HomeMy WebLinkAboutBLD25236 Final Mobile Home - BLD Permit / Conditions - 9/6/1990 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL: 4u,-X
Mobile -Home:
Smoke Detector:
Remarks: 6 v ioew6iL
Doting: AL .rsvTerhtnr76 �I✓lf',
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 25236 No. Floors Sq Ftg 784
Owner DOVER, Marcus Tel 427-0316 Date2-28-90
Address E 1561 Crestview Dr Shelton Zip
ContractorChar] ies
Address Olympia Zip
Legal Description Lake Limerick Div 5, Lot 62
Direction to project site Turn right on Old Lyme Rd, follov
for .7 mile, lot on ri ht side of rd.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Tarage Zarport
Basement ---I�oft Other
1989 1456 2 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 D
427-9670 DATE ISSUED" (:2
PERMITNO.,--2,5-c;,N
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNERDIRECT �I/1C'�/S V C� C��SY✓/FiJ `�v,� vZ O /
ONS
TO JOB SITEaleAl Anyr aAl Lb Zxee lep, DL/Ow a/p ,-- lep /'g/e
7110 o T ON 1C Y ,s/fC o� /1.aA D-
PAACEL LEGAL
NUMBER )a7-5#-60o6� IDESCR]
Div J LO ,2 l lq E
NAME MAIL ADDRESS CrTY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR chyle- S
USE OF /2
BUILDING A e S /7> r•w c e
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK I C95 TIO/V M9,5211E d 4-241 ID 7- jrOte e'v
e eAJC-L
BEDROOMS DECKS _ CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. 71�S FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT V SHORELINE
SEASONA
OW/ERAFFIDAVIT CONTRACTORS AFFIDAVIT
I CETHAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGON LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQNTS 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 RMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAPPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XO ATE /� '� X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YESPPROVENo DEPARTMENT YESPPROVENo BUILDING VALUATION Q
L
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT a
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY Z o VED R SSUANCE PERMITVALIDATION
lam— TOTAL
Z_2-`�O BY CASH CK MO
PLOT PLAN
ADDRESS PERMIT NO. i 0
LEGAL
DESCRIPTION LOT BLK ADDITION
SITE AREA �J,i �n�� Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS /-7&5 Sq. Ft. , J
INSTRUCTIONS TO APPLICANT Qj
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- 0
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 (T(
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
!Y
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
O �
NZI
lei
'C1
� Rt
fi
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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.
1'��21912(7c(s T)QV&-/c7 0I 9��
NAME(a) OF OWNER(S) OF S1TE a STRUCTUREISI (PRINT) SIGNATURE OF OWNER(!) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE