HomeMy WebLinkAboutBLD20187 Final Mobile Home - BLD Permit / Conditions - 8/18/1988 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL: 777 7
Mobile' Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 20187 No. Floors 1 Sq Ftg 980
Owner LAPINSKI. Anthony Tel 275-4686 Date 5-1-87
Address NE 22581 Hwy 3 Belfair Zip
Contractor None
Address Zip
Legal Description Beard's Cove Div. 5 Lot 68
Direction to project site IjI, S ndhill to Tar�;nn H1--ud-_JJa__
Larson Lake Turn right Go to end of Larson Take T.anP_
Lot is on right
Plumbing c anic wer Wo Stove
Fireplace Deck Garage Carport
Basement Loft Other
1979 14x70 2 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON WASHINGTON 98584
426-5593 DATE ISSUED✓
NT IV - , A3
PERMIT NO.��/
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER R /V- LA i'
DIRECTIONS
TO JOB SITE -
PARCEL LEGAL
NUMBER DESCR. fig
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASSOF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK
/ � 7z, zze
BEDROOMS :2, DECKS CARPORT NOTICE
SEPARATE 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. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE'
SEASON L
OWNE SAFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
EQUIR MENTS 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
CO FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
TAI NG APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
O NE
R Z DATE�- S 7 XBY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
SPPROVENo DEPARTMENT YES NO
BUILDING VALUATION
HEALTH U PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT L f�
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP _ 3 PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS C /K BY APPROVED FOR ISSUANCE PERMIT VALIDATION '
C� ' "LL ,>C�D BY,ee�� CASH CK MO TOTAL
PLOT PLAN
ADDRESS -2 2- �/ 2 , "
PERMIT NO. F a
= o
LEGAL
�GA2AS G a
DESCRIPTION C J L LOT O �( C. BLK ADDITION u
SITE AREA 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 CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
All
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.
NAMES) OF Of
NER(S) OF SITE STRUCTURES) (PRINT) IGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE