HomeMy WebLinkAboutBLD27107 Final Mobile Home - BLD Permit / Conditions - 1/29/1991 Shorelines: Plumbing:
Setback: Mechanical:
Special - Interior:
Conditions: FINAL: e.
Mobile ome:
` Smoke Detector:
Remarks:
noting:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HONE
Permit No. 27107 No. Floors 1 Sq Ftg 1782
Owner APLING,, T�L. Tel-7227 Date(
Address 1602 NavalAve #28 Bremer on Zip
Contractor .
Address Zip
Legal Description 9-23-2 Hil
Direction to project site NE 111 Bedrocka Uya
Munsor• Tracts lot 14
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck 7arage arport
Basement loft Other
BUILDING PERMIT APPLICATION �
MASON COUNTY
DEPARTMENT of GENERAL SERVICES C
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT N
NAME MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER A filu 61Z t) vD a 1¢ :2,P WA wa. 4179 7�
DIRECTIONS
TO JOB SITE SEA' P - /IJ444, .v 4C -�
AIE /1 t S d 2oc k R I !a! Guas 7evr p
PARCEL LEGAL ,SE y of Sr-c�1 o�u Tpcurt, �i r�o 23iu I?Anft �
NUMBER 30 DESCR.
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR /a v J�-, T mo -�3t1- r- 23 9S- 63
USE OF a nn
BUILDING m { ^ 'tar4 ew<-c.
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK
DESCRIBE
WORK /ffC
BEDROOMS DECKS ,r R N CARPORT NOTICE
TOTAL SQ.FT.
DECK GARAGE SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. 99 TOTAL SO.FT. CONDITIONING.
NO.OF STORIES BASEMENT Y OR N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
LIVING AREA > n BASEMENT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SO.FT. /7�0� TOTAL SQ.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 CERTf 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
RE 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 NFORMANICE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OB INING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
XOWNER DATE X DATE 64P796
FOR OFFICE SE ON LY
DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP B ` PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE U
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK SY AP OVED FOR ISSUANCE PERMIT VALIDATION
BY CASH CK MO TOTAL /� 'J
PLOT PLAN
ADDRESS /V E /2ED C ock- � � �A�u.IA. LUJ� PERMIT NO. 0 o
�^ L 7 Oleo" : •
LEGAL
DESCRIPTION LOT BLK ADDITION
SITE AREA :Vl F26 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS ��7 � _Sq. Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE I�
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) O
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF Q �j
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. SH(.W LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY TINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
r\
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE
� y
s�
0
L.o
YY Ia11
I/We certify that the proposed construction will conform to the dlmensi17ns and uses shown above and that no changes will be made without
first obtaining approval.
NAMES) OF OWNER(a) OF SITE ! STRUCTURE(S) (PRINT) I ATURE OF OWNER(!) OR AUTHORIZED REP ESENTATIVE
DO NOT WRITE B LOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE