HomeMy WebLinkAboutBLD12558 Cancelled Mobile Home - BLD Permit / Conditions - 6/10/1982 Weston, Susan K. #12558
382-3293, Seattle-days 6/10/82
542-7780, Seattle-home
Lake Limerick, Division 4, Lot 146
Corner of Dartmoor and Errigal
Mobile Home Contractor:
40'x20' , 1968 Charlies Home CentEl
$10,000.00 Shoreline Exemtpiorl'
J
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fi-replace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:
Remarks:
PERMIT
nATE BY
' BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
a l onJ �3 c�� c 61 14 F,61,77 Az3.2y
DIRECTIONS 401� J-Y.2 77
TO JOB SITE
FD
GAL / (0 SEE ATTACHED SHEET)
SCR. Lk L, �/i �7J cvf S�6
CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
�
USE OF /
BUILDING ��c�r,e-�i On c/ Ud c c. `D�✓ /BPS���n c `z
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION C REPAIR ❑ MOVE [I REMOVE
Describe work: /
/,r /Ll57-7'- C-
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS _ CARPORT L_I NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE L]
ATTACHED I_ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
S J
NO. OF STORIES BASEMENT Li OR AIR CONDITIONING.
TOTAL SO. 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 the
aware of the FOR
R OFFICE
F F I C E 1 1 C ONLY
ordinance requirements regulating the work for which r r r G V�+
the permit is issued and all work done will be in
conformance therewith. PERMANENT I_] SHORELINES
SEASONAL I FLOODPLAIN Ll
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZO
OWNERS AFFIDAVIT HEALTH DE .
P
I certify that I am exempt from the requirements of the FIRE MARSHAL
146
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 /inonformance thherewith. MOTOR VEHICLE PERMIT
OWnef - ��" Date. d z APPLICATIOAqCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
,
PLOT PLAN
ADDRESS S<< G-►— PERMIT NO. f o
= v
n >
a °
°
LEGAL / low
DESCRIPTION LOT
f IfCC'� --Bt1f y ADDITION
SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft.
INSTRUCTIONS TO APPLICANT J '
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20, ARE 1
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"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL ( Q
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
N
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' �
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.
lac
NAMES) OF OWNERM OF S1TE 6 STRUCTURE(S) (PRINT) tIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3