HomeMy WebLinkAboutBLD20727 Mobile Home - BLD Permit / Conditions - 8/11/1987 Shorelines: Plumbing:
Setback: Mechanical :
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
Footing:
Setback:
Foundation
Walls:
Framing:
Fireplace: NULL & VOM 8 E P'J7
Wood Stove:
TYPE 410BILE HOME
Permit No. 20727 No. Floors Sq Ftg 784
Owner JOHNS, Marjorie Tel 877-9498 Date 8-11-87
Address F 0 Box IUJ Li iwaup Zip
Contractor None
Address Zip
Legal Description Lilliwaup Falls B1 22 Lot 1
Direction to project sl e South side of N 31 Liliiwaup St.
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1988 14x56 2 bdrm
I c - �V
BUILDING PERMIT APPLICATION
MASON COUNTY
f It. � DEPARTMENT of GENERAL SERVICES
- P.O. BOX 186 SHELTON, WASHINGTON 98584
nL
426-5593 DATE ISSUED 7
PERMIT NO.�(`�
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
R JOR1F O N S P o,aoX IcS- W,F -'Sss s 4f77 8
DIRECTIONS IF I
TO JOB SITE DSO 147-1+ S I D4 O F /V• 31 L j L t_i w.4Ll P STR ere%
i
PARCEL LEGAL
NUMBER ' ' DESCR. ,LDT / �11�J ✓.4G i`1��r i fji k :tz c /c�iul,gc ' S
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING t' S / ,D�-/V G c
CLASS OF NEW X ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE pp _ _ �/ 6-
WORK
BEDROOMS_ DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS_ TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORIES BASEMENT ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTALS . FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANEN SHORELINE
SEASONAL
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
JREGITRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
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
ORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
G APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
R/ DATE X BY DATE
FOR OFFICE USE ONLY Z, �Z
DEPARTMENT YES
PPROVENo DEPARTMENT YES No BUILDING VALUATION
HEALTH t PUBLIC WORKS FEE
PLANNING ►w�. FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
?LJC� l SHORELINE
7 ` WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE )
STATE SURCHARGE
APPLICATION ACCEPTED BY P H PR S PERMIT VALIDATION
i
Y CASH CK MO TOTAL ��_ �-
I)2,iz �� ,y��t��(} ` PLOT PLAN
ADDRESS PERMIT NO.
0
= a
n s
a o
LEGAL _
DESCRIPTION LOT , AA1.D AhpJ VAC /4lc li L BLK /Z- � ADDITION L lL1W,40 ' /—J`}L<S
SITE AREA `�~16 C Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS_ /sue 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 GRAPH SQUARES ARE 5' X 5' OR 1"=20'
C- -
:J
r
o
I/We certify that the proposed conr ruction will wnformkhe dirtwnsidns and uses s wn above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE 6 STRUCTURE(S) (PRINT) IGNATURE OF OWNERS) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE