HomeMy WebLinkAboutBLD14783 Mobile Home - BLD Permit / Conditions - 10/10/1983 SUN MOBILE HOME SALES #14783
10-10-83
36-21-3, Tract 9, w2,SF 4,SE 4,NW4
Deer Creek Area, Highway 3, Sales Lot
Contractor
Self 426-2907
Mobile Home
$10,800.00
J
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:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 '� r V
DATEISSUED
PERMIT NO. ' 4-7 S
NAME MAIL ADDRESS CITY�`STATE ZIP PHONE
OWNER SJr. h.ci,� ul 61 / 3 /1! i 1,;, � 'j-'f �YQ
DIRECTIONS
TO JOB SITEF er CrCe4 'GO
LEGAL
DESCR. 3 — A I 3 �(❑ SEE ATTACHED SHEET)
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR A1�, (T
USE OF
BUILDING en ?C7'rs/C{?_
Class of work: < NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
471, 6 60"L e-
Describe work:
A'7 i /� 7��, tea.- �« 41-f G�
11-d b: IR (7�i...Q L✓ 1 C .� o ; C ���` - .��Z1. i.J �yx3�
to `7 fAL
Valuation of work: $ Q�1,O 0PLAN CHECK FEE PERMIT FEE4� -2,S
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT L I NOTICE
BATHROOMS TOTAL SO. FT. GARAGE
ATTACHED SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT I OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE G 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 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 f 1 FLOODPLAIN I 1
Firm E.D. NO. S.E.P.A. [I
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
HEALTH DEPT.
OWNERS AFFIDAVIT
PUBLIC WORKS
I certi that I am exempt from the requirements of the FIRE MARSHAL
con act or registration law RCW 18.27, and am aware
of he Mason County ordinance requirements for BUILDING DEPT. /O///y3
%yfiich this permit is issued and that all work done will ROAD ACCESS
e in conformance therewith. MOTOR YEHICLE PERMIT
/ p y ICATION ACC T Y PLANS HECK BY APPROVED FOR ISSUANCE
Vw er C Date �/! BY
Cell
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. ► M.O. CASH
PLOT PLAN
ADDRESS / 1 PERMIT NO. f
0
LEGAL
DESCRIPTION LOT BLK ADDITION ]� u
SITE AREA `I rC Sgrtt. 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 Cam'
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 BUI LDING,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.
F
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
r
r
I r
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.
i h
NAMEM OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED l O —_(D -
DISTRICT AS NOTED DATE t
SHELTON PRINTIN3