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HomeMy WebLinkAboutBLD14351 Mobile Home - BLD Permit / Conditions - 7/11/1983 Savunen, Gary #14351 No Phone 7/11/83 Tract 3A of NW 1/4 of NW 1/4, 32-21-3 Brockdale Road on Jensen, 1 mile up Jensen Road at E 1200 Jensen Road. Mobile Home Contractor: 1,344 Sq. Ft. Robin Hood $24,864.00 �� -3-a Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior : Interior : Final: Stop Work: Mobile Home: Smoke Detector : Remar ks: �MPevG�P .�a6GtsS , � NULL & D�R�tT a a^,. a DATES A 1 BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED 7/ PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE G A C It/ 0IJ& lU eAJ rce)A1) Sl—e—&OAv NU A") DIRECTIONS _TO JOB SITE OU / lar — (P D Y\ (. ✓L)FcrMd LEGAL f ' (0 SE ATTACHED SHEET) DEsCR. fits P��1 0"J /V L� �L/ 7�/CJ/�P5t� Ae 3 GCJ.GCJ I�/L' NAME / MAIL ADDRESS CITY&,STATE L CENSE NO. PHONE CONTRACTOR jeCI3%/� t'r©UL� -3ICCU Q( .t-'L ✓ C !`tC� �V lP I USE OF �/.� t 6 f� BUILDING / /� MC T Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 3�13-D — —000 Valuation of work: $ C'6t?/ PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: BEDROOMS {DECKS CARPORT ❑ NOTICE BATHROOMS I TOTAL SO. FT. GARAGE [J 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 that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES 1-1 SEASONAL Li FLOODPLAIN I 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. ✓ 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 his permit is issued and that all work done will ROAD ACCESS be onform nce erewith. MOTOR VEHICLE PERMIT 7_ // . �� ICATION ACC PTED Y PLANS CHECK BY A OVED FO SSUANCE Owner Date . 1 Y PLA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS t a 0 a \Te h S C__!/J Ed PERMIT NO. f o J•A C G�•'6t. l/L/ Oj / )4& ` q J-'r3 �Lt J/�-LSN�' J/ tii 1�' �J. L 'I . ; �► LEGAL DESCRIPTION LOT SILK ADDITION r\u SITE AREA —Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS—d-3 C/(_j_ Sq.Ft. W 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. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' �J c. C 1J u' , II I/We certify that the proposed construction will conform to the d(mensiOns 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) FE' TUP OF OWNER(5) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THl LINE APPROVED DISTRICT AS NOTED DATE GHELTON PR!NTINi