HomeMy WebLinkAboutBLD28386 Mobile Home - BLD Application - 6/14/1991 Shorelines: Plumbing:
Setback: Mechanics
Special Interior:
Conditions: FINAL:
Mobile Rome:
Smoke Detector:
Remarks
Footing-
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE - - -M0BILE -HOME
Permit No. 28386 No. Floors 1 Sq g980
Owner WHITTIER Tel �75 De 6-1 4-910a
Address p.O. Box 1876, Bel air Zip
Contractor Self Zip
Address
Legal Description B_a o div 8 lot 130
Direction to project site _ Rt on Sandhi] ] left on Tar.gnn
P um ing Mechanic Sewer Wood Stove
Fireplace Deck arage arport
Basement soft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 Ll`�l
427-9670 DATE ISSUED
PERMIT NO. '
ME M ADDRESS CITY ST T ZIP PHONE
OWNER A % � 4 -7,c _
DIRECTIONS I TO JOB SITE
PARCEL LEGAL
NUMBER 1-' DESCR. ar s alVO
NAME MAILADDRESS CITY SSTATE LICENS ZIP PHONE
CONTRACTOR
USE OF
BUILDING m
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE J�
WORK (,�
BEDROOMS DECKS CARPORT �� NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SO.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. (ffla FIREPLACE '� DETACHED ABANDONEDFORAPERIODOF180 DAYS AT ANYTIME AFTER WORK ISCOMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS 1 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 1 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 APPROVA M T BUILDING DEPARTMENT. � APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE / ',2 e-!/ X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
PPROVENo DEPARTMENT YESPPROVENQ BUILDING VALUATION �)
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT zi ,
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
f
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE '
APPLICATION ACCEPTED BY PLANS CHECK BY APPR VE R ISS&NCEPERMIT VALIDATION
q TOTAL
�- --{I BY, CASH CK MO
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME AIL A RES �o CITY&STATE ZIP PHONE
OWNER W
�,/D IS 32 2
DIRECTIONS
TO JOB SITE ev
PARCEL LEGAL
NUMBER DESCR.
Indicate below;.- roperty lines and dimensions.
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.
Fri
r
a
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.
SIGNATURE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE ,
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE