HomeMy WebLinkAboutBLD28582 Mobile Home - BLD Permit / Conditions - 7/12/1991 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:Q<y-"7
Mobile Home:
Smoke Detector:j,4w-)rj iD-l0�
Remarks:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOI,E
Permit No. 28582 No. Floors Sq Ftg 650
Owner Kenneth Lewis Tel Date 12 91
Address E 1931 Mason Lake Dr E Gra.peview Zip9S546
Contractor Same
Address zip
Legal Description IDiv 8 Lot 101)
Direction to pro ect site Northshore Rd to Sand
.,right to NeIarson Blvd , turn L to near end. fNNWF
on L, will see new mail box on
P um ing x Mechanical x Sewer Wood Stove
Fireplace Deck age -7arport
Basement —Loft Other
PUMP SEPTIC TANK
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED r
PERMIT NO.� '
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
F I LEw S E-1 x) LK- P E
DIRECTIONS /
TO JOB SITE S tJIJI L� T ` N'c Lq/,� O LYp f-� D ��}lZ
IENd - I y i NE LARSo,) BL VD oN ;LL Sf i- NEWtrqiL Box o/J
PARCEL LEGAL y
NUMBER DESCR. L O M 9 1Q/ 4r/¢KDS Coal /jk'z 4i-/<
NAME MAIL ADDRESS CITY&STATE ZIP PHONE LICENSE W.
CONTRACTOR S L
USE OF j
BUILDING i'j 0 hw E
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK M,5 v /y1, 140mc /Y z1l'R_Q1t1 /5 . em
V__9�401_Ell) dcl A7&I52, 56 ) l0
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE &.M_SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.9, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
�Sg ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT Ft FIREPLACE IS CARPORT/GARAGE
GARAGE SgFt ATTACHED❑DETACHED 94
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 BUILDING DEPARTMENT. // APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE l0 U XBY _ DATE
FOR OFFICE USE ONLY ,
DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVENO BUILDING VALUATION 0 ly
HEALTH PUBLIC WORKS FEE
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
APPLICATION ACCEPTED BY I PLANS CHECK/ AP OV OR I NCE PERMIT VALIDATION TOTAL
I� �/ CASH CK MO
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DA7;SSUED
PERMIT NC.
NAME MAIL A00RESS C1 TY 3 STATE ZIP PHCNE;
OWNER
CIRECTICNS I
TO J08 SITE N , �£ +C, SA.UC� I 1 I LL - I N f- L--A RSOA) B L l/b f �^
i
c I Ll I V. L05o�J BLUR LIF-Ag S COQL> �1 A LWd 0�61)zgox; QLUD bu L �
PARCEL '
NUMBER LET � OS DIVt�� DESCR I S�_A(z_dS COOL L0-� l O� D( u 6
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.
I ( 1 I I I I I
I s.
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4
I I L17 ( I I I I 11 I 1111
1 I I I 1 1 LEI 1=1 I I LJ I CID
Lof�
1 1 � I-F TT I I I I I I I I L ( I I I I I
I/we non w;:: dirn.ens,cns ani,uses a ove 3^L':hat no cha^g-es-Nil,be ^aCe x;t.,,c:t ti/St obt3ink-.9 aporoval.
S. Garden Craig
the
.. asses
IIaa r
we b,ave recently received a cow► of tax cercificacn for mobile hocm:
movement on your mobile home.
Za order chic we may accurately value you mobile hones, please cooplece
Lhe questions below and return this fora to our office by
Ic is imperative chat this information be provided to prevent a
possible double assessment.
M,oa rLZI Ham DATA
MArr- COL hj P I fi maces. YEARCn
MCIS E KOtiB LCCATICM INFOMIATICH SMIAL
s_ My privxcaly owned Land-
3- If canted or Laased Land who from? MUM DAut'D CALDIUE&L
A M=S J3 -2 -77 . Swcrr & srA= �fa�cG,, w�
C_ Itea L Frope rty Parcel of (cax scacmenc #)
O_ Mailing oam/e and addrezz for owner of mobil* home -
KAlit '`f✓IU KJ y1 �i B ON N I I- S
AMG2=Sr__ jg3 CITY & STA= GP,6pF1iCw
Location address of mobile hooe ,��t31 MJ4Saa%LK.DR.ECITr Cr2/3/JEd�EW
F- Dace mobile home vas placed on present site ( 9 76
C. Purebase Price °%
TYPE OR PSLMT HA ic- !_>o10<v,E
TT�P HONE Nina y;2-� o/�
Courr'icuse Shel[on W�enlrtrttn Oaao a ow..-_ �-rr �e�n