HomeMy WebLinkAboutBLD15878 Final Mobile Home - BLD Permit / Conditions - 10/22/1984 PERALTA, Daniel #15878
3-24-84
Beard's Cove Div. 8, Lot 53
2105 25th Ave. So.
Seattle, Wash. 98144 325-4984
Belfair Beards cove, turn right at Cemetery, left at NE
Larsen Blvd. , left at Larsen Lake Dr. , on left side.
Contractor
S&S Mobile Home
Mobile Home 1979 14x67 2 bdrm. Hauling
$17,353.00
Shorelines: 1l14
Setback: C
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
FinaI:61 �O
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION -L°
MASON COUNTY 06)
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED f/� 7"
PERMIT NO. A� 7C
OWNER�)az
ME MAIL ADDRESS Itle CITY&STATE ZIP PHONE
r 1 A �g14
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE ATT HED SHEET)�r S(
DESCR. �•�.rd V ]Div ` t
NAME MAIL DDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING M0611-t Q Me
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
97
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS {DECKS CARPORT L' NOTICE
BATHROOMS__ (TOTAL SQ. FT. GARAGE C
ATTACHED I_; LSEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT Li AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE C DETACHED I'
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 OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES
SEASONAL ❑ FLOODPLAIN
Firm
E.D. NO. S.E.P.A. i
By Special Approvals IN OUT YES APPROVED NO
Lic. o. Date ZONING
PLANNING DEPT.
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.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance the ith. MOTOR VEHICLE PERMIT
A LICAT ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own - Date 2 BY
r
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. f ;
A D
2 O
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"ID 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.
1 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
TI QI
1 l �
f
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.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6HELTON PRINTIN3