HomeMy WebLinkAboutBLD12299 Mobile Home - BLD Permit / Conditions - 4/16/1982 1
Whitaker, Richard L. #12299
396-4310, Bremerton 4/16/82
Collins Lake, Div. 3, Lot 76 (Rich C. Burrows)
Past Belfair St. Park, follow signs to Collins Lake
Mobile Home Contractor:
12'x60' , 1975 None Listed
$9,000.00
Shorelines:
Setback:
Special Conditions:
Footing: �-
Setback:
Foundation-Walls.-
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:_
Exterior:
Interior:
Final:
Stop Work:
Mobile Home
Remarks: r
PERMIT
—_{ -fie— 1 z'`
D AT-i- f t t�`. -ram
• BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593
DATE ISSUED /a'_��09 O
PERMIT NO.
OWNER NAME MAIL ADDRESS CITY 8 STATE ZIP CCPHONE
DIRECTIONS
TO JOB SITE�W dFLF Ir alit' 7'PAA.4e 1p- i 'S T e44 A J £
LEGAL C-7-w��GJV 7 (L7 SEE ATTACHED HEET)
DE
NAME MAIL ApbRESS TY 9STATE LICENSE N . PHONE
CONTRACTOR
USE OF
BUILDING
Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work: p /
/7 9911 l '745 aA..tayz
S ovr Z �Ox //011 %Nu 9-75
7_�o
Valuation of work: $ O PLAN CHECK FEE PERMIT F,F,� _
7,� 7.�S
SPECIAL CONDITIONS:
BEDROOMS DECKS CARPORT L NOTICE
BATHROOMS (TOTAL SO. FT. _ GARAGE []
ATTACHED L' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT L; OR AIR CONDITIONING.
TOTAL SO. FT. FIREPLACE G 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 that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FO OFFICE USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT SHORELINES IJ
SEASONAL f 1 FLOODPLAIN [I
Firm E.D. NO. S.E.P.A. L]
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH EPT.
PUMC7NRKS
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 at all work done will ROAD ACCESS
be in co formance,therewit MOTOR VEHICLE PERMIT
✓�� LI A CATION AC EPTED BY PLANS CHECK BY APPROVED FOR ISSUANCE
Owner _ Date . ZIfZ �)/ _ n
PW CHECK VALIDATION CK. M.O. CASH V T VALIDATION K. M.O. CASH
PLOT PLAN
ADDRESS PERMIT NO. 0 o
z o
n >
� 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"ID 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'
7
r ,
s' l
J 4'
1/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 h STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED
DISTRICT AS NOTED DATE
SHELTON PRINTINi
i