HomeMy WebLinkAboutBLD16668 Cancelled Mobile Home - BLD Permit / Conditions - 1/9/1991 TURNER, John M. #16668
4-11-85
Tract 4 W-1/2, W-1/2, SE-1/2, SE-1/4 31-21-3
E 3033 Brockdale Rd. Shelton 426-4483
1st house on left past Shelton Screw Products
Contractor
None listed
Mobiel Home 14x56 1984
$14,504.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
PERMIT
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY R STATE ZIP PHONE
- 9 C
DIRECTIONS �o
TO JOB SITE � .9,f G 0/a• f v / �'� {C'7�r
LEGAL i (❑ SEE ATTACHED SHEET)
DESCR. l t
6� ' 5I —CONTRACTOR
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
USE OF
BUILDING jgffle
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION___D-REP MOVE ❑ REMOVE
Describe work:
e �
Valuation of work: $ / / PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOM TOTAL SQ. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. 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 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 am aware of the E U S E ONLY
ordi ance requirements regulating the work for which FO F F I C
the ermit is issued and all work done will be in
con ormance therewith. PERMANENT SHORELINES
SEASONAL ❑ FLOODPLAIN ❑
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. 401� eJ Y
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
,e/�` p�� APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
wrier � '� Date, L O BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
ti
PLOT PLAN
ADDRESS 3D 33 4 1-4 C�/��/ /.�f l�� /1
f �dG !i / Li PERMIT NO. o
= a
n >
LEGAL : o
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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"=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 Al"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.
ry INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
i pry
1 Y
a`4
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.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6HELTON PWNTINi