HomeMy WebLinkAboutBLD28130 Mobile Home - BLD Permit / Conditions - 5/16/1991 32 t 5-2 - Z-3 - 9'00 32
ng
Shorelines: Plumbi =Mechanics
Setback: Interior:
Special FINAL:
Conditions: Mobile cme:
Smoke Detector:
Remarks:
ooting:
Setback:
Foundation
Walls:
Framing:
Fireplace: LL
Wood Stove: DATE -- Y —
TYPE MOBILE HOME
28130 No, Floors 1 Sq Ftg 720
Permit No. Tel 427-8507 Date 5-16-91
Owner uDEBION Zip
Address
Contractor ip _
Address
Legal Description 3-21-32 E% SW' '
Direction to project site n Rd R o about 2 mi a ter
turns L ro ert on R side ss drive with hone cable
o nex ri ew o R Sewer �„� Stove wa1ng c anica ar rt I
Fireplace Deck arage Po
Basement Other
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BUILDING PERM!T APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
426 W. CEDAR/P.O. BOX 186 SHELTON,WASHINGTON 98584
427-9670 DATE ISSUED
321 'a3^ PERMIT NO.r--25 30
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER
12_O N 2- 0 rri cc
DIRECTIONS _ ,j,j''
TO JOB SITE ( c 2 b, Lc`� 0 rn l 04-r t-d lk t ry re- an -4
IV
PARCEL / LEGAL
DESCR.NUMBER
NAME MAILADDRESS CITY SSTATE 2P PHWE LICENSE NO.
CONTRACTOR
USE OF
BUILDING �t)--S ) e WAS' L
C WORK LASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
✓
DESCRIBE '•\ 0
WORK U t
AREA: NUMBER OF: PLEASE INDICATE: NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
RESIDENCE SgFt STORIES SHORELINE❑ CONDITIONING.
BASEMENT SgFt BEDROOMS PRIMARY RES.O THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
DECKS S Ft BATHROOMS SEASONAL RES.❑ COMMENCED WITHIN 180 DAYS, 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❑DETACHED Cl
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
.P f
I CERTIFY T4T I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTRAT N LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIRE NTS 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 CONfbRMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTTA1N G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
Wry X NER ����/ /s `{",bj'�ti DATE tj X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
APPROVEDJO DEPARTMENT YES DEPARTMENT
BUILDING VALUATION L�
HEALTH PUBLIC WORKS FEE
PLANNING DR
FIRE MARSHAL BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP } r PRE-INSPECTION
SHORELINE
- �� � � s WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
A,PLICATION ACCEPTED BY PLANS CHECK BY APPR ZEDTISSUANCE PERMIT VALIDATION
-- _ TOTAL
BY ' l� CASH CK MO
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER
DIRECTIONS
TO JOB SITE --NE PO x L
&-x
PARCEL LEGAL p4I
NUMBER DESCR. SW Al OF J 32, wrN
e ON
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.
0 O Location of proposed construction on property.
O Building& septic system setback distances from all property lines& easements.
Indicate North 0 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.
C
i 21. o J
r a,
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes ill be made without first obtaining approval.
Y
9fGWUfiE OF OWNERS)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
S. Gordon Craig
the
133 ZS012 COtMty
assessol--
Dea C.
We have rccencly recaived a copy of tax csrtificace for mobile home
movement on your mobil* home.
In order chat. we may accurately value you mobile home, please complete
the questions below and recur= this for= to our office by
Ic is imperative that this information be provided to prevent a
peasible double assessment.
MOBILE HOME DATA L,EHG� GtIDTH
T!lODQ,
MArr lemma. YEAR la 7
MOB= HMM WCATIOI 21FORMATTMI SULLtL �
A_ Hy, privately owned land- ZESS k NO
8- If rented or leased Land vbc from? MA
ADDRESS kwl= & STALE*
C_ ZeaL Zropeccy Partel ,i (caz statement #)
D. Hailing name/-and address for owner of mobile home -
KAME V, trpj
c=-r s szArE Ul it/ '8Sv7
E- Location address of mobile homeUAy /��7/J,lF/T CITY d o�5
F- Dace mobile home was Placed on present sire
C. Pure:hase Pried Qp(�
DATE: aia,,c t94 stcv�Ttra� mot/
n�E as esz1rT NAHE lq V 0 C _jC)Al
Tr-r .-HONE N[*20EB (4
CJurvicuse Shelton, WaSnington 98584 Phone 427-9570