HomeMy WebLinkAboutBLD20983 Final Mobile Home - BLD Permit / Conditions - 11/4/1989 Shorelines: N,,� Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobil Ikme
Smoke Detector:
Remarks:
Foot erg
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 20983 No. Floors Sq Ftg 1248
Owner JACOB, Robert E Tel 426-7532 Date 9-28-87
Address E 2 1 Peebles Ct Shelton Zip
Contractor None
Address
Legal Description Lake Limerick Div 4 Lot 98ip
Direction to project Site E 310 Dartmoor Dr.
P um ing Mechanical ewer Love
Fireplace Deck Garage Carport
Basement Loft Other
1979 24x52 2 bdrm
1
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT NO:�(" �O
NAME MAIL ADDRESS / CITY&STATE ZIP PHONE
OWNER Ar,C / ,4 i31e5 ef/ 51ic�1`ow �StJ"�r5� �zG-'S 3
DIRECTIONS TO JOB SITE �3/C� �� �-T/YaL�67
PARCEL LEGAL
NUMBER 3a� 7 DESCR. L y
CONTRACTOR NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WOOK
DESCRIBE
WORK
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
Q� 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 ANYTIME AFTER WORK IS COMMENCED.
PERMANENT YC5 SHORELINEt�
SEASONAL
OWNERSAFFIDAVIT 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
REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
�PVVNER �TATE t' X BY DATE
= FOR OFFICE USE ONLY
APPROVED APPROVED Q
DEPA TMENT YES No DEPARTMENT YES No BUILDING VALUATION r
HEAL H C 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 j o}
STATE SURCHARGE
APPLICATION ACCEPTE HEC AP V D F I CE PERMIT VALIDATION 7y� �
A CASH CK MO TOTAL
-- -- ------PLOT PLAN
/ADDRESS �" +^O� / / �1�/C> C S// /' PERMIT NO. y o
= s
LEGAL
/ n s
DESCRIPTIONv LOT l �� BLK ADDITION
SITE AREA Sq. Ft. �REA OF SIT C PIED BY BUILDING Sq. Ft.
INSTRUCTIONS TO APPLIC NT — —----
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'
�1
_ J
II/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(a) OF SITE • STRUCTURE(!) (PR NT1 I ATUR F OWNE OR UTM RIZED qEP ElEN TA TIVE
DO T W TE BELOW THIS LINE
RID D
DISTRICT NO ED DATE 7a