HomeMy WebLinkAboutBLD17579 Final Mobile Home - BLD Permit / Conditions - 10/24/1985 AYERS, Richard R. #17579
6-26-85
Mission Creek Block 5, Lot 9
P. 0. Box 263 Tracyton 98393 373-7523
Mission Creek Inc. , 2nd lot past culvert or bridge creek.
Contractor
None listed
Mobile Home 1985 24 x 50 2 bdrm.
$22,200.00 SHARING SEPTIC SYSTEM WITH PEARL PERRY.
SYSTEM IS SIZED FOR 3 BDRMS.
Shorelines: C
Setback: e /C'
Special Conditions:
Footing:
Setback:
Foundation Walls :
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior:
Interior:
Final: ,%/r
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT-APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED /!l'
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP PHONE
DIRECTIONS
TO JOB SITE
LEGAL 9,.t-Y( Q�� S �j7'Jc�ac��- o vc� (❑ SEE ATTACHED SHEET)
D E S C R. .ice'✓ 'L �l� S c� 6� !�' ,�Lt'l.�C�stsd
NAME MAIL ADDRESt V V CITY 8 STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING erne
Class of work: NEW ❑ ADDITION ❑ ALTERATION REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE
II?� 7� a-15
SPECIAL CONDITIONS:
r7 0fp T/ >h ark J rr blLs Ael- _ T As
r �3 c✓r�s a
BEDROOMS {DECKS CARPORT ❑ ---'NOTICE
BATHROOMS (TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE f] 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 FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the S ate of Washington and I the
aware of the FO F F I C E U S ONLY
ordin nce requirements regulating the work for which
the ermit is issued and all work done will be in
I rmance therewith. PERMANENT IV"' SHORELINES
SEASONAL[] FLOODPLAIN i
Firm E.D. NO. S.E.P.A. C
By Special Approvals IN OUT YES APPROVED NO
Lic. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
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
1 APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Own e Date . !/ P BY
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS'?I L kC: �.d ,O_jl S PERMIT NO. 0 o
z °
LEGAL
DESCRIPTION LOT BLK ADDITION S I 0 C"<• �( 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.
INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
c
� f v
1
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 Q STRUCTURE(S) (PRINT) tIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING