HomeMy WebLinkAboutBLD26626 Mobile Home - BLD Permit / Conditions - 9/4/1990 Shorelines: Plumbing:
Setback: Mechanics
Special Interior:
Conditions: FINAL: / 3 !�
Mobile ome:
Smoke Detector:
Remarks:mac; /nc st
Foot irg: o
Setback:
Foundat io Walls: oil /O t
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME W/ RIBBON FOOTINGS
Permit No. 26626 No. Floors Sq
II
Owner BR Tel�48-49�8Datg 9 e --47- —
Address ve uyallup Zi —
Conrractor p
Address
Legal Description ip
Direction to project site "orW!"777Marson d
Rt to Matthew Dr L 2 blks to barbalu n R JL11 IULon
side
P um ing Mechanical ewer111,111Ktove
Fireplace Deck 7a-age carport
Basement soft Other XX--
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584 �)
427-9670 DATE ISSUED -4`
J �
PERMIT NO.
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER omu goupatz140,22 10AW-oovol, V y/
DIRECTIONS //8141/�6
TO JOB SITE o&V S/� 7 ,1
&X*,u tC` 1? i leT � ,4 64KS Q 2
it rd L lt-s ec
ti 7-• zH��T o.v 7►. S O - .
PARCEL 13.7G-,f 3-Od/Ot�/ LEGAL
NUMBER DESCR. D _
NAME MAIL ADDRESS CITY& TAT LICENS NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK r
DESCRIBE `
WORK 5&T v 1WO1311 c .y YO 2 )5�ef
s,ERi�L sozo
BEDROOMS DECKS&R N CARPORT NOTICE
TOTAL SQ.FT.
DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS-_. TOTAL SO.FT. TOTAL SO.FT. CONDITIONING.
NO.OF STORIES BASEMENT Y OO THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
LIVING AREA BASEMENT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT. ?Ga TOTAL SQ.FT. CHECKONE ABANDONED FORA PERIODOF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED.
PERMANENT FIREPLACE V&5 ATTACHED
SEASONAL_____ - _-_ _ SHORELINE DETACHED
—
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY AT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGISTR ON LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUIR ENTS 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 CO FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTA ING APPROVAL----FROM//THHE��BUUILDIINIIG--DEEPA__RTMENT. �,, APPROVAL FROM THE BUILDING DEPARTMENT.
W N ER /t.fi�✓� ""DATE d �� / X BY _ _--DATE
FOR OFFICE USE ONLY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO 0 60
«
HEALTH a �- PUBLIC WORKS FEE
PLANNING DA FIRE BUILDING PERMIT
D.O.T. BUILDING ��< D� $ 30- v PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP 3 PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
r77CCEPTEDBY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION
8-.?,; BY ��' g-3d�y0 CASH CK MO TOTAL ��
PLOT PLAN
ADDRESS PERMIT NO. i g
� o
LEGAL
DESCRIPTION LOT BLK ADDITION
SITE AREA 37 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS 2 y 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 AND 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 /3Q/}'l1�� GRAPH SQUARES ARE 5' X 5' OR 1"=20'
6
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2 r �
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I/We certify that the proposed construction will t9WA shown above and that no changes will be made without
first obtaining approval.
NAME(f) OF OWNER(S) OF SITE & STRUCTURE(!) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED D -30 -y0 DATE
'-RICT AS NOTED _�'