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HomeMy WebLinkAboutBLD16782 Mobile Home - BLD Permit / Conditions - 5/7/1985 LAPINSKI, Stan #16782 5-7-85 Beard's Cove Div. 8, Lot 93 3170 Hwy 300 Belfair 275-3382 Corner of Brigadoon 6 Santa Maria Contractor None listed Mobile Home 1974 14x66 3 bdrm. $11,550.00 Shorelines: Ally_ Setback: t/t�' Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: �28 y S— ,-�-- Stop Work: Mobile Home: Smoke Detector: Remarks: BUILDING PERMIT APPLICATION- MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. NAME / MAIL ADDRESS CITY 6 STATE ZIP (� PHONE OWNER l oe L- l r5—A 6 DIRECTIONS D TO JOB SITE �/! d l�G 0Al A"d A LEGAL (❑ SEE ATTACHED SHEET) DESCR. �3 �R0 co V 14 '+1©, �7 �—O T 3 CONTRACTOR NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR MOVE ❑ REMOVE Describe work: v lye l 9-� (o Valuation of work: $ a PLAN CHECK FEE PERMIT FEE,Z� SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED 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 at I am a currently registered contractor in WORK IS COMMENCED. the St a of Washington and I the aware of the FOR F F I C E USE ONLY ordina ce requirements regulating the work for which eye is issued and all work done will be in Conf rmance therewith. PERMANENT SHORELINES SEASONAL ❑ FLOODPLAIN ❑ Firm E.D. NO. S.E.P.A. By Special Approvals IN OUT YES APPROVED NO Lic. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. /'" S, 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 conformance ther ith. MOTOR VEHICLE PERMIT APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE Ow-;�� ate.` �' Un LL — 1!� - PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH CHRISTMASTOWN PRINTING LOT PLAN ADDRESS ZYGd PERM IT NO. 0 = o M D A OO LEGAL DESCRIPTION LOT BLK ADDITION u SITE AREA Scl. 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. 0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' y f r I 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 SHELTON PR7NTINi