HomeMy WebLinkAboutBLD15711 Final Mobile Home - BLD Permit / Conditions - 7/26/1984 POLLARD, Roy #15711
6-21-84
Beard's Cove Div. 8, LOt 30
Belfair, North Shore to Beard's Cove, corner NE Saber
Drive and Capt. Hook
NE 131 Pine Tree Place
Tahuya, Wash 98588 275-3022 Contractor
Hunt's Mobile
Homes
Mobile Home 1984 24x56 3 bdrms.
$24,864.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:—"
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: (g/�7 5 L En T
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
PLOT PLAN
ADDRESS 13 ' /Q /110, Gc M�J ,,fXPERMITN0.
0 0
f a
o
LEGAL
DESCRIPTION Dj O F LOT G BLK ADDITION u
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS T L 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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
I
o
J
fz-
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 OWNER(3) OF 31TE 6 STRUCTURF(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTING
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER MAIL ADDRESS CITY&STATE ZIP PHONE
o4 I OnLC.Q
DIRECTIONS IfQQ / � �1
TO JOB SITE L.F'/4/lam A n+S/ /Je�4,eD5 �UG C-!J' �4 �R t'��G A)f SA'd&/L 0 Z,
LEGAL �j (❑ SEE ATTACHED SHEET) ` T'/
DESCR. &0T 3 0D/U O Ig&A-/L-OS &,V-e—
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
vN o 5 00
USE OF /`U/�&
BUILDING G•
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe ork:
xsh oz4 -
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT LJ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE ',-
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING. VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I I DETACHED L
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 certif/ef
m a currently registered contractor in WORK IS COMMENCED.
the Stashington and I th aware of theFO OFFICE USE ONLY
ordinanments regulating the work for which
the p mit is issued and all work done will be in
conf rmance therewith. PERMANENT SHORELINES
SEASONAL 1 1 FLOODPLAIN I 1
Fir
E.D. NO. S.E.P.A. I1
By Special Approvals IN OUT YES APPROVED NO
Lie. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
1 certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conforman with. MOTOR VEHICLE PERMIT
//__ A LICATly ACCEPTED BY PLANS CHECK BY V D FOR ISSUANCE
I w Date. (D `y/ Q l
{-C BY• +(^L�Z
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH