HomeMy WebLinkAboutBLD92-00257 MFG Home with Runners - BLD Permit / Conditions - 11/17/1992 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date Z by Gas Piping date l�' `� _ b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date �� '�. by .
FRAMING Walls FIRE DEP .
date by date by date by
PLUMBING OTHER
Groundwork Attic ,
d date by <
ate b
D.W.V. WALLBOARD NAILING --
date by date by
Water Line FINAL INSPECTION
date by date by date by
—,44L�4' �,1 r' 51.VA& Z r e7 s % J`C
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BUILDING PERMIT APPLICATION - �
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W.CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584 '
427-9670 DATE ISSUED
PERMIT NO.
OWNER NAME MAILADDRESS CITY BSTATE ZIP PHONE
Rb%@eT +VFW ,g&k 5.001 c-oLLE"l- G7-SE 1'G 307 w44 qs-sbj ! 423-646 9
DIRECTIONS '
TO JOB SITE MAT011 Lore-Pp It, L 4/.w.99JcC sv6.bIv's100, r*A-b STt1g-'TpN Rµ Else- 3T $748 rOv7
k 4-c rD6 4iF-T&f_TpAI,v T 9rz ) CLw 4KIC aaiVC- 0-05-4r Cal- W-S4-c--
PARCEL LEGAL S ez_ra w.A grfff F
NUMBER 34-14 ] 6 00641 DESCR. JI IV.� L0T'4q . Cll C-LAN K(L7' bp_iVe_ t,4y LIA4 ick 5
NAME MAILADDRESS CITY BSTATE ZIP PHONE LICENSE NO.
CONTRACTOR jelJ,'U �� C zl 3 �V� wq G �� 26- z t1 Ti4L{Luc 161�6
USE OF
BUILDING f_EiS c sA,'Tlq-L SIN6_4_� pitl LY
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE e'W
WORK 1,1sr4tL sePnc- r,,gvK q,44 bg4lA✓1,0"- /4/.1rq_tG VVh4j-20A.) kVIV NiM-C _ IAIJ7�,t
.vvF4cTukA tfvAk'R I.vr « AQ�0 / -+ 44k Dezk-s . 7 L I
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE I/74 SgFt STORIES SHORELINE 0 /uU CONDITIONING.
BASEMENT SgFt BEDROOMS _ PRIMARY RES THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS Ft BATHROOMS �- SEASONAL RES.❑ COMMENCED WITHIN 180 ✓AYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT /VoNLf' SgFt FIREPLACE IS CARPORT/GARA //��--
GARAGE SgFt ATTACHED O DI AHE*
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 APPRQyAj
XOWNER .FROOM��UI��PARTMENT. q APPROVALFROMTH UIL�G ARTM
DATE S� l XBYIl DATE
FOR OFFICE USE ON L
DEPARTMENT YES APPROVE NO DEPARTMENT YESPPROVEDIO BUILDING VALUATION � J
HEALTH ,Aqr PUBLIC WORKS FEE I
PLANNING FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
e / a, /c S SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE 5
APPLICATION ACCEPTED BY PLANS CHECK BY AP VE R ISS A E PERMIT VALIDATION
IB/ CASH CK MID TOTAL ' S
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME AIL ADDRESS CITY&STATE ZIP PHONE
OWNER R09MT-+ Y61Z4 02,4-SC9- -6 o I "LL66.6 gr Ler APT-&3o7 " uv4 g975b3 zo()1(43-644
DIRECTIONS 4,oe:r# oN
TO JOB SITE ft I-Aw Ab 7v c¢ pN R-16-1kr- Cr F7eI1e-
i2 irztrrce _ Ri6-Q-T- -m "-PAIVLT-
PARCEL LEGAL Av S, Lar ytq 64kee i-ict�cy- rvBb-vr•ilw -
NUMBER 131a��') dRO�Q DESCR. C.11 cLo.vgK�LT �)RjVe 6� �70 / U/4 QSYS�T
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
O Location of proposed construction on property.
O Building & septic system setback distances from all property lines & easements.
IndicatW North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams, wetlands, drainage.
O Attach copy of septic system "as built" or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
. t
t
f
I
✓4-Lve
I/We cylity that the proposed construco on will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval.
DIVISION S
CCory p,eILTY �2• < LET 4q
GvL D6s4¢c < (/
I Q KE LIfA4ER!UK 1, SIGNATURE OF OWNER(S)OR AUTHORI ED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NnTFn MA7=
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
il
j;
1
the
mason county
assessor
Darryl Cleveland
Dear
We have received a copy of- the tax certificate for movement of your
mobile home . In order that we may accurately value your mobile
home . please complete the questions below and return this form to
our office by
This information is imperative to prevent a possible double
assessment on your mobile home .
MGNU 74 c?�
MOBILE HOME DATA LENGTH ``� 4k WIDTH o� /
MODEL
MAKE MODEL YEAR
MOBILE HOME LOCATION INFORMATION SERIAL # 6PGpn2y
A . My privately owned land yes no
OR
B . If rented or leased land who from? NAME
ADDRESS 5// CL61V4X1L7:k Zp_ (4¢KCLµt�R+cK� CITY & STATE SWINA1 �,4 aJ0SfY
-T
C . Real Property Parcel # 3�17 5,y 000 ( from tax
statement of new location )
D . Mailing name and address for owner of mobile home
NAME LO 6 PEL+ V&A F,eA 9�'s2
ADDRESS S_OO/ CITY & STATE
-�T
E . Location address of mobile home .614-C-7V City
U/lLL QF_
F . Date mobile home was placed on present site _/; %"f- x ✓ti�� �c� cgy2
G . Purchase Price 5
DATE `�� 7 Z SIGNATURE ZLe&La
TYPE 0R PRINT NAME E0,6b2T- C F2i9-_P6
TELEPHONE NUMBERL;?-06) y l3- 4465
411 N_ Sth P 0 Rny I Chnitnn WnoHii t. nocaA nL._.._ ...-, ,,. 1