HomeMy WebLinkAboutBLD15694 Mobile Home - BLD Permit / Conditions - 6/19/1984 WININGER, Edward L. #15694
6-19-84
W-1/2, SE-1/4, SE-1/4, NE-1/4 34-21-3
362 E Mikkelsen Rd.
Shelton, Wash 98584 426-0962
Mason Lake Rd. turn right under powerlines and at mail
boxes lst drive on left.
Contractor
Aurora Mobile Homes
Mobile Home 1982 28x66 3 bdrm.
$34,188.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
o eir iij -y F)MARATIO 1
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
C�q oorc DATE ISSUED
.343L4 (q 7 1 000 PERMIT NO.
OWNER NAME MAIL ADDRESS ITY&STATE ZIP PHONE
lei�11)1')Q 3/1
DIRECTIONS
TO JOB SITE pn 4 ,( (/�� �� `tf14 IIJ4.1 U, r�/vj e" /IV;/6U�r'lASfGl�w o.�
LEGAL , 1 7 ❑ SEE ATTACHED SHEET)
3� — V7_ ��C4 f/� ( �� e✓�� �E' E'
0
DESCR.
NAME MAIL AD15RESS CI TA STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING 1
Class of work: �10 NEW fpWit6N ❑ ALTERATION ❑ R AIR ❑ MOVE ❑ REMOVE
Describe work: 11 L
UC �' ,� 7i �u /� .Q�cG,J y UGv d
12,1
a
Valuation of work: $ p P �y PLAN CHECK FEE PERMIT FEE
�J t�
SPECIAL CONDITIONS:*, � J d
BEDROOMS I DECKS CARPORT 1-i NOTICE
BATHROOMS TOTAL SO. FT. GARAGE [7
ATTACHED L] SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED
Ll 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 certif that I am a currently registered contractor in WORK IS COMMENCED.
the S to of Washington and I the
aware of the FOR OFFICE USE ONLY
ordina ce requirements regulating the work for which
the p rmit is issued and all work done will be in
confo ance therewith. PERMANENT ty SHORELINES!n (L
SEASONAL I FLOODPLAIN i
Firm
E.D. NO. S.E.P.A. fl
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. a� q
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 therewith. / MOTOR VEHICLE PERMIT
/
Y p_Y ICATIO ACCEPTED BY PLANS CHECK BY APPRO ED FOR ISSUANCE
Own e _ Date .� �DD UUU AP L
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS
PLOT PLAN
4DDRESS ��(: �) �r"�s1,z (�G'� PERMIT NO, f
a o
_EGAL a
DESCRIPTION LOT BLK ADDITION ! u
SITE AREA Sq. 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"ID 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 T
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
s I �
An
I�
�t
I/We certify that the propos ction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
(S) OF OWNER(S) OF SITE p STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED b %
CT AS NOTED DATE � lei
ON PRINT INS