HomeMy WebLinkAboutBLD26273 Mobile Home - BLD Permit / Conditions - 7/26/1990 Shorelines: Plumbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:
Mobile cme:
Smoke Detector:
Remarks: oT GZr t o
Footing:, / R-10 -so i a,-
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE -MOBILE- HOME
Permit No. 26273 No. Floors 1 Sq Ftg 1568
Owner THOMA Tel—=- 105 Date—T- 777
Address 5817 SE Pennswood P1 Port r0 cTar _ Zip_S
Contractor - HF Hatfield
Address E 210 Pickering Dr Shelton Zip
Legal Description 4-23-2 Ir 9 survey4/120
Direction to project site ric son r
West on Bear Crk Dewatto 2.5 miles rom oonervi e
to Erickson Dr left 2 mile to property on right
Lm ing Mechanical ewer Wood Stove
Fireplace Deck arage —Carport
Basement Loft Other ��
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAME MAILADDRESS CITY SSTATE ZIP PHONE
OWNER ) IPA Ll> -�'o.h�/ -S, s a —o / 5 3 6 bP17 G 9,1 a
DIRECTIONS S i 04-1 6 enlLc-itice:X_ pev"QTTO L,���
TO JOB SITE ,S IL-CS gy cz-<-L0(.,iK To VIC1GKf as✓ Dlt _ �2- L-C D i"rT
dN IL4 CE�9 c•-"
PARCEL LEGAL
NUMBER Q�j j� DESCR.
NAME MAIL ADDRESS CITY d STATE LICENSE NO. ZIP PHONE
CONTRACTOR �- f-c. Cam.-�u-77 (E. �/o 'r1u �N� S t✓�✓� 7" 2 7 L6 5302
USE OF ,
BUILDING 17,c5 ro<:pLf
CLASS OF WORK ✓ EW ✓ ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE �+ 1
WORK d ev U V\0 I ue ►do
BEDROOMS _ DECKS YO N CARPORT NOTICE
TOTAL SO.FT.
DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_,e _ TOTAL SO.FT. TOTAL SO.FT. CONDITIONING.
NO.OF STORIES j— BASEMENT Y O N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
LIVING AREA BASEMENT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. i 3 TOTAL SQ.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT t FIREPLACE ATTACHED
SEASONAL SHORELINE DETACHED
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I RTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
R ISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
QUIREMENTS 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
JCONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
STAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNE _ -DATE X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES
PPROVENo DEPARTMENT YESPPROVENQ BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT 96 , 60
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP ( PRE-INSPECTION
0 SHORELINE
K I i7�P►1 n1 F 1.n WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE 5�
STATE SURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY I AWMUID FO I UANCE PERMIT VALIDATION
�y1v TOTAL
-��j - BY CASH CK MO
PLOT PLAN
ADDRESS ly 6-, q l O LFz1C_KS",' I)j'1_i gr LifA ( z PERMIT NO. = o
,? Ro Y 7o t,r p 5.
LEGAL Y o f S-ox_a<, y ���cl (1►�
DESCRIPTION LOT BLK ADDITION
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. ..J
r.
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- L
TION THEREOF. `J
V
c
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'tu
�Al
r .� ►'�' r f- r�
1 A S rJ�
v ` �
t=�
L
I/We certify that the proposed construction wi 1 idns and uaaa shown above and that no changes will be made without
first obtaining approval.
TT-
NAME(SI OF OWNER(al OF SIT a STRUCTURE(!) (PRINT) SIGN TURF OF OWNER(!) OR AUTHORIZED RED ElENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE