HomeMy WebLinkAboutBLD15052 Final Mobile Home - BLD Permit / Conditions - 4/12/1984 E
FEWEL, Richard L. #15052
1-3-84
SW-1/4,NW-1/4 10-23-2
Old Belfair Hwy to Bear Creed-Dewatto Road. Go
approx. 7-1/2 miles to B.G.Buffon sign to left.
Follow approx. 1.7 miles to a "T", go left. lst
driveway to right.
Contractor
Mobile Home Harbor Homes '3-71-446 t
824.864.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:—
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior:
Final: C 1 s
Stop Work:
Mobile Home :
Smiike Detector:
Remarks:
r BUILDING PERMIT APPLICATION
r MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO.
OWNERk2/
NAME MAI ADDRESS s0� p�(��/ 3� CITY&STAT,E,pp ZIP i � - PHONE
R F -�E ,e C EK Sy` �J�LF LtJ �T0 9
DIRECTIONS ELFiP/R wY 7"0 �iS3C',e�C�K .� /�Jff�jp Oryl> GO �PPjed/C� 2 �'J/LE.S
TO JOB SITE re) LFFT_ LGOLr/ #;0"P' ,60/ A 7414&f TD
LEGAL I o (❑ SEE ATTACHED SHEET)
DESCR. .uJ/� aF .taJ y of .�EC1�ioNi 7'4ccl�✓sr�'/P Ti�JE,rr /P �! /!/9')/6 /a lt�,./�1,
AME MAIL ADDIIESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR ,��T.4vQDpZIO-4-415
7` W/
USE OF � �
BUILDING /iC.S��L��yC�
Class of work: EW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: � ,n^
i � 4 tj 631-) 18 . E
Valuation of work: $ / PLAN CHECK FEE PERMIT OE 93'_ C-25
(C�
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SQ. FT. GARAGE 1.7
ATTACHED i_. SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE [I DETACHED I I L
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 FO 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 t�s:
SEASONAL I I FLOODPLAIN LI
Firm
E.D. NO. S.E.P.A. [ i
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. Uk Or 3 6d dQ.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware
of the Mason County ordinance requirements for BUILDING DEPT.
whi this permit is issued and that all work done will ROAD ACCESS
b ' conformance ztherew' h. MOTOR VEHICLE PERMIT
OW r"-' s Date Mm
PLANS CHECK BY APPROVED FOR ISSUANCE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
r
ADDRESS PERMIT NO. /�SD� �/ o
' � o
A D
a o
LEGAL
DESCRIPTION LOT BLK ADDITION u
c
SITE AREA 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
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 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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
ri I I
1/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.
AM S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) tIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTIN3