HomeMy WebLinkAboutBLD15597 Final Mobile Home - BLD Permit / Conditions - 7/3/1984 COLUMBETTI, Robert #15597
- 5-29-84
Beards Cove, Div. 5, Lot 64
8651 St. Hwy 3 SW #38
Pt. Orchard, Wash 98366 674-2549
NE 1470 Larson Lake Rd.
Belfair, Wash. 98528 Contractor
None listed
Mobile Home 1983 14x60 2 bdrm.
$15,540.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical :
Roof :
Exterior:
Interior :
Final : '�7
Stop Work:
Mobile Home:
Smoke Detector•
Remarks:
t
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COLUMBETTI, Robert
#15597
Beard's Cove, Div. 59 Lot 64 5-29-84
8651 St. Hwy 3 SW #38
Pt. Orchard, Wash 98366 674-2549
NE 1470 Larson Lake Rd
( Belfair, Wash. 98528
Contractor
None listed
Mobile Home 1983 14x60 2 bdrm.
$15,540.00
IN.
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BUILDING PERMIT APPLICATIOA1
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED %1 — 9- —
PERMIT NO.gn
OWNER NAME MAIL ADDRESS CITY STATE P PHONE
o �$ �' 6r
DIRECTIONS !74l-2S
TO JOB SITE
LEGAL ��e J,tl (❑ SEE ATTACHED SHEET)
DESCR. �Cr(� IV
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING p Mehl lell /
Class of work: ❑ N ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe Tlaole_ Ln
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Valuation of work: $ t— �b C�t� PLAN CHECK FEE PERMIT FEE�O
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT [ ; NOTICE
BATHROOMS TOTAL SO. FT. GARAGE I J
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT t) FIREPLACE ❑ DETACHED
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FO OFFICE USE ONLY
ordinance requirements regulating the work for which
thB permit is issued and all work done will be in
onformance therewith. PERMANENT SHORELINES „A
SEASONAL L; FLOODPLAIN
Firm
E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. 10
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance erewith. MOTOR VEHICLE PERMIT
PLICA ON ACCEPTED Y PLANS CHECK BY APPROVED FOR ISSUANCE
Owner ate
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS C J'� / Le PERMIT NO. f
LEGAL
DESCRIPTION- O LOT Cp $� / )(/�� BLK ADDITION : �u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. O
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 ;,,3
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION A"ID 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.
Z
0 1'
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
i
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.
NAME(31 OF OWNERM OF 31TE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
BMELTON PWNTIN�