HomeMy WebLinkAboutBLD28372 Mobile Home - BLD Permit / Conditions - 6/13/1991 Ll
Shorelines: Plumbing:
Setback: Mechanica :
Special Interior:
Conditions: FINAL:
Mobile Hone:
Smoke Detector:
Remarks
0o 1ng:&La vA
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE - -MOBIE EOME _ - -
Permit No. 28372 No. Floors 1 Sq g924
Te �7 - 73Dae h-1 -A1R Owner WEL E
Address P.O. Box 125 Bel air Zip
Contractor el
Address Zip
Legal Description 29 23 1 Tr 6 SW SF
Direction to project site RPl fai r ltrPPt hpt .7PPn
1:�jgP t Sound National Rank and ' I nppi ng C Pn tPY �rrj �1_ar A
un ing ec anica nn left Sewer Wood Stove
Fireplace Deck arage arport
Basement soft Other
MOBILE IS TO BE OCCUPIED BY IMMEDIATE FAMILY MEMBERS
ONLY. SET UP MUST MEET Al- REQUIRED SETBACKS
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED - 1 1
PERMIT NO.
NAME MAIL ADDR CI Si E ZIP PHONE
OWNER Ltq A 1. fO &.-xIGb CITY
eLLe ,� d
DIRECTIONS
L� L
TO JOB SITE Be � � �1"�zet- /+-1 e- L,f i�.)�'ew r a e f & A .f Al
PARCEL LEGAL
NUMBER 3 DESCR. S�
CONTRACTOR NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. ZIP PHONE
USE OF
BUILDING �D1.(1�_a'� � Y�
CLASS OF WORK NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCR
WORK IBE m 6ve I N
Ob
BEDROOMS_ DECKS CARP NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. lots GARAGE CONDITIONING.
NO.OF STORI ES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALSQ.FT.�/ " FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT y 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 APPR AL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
YOWNE, `� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT Y SPPROVEDJO DEPARTMENT YEAPPROVED'O BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
rl MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY AP O FOR I S ANCE PERMIT VALIDATION
TOTAL
CASH CK MO
CO
/ a4 n11 4-
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BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
_ PERMIT NO.
NAME AIL ADDRESS CITY&STATE ZIP PHONE
OWNER Vl; LC r Po l3c,� I�2 v &VA M6. 4 ,7's--,77:3
DIRECTIONS 7 G
TO JOB SITE EILI=f}I f2 — /�iG (�K q� L
PARCEL LEGAL
NUMBER �3� �� DESCR.
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
O Location of proposed construction on property.
O Building &septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.
O Attach copy of septic system as built or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
'�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.
V
SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT W.RIZE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
I