditions - 5/15/1984 REES, Robert #0159
FOLEY, Betty Jo 5-15-84
Beards Cove, Div 6, Lot 43
P.O.Box 443
Belfair, Wash 98528 275-5172
Contractor
Self
NE 50 Salty Dr.
Beards Cove
Mobile Home 1978 14x66
$17,094.00
Shorelines:
Setback-
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace•
Wood Stove:
Plumbing:
Mechanical :
Roof :
Exterior:
Interior:
F Ina l •
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
PERMIT
Y nP
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
o r QcE5 .ice a, PDT a ,z�S
DIRECTIONS
TO JOB SITE N6
LEGAL / (❑ SEE ATTACHED SHEET)
DESCR. o y 3 O-e J 6 Be
Rd s Gv� `v
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR SA
S 'F
USE OF % 1
BUILDING
Class of work: ❑ NEW ❑ A DITION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE
Describe work:
is/x a
Valuation of work: $ f� d� PLAN CHECK FEE PERMIT FEE
6 117/ca5
SPECIAL CONDITIONS: y '
BEDROOMS�� I DECKS CARPORT [, NOTICE
BATHROOMS TOTAL SO. FT. GARAGE I]
ATTACHED L- SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L OR AIR CONDITIONING.
TOTAL SO. FT FIREPLACE I_] 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.
th ' State of Washington and I the
aware of the FOR OFFICE USE ONLY
or finance requirements regulating the work for which
t permit is issued and all work done will be in
nformance therewith. PERMANENT I 1 SHORELINES I i
SEASONAL I FLOODPLAIN i
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
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
APPLICATION ACCEPTED BY PLA s ECK BY PPROVED FOR ISSUANCE
Owner Date ` BY4 f
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. f o
z
a o
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
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'
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 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6H '
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ON
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