HomeMy WebLinkAboutBLD28478 Mobile Home - BLD Permit / Conditions - 7/1/1991 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:O/C
Mobile Home:
Smoke Detector:,-0s;,
Remarks:
Foot ing:.A,�»y
Setback j, .
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE Mobile
Permit No. 28478 No. Floors 1 Sq Ftg 954.
Owner Rod Halbaccen Tel Date �-
Address PO Box au s o zip�—
Gontractor Seie
Address ip
Legal sc r i pt iorf, ear scove Div 8 Lot im
Direction to projeFt site
P Lm ing x Mechanical ewer WoodStove
Fireplace Deck Garage 7arport
Basement Loft Other
BUILDING PERMIT APPLICATION '
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED ✓�
r
PERMIT NO.
OWNER NAME"' A 0,01\ MAILADDRESS CITY BSTATE ZIP PHONE
bnk C. '3( I a I �{L -I� b i5 ti 7ti- 5s �'
DIRECTIONS
TO JOB SITE rt a.c_.r��
PARCEL ILEGAL n •` rJ^ w ���5 �U` e
NUMBER 0Y3/—S'/- DESCR. /_0 T-
NAME
A MAIL ADDRESS CITY 8 STATE ZIP PHONE LICENSE NO.
CONTRACTOR
USE OF
BUILDING �QC
CLASS OF NEW `.' ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE <-` „ L 1 1 `�^ c,(` C � - /
WORK i�'�1 V`- \ 1( \ �l
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE'. C SgFt STORIES / SHORELINE Cl CONDITIONING.
BASEMENT 04 SgFt BEDROOMS _ PRIMARY RES. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS ,� SEASONAL RES.❑ COMMENCED WITHIN 180 JAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
g ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
CARPORT-- SgFt FIREPLACE_ IS CARPORT/GARAGE
GARAGE - SgFt ATTACHED U DETACHED❑
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS 1 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
OBT INING APPROVAL FROM THE
BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
WNER �a :� /��^� DATE �w X BY DATE
FOR OFFICE USE ONLY
APPROVED APPROVED
DEPARTMENT ves NQ DEPARTMENT YES NQ BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING MV FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP ,��{ PRE-INSPECTION jr)
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE Z,
APPLICATION ACCEPTED BY PLANS CHECK BY APPR E R ISSUANCE PERMIT VALIDATION �+ l'
C+ BY /r,(, ASH CK MO TOTAL > >6
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 oar ISSUEn
PERMIT No.
M AIL A 0 SS 1 STATE Zip PHONE
OWNER I '�;A�
OIRECTIONS
�O.lois SITE LK _
PARCEL //��` LEGAL //
NUMBER I �_J/V I G .t r3 " V, ec:r\`>
UI -13
Indicate below, O Properly 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.
'1 O Building & septic system setback distances from all property lines & easements.
Indicate North O Well and water line.
O Saltwater, lakes, rivers, streams,wetlands,drainage.
In Circle O Attach copy of septic system"as built"or septic permit-approval.
O Indicate topography profile of property and structure on reverse side.
V K1j I I -Vj
Tl I I �y I I I I I I
I I I IJ 1 1, t--- I L
II I I
• I I
I I II
l l i l
III
_�- I I I I I • ��' I I
I/We cer-;/l df:nd�,:aied "„ .. _�i;.z^S.Cns and usas S`Jwn abaw arc:me no C'43:y'_s nill SZ -tade wanou'.:ic5:obtair.ins
r
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
IT
I I I
i
i
I
I I I I i
II
I it
I
I11
I
i
ii
427-9670 BUILDING DEPARTMENT
ALL PERSONS ARE HEREBY ORDERED TO AT ONCE
STOP WORK
On these Premises at
_.... ............................................................................................................................................._.
......................................................_......................_....................._....................................................................................................._
This order is issued because ........................................ :........ :::.................... .
........................................................................_....................................................._...................... ...........
A.M.
Posted ............................._...........P.M. ....._..................................................... 19.................. By
WARNING The failure to stop work, the resuming of work without permission from the
Building Official, or the removal, mutilation, destruction or concealment of
this Notice is punishable by fine and Imprisonment.
,F
4
S. Gordon Craig
7-
the
mason county
r
lea r
We have recently received a copy of tax certificate for mobile home
movement on your mobile home.
In order chat we may accurately value you mobile home, please complete
the questions below and return this form to our office by
It is imperative chat this information be provided to prevent a
possible double assess"nc_
MOBILE HOME DATA LEHCH WIDTH
MODES.
MAYE1 L-r i h c�0��_ ZiODEL MEAR 1`17 L
MOBME HOME LOCATION IHFORMATIOH SERIAL It
A- My privately owned land- YES_ NO
B- If tented or leased land who from? mum \V�
ADDRESS CITY & STATE
C_ Real Property Parcel rt (tax statement
D. Mailing name and address for owner of mobile home
NAME`,C��e_ �1«��aka
ADDRESS n.�p ,r I / CITY 6 STATE�,E_,/
E. Location address of mobile home CITY
F. Dace mobile home was placed on present site
C. Purchase Price
DATE:/ /%[C SIC:IATVR .�..�
TYPE OR PRINT NAME.1�\('�! A IbA ken
TELEPHONE NUMBER 7?7- (,5 f3
Courthouse Shelton, Washington 98584 Phone 427-9670