HomeMy WebLinkAboutBLD29930 Final Mobile Home - BLD Permit / Conditions - 3/24/1992 horelines: Plum mg:
ietback: Mechanical:
pecial Interior:
:onditions: FinahoKli , Eq 192
Mobile Home:
Smoke Detector:M a4
Remarks:
looting:
etback: -A-J' pg-'tA 3 ze-49v-
11 oundation
Valls:
Taming-
'ireplace:
Voodstove:
%REA: #1 - DON FAWVER TYPE: MOBILE
)wner: LAPINSKI, ANTHONYTel: 275-4686 Date: 02-11-92
4.ddress: NE 22581 HWY 3, BELFAIR
:'ermit #: 29930 Floors: 1 Sq Ft: 784
'ontractor: SELF
.'hone:
..,egal Description: BEARDS COVE, LOT 49 DIV 6
')irection to job site: NORTH SHORE TO LARSON BLVD TO
.:APT HOOK, LEFT, THIRD LOT IN
Plumbing Mechanical Woodstove
!'fireplace Deck Garage
;:arport Basement Loft
;;onditions: MINIMUM 5 FT SIDE YARD SETBACK
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
1JQ
427-9670 DATE ISSUED l6
PERMIT NO.
OWNER AM MAIL AD PRESS CITY&STATE ZIP PHONE
8 - 3 sax 6 8
DIRECTIONS
TO JOB SITE
PARCEL LEGAL V Q
NUMBER DESCR. jaZ � # 1 �'
CONTRACTOR NAME MAIL ADDRESS CITY&STATE ZIP PIADNE LICENSE NO.
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE y�-
WORK
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
g ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED U DETACHED❑
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 APPROVAL FROM THE BUILDII G D ARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER , DATE _ X BY — _ DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
FOR STORAGE ONLY. NO ELECTRICAL, WATER SHORELINE
OR SEWER TO BE HOOKED U.P. NO OCCUPANCY. WOODSTOVE
)nr
PLUMBING
�
MECHANICAL
STATE BUILDING FEE
APPLICATIO CCEPTED BY PLANS CHECK BY AP ROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL
I BY CASH CK MO
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
� I
PERMIT NO. ::!! `1
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER Iq "' o1- -114 , luS Q.51 7`5' 8
DIRECTIONS
TO JOB SITE
PARCEL FDE
L
T �7
NUMBER R. vG (.BU-e (O Cli
CONTRACTOR NAME MAIL ADDRESS CITY&STATE ZIP PHMW LICENSE NO.
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
WORK DESCRIBE
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE,- ', SgFt STORIES SHORELINE CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
q SEASONAL RES.❑ ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED,
CARPORT SgFt FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED O DETACHED❑
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 APPROVAL FRO THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER u DATE _ X BY DATE
FOR OFFICE USE ONLY
APPROVED APPROVED
DEPARTMENT YES No DEPARTMENT YES No BUILDING VALUATION ��
HEALTH PUBLIC WORKS FEE
PLANNING 1 FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP � � PRE-INSPECTION
Jj II SHORELINE
rovr✓ R S it l4� (ft✓1 C c7( ft7Jf� a WOODSTOVE
PLUMBING
MECHANICAL _
STATE BUILDING FEE
APPLICAJION ACCEPTED BY PLA CHECK BY APP. D F ISSUA PERMIT VALIDATION J
' L/ TOTAL
1 BY SH CK MO
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
F.O. ocx 186 SHE1 TON, WASHING TON C-S54-34
4�7-::6?n
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illE�s�� _�,�.� � ,��ate✓
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1017
to
O E?semen,s and rcads.
O Septic, drainfield and reserve area, or s2wer.
O Septic tank and drainfield settack dis,ances from fcundaticns.
O Leztien of proposed cons,ruction on propert .
O building I septic sys,ern set5ack distances from all prcperty fines easer„erit;.
Indicate Nor:h O Well and water fire.
O SaftWater, lakes, rivers, sti ean7s, wetlands, dfa:n�ge. -
(n Circle Q At-ach Copy of septic sys,2rm"as built'or Septic permit apprcval.
O indicate tepagraphy arc File of property and structure on reverse side.
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