HomeMy WebLinkAboutBLD27540 Mobile Home - BLD Application - 2/21/1991 a "3 - qov ID
Shorelines: Plumbing:
Setback: Mechanical:
Slal Interior:
itions: FINAL:
Mobile Home:
Swke Detector:
Remarks:
oot ing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 27540 No. Floors 1 Sq Ftg 1272
Owner HUNTER, Te1-726-9032 Date 2-21-91
Address ZJ11 N Adams -----Melton Zip
Contractor The Housing Mart a
Address Zip
Legal Description IF 7 SU NE Tr B SP 785 34121-3
Direction to project site 5 mi out HwY 3 turn L on Mason
Lk Rd 3/4 mi up Mason Lk Rd to Mi kkl eson Rd a mi down
eson Rd to dirt driveway to L tor) of hil
Plumbing Mechanical Sewer Wood Stove d/
Fireplace Deck TarageCarport
Basement soft —Other
,�.•,�. NNW
id y.
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER
NAME MAILADDRESS CITY&STATE ZIP PHONE� _r�0
Cl C
DIRECTIONS
TO JOB SITE 31 y m
2A
i ueunLl fo R E5 propk-oq o ; i I gg rn I ItKI-f ACU+ (CM
a IQ L w. Lb rn, I s n lz 'I (h,' ► LI ,off 4 v
PARCEL LEGAL
NUMBER DESCR. 1'. ., p nL S ✓1� 5a 9 6 �� z Cjs
i 90d7 L�
NAME MAIL ADDRESS CITY&STATE LICEN ENO. ZIP PHONE
CONTRACTOR -1-
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE T
WORK / V '4-O Abe- OrbiDe-FkA
BEDROOMS_ DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_ TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES -t- BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. /al a FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
SEASONAL
OWNERS FFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY HAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
CERTIFY
N LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIREM TS 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 CONFO MANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAIN PPROVALL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNE �C-CSL r DATE �' X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO •�
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP _3 06/LC PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY I PLAN CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
TOTAL 8 C
BY GU�� „�-_,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 MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER JI n. clam �I"1��—cbG 3C 4,1(r6- 63,E
DIRECTIONS
TO JOB SITE F)- /Y), /e- ouj } (J r lc On r)-iunnn Lk3 U M� 1 O
Ie fMP--ir1q CO r(bP G'; h - yy5 ;-n - IL.� . ejcn eC� .
rn 1,v k Y r) 2+ o l f" 2
PARCEL I LEGAL
NUMBER 3 900 DESCR. TR. 1 U CJ� n 1.1(� -T f IJ
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.
O Location of proposed construction on property.
O Building& septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams, wetlands, drainage.
O Attach copy of septic system as built or septic permit approval.
O Indicate topography profile of property and structure on rev rse side.
D1, 1 �
�1 S47'
ti u�j
S;T�
iFrT MIN IGU `
r E
U
h
l
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.
_� -
SIGNATUR OF WNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE