HomeMy WebLinkAboutBLD17602 Final Mobile Home - BLD Permit / Conditions - 9/19/1985 TYPE MOBILE HOME
Permit No. 17603 No. Floors 1 Sq Ftg 500
Owner HOWELL, Edie Tel 275-6176 Date 7-3-85
Address NE 1660 Tahuya River Dr. Tahuya Zip 98588
Contractor None listed
Address Zip
Legal Description Collins Lake Div. 3, Lot 60
Direction to project site None given
Plumbing Mechanical Sewer Wood Stove
Fireplace Deck Garage Carport
Basement Loft Other
$2,500.00
I
Shorelines: A/11,
Setback: /,/'
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Interior:
Final:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY ,
P.O. Box 186 Shelton, Washington 98584
426-5593 �
DATE ISSUED ��'' xx
PERMIT NO. / �(.(�N
OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE
i Lo` r' ?_ A Mai '
DIRECTIONS
TO JOB SITE — 1'
LEGAL (❑ SEE ATTACHED SHEET)
DESCR. G I <U J �" Lto A
NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE
CONTRACTOR
USE OF
BUILDING -
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: ,
Valuation of work: $ PLAN CHECK FEE PE� �ITFE(�
SPEciAt CONDITIONS:
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BEDROOMS CPU j FDECKS CARPORT G NOTI
BATHROOMS TOTAL SO. FT. GARAGE L
ATTACHED IJ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT [) OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE [I DETACHED L
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 certiy that I am a currently registered contractor in WORK IS COMMENCED.
the tate of Washington and I the
aware of the FOR OFFICE USE ONLY
ord' ance requirements regulating the work for which
th permit is issued and all work done will be in
c nformance therewith. PERMANENT f1Y SHORELINES
SEASONAL I i FLOODPLAIN
Firm E.D. NO. S.E.P.A. ,
By Special Approvals IN OUT YES APPROVED NO
Lic. No. 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
of the Mason County ordinance requirements for BUILDING DEPT.
which this permit is i ueVan.d Mat all work done will ROAD ACCESS
be formance re MOTOR VEHICLE PERMIT
ti APP ATION ACC TED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner � ate . BY
fit
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS / PERMIT NO f
0
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ICI D
LEGAL A
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 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.
0 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
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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 _
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NAME(S) OF OWNER(S) OF SITE A STRUCTURE(S) (PRINT) IGNA TURF F OWNE (S) OR A NORIZED REP' ESEN TATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
CHRISTMASTOWN PRINTING