HomeMy WebLinkAboutBLD27284 Final Mobile Home - BLD Permit / Conditions - 3/13/1991 Shorfalines: Plumbing:
Setback: Mechanica :
Special Interior:
Conditions: FINAL: &;w 3-13•s/
Mobile :o/rr ,o
Smoke Detector: s-is-
Remarks:
noting:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE - Mf B I Lf- HOME- - - -
Permit No. 27284 No. Floors Sq Ftg 1848
Owner BLACKWELL, SHELBY Tel Date 12-27-90
Address Zip
Contractor Land Pak Inc.
Address Zip
Legal Description Blacksmith Lk lot 63
Direction to project site Bear Crk Rd Tiger Lk Rd L to
Blacksmith Lk Rd pass 1st 90 curve to R go approx 600'
to lot on R
P Lm ing Mechanical Sewer Wood Stove
Fireplace Deck image import
Basement Loft Other
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO. :� / 0
NAME MAILADDRESS CITY&STATE ZIP PHONE
OWNER
DIRECTIONS
TO JOB SITE C ,20z!�7 1r,kZZ C I< U 10 15LOCI M -'1-i
S� S�° c ✓iZ T1 Q1 GI, c0 AD 6 70 l_0 /� via ss LA�1iz
PARCEL LEGAL _ l C�
NUMBER 2Z3 / c7_/ - 3 DESCR. /-0 6Z 64ACA Sn4 /�/.� LAI�iZ /�/�C1-S
NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP79.36( PHONE
4
CONTRACTOR 4-� QRiC �,�JG RO ,l30x Y J�f�i O�Gaa2U w� L��✓0 i W
USE OF
BUILDING N G
CLASS OF NEW I�� ADDITION ALTERATION REPAIR MOVE REMOVE
WORK ✓
DESCRIBE
WORK P11) CZ ZL-x66 /1-!08/CZ_ /1vAlr� OV .3`i7iC-
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS �" TOTALSQ.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
TOTAL SQ.FT. FIREPLACE DETACHED— ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE 54�m
SEASONAL
OWNER AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIF THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST TION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI MENTS 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 CO FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAI ING APPROVAL FROM THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDI DEPARTMENT.
X O NER DATE X BY ����pe �DATE �,13
FOR OFFICE USE ONLY
APPROVED APPROVED ' r'
3
DEPARTMENT YES NO DEPARTMENT YES No BUILDING VALUATION l
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP PRE-INSPECTION
A SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY A ED F I LANCE PERMIT VALIDATION
/BY CASH CK MO TOTAL