HomeMy WebLinkAboutBLD13704 Final Mobile Home - BLD Permit / Conditions - 8/2/1983I
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 ��
DATE ISSUED
PERMIT NO.
OWNER i NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL (❑ SEE A04ED SHEET)
DESCR. / / / I / I / I /
CONTRACTO NAME MAIL ADDRESS CITY S STATE LICENSE NO. PHONE
USE OF
BUILDING
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe rk:
x /
Valuation of work: $ C�pe ��OZ13 PLAN CHECK FEE PERMIT FEE
SPECI COND
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SO. FT/��o FIREPLACE ❑ DETACHED ❑
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 FORA PERIOD OF 180 DAYS AT ANYTIME 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
conformance therewith. PERMANENT SHORELINES
SEASONAL ❑ FLOODPLAIN Lj
Firm E.D. NO. S.E.P.A. ❑
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
which this permit is issued and that all work done will ROAD ACCESS
be in rmance therewith. MOTOR VEHICLE PERMIT
APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR SSUANCE
Ow er Date. //9 3
P CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. I M.O. CASH
PLOT PLAN
ADDRESS 1�4. O ��� ? PERMIT NO. f o
A >
LEGAL
DESCRIPTION LOT ADDITIO I 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"'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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
ry
I�R
V \
J
I/We certify that the propoJ6c �onetS ction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval. t'
4�_ � a <„J1 / 4ry- y V � J�1�!/l1 �L
NAME Sr OF OWNE (S) OF 31TE 6 STRU'CTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
GHELTON PftIN TINT
Chandler, E. R. #13704
824-9699, Seattle 3/11/83
Lot 198, Division 4, Lake Limerick
Lot 198, Div. 4 Olde Lyme Road on Cranberry Creek
9 > > Ym Y
Mobile Home Contractor:
26'x60' , 1981 Modern Living, Inc. , Seattle
$28,860.00 Shoreline Exemption
Shorelines: 4-1
Setback: V
Special Conditions: -�
Footing: �--�
Setback: c
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: X-A- 5 "-O
Stop Work:
Mobile Home:
Smoke Detector:
Remarks: �r/p, A;,,?r.s H Ar✓-rTtw