HomeMy WebLinkAboutBLD19595 Final Mobile Home - BLD Permit / Conditions - 5/12/1987 TYPE MOBILE HOME
Permit No. 19595 No. Floors Sq Ftg 1344
Owner JOHNSTAD, Joy M. Tel 598-4764 Date 11-19-86
Address 6901 Silver Springs Ln. NE Poulsb0 Zip
Contractor Nc)„P
Address Zip
Legal Description SE,NE Tr 19 9-23-
Direction to project site 2 mi off Bear Creek Dewatto Rd.
on Blacksmith Lake Dr.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1984 28x48 2 bdrm
Shorelines: PlLmbing:
Setback: Mechanical:
Special Interior:
Conditions: FINAL:4
mobile Home:
Smoke Detector:
Remarks-
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584Fp/l9
426-5593 DATE ISSUED �7 CEO j�
O)a PERMIT NO.
MPtILADDREss CITY&STATE �N p' L
NAME �---
� ZIP 1_ _7?��
OWNER 0 l�,•� TJ9 4'y`0POu,�SPHONE
8d r>1f�
DIRECTION
TO JOB SITE A RJ�C,�h- /.lz.�.t�r'-t c o un__ K lr2
�C �r,ItL .t.o r
LEGAL �. �/t.l,��' A)Z < Sti t t�'� %�ii✓31C� � .k .,C�1� �'
DESCR.
N MAIL ADD SS ITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR l/
USE O F ` C� '7f7- f�C
BUILDING
CLASS OF �( ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓ \ i p
DESCRIBE / /J`J/�L/ / mil• ���
WORK G�
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS. = TOTAL SQ.FT. GARAGE CONDITIONING.
HORIZED IS
NO.OF STORIES 1 BASEMENT ATTACHED THIS PERMIT COMMENCEDBWITOHINS NULL AN180 D YSD ORIDIFF WORK OR CONSTRUCTION OR WORK TRUCTION AIST NOT
DOR
TOTAL SQ.FT. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED,
PERMANENT SHORELINE
SEASONAL
OWNER AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTI Y THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIS ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQU EMENTS 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 NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCEAPPROVAL
THE THEREWITH.
BUILDI NO CHANGES DEPARTMENT.ALL BE MADE WITHOUT FIRST OBTAINING
OB INING APPROVAL FROM THE BUILDING DEPARTMENT. /
J� /-�90 0fa XBY DATE
XOWNE �" ' DATE
FOR OFFICE USE ON LY -
APPROVED APPROVED BUILDIN�V;;TION
DEPARTMENT ves No DEPARTMENT YES No
HEALTH
PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP �- 'j PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE .7
APPLICATION ACCEPTED BY PLANS CHEO.BY �f FAPyPRO?VED FOR 1 ANCE PERMIT VALIDATIONTOTAL�� CASH CK MO
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