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HomeMy WebLinkAboutBLD9825 Final Mobile Home - BLD Permit / Conditions - 1/14/1985 Pignataro, James #9825 (377-6944) 2/23/82 Tract 22, Belfair Manor Mobile Home Contractor; Robin Hood Sales $14,000.00 Shorelines: Setback: Snecial Conditions: Footing: Setback: Foundation Walls: Framing: Firenlace: Tlbod Stove: Plumbinq: mechanical: Roof.: Exterior: Interior: Final: </ Stop ?fork: Mobile Nome_ RemaAr/ks BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 _ DATE ISSUED � �� r8� K �l PERMIT NO. �U OWNER N E MAIL ADD SS TY 8 ST TE ZIP PHONE DIRECTIONS TO JOB SITE - �h LEGAL (El SEE ATTACHED SHEET) DESCR. /Z E MAIL A DRES _ CITY d STATE LICENSE NO. PHONE CONTRACTORUrJ- �LGI USE OF , BUILDING Class of work: NEW &ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ C)p PLAN CHECK FEE PERMIT FEE _ o�G SPECIAL CONDITIONS: BEDROOMS I DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SQ. FT. __ GARAGE [] � ATTACHED iJ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [] OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE I l DETACHED 171 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 FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT I I SHORELINES i 1 SEASONAL [] FLOODPLAIN u Firm E.D. NO. S.E.P.A. [ By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. ,SS OWNERS AFFIDAVIT HEALTH DEPT. 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. L which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. �j q MOTOR VEHICLE PERMIT Owner �Q���/� C- _ Date .� " 3' Odd" APPLICATION ACCEPTED BY /PL/y.St9HECK BY APPROVED FOR ISSUANCE �✓✓ rJ BY PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS PERMIT NO. i o = o n s a o 0 LEGAL DESCRIPTION LOT 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 A"'D 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. ' INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' 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 NAMEISI OF OWNER(S) OF SITE a 3TRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE III DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE 6HELTON PWNTiNi