HomeMy WebLinkAboutBLD18021 Final Mobile Home - BLD Permit / Conditions - 11/6/1985 TYPE MOBILE HOME
Permit No. 18021 No. Floors Sq Ftg 1120
Owner SMITH, David L. Tel 275-3114 bate 10-2-85
Address NE 2080 Haven Way Tahuya Zip 98588
Contractor American Mobile Homes
Address 3722 St. Hwy 3 Bremerton Zip
Legal Description Haven Lake Lot 398
Direction to project site
NE 2080 Haven Way Tahuya
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
1986 28x40 3 bdrm.
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Interior:
Final: r G 5
Mobile Home: `
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 pc'
DATE ISSUED
PERMIT NO. A!51I'Qa
OWNER NAME MAIL ADDRESS CITY 6 STATE ZIP PHONE
DIRECTIONS
TO JOB SITE w Q?Q'?Q _114aUle elzk
LEGAL / / ��� (❑ 9EE ATTACHED SHEET)
NAME MAIL ADDRESS CITY 6 STATE LICENSE NO. PHONE
1 Ames CONTRACTOR oj o Qa
merlyn
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
ra rE, SSu,--Cy
Valuation of work: O/ /�� _ PLAN CHECK FEE PER IT FEE '
/ a
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT ❑ NOTICE
BATHROOMS TOTAL SO. FT. GARAGE ❑
ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING.
TOTAL SO. FT FIREPLACE ❑ 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 th m a currently registered contractor in WORK IS COMMENCED.
the St of Washington and I the
aware of the F O OFFICE USE ONLY
ordin requirements regulating the work for which
the ermce it is issued and all work done will be in
corAormance therewith. PERMANENT = SHORELINES
SEASONAL ElFLOODPLAIN L7
Firm E.D. NO. S.E.P.A. ❑
By Special Approvals IN OUT YES APPROVED NO
Lic. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT�j
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
APPLICATION ACCEPTED BY PLANS CHECK BY ,OED FOR ISSUANC
O Date. Y
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
CHRISTMASTOWN PRINTING
PLOT PLAN
ADDRESS PERMIT NO. o 0
ie
n >
a o
LEGAL
DESCRIPTION LOT BLK ADDITION 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'
-7-111
1
c�
r
I/We certify that the proposed construction will conform to the dlmensiOns and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(!) OF SITE 6 STRUCTURE(S) (PRINT) SIGNATURE OF OWNERS) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING