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Home My WebLink AboutBLD26743 Final Mobile Home - BLD Application - 1/30/1991 Shorelines: Plumbing: Setback: Mechanica Special Interior: Conditions: FINAL: 3 d Mobile ome: Smoke Detector: Remark noting: Z o 1 Jetback: Fou ndat ion NULL V Walls: 51 Framing: Fireplace: Wood Stove: TYPE MOBILE HOME Permit No. 26743 No. Floors . 1 Sq Ftg 1700 - Owner uFRTH RAIPH Tel 27_s-384s Date -1 -90 Address NF snn Haven I k Dr— Tah uya Zip 98588 Contractor self Address Zip Legal Description 30_-23-2 Tr 1 survey 6/62 Direction to project site Off North Shore rd Belfair Tahiiva Rd to Haven Lk to E Haven 4Jv to NE 300 Haven Lk Dr utn ing Mechanical ewer Wood Stove Fireplace Deck Garage Carport Basement soft Other BUILDING PERMIT APPLICATION MASON COUNTY I14 DEPARTMENT of GENERAL SERVICES P.O. BOX 186 SHELTON, WASHINGTON 98584 03� 427-9670 \ DATE ISSUEl PERMIT NO,-, ^ L ME // MAIL ADDRESS CITY&STATE ZIP PHONE OWNER avL t3h�f. - 3cG c,v2 TrY -t"e 0?S' Ir=t DIRECT TO JOBIONS SITE o/ /- 44, e, Ra d g zo6�q,'h /q{j To is ,,4,u,n h/ Ta /1/t 30Q /�4veh PARCEL LEGAL SGY e 1 NUMBER 2 3 30-77-000 IQ DESCR. T/Q K+ L 2 NAME MAILADDRESS CITY&STATE LICENSE NO. ZIP PHONE CONTRACTOR U USE OF // BUILDING /yQ CLASS OF NEW ADDITION ALTERATION REPAIR MOVE REMOVE WORK ✓ DESCRIBE /y _ WORK i /oLrh I�'Io6.' C Of1� GY,,1'tr'ps �2� 4 � 7 .;Z '7 70'o s BEDROOMS DECKS YO N CARPORT TOTAL NOTICE TOTAL SQ.FT. DECK GARAGESEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR BATHROOMS TOTAL SO.FT. TOTAL SQ.FT. � CONDITIONING. NO.OF STORIES BASEMENT Y O N THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT LIVING AREA BASEMENT COMMENCED WITHIN 180 SAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR TOTAL SO.FT. / 700 TOTAL SO.FT. $� CHECK ONE ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PERMANENT- X FIREPLACE '$- ATTACHED SEASONAL SHORELINE DETACHED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIREMENTS OF THE CONTRACTORS I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR IN THE STATE OF REGISTRATION LAW RCW 18.27, AND AM AWARE OF THE MASON COUNTY ORDINANCE WASHINGTON AND I AM AWARE OF THE ORDINANCE REQUIREMENTS REGULATING THE REQUIREMENTS 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 CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING OBTAINING APPROVAL FROM TH BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT. X OWNER DATFl y ��' X BY DATE FOR OFFICE USE ONLY DEPARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION YES NO YES NO J HEALTH % 3/gyp PUBLIC WORKS FEE PLANNING FIRE BUILDING PERMIT D.O.T. BUILDING de- PLAN CHECK SPECIAL CONDITIONS BUILDING GROUP -3 PRE-INSPECTION ro wd abt! X—IE-3 SHORELINE WOODSTOVE PLUMBING MECHANICAL STATE BUILDING FEE STATE SURCHARGE APPLICATION ACCEPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE PERMIT VALIDATION '- -94 TOTAL BY 8 •3/ CASH CK MO PLOT PLAN ADDRESS 91Tv eh L /` b PERMIT NO f o LEGAL W- DESCRIPTION LOT BLK ADDITION SITE AREA-6 I a!- . 1700 �1 Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq.Ft. INSTRUCTIONS TO APPLICANT (Aj THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1" 20' ARE Q 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' J _4 d 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 & STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE CHRISTIVASTOWN PRINTING PLOT PLAN ADDRESS /Y�. ��Od !/c1YL' 1} �� /- /41 uy� / YSd�� PERMIT NO. o � Sub-v e 6 6 2 o LEGAL 7 Q � J / DESCRIPTION // LOT BILK ADDITION SITE AREA b Ati Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS ��d Sq. Ft. ri`I INSTRUCTIONS TO APPLICANT W Q THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE Q 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 AND SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL (b 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' �l � I ov h a r b I ( f-, I/We certify that the proposed construction will conform to the dlmsnsiorn and uses shown above and that no changes will be made without first obtaining approval. NAME(SI OF OWNER(a) OF S1TE a STRUCTURE(S) (PRINT) SIGNATURE OF OWNERIS) OR AUTHORIZED REPRESENTATIVE 00 NOT WRITE BELOW THIS LINE APPROVE j- 9v DISTRICT AS NOTED DATE