HomeMy WebLinkAboutBLD28064 Mobile Home - BLD Permit / Conditions - 5/10/1991 Shorelines: PiLubing:
Setback: Mechanics :
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
REmarks:
Footing:
Setback:
Foundation
Walls:
Framing: PERMIT
Fireplace: NjIL!_ & Volp BY EXPIRATION
Wood Stove:
TYPE MOBILE HOME
Permit No. 28064 No. Floors 1 Sq Ftg 750
Owner BROWN, SHARON Tel 884-9884 Date 5-10-91
Address P.O. Box 286 Lake Ba WA ZiP 98349
Contractor Self
Address Zip
Legal Description Lake Limerick div 4 lot 148
Direction to project site ,rn rt off Mason U merick Rd
onto Dartmoor continue on to where intersects with
um ing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement —Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAIL ADDRESS CITY STATE ZIP PHONE
OWNER 9X::�
DIRECTIONS
TO JOB SITE ' �G�
PARCEL LEGAL
NUMBER Y, L _ —(� DESCR. Lip L-t "
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING LCI
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 I TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES BASEM ENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. FI REPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS AFFIDAVIT 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.
X OW DAT /?IX BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION 0 J ✓
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT �Z
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTIONbw ,
/ ✓ — SHORELINE
_ WOODSTOVE
PLUMBING
y _ MECHANICAL
STATE BUILDING FEE , 5
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY j APPROV=S§UANPERMIT VALIDATION `�_ . 4" / TOTAL ((//j�l / . BYCASH CK MO