HomeMy WebLinkAboutBLD21355 Final Mobile Home - BLD Permit / Conditions - 2/3/1988 Shorelines: Plumbjgg:
Setback: Mechanica
Special Interior.-
Conditions: FINAL:,!I ,
Mobile ome:
Smoke Detector:
ootlng: Remarks:_
Setback:
�7
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 21355 No. Floors Sq Ftg 924
Owner JACOB, Robert E Te1426-7532 Date 12-25-87
Address E 231 Peebles -Shelton-
Con tr None
Address Zip
Legal Description Lake Limerick Div 4 Lot 99
Direction to project site 1st right past Mini Mart,
follow Dartmore Dr to Fissl double wide. Mobile is on
next lot.
Plumbing Mechanical Sewer Wood Stove
Fire place Deck Garage Carport
Basement Loft Other
1982 14x66 3 bdrm
Q,C'D��'�C� I4-�� Ca�BZ►oC� - C�58 �t
�I O
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 l 7
426-5593 DATE ISSUED
66) gq PERMIT NO�A 3
s
NAME MAIL ADDRESS CITY&STAT ZIP PHONE
OWNER
DIRECTIONS
TO JOB SITE ,�J�Sfe /�� � r2C�►cv �u� Sxc- 7t� vQt� L�'/ tl�
�. �, j Me F 3�3G
PARCEL - LEGAL 1 �
NUMBER G _ � DESCR. Z.ltf �/ �/'/� 02
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF �yy�
BUILDING �/yip a e
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK
BEDROOMS_ DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS Z- ' TOTALSQ.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 SQ.FT. %� FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNJFH
FFIDAVIT CONTRACTORS AFFIDAVIT
I CERTAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIRS 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 COANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OW - ATE 11' D X BY DATE
FOR OFFICE USE ONLY
DEP MENT YES APPROVEDJO DEPARTMENT YEAPPROVED 0 BUILDING VALUATION l
HEAL H PUBLIC WORKS FEE
PLANNING ympFIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP - PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY; P CH BY OR SU PERMIT VALIDATION
Y ASH CK MO TOTAL
PLOT RLAN
!^ (n^• j ' L
ADDRESS � XL �• � -� PERMIT NO os o
z s
LEGAL 12
DESCRIPTION hi 0 LOT I BILK ADDITION
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 9 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 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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
4
'4
I/We certify that the proposed construction will conform to the dimansidns and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SIT a STRUCTUREM (PRI ) IGNATURE OF OWN R(e) OR AU HORIZED REPRESENTATIVE
O NO RITE ELOW THIS LINE
PRO ED
DISTRIC a �L '' ^ SNO D DATE