HomeMy WebLinkAboutBLD25590 Final Mobile Home - BLD Permit / Conditions - 9/20/1990 Shorelines: Plumbing:
Setback: Mechanica :
Special Interior:
Conditions: FINALs�1�;
Mobile Home:
Smoke Detector:
Footing:
Remarks:
�,
Setback:
Foundation
Walls:
Framing:
Fireplace:
Wood Stove:
TYPE MOBILE HOME
Permit No. 25590 No. Floors Sq Ftg 924
5-
Owner WALTON, William Tel 274638 Date
Address p 0 Rix 807 RPlfair Zip
Contractor Self
Address Zip
Legal Description Collins Lake Div l Lot 38
Direction to project site North side Collins Lk East of Public
ank NE 1041 Collins L
Ike Rd
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck garage rport
Basement soft Other
1985 14x66 2 bdrm
BUILDING PERMIT APPLICATION
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
P.O. BOX 186 SHELTON, WASHINGTON 98584
427-9670 DATE ISSUED
PERMIT NO.<=2%f �'57Q
OWNER NAME MAILADDRESS CITY&STATE ZIP PHONE
DIRECTIONS
TO JOB SITEr LIZ:�71 4"
,.t
PARCEL LEGAL
NUMBER p� 3 --Q®� DESCR. L���
NAME MAIL ADDRESS CITY&STATE LICENSE NO. ZIP PHONE
CONTRACTOR
USE OF
BUILDING
CLASS OF NEW ADDITION ALTERATION REPAIR MOVE X REMOVE
WORK ✓
DESCRIBE
WORK Lj" --
L�
BEDROOMS DECKS CARPORT NOTICE
SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING OR AIR
BATHROOMS TOTAL SQ.FT. GARAGE CONDITIONING.
NO.OF STORI ES BASEM ENT 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. FIREPLACE DETACHED ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED.
PERMANENT SHORELINE
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 CONFOR ANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST CONFORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING
OBTAINING PPROVAL FROM THE BUILDING DEPARTMENT. Q p/� APPROVAL FROM THE BUILDING DEPARTMENT.
X OW R ATE ✓ ' / !/ X BY DATE
FOR OFFICE USE ONLY
DE ARTMENT APPROVED DEPARTMENT APPROVED BUILDING VALUATION
YES NO YES NO J
HEALTH PUBLIC WORKS FEE
PLANNING FIRE BUILDING PERMIT
D.O.T. BUILDING PLAN CHECK
SPECIAL CONDITIONS BUILDINGGROUP PRE-INSPECTION
SHORELINE
WOODSTOVE
PLUMBING
MECHANICAL
STATE BUILDING FEE
STATESURCHARGE
APPLICATION ACCEPTED BY I PLANS CHECK BY D F ISSUANCE PERMIT VALIDATION
r, c n TOTAL ,
J — D� j c1 BY CASH CK MO
PLOT PLAN
ADDRESS E Z 12'j j CPERMIT N0. f10
LEGAL
DESCRIPTION LOT i ' BLK � ADDITION M��� � �.,� ,.
SITE AREA Z4 - Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS C7Vn 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 AND 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'
i
o
a
Q
l
I/We certify that the proposed construction will conform o • tttensia"s and uses shown above and that no changes will be made without
first obtaining approval.
LA III,4t1XM wxy-72W
NAME(s) OF OWNER(S) OF SITE STRUCTURE(!) (PRINT) �I�.N TURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE