HomeMy WebLinkAboutBLD16202 Final Mobile Home - BLD Permit / Conditions - 11/15/1984 COLE, Harold _ #16202
10-2-84
Blacksmith Lake II, Tract 39
P. 0. Box 5051
Belfair, Wash 98528 275-4778
Bear Creek Rd. (7 miles) to Blacksmith Lake Rd - sign
says Buffon - go to T, left, 3rd from corner
Contractor
None listed
Mobile Home 28x60 1984 3 bdrm.
$31,080.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: (;" //
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING .PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 ////��
DATE ISSUED_L0" 94-
PERMIT NO. /6Q O oL
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
xS�C/ GL v�7S- Y 1V,9
DIRECTIONS
TO JOB SITE[&
/!7/ N
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. , tom
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF L/
BUILDING
Class of work: X NEW ❑ ADD TION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
-� rid// m agX 60 '
Valuation of work: $ I 0 ^ O PLAN CHECK FEE PERMIT FED 'O' ,
SPECIAL CONDITIONS: (,1
BEDROOMS_—_ I DECKS CARPORT NOT I C E
BATHROOMS (. TOTAL SQ. FT GARAGE[;
ATTACHED)( SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIE/S / BASEMENT ElOR AIR CONDITIONING.
TOTAL SQ. FT/ �e FIREPLACE C: DETACHED L1
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 hat I am a currently registered contractor in WORK IS COMMENCED.
the St ye of Washington and I aware of the FOR OFFICE USE ONLY
ordina ce requirements regulating the work for which
the p _'it
is issued and all work done will be in
cont mance therewith. PERMANENT X.00" SHORELINES ",
SEASONAL L: FLOODPLAIN
Firm a1—_
\1 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. - H-1(y•Y
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 BUILDING DEPT.
of the Mason County ordinance requirements for
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
/10 l _� APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSU I`jCE
Owner � —Date. o� J
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLDT PLAN
ADDRESS �� �� ��fs'/,P 2L 3"&_ PERMIT NO. = o
A D
LEGAL
D O
DESCRIPTION / ✓�%� )�� LOT K�✓�'r' � v7 , 18LK ADDITION u
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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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.
NAME(S) OF OWNER(S) OF SITE & STRUCTUREIS) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
GHELTON PRINTIN3
CIO
3 S
� � Oro
AS SHOWN ON SURVEY RECORDEDvDECEMBER 12, 1983, IN VOLUME 10 OF SURVEYS, PAGE
422692. —�
TOGETH 1Z WITH AND SUBJECT TO EASEMENTS, RESTRICTIONS, RESERVATIONS AND COVED! OBE C'~R0 £BEAN)
IVATE EASEMENT FOR
NE
SW 114 .. EGRESS, DRA 1 NAGE
EXISTING L} �Y, PURPOSES.
FENCE ': -
(PATRICIA ANTON)
8171
781.0g (REC
\ ��•+ 5�81�15 E )
�. ,.• ;,O 1944
E 780.74 (CALC)
151.36
350.00 ,�
60.08 o66.41 279.38
//�� 230.60 `
Lu
L O T 3 v 0)
"o /, 1 .24 AC.
7 LOT 4
r
T z- . � i
LO cv \ �t 33
��n WELL HOUSE 1 22 AC � �_ 1 . 73 AC. /
11301 N z / \�\ �� v N
I 7a _ 04SN
0 ED CENTERLINE 000
0
149 g,3 UNNAMED z z
175 83 CREEK
\
160.90 _ _
255.34 S 8150 54' E _
S 8151 41` E (CALL) 246.3,)
7 78080.4141
i' (REC)
100 ' PRO YE SETBACK �pD
' dFORELLS I TE RQS,
r r.
THESE PLANS MUST BE
(JEFFREY ST I VER) ON THE JOB SITE
FOR INSPECTION.
LINE TABLE
N0. BEARING DISTANCE
T REPRESENTS A L 1 S 52'00 '00" E 37.G9
A SURVEY BY L2 S 06 23 '37" E 95. .)0
RECORDED IN L 3 S 14'35 '24" W 40. 61
102, RECORDS L 4 S 05 21 '16" E 47. 17
Y, WASH 1 NGTON. L 5 S 01 '14 '46" E 105. 54
L 6 N 08'38 '06" E 20.00