HomeMy WebLinkAboutBLD23585 Mobile Home - BLD Permit / Conditions - 4/21/1989 5 CSC
Shorelines: Plumbing:
Setback: Mechanica
Special Interior: _
Conditions: FINAL:
Mobile--:
Smoke Detector:
Remarks: rn
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 23585 No, Floors Sq Ftg
784
Owner MARTIN, Melvin_ Tel______ Date 4-221-89�
Address P 0 Box 2503 Si1v rdale Zip
Contractor one Z
Address p
Legal Description Beard's Cove Div 6 lot 19
Direction to project site Sandhi11 Rd to I �rson Blvd_
left on Santa aria to 3rd lot on 12ft
um ingcan ca sewer Stove
Fireplace Deck arage �a port
Basement -,oft Other
1981 14x56 2 bdrm
a
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.'-=23
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER s, Q
DIRECTIONS
TO JOB SITE -cAAjd f4-1114
C , 42
PARCEL _ LEGAL
NUMBER 3 0 DESCR. LG7'' !1 +L (� L .
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK 4
lo?l /4I X �J
BEDROOMS DECKS CARPORT r" NOTICE
/ i+ PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.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 SQ.FT. 7jj� 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 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
REQUIREM 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 ININ CONFPTS
MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI APPROVAL FROM THE BUIL�DIIN,(GDEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X O EFY/�IlGw�a" DATE /d ' �/ X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
SPPROVE NO DEPARTMENT YES NO BUILDING VALUATION
..-
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDINGS PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP -3 PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE -U
STATESURCHARGE ,
APP (CATION ACCEPTED BY PLANS CH CK BY APPROVED FOR IS ANCE FPERMITVALIDAT'ION
BY �` H CK MO TOTAL �/3, ��
PLOT PLAN
ADDRESS lb / I Z4A ' &4,� PERMIT NO. f 8
s o
0
LEGAL '
DESCRIPTION LOT `�' BLK ADDITION
M
\ 1
SITE AREA /4 2 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.
ref
�l
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
I
Iy
EIE ET
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.
1ME(!1 OF OWNER !) OF SITE a lTRUC UREI ) (PAIN TI SIGNATURE OF OWNER(!) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
71CT AS NOTED DATE