HomeMy WebLinkAboutBLD12327 Final Office/Mobile Home - BLD Permit / Conditions - 8/21/1984 Wells , William A. #12327
426-2907 4/26/82
36-21-3, Tract 9, SE 1/4, NW 1/4
Highway 3, 6 miles Deer Creek Area, East 5961 Highway 3.
Office/Mobile Home 1968 Contractor:
Not Residence - Replacement None Listed
$5,000.00
Shorelines:
Setback: 6
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Rogf:
Exterior:
Interior:
Final: /
Stop Work:
Mobile Home
Remarks:
F. BUILDING PERMIT APPLICkTION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. ���
/�N�ME / MAI ADDRESS / CITY&STATE ZIP HONE
OWNER �Ve S f.� x
DIRECTIONS
TO JOB SITE 3
LEGAL L nr 1,,C� (❑ SEE ATTACHED SHEET)
DESCR.
NAME MAIL ADDRESS CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF /�� ���/
BUILDING �/
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE/r<e //EMOVE
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Describe work:
Ile 4,(e x, 4..,e
2h ;W S
Valuation of work: $ PLAN CHECK FEE PERMIT FED._
SPECIAL CONDITIONS: Y�
BEDROOMS DECKS _ CARPORT [] NOTICE
BATHROOM TOTAL SQ. FT. GARAGE [
ATTACHED Ll SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE ❑ DETACHED L
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
SEASONAL ❑ FLOODPLAIN L
Firm
E.D. NO. S.E.P.A. C]
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 BUILDING DEPT. 4
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. J� MOTOR VEHICLE PERMIT
f� L/2, ' LIGATION C E TIED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner WWW Date . BY t J
PLV CHECK VALIDATION CK. M.O. CASH ERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS / Y' ' �/v — t L/ 1 PERMIT NO. 0
f o
= o
n >
a o
0
LEGAL
DESCRIPTION LOT BILK ADDITION u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. I
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"'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'
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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.
(3) OF OWNER(3) OF SITE h STRUCTURE(S) (PRINT) (GNAT RE OF OWNER SI R AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
ICT AS NOTED DATE
MT-N PilIN TIN3