HomeMy WebLinkAboutBLD21328 Final Mobile Home - BLD Permit / Conditions - 12/30/1987 Shorelines: Plunbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL: OK 'q /1A-70- 77
Mobile
Smoke Detector:
Remarks:
Footing: 0 A
Setback:Qk,�
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 21328 No. Floors Sq Ftg 924
Owner — JACOB, Robert E Tel 426-7532 Date 12-16-87
Address E 231 Peebles Ct Shelton Zip
Contractor Voi ht Enterprises
Address Fife Zip
Legal Description Lake Limerick Div 5, Lot 30
Direction to project site Lk Limerick 3rd entry on right,
go to Clonakilt
y Dr to S leaford. To end of Sleaford.
P um ing Mechanical Sewer Wood Stove
Fire place Deck �r-age :-Carport
j Basement Loft Other
1981 14x66 3 bdrm
I
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.,-'�Xf-�9
Ne/1 E MAILADDRESS CITY&STATE / ZIP (PHOrNE
OWNER =. 6 �.
N." -.2" S �� 5.�,�� �a W'j 15J
DIRECTIONS / `
TO JOB SITE �� /Llf��'toly X
l t�Tt-lt s � ZL
el. gnel—
PARCEL LEGAL e _ / // /
� �<�� DESCR. �C_ ��✓
NUMBER ,-
AME MAIL ADDRESS ITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF WORK NEW ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE / / /L�
WORK > (�J x
BEDROOMS 3 DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
q COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. /� FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT v' 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 ONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBT INING APPROVAL FROM THE BUILDINP DEPARTMENT. f/ �7 APPROVAL FROM THE BUILDING DEPARTMENT.
O NER � � STATE �� i ! / X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVEDJQ DEPARTMENT YES DEPARTMENTBUILDING VALUATION - G_i
HEALTH L PUBLIC WORKS FEE
PLANNING ( FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY AP PERMIT VALIDATION
TOTAL �GI,
BY CASH CK MO
PLOT PLAN
ADDRESS PERMIT NO. t o
•
n s aa
o
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"a20' 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 AND 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 POW
TION THEREOF.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
t
1 r'
3 ? •
I/We certify that the proposed construction will oonform4 a Idns and uses shown above and that no changes will be made without
first obtaining approval. l ry
T e-. '-
NAME(S) OF OWNER($) OF SITE \ STRUCTURE(S) (PRINT) IIINATURE OF OWNERISI AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE