HomeMy WebLinkAboutBLD13265 Mobile Home - BLD Permit / Conditions - 11/12/1982 Burdick, Harry R. #13265
364-4936, Seattle 11/12/82
Lake Limerick, Division 4, Lot 114
Right on Dartmoor, left on Balbriggen, lot on left.
Mobile Home Contractor..
14'x56' , 1983 Sun Mobile Homes
$13,468.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:n/C
Smoke Detector'
Remarks:
'S
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. &d
OWNER NAME \ UDC IJ(�MAIL ADDRESS N� L CITY ?,A_-f e W q tl �61
ZIP
DIRECTIONS nn !K� 1J �^ - I / C/ n , I
TO JOB SITE L_Pe� Lt�f�2(Ctc_ I VI S/o � �/ /L &(.Qjej�`IN
LEGAL J� (E] SEE ATTACHED SHEET)
DESCR. Af
NAME MAIL ADDRESS CITY&STATE L ENSE NO. PHONE
CONTRACTOR u• f �J es 4 _ �CJO
USE OF N • / � /
BUILDING Ord 2 s (cl atl C 2—
Class of work: EI NEW ❑ AD61TION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE
Describe work:
move- rmo6, oYvA e -4p 1p4 rA ea lev
✓/q X s-& ChB rA i o orr C
Valuation of work: $ PLAN CHECK FEE PERMIT F%
/3 q6 S-. o v tea.a s
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT Ll NOTICE
BATHROOMS TOTAL SO FT. GARAGE LJ
ATTACHED 1' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L: OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE [ DETACHED LI
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 rn
conformance therewith. PERMANENT SHORELINES A
SEASONAL FLOODPLAIN i i
Firm E.D. NO. S.E.P.A. 11
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 = �2 42
which this permit is issued and that all work done will ROAD ACCESS
be i conformance t rewit MOTOR VEHICLE PERMIT
/ 4,1fl� (CATION ACCEPT D_BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner to . 1�
PL CHECK VALIDATION CK. M.O. CASH RMIT VALIDATION M.O.
CASH
PLOT PLAN
ADDRESS PERMIT NO. o
Zv
n >
a o
0
LEGAL
DESCRIPTION LOT ( BLK ADDITION u
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-ID 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 r GRAPH SQUARES ARE 5' X 5' OR 1"=20'
Iw-
al
r
r
i
9
I/We certify that the proposed constru ' sl nform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED � _? DATE
DISTRICT AS NOTED
SHELTON PRINTING