HomeMy WebLinkAboutBLD0656 Final Mobile Home - BLD Permit / Conditions - 10/9/1990 Shorelines:Setback Plumbing:
special 11?chanical
Conditions: Interior:
N FINAL:
ii —
Smoke Detect or:
�.;r.
o ing: Remarks:
Setback:
Foundation %'7r�
Walls:
F'rami ng:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit NO. 0656 No. Floors
Owner GREEN, Ethan C � Ftg 1344
Address P o Box g7 `Ie1275-2473 Dete4-26-88
Contractor one Tahuya
N Zip
Address
Iegal Description Beards Cove Div 6, Lot 34 1p
Direction to proj Sl e NE 1021 Larson T I-
MChanic Fireplace D�k t, r WoodStove
Basement Loft Garage Carport
Other _
1985 28x48 3 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED h tl
PERMIT NO. 4`96 �!5
OWNER NAME MAILADDRESS CITYATE ZIP PHONE
5' - S'
DIRECTIONS
TO JOB SITE t f _ 1
r1 GCS��
PARCEL LEGAL n n
NUMBER DESCR. �� � /'Gt
CONTRACTOR NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHO
USE OF ,
BUILDING C E
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE ,
WORK > - GoLdC�t� 7�C`L�G�CL /e4z>r Q
BEDROOMS_ DECKS i,:; CARPORT 1,-t, NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE yL-r. CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. I�y`f FIREPLACE )uJ DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT 1`' SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATION LAW RCW 18,27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN
IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH,NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT,
X WNER C C Ali'p ,< DATE 42/9O X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING 1 (j FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP '- PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS C CK BY /� APPROVED FOR SUANCE PERMIT VALIDATION
�^ LCl z.�" BY X�� CASH CK MO TOTAL el
��f
PLOT PLAN
ADDRESS �� /D�n� /1�iY�� 2/fI PERMIT NO. s
n s
s o
0
LEGAL /
DESCRIPTION y LOT /t/[ar BLK ADDITION u
SITE AREA L 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 AND 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.
0 INDICATE NORTH IN CIRC E GRAPH SQUARES ARE 5' X 5' OR 1"=20'
��
s
41OL4"T
I 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.
AY"
NAME(S) OF OINNER(S) OF SITE & STRUCTURE(!) (PRINT) t��IGNATUR OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE