HomeMy WebLinkAboutBLD11658 Mobile Home - BLD Permit / Conditions - 10/29/1981 Webster, David L. #11658
10/29/81
Beard's Cove; Division 6, Lot 38
Larson Lane to Trouncer, right on Marie's Lane
Mob ile Home Contractor:
None
$24,864.00
BUILDING PERMIT APPLICATION
r MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 a / ¢
DATE ISSUED f ' (1
PERMIT NO. Ns8�
OWNER NAME _ MAIL ADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITE ��Rs'p�(f �,/�✓t/� 7127 `c l
LEGAL p (❑ SEE ATTACHED SHEET)
DESCR. �-�O 'S d �
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING A fAI
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: ,
3�
IV14 AW h Ste' �l
D
Valuation of work: $ 4-111 j6 Veo '
PLAN CHECK FEE PERMIT FEE a
SPECIAL CONDITIONS:: u 1 _4-"�)��, �s g 7 36671
'' �v —
S dt r+�-v►
BEDROOMS {DECKS �—' CARPORT ❑ /J� NOTICE
S BATHROOM (TOTAL SQ. FT._ L GARAGE
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i_1 e; OR AIR CONDITIONING.
TOTAL SQ. FT.�Q1 FIREPLACE C_1 DETACHED
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 ofWashington and I aware of the FOR OFFICE USE ONLY
ordinance requirements
the regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT I l SHORELINES 1-1
SEASONAL41 FLOODPLAIN ❑
Firm
E.D. NO. S.E.P.A. [7
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conforman therewi n ACCEPTED BY MOTOR VEHICLE PERMIT
Owner �� Date/a�7 �/ A LIGATION PLANS CHECK BY APPROVED FOR ISSUANCE
BY
P N CHECK VALIDATION CK. M.O. CASH 'PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. f o
n D
LEGAL
DESCRIPTION LOT y BLK ADDITION
r
SITE AREA � x. / 3$�f' 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-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.
' INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
Vi
(
I
I/We certify that the proposed construction will conform to the dimensicrns and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) bF OWNER(S1 OF SITE a STR CTURE(SI (PRINT) 319NATURE OF OWNER(SI OR AU HURIZED REPRE51ENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED /
DISTRICT AS NOTED DATE
6HELTON PRINTING