HomeMy WebLinkAboutBLD22143 Mobile Home - BLD Permit / Conditions - 6/13/1988 -000q
Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
Footing: , 7'� 2, 7-T
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 22143 No. Floors Sq Ftg 784
Owner BALDWIN , Brian Tel 275-3899 Date 6-13-88
Address P O Box 4 Belfair Zip
Contractor None
Address Zip
Legal Description Beards Cove Div 6, Lot 14
Direction to project site West down Northshore approx_ 1
mile to Sandhill Rd. Up Sandhill approx. 2/10 mi _ to
Larson Bld.approx. 2/10 mi. Lot on left
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1983 14x56 2 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. /
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER J Q. ^O : 4 aLq-.* 8528 -27 5NS87
DIRECTIONS _
TO JOB SITE ~J� I `w Q IUJ 1 . arl It ' W ,\\
Pw mr CA2$oN vJ uF AP o " Ll o m Lo j N r .
PARCEL LEGAL
NUMBER I�33v`J0ou' DESCR. j5.7- 0vCLot
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
7W�l
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTALSQ.FT. GARAGE 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 SO.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT X SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CER FY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIS ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI EMENTS 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 C FORMANCE THEREWITH, NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X NER DATE X BY_ DATE
FOR OFFICE USE ONLY o
DEPARTMENT YES
PPROVENo DEPARTMENT YES NO
BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERM1T�5h; �
D.O.T. BUILDING / PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
[APEPLICATIONCCEPTED BY PLAN CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
,(�lLc BY L/ff CASH CK MO p .-y
PLOT PLAN
ADDRESSL,,[ I �. QSOf\ 910) PERMIT N0. 4 0
= s
LEGAL t 4;
Loy � ✓
DESCRIPTION LOT BLK ADDITION
SITE AREA / 1,000 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS �7 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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
� s
I
i
i%
I/We certify that the proposed construction will confor to the dimensio"s a uses shown above and that no changes will be made without
first obtaining approval.
1[(el OF OWNERM OF 71TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(3) OR AUTHORIZED REP E3ENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
CT AS NOTED DATE