HomeMy WebLinkAboutBLD27352 Mobile Home - BLD Permit / Conditions - 1/11/1991 Shorelines: Plumbing:
Setback: Mechanica
Special Interior:
Conditions: FINAL:
Mobile ome:
Smoke Detector:
Footing: Remarks:
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE - ,19RI-L-E f.,WIF - _
Permit No. 27352 No. Floors 1 Sq Ftg 960
Owner 11HITLOCK. SHERRI & KEVINTel 275-0711 Date 1-11-91
Address NE 261 _Lk Christine Tahuva Zip
Contractor none
Address Zip
Legal Description LK Christine div 1 lot 58 & 59
Direction to project site _Pasdt Belfair State Pk-uphill
thru Elfendahl Pass over bridge past Haven Lk to stop sign
PILmbing Mechanical Sewer Wood Stove
Fireplace Deck gage carport
Basement Loft Other
Septic system to be inspected prior to set up inspection
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
NAM MAIL ADDRESS CITY&STATE ZIP PHONE
OWNER r2J i 1 UC _ 6 ct Livt�Irt cut A.
9S :Z7r07
DIRECTIONS S f a',
TO JOB SITE f Qte 2LLL
PARCEL LEGAL
NUMBER - ( DESCR. V
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS
WORK Or N-EW '�\ ADDITION ALTERATION REPAIR MOVE REMOVE
DESCRIBE _
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 J' 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 X SHORELINE z_
SEASONAL
OWNE AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERT THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF
REGIST ATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE
REQUI 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 C FORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OB A ING APPROVAL FROM THE BUILDING DEPARTMENT. �J APPROVAL FROM THE BUILDING DEPARTMENT.
X OWNER DATE ��[-.3 w X BY DATE
FOR OFFICE USE ONLY
DEPARTMENT YES APPROVEDJO DEPARTMENT YES DEPARTMENT BUILDING VALUATION
HEALTH PUBLIC WORKS F EESo
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING L{ PLAN CHECK
SPECIAL CONDITIONS BUILDING GROUP R-3 PRE-INSPECTION
AS p er S r4-C. G rnC,Le N r la+ , SHORELINE
6 a 1 r,'�•-�-a n d ra,Uk F !p( a r 2'CL WOODSTOVE
/ S ����� ,� PLUMBING
MECHANICAL
- ' � STATE BUILDING FEE
STATESURCHARGE
APPLICATIgt ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION w�I��
1 ) TOTAL �111
a BY A � CASH CK MO 66
BUILDING PERMIT PLOT PLAN
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. Box 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.
OWNER
NAME AIL ADDRESS CITY&STATE ZIP PHONE
k��'n _
DIRECTIONS
TO JOB SITE
1 ( rL
PAR L LEGAL �
NUMBER _tf66 DESCR.
Indicate below: O Property lines and dimensions.
O Easements and roads.
O Septic, drainfield and reserve area, or sewer.
O Septic tank and drainfield setback distances from foundations.
0 O Location of proposed construction on property.
O Building& septic system setback distances from all property lines& easements.
Indicate North O Well and water line.
In Circle O Saltwater, lakes, rivers, streams,wetlands, drainage.
O Attach copy of septic system as built or septic permit approval.
O Indicate topography profile of property and structure on reverse side.
1 �
/ o
'V
4%
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I
I
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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.
SIGNA RE OF OWNER(S)OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
TOPOGRAPHY PROFILE OF PROPERTY AND LOCATION OF STRUCTURE
04/16/2009 09:32 FAX 360 427 7798 MASON CO PERMIT CTR U 001
TX REPORT
TRANSMISSION OK
TX/RX NO 4264
CONNECTION TEL 94277179
CONNECTION ID
ST. TIME 04/16 09:30
USAGE T 01'49
PGS. SENT 10
RESULT OK
FAX TRANSNHTTAL
TO: ��.✓� ✓�C�
COIVIPAI,;VAGENCY:
FAX #: � ..I
PHONE#
FROM: Debbera CAer
MASON COUNTY PERMIT ASSMTANCE CENTER
P.O. Box 186, Shelton, W.A. 98584
Phone: (360) 427-9670 EXT. 510
Fax: (360) 427-7798
E-mail: 'Dlcaco.mason.wa.us
COMM11-,N'JS. ���, �Yc.7') 'ca ce f � � _ gyp- o v0-s-8 _
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Pages faxed, including Ithis page��_ Date/Time