HomeMy WebLinkAboutBLD21641 Final Mobile Home - BLD Permit / Conditions - 4/12/1988 Shorelines: rt/,4 Plumbing:
Setback: Aiechanica :
Special Interior:
Conditions: FINAL:,,KY (
Abbile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing-
Fireplace:
Wood Stove:
TypE MOBILE HOME
PL-tmit 1,b, 21641 No. Floors Sq Ftg 924
Owner GREEN, Ethan C. Te1275-2473 Date 3-10-88
Address P o Box 87 Tahuya Zip
Contractor None
Address Zip
Legal Description Beard's cove Div 8, Lot 46
Direction to ro'e ct site P ] Larson Rd. , left on Saber, left
on Santa Maria. Lot on left
Phinbing YlechanicaL Sewer Wood Stove
Fireplace Deck age sport
Basement Loft Other
1984 14x66 2 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 /J
427-9670 DATE ISSUED e'�`
PERMIT NO.- )
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
G o aLV= F- 5- 8 '7} 73
DIRECTIONS
TO JOB SITE _ L LZ2
PARCEL LEGAL
N U M B E R1,'9 3_ C`f `�' Sr^ DESCR. .U.t�J ✓Q �,c �y� r
CONTRACTOR NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK I✓Ci .� �"i 7�LGts�,�.
BEDROOMS DECKS CARPORT "i-1.r� NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE --lln� CONDITIONING.
NO.OF STORIES BASEMENT -k-<,) 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 SQ.FT. FIREPLACE X0 DETACHED - ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE - Z
SEASONAL
OWNERSAFF AVIT CONTRACTORS AFFIDAVIT
I CERTIFY T I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRATI LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREM TS 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 CONF MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINI APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
NER . ►� ,/0� DATE / /�d X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO /
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP -3 PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS C CK BY APPROVED FOR I UANCE PERMIT VALIDATION
TOTAL
>- � BY /.7 CASH CK MO
PLOT PLAN
ADDRESS L 7-�c -w L�.C/�LC�J�. - PERMIT NO. 0
10
P 1
' °o
LEGAL
DESCRIPTION LOT y - BLK ADDITION
SITE AREA 9161,;L 5_ Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 1 `f 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.) Z
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 AND 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.
f�
0
INDICATE NC RTH IN CIRCLE 7 GRAPH SQUARE S ARE 5' X 5' OR 1"=20'
s� n
4
1
I/We certify that the proposed construction will conform tQ the dimensions and uses shown above and that 6o.rll�nyes will be made without
li
first obtaining approval.
-�Z lct u -. � nw a,
�=7-i�AYN C EEiJ
NAME(a) OF OWNER(!) OF 31TE a STRUCTURE(a) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE