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Home My WebLink AboutBLD25123 Mobile Home - BLD Permit / Conditions - 2/6/1990 TYPE MOBILE HONE 1 Permit No. 25123 No. Floors Sq Ftg 644 Owner ROCHON, Rene G Te137370155 Date 2-6-90 Address 1307 Park Ave #B Bremerton Zip Contractor Bob Pa_ysse Address, 3083 Mason Benson Rd Grapeview Zip Legal Description Beard's Cove Div 8, Lot 48 Direction to project site Northshore Rd from Belfair, turn rt on Larson Lk Rd, go .7 mi.Lot on left side of rd. 781 Larson Lk Rd. tm ing Mechanical Sewer Wood Stove Fireplace Deck Tarage Z�arport Basement ---I�oft Other 1989 1446 2 bdrm Q E2331-5 l ' � BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED omonlo PERMIT NO. AME MAIL ADDRESS CITY&STATE ZIP PHONE OWNER Q e # jI _ eyvlol DIRECTIONS TO JOB SITE Tckxf lV0411 ev Q U >r vi rl,q0 i - Lot is L de rest J. o►✓fie L In i PARCEL LEGAL . NUMBER _ DESCR. ea/is e v! AIL ADDRES?S f�ITY&STATE LICENSE NO. ZIP I[— /PHONE CONTRACTOR NAMEF, »t><r , �! a9, 1YIASCn D'h� d, y y 2,66 USE OF r BUILDING Bk Q (�(' e 1"yyl vl PSI E CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE WORK kvvi � � A( (` I BEDROOMS DECKS CARPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING. NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. I REPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT SHORELINE SEASONAL 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 REGISTR 'ON LAW RCW 18.27,AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIRE ENTS 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 CON ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAIN APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. n X O NE "TE klii,,2 X BY DATE OR OFFICE USE ONLY DEPARTMENT YESPPROVE NO DEPARTMENT YESPPROVEND BUILDING VALUATION IF HEALTH PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING PLAN CHECK ' SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE ,IO U STATESURCHARGE APPLICATIOJACCEPTEDBY PLANSCHECKBY APPR LtTF ISSUANCE PERMIT VALIDATION I)- -4''1% BY I pAj- CASH CK MO TOTAL �"O J PLOW PLAN ADDRESS PERMIT NO. s o LEGAL pta j !S ! '± DESCRIPTION COS J LOT `�I`L/. L 1)T "!ZZ BLK ADDITION 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 c� PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE, AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION AND SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL 5 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' 2 �1 - J 1` v a� �- 1 d `d^ v 1 r� 5 2 17 n 33 � v I/We certify that the proposed construction will conform to the dlmanaiOns and uses shown above and that no changes will be made without first obtaining approval. NAME(A) OF OWNER(S) OF SITE ! STRUCTURE(!) (PRINT) CGINATURE OF OWNER(S) OR AUTHORIZED REP ESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE