HomeMy WebLinkAboutBLD13756 Final Mobile Home - BLD Permit / Conditions - 5/5/1983 Fryer, Melvin & Lois #13756
.275-6460 3/24/83
Mission Creek Tracts, Block 3, Lot 4
Ike-<r.�
2 miles m/ h of Belfair State Park on Mis
sion Creek
Road at NE 201 Rain
bow Lane
Mobile Home Contractor;
24'x32' , 1981 Harbor Homes
$14,208.00
C �
� �5
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
Please Make Check Payable to Mason County Treasurer
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED
PERMIT NO. 1-3
OWNER NAME MAIL ADDRESS CITY 3ITATE ZIP PHONE
27,S���
DIRECTIONS _ A► 0 �
TO JOB SITE
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. �+
CONTRACTOR
NAME MAIL ADDRESS CITY 8 STATE LICENSE� NO, PHONE
R �
USE OF '
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Set up mobile home.. .;21 1
ay X3.4 /V/
Valuation of work: $ _ _ _ J,/dO�OD PLAN CHECK FEE PERMIT FEE
0SPECIAL CONDITIONS:
w
BEDROOMS DECKS CARPORT [] NOTICE
BATHROOMS TOTAL SO. FT. GARAGE L:
ATTACHED LI SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT i_; OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE DETACHED L
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
7"WO SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State ofWashington and I aware of the FOR OFFICE USE ONLY
ordinance requirements
the regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES r1]
SEASONAL I, FLOODPLAIN Li
Firm E.D. N0. S.E.P.A, Ll
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT. +►�o� / �/
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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
LIGATION CCEPTED PLANS CHECK BY APPROVED FOR ISSUANCE
Owner Date3 13 s�
PL)JA CHECK VALIDATION CK. M.O. CASH PER IT VALIDATION CK, M.O. CASH
PLOT,PLAN
ADDRESS �� �( �� SL/ � / PERMIT NO. f o
= v
� n >
a O
O
LEGAL
DESCRIPTION LOT BILK ADDITIONj� j� .!/�� u
SITE AREASq. 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.
INDICATE NORTH IN CIRCLE �s, GRAPH SQUARES ARE 5' X 5' OR 1"=20'
11/
�rI, !
� I
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. .5
�NAME(S) OF OWNER(S) OF SITE 6 STR CTURE(S) (PRINT) /SIGNATURE OF OWNER(SVOR/IAUTHORIZEID REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE 3
SHELTON PRINTIN3