HomeMy WebLinkAboutBLD15332 Final Mobile Home - BLD Permit / Conditions - 8/8/1984 -�1
WILLIAMS, Lillian R. #15332
3-30-84
Lake Limerick Div 4, Lot 152
78-4000 Flynn St
Bellingham, Wash 98226 733-1431
1
Dartmore to Ballbrigan to Errigal Place
Contractor
Self
Mobile Home 1970 12x60 2bdrm
$3,600.00
Shorelines: /_4
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior :
Final:,f/• -7 7 5'4
Stop Work:
Remarks:
BUILDING PERMIT APPLICATION
r
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. /-,,5 t
NAM M
ADDRESS CITY 8 STATE19" ZIP ' PHONE
OWNER . & S70 -&
DIRECTIONS
TO JOB SITE U .TI'd 4
P1 y- A C e-
LEGAL '� Or /�� (D SEE ATTACHED SHEET)
DESCR
CONTRACTOR NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
USE OF
BUILDINGlot, �lr' A4 .�
Class of work: rl N W ❑ AD I ION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $�10�� PLAN CHECK FEE PERMIT FE��'�`,5
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT D NOTICE
BATHROOMS_ TOTAL SO. FT. GARAGE []
SEPARATE
CONDITIONING.RE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i ATTACHED OR AIR
TOTAL SQ. FT. FIREPLACE i DETACHED L:
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 am aware of the FOR OFFICE USE ONLY
ordinance re ire the regulating the work for which
the permi Is issued and all work done will be in
conform Ce therewith. PERMANENT SHORELINES
SEASONAL I i FLOODPLAIN , i
Firm E.D. NO. S.E.P.A. f'
By Special Approvals IN OUT YES APPROVED NO
Lic. No.— Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. ,r--�
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in c formance therewith. MOTOR VEHICLE PERMIT
LICATI N ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own ate - Q- BY
f F 14l'i-Izzli) I
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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PLOT PLAN
f
ADDRESS C,ta L PERMIT NO. 0 o
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D O
LEGAL
DESCRIPTION I / LOT BILK 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 Al"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.
Io I S
C INDICATE NORTH IN CIRCLE f vl I GRAPH SQUARES ARE 5' X 5' OR 20'
It
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I/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.
3 a
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NAME(S) OF OWNER(S) OF SI E e STRUCTURE(S) (PRINT) I A URE O WNER(S) O A THOR ca ENTATIVE
DO NOT WRITE BEL W THIS LINE
APPROVED
DISTRICT AS NOTED TE
GHELTON f R:N-1N3