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HomeMy WebLinkAboutBLD16717 Mobile Home - BLD Permit / Conditions - 4/22/1985 CONRAD, Carlysle #16717 4-22-85 3112 No. Mason Tacoma 98407 759-1006 Second Lk. Limerick sign turn right to Clonakilty Dt. , turn left. Contractor Self Mobile Home 1978 14x66 2 bdrm. $11,550.00 Shorelines: Setback: C Special Conditions: Footing: Setback: Foundation Walls: Framing: Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final:Q y y75' Stop Work: Mobile Home: Smoke Detector: Remarks: BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED / J PERMIT NO. OWNER NAME MAIL ADDRESS CITY&STATE (� ZIP PHONE �L S d t"Vt.d o 2 A/17 sop vA 4 0 77S�q�v4L DIRECTIONS TO JOB SITEJ�ji�opjje " L C 'L L U L� LEGAL _ (❑ SEE ATTACHED SHEET) DESCR. CONTRACTOR NAME I MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE USE OF BUILDING 45r'�/�� Class of work: )i NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: L0C o"& \ Valuation of work: $ j / i?^�PCAN CHECK FEE PERMIT FEE�� SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE ❑ /•O/i ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [I //n OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE [I/f'(f�fj DETACHED ❑ 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 that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT ❑ SHORELINES 0 1� A , SEASONAL FLOODPLAIN Ll Firm /V E.D. NO. S.E.P.A. ❑ By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT.a O .2j 5 . 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 (� 7— _ 7``. APPLICATION ACCEPTED BY PLANS CHECK BY BYPROVED FOR ISSUANCE Owner Date PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH CHRISTMASTOWN PRINTING BUILDING PERMIT # V 00 DATE 3 6 \ O Planner Area SLO i Parcel # Z. � z S 1 00'00 CHECKLIST FOR PROPOSED CONSTRUCTION Comp Plan Designation UGA RAC RCC RA For IH Yes No ( ] [ ] Within 200 FT of SMP designated shoreline, wetlands, etc. Where? [ ] [ Located near possible Critical Area, What Kind? (Wetlands, Streams, Lakes, Slopes) [ ] [ ] RLC already done? [ ] Proposed construction within floodplain [ ] Eagle nest [ ] Six year moratorium [ [ ] Multi-Setbacks [ ] [ State road access needed [ ] Commercial Development (parking standards, sign ordinance, public works review, other applicable agencies) [ ] ] Mobile Home or RV Park Zv all, cc— ,1 ° �US`�rcas�s ccish:�.cp►vu'� ! ' (� J S-lrucf � LL e tit I x VS �v (l_5 W�" I51 ` 10 u4,