HomeMy WebLinkAboutBLD0226 Mobile Home - BLD Permit / Conditions - 1/9/1990 136
Shorelines: Plunbing:
Setback: Mechanica
Special Interior:
Conditions: FINAL:
Mobile Home:
Smoke Detector:
Remarks:
emarks:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOPE
Permit No. 0226 No. Floors Sq Ftg 1456
Owner FARLEY, Vernon Te1372_2708 Date1_9-90
Address -NE 416 Blacksmith Lk Dr RPlfair Zip
Contractor None
Address Zip
Legal Description Tr 13 Survey Vim 10-23-2
Direction to project site Left on Dewatto Rd, 8 miles up, left on
Blacksmith Lk Rd, 6th property on driveway on right side
Plumbing Mechanicai Sewer Wood Stove
Fireplace Deck Zia age -sport
Basement Loft Other
1969 28x52 3 bdrm
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BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. (ID ZZcQ
AME MAIL ADDRESS CITY 8 STATE ZIP
14036:_Vol-
OWNER EPSIA - le'4q-�4' L 4K,
DIRECTIONS I
.TO JOB SITE L oAt
e Y
PARCEL LEGAL /
NUMBER ' - - DESCR. QU 4J ,
NAME MAILADDRESS CITY BSTATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING ol In
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK
x
BEDROOMS DECKS — CARPORT 0_0t NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS. TOTAL SQ.FT. GARAGES 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
TOTAL SQ.FT. GSX FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT , SHORELINE t.,_.,L,z_11E
SEASONAL
OWNERS AFFIDAVIT CONTRACT S AFFIDAVIT
I CER IFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A RENTLY REGISTERED CONTRACTOR E STATE OF
REGIS RATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWAR THE ORDINANCE REQUIR S REGULATING THE
REQU EMENTS FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE WORK FOR WHICH THE PERMIT I ISSUED AND ORK DONE WILL BE IN
IN C NFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES MADE WITHOUT FIRST OBTAINING
OBT ING APP VAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEP T,
4 O NER "4 `^'1 TE ATE
FOR OFFICE USE ON LY
DEPARTMENT YESPPROVE NO DEPARTMENT YES
PPROVENO BUILDING VALUATION
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING 5ZL- PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
�{�(nLT PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY EDROR ISSUANCE PERMIT VALIDATION
TOTAL 7,611
7BY = CASH CK MO
PLOT PLAN
ADDRESS �� `/— �� /� (�� ► % x E� PERMIT NO. = o
LEGAL
A >
DESCRIPTION ���'� /�� LOT Qt(�I��j�J� :� BLXAAt+ t _--) ADDITION (,(f/1"
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 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 GR-APWS0UAARES-A-RE3' X 5'-0A 1`20'
_a
l
JC 'I
C
1 r
1
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.
NER(S) OF SITE a STRUCTUREM (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED DATE
AS NOTED
rmh I
/W,4I �4 s Ses r.
EXHIBIT "A"
A tract of land in the north half of the northeast quarter
of section 10, township 23 north, range 2 west, W.M. ,
particularly described as follows:
Commencing at the northeast corner of the northwest quarter
of the northeast quarter of said section 10 ; thence north 84
degrees 47 ' 30" west, along the north line of said subdivision,
160 . 00 feet; thence south 05 degrees 12 ' 30" west 299 . 04 feet
to the point of beginning of the tract of land hereby described;
thence continuing south 05 degrees 12 ' 30" west 575 . 28 feet;
thence south 84 degrees 47 ' 30" east 371 . 11 feet; thence on a
curve to the left, having a radius of 400 . 00 feet, with a
central angle of 02 degrees 39 ' 33" for an arc length of
18 . 56 feet; thence north 05 degrees 12130" east 590 . 88 feet;
thence north 87 degrees 08 ' 53" west 390 . 00 feet to the point
of beginning, excepting therefrom road rights-of-way; said land
also known and described as tract 13, of survey recorded
a
. October 22 , 1979, in volume 5 of surveys, page 138, under
Auditor' s File No. 368714 .