HomeMy WebLinkAboutBLD19028 Final Mobile Home - BLD Permit / Conditions - 8/18/1986 TYPE MOBILE HOME
Permit No. 19028 No. Floors Sq Ftg 1344
Owner WORKMAN, Robert M. del 275-5614 Date 7-2 -W
Address 101 Eagle View Dr. NE Tahuya Zip
Contractor None
Address Zip
Iegal Description N-1/2 G.L. 1 & 2 30-23-2
Direction to project site From Belfair St. Pk. ,to Belfair-
Tahuya Rd. Follow 6 mi. to Haven Lk.sign,go left.Past
Lk.Dr. to dirt rd. on left.Top of hill go left.Follow
Plumbing Mechanical f4echanical Sewer Wood Stove around.)
Fireplace Deck Garage Carport
Basement Loft Other
1986 28x48 2 bdrm.
d a33o-16- 000(P o
Shorelines:
Setback: Mechanicar:
Special Interior:
Conditions: FINAL: 07,C F - , -
Mobile Home
Smoke Detect
Rema ks
Footing ; -t
Setback: /
Foundation - -
Walls: 56 i4^'�P,
Framing:
Fireplace:
Wood Stove:
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
426-5593 DATE ISSUED
PERMIT NO.
D AM� MAIL ADDRESS CITY B ST TE ZIP PHONE
OWNER d42 i/ l��
DIRECTIONS
TO JOB SITE / Q �o �D
LE AL
DESCR. 1AC- dTS /4L
NAME MAIL ADDRESS CITY B TATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING e d/J�E_ a.b�le 14leCLASS
WORK OF ALTERATION NEW �� ADDITION ALTERATION REPAIR ^MOVE REMOVE
DESCRIBE
WORK �i9�
x 13
BEDROOMS DECKS CARPORT /0 NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT.'' GARAGE U CONDITIONING.
NO.OF STORIES BASEMENT� ATTACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT
,,��� COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
TOTAL SQ.FT./�� FIREPLACES DETACHED d ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE _LL
SEASONAL
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 THE BUILDING DEPARTMENT. APPROVAL FROM THE BUILDING DEPARTMENT.
� y DATE� .
X WNER � X BY DATE
FOR OFFICE USE ONLY
DEPARTMENY YESPPRovE NO DEPARTMENT YES NO
BUILDING VALUATION
G '
HEALTH PUBLIC WORKS FEE
PLANNIN FIRE BUILDING PERMIT
D.O. . BUILDING PLAN CHECK
SPEC LCONDITIONS BUILDING GROUP PRE-INSPECTION
SHORELINE
PLANNING
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATE SURCHARGE
APPLICATION ACCEPTED BY PLANS CHECK BY AP OVV ORR ISSUANCE PERMIT VALIDATION
/.C-L Q CASH CK MO TOTAL
PLOT PLAN
ADDRESS 6-1 L/� J 2�fr6�PERMITN0. ��� ✓ �"' o
f o
= o
n >
a o
LEGAL a
n
DESCRIPTION LOT BLK ADDITION u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Scl. 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 Al"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'
b
t
Q �
c
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.
T)/ I/ l , 1 I ` --_ -
NAMES) OF OWNER(S) OF SITE h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
6HELTON PRINTIN3