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Home My WebLink AboutBLD26634 Mobile Home - BLD Permit / Conditions - 9/5/1990 aa36* - q5 - 006-70 Shorelines: Plumbing: Setback: Mechanics tdc ial Interior: itions: FINAL: Mobile Hcme: Smoke Detector: Remarks: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: TYPE MOBILE HOME Permit No. 26614 No. Floors 1 Sq Ftg _11B2 Owner HIIXFORp,, :10SFpH Tel 47q-4S 11 Date 9_5_g0 Address 2A2O N Mission Ik Rd W RUM Zip QR�12 Contractor Fred Horsley Zip Address Legal Description �� Tr 7 Siirv�y Fi/151 Direction to project site Bear Crk Dewatto Rd-7 mi from B lfair -Old Belfair Hwv, to Blacksmith Lk (:country Rd Pl un ing c anica ewer o Stove Fireplace Deck Garage Carport Basement —Loft Other XX ra C74- 7 . 3 �o N gJ yx i+h LG(,wo ryJFc!. 'fiowe..q// vG +wo r ow-e-s w 1+-h " T-rccc-+ - " anol out.t,JAm f " 4u x�xd " Lt)i+h Oran e VD' 6bboX) CA- tht corner o(-th t �L �irs+ leF u)\) Th t Comer o-C +ra.ok card OkA- d�- +Tac, - 7 . \ 4401-es ar{ d LA 0 n-d rifa dJ �i 1 i pol e S a►�d cx r1�� (2,labon) a OITJ BNf 2 I-I wy 3 gorf+ --Or / 9/ 9 U (+ to A n 7 -7) QA 4 j Vf3—q S� V-A4 e� A"Mo i Everett Pad & Paper Co., Inc. - ~ j RULED TABLET 50 SHEETS 81/2xll 72-110 WHITE. . . . . . . . . . . . . . . . . .LETTER RULED 72-210 CANARY . . . . .. . . . . . . . . . .LETTER RULED 72-214 CANARY. . . . . . . . . . . . . . .NARROW RULED 72-310 GREEN TINT . .. . . . . . . . . . .LETTER RULED 74.110 WHITE. . . . .. . . . . . . . . . . . . .LEGAL RULED 74-210 CANARY. . . . . . . . . . . . . . . . .LEGAL RULED 75-180 WHITE. . . .. . . . . . . . . . .QUADRILLE 4 SQS. 75-280 CANARY. . . . . . . . . . . . .QUADRILLE 4 SQS. 75-380 GREEN TINT . . . . . . . . . .QUADRILLE 4 SQS. EVERETI'PAD&PAPER CO..INC, Everett,WA98201 EV-1000 1 BUILDING PERMIT APPLICATION MASON COUNTY DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 427-9670 DATE ISSUED PERMIT NO. ME �JIM S A, CITY& TA�E� , ZIP /� PHONE OWNER �'.f"�ISS I�f�; � � I.V• Y �I � `1 47q .� DIRECTIONS TO JOB SITE W46 ( 6- ni IRory) Ol C LLA D I ih LO t2 I L I' 10_rj no .3Y1 < j K PARCEL 1 ` LEGAL �' L' 1/� NUMBER a?)( J - 095R DESCR. NAME 4AILADn" SS C Y&STATE LIC�ErNSE�y'0�' ZIP PHONE CONTRACTOR of -r� USE OF BUILDING CLASS OF NE\IV >✓ ADDITION ALTERATION REPAIR MOVE REMOVE WORK r A�n1 DESCRIBE � I� WORK via N BEDROOMS DECKS YO CARPORT _ NOTICE / TOTAL SQ.FT. IECK �} SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS OTAL SQ.FT. y TOTAL SO.FT. CONDITIONING. NO.OF STORIES BASEMENT Y O N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA ( I� BASEMENT _4 COMMENCED WITHIN 180 DAYS, 08 IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. TOTAL SO.FT. CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT FIREPLACE ATTACHED SEASONAL SHORELINE DETACHED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT ` I CE !FY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REG TRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE RE IREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING JAINING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. WNER 4�YWDATE (�/Z X BY DATE .� FOR OFFICE USE ONLY DEPARTMENT YES PPROVENo DEPARTMENT YESPPRovENO BUILDING VALUATION HEALTH 30-/v PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT 77— D.O.T. BUILDING D1% L PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP 2-•3 PRE-INSPECTION X 2y 1152 SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE J STATE SURCHARGE APPLICATION ACCEPTED BY P S CHECK BY APPR VED FOR ISSUANCE PERMIT VALIDATION BY� "90 TOTAL /7 CASH CK MO PLOT PLAN ADDRESS Qd PERMIT NO, f o ,_ LEGAL -trox,+ 7 0 DESCRIPTION LOT BILK ADDITION a SITE AREA :f 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 t 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 GRAPH SQUARES ARE 5' X 5' OR 1"=20' r fy (1hl t 1 J 3 r` II 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. NAME(S) OF OW ER(a) OF SITE • aT UGTURE(3) (PRINT) IG TURE OF OW R(S) OR AU THORI R P E3EN A IV DO NOT WRITE LOW THIS LINE APPROVED f,.�v GO Q /�3/nJ DISTRICT AS NOTED f DATE [J �7 _ S. Gordon Craig the mason county ;. assessor Dea r We have recently received a copy of tax certificate for mobile home movement on your mobile home. In order that we may accurately value you mobile home, please complete the questions below and return this form to our office by It is imperative that this information be provided to prevent a possible double assessment. MOBILE HOME DATA LENCH WIDTH 7 MODEL MAKE 14 C'�I1�C� HODEL` E L 'I( YAR l MOBILE HOME LOCATION INFORrlATION sni" A. My privately owned land. YE3_y _ NO B. If rented or leased land who from? NAME ADDRESS CITY & STATE C. Real Property Parcel # (tax statement ) �p��Xl -75 (100/ D. Mailing name and address for owner of mobile home 99 ADDRESSO CITY & STATE 'Pirri z l boa E. Location address of mobile home CITY_ {� F. Date mobile home was placed on present site C. Purchase Price_�� 0� DATE: SIGNATURE TYPE OR PRINT NAM �� TELEPHONE NUMBER '7Cj- �j: Courthouse Shelton, Washington 98584 Phone 427-9670 MASON COUNTY 0Egi4RTMEN7 of aVERAL Sc--k`/TC3 �: Iwa�.ae eae.ml►91d�m a�v�Ga.r 9w.ma. wow 91SB4 (ZDs)477-%= '_ ��''"� .a.:vat..,d b..iel: am�s+Q brads pr�a�ree•voon APlt=CAxr- C ITS C I C I Huildia Peres t _ g 2� ARpl_catioa _ (iaclsdinq a / al deer_- a_ � -pt_on, aCQress. dt.�ec-.:aaa to the Job itte and all at requested inioraat_oa) . I C J Accurate site/ lot Cplease see t.heptollorin plan - tvo caries g pages :for- -plan requirements: permit will not be processed unless all required iniormatiar_ included). r-•_ C • J C I � - Plumbing-Mechanical Form Ci_ requi-red) . - C I C J Energy Audit (ir re qui-ed) . C I C I 81ue Prints - tvo cosfes (to ine+ude- case s+Ct2aa 1. CN I C I Septic System Records_ C�I C J 2iobile I. D. Foz--a (1-1 required) . C I C I Shoreline Exempt. . (In r7.th2n 200 :eet of a designated horQl:n� retland' ar =lacd plain boundary' 7 - C_ I C I: _ .. Pre-_aspaction Fee (_f _ requ-.eC) . Yr PLEASE Ii�TE'- IF AMY CF- TM:-' R=UIRED THFORIIATIOH C as ou and oa 1 =40 Solacvin tuned a�ays IZ' YILL 8E 4 pages) ZS :SZSSIHG FROM A SUBMIT= APPLICATTCH ` RETURNED TQ THE APPLIC.IHT' FOR =rlpL_�IQH_ Proposed do-elopmenz" li-eGti Vom /G Applicants signature Date VL FOR OFFICE USE ONLY . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;,• Received by � Time Date Health Exempt v Cirsitials o! Health O,ji -• ce_ Planning Exempt tinitials 01 Planner) r anner)