HomeMy WebLinkAboutBLD10425 Mobile Home - BLD Permit / Conditions - 4/20/1981 HATLEM, Harry N. #10425
04-20-81
Beards Cove
Lot 60, Div. 8, Beverly Lane, Beards Cove, Belfair
Contractor
Lin Tucker
Mobile Home
$17,760.00
{ BUILDING PERMIT APPLICATION
• MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426 5593 ^-1
DATE ISSUED c� r
PERMIT NO.
OWNER NAME M?ADDRESS CITY 8 STATE ZIP PHONE
-�
DIRECTIONS
TO JOB SITE
LEGAL t ��L�H Q (❑ SEE ATTACHED SHEET)
DESCR. 0
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
CONTRACTOR rlC II i S W A a/4t
USE OF
BUILDING es; 0 CA)C C'.-
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
D 3 Ird 41(1/R Se 43A S jr e4l X
Valuation of work: $ / PLAN CHECK FE PERMI�EE( /
C f
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS_ TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIESBASEMENT Li ATTACHED AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE ❑ DETACHED ❑ 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 USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES I
SEASONAL ❑ FLOODPLAIN
Firm
E.D. NO. S.E.P.A. C1
By Special Approvals IN OUT YES APPROVED NO
Lic. No. 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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in c nformance therewith. MOTOR VEHICLE PERMIT
L ATION ACCEPTED BY PLANS CHECK BY PROVED F ISSUANCE
Owner Date .
P AN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
Gip /
ADDRESS '�� �X �37� dR7—OiRC�/I,eo, W4 !a `3�r PERMIT NO. f
o
a o
0
LEGAL n` PHKr�'s bev, y
DESCRIPTION LOT �� ()%�f i Ct�✓� BLK ADDITION u
ve d Folk �Vrtj'
-
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"'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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
IIWe 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 OW ER(S) OF SITE Ili STRUCTURE(S) (PRINT) 31G AT RE OF NER(S OR HO D R P SEN TATIVE
DO NOT WRITE BELOW T S LINE
APPROVED
DISTRICT AS NOTED DATE
6HELTON PRINTING