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BLD2008-00925 ATF Park Model Replacement and Water Adequacy - BLD Permit / Conditions - 7/24/2008
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X ::r [4 i 0 I § 0 $ § � < CD tT 6 0 � cr / / kM : 9 / z 90 CL -0 � ) )_ § § 2 £ » � 2L _ < C 0 L . � ® s2 R § 0 q o a_ • � o \ � f0 k \kW E � ■ W k D Q) ƒ 0 E • :30 CD 0 \ . § / 8 « � § � 2 CDErr � � k E > iCL ® - ° dk / ) / i \ W g � E / i _kko Vi § \ «I \ k ' \ 8 0 R 33 - { kE 2 ] Ek ] k % ƒ < vr / k2 � k \ ACD FL � k CD k \ � . \ ± � CA 3 s0 ° # § co C) 2 CL 0 � ƒ 7 � a k ƒ/ ° / 0 M CD_ o � 2 , s \ � � & � f''n f Y Q � • a t s� .4 •c- ,�L - • s F } r i FORM YUSTJR& COMPLETED IN INK J� (� P SE PRESS MASON COUNTY PERMIT NO. W3 �J-Lb q fBUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 D C r on (360) 427-9670 • Belfair(360) 275-4467 • Elma (360) 482-1 �6 E I VOn the web www.co.mason.wa.us I I ATION CONTRACTOR INFORMATIr Dz--0��3/✓�y Company Name g Address po /�16" Mailing Address AIR OFFiCr, City -yam State")A Zip Code City State Zip Code Phone 40 -12 Other Ph Sot-o Phone Other Ph. Contractor Reg. # Exp. €M.261-address E Mail Address nr4.Qrs Lin-4 Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Nf4s Existing Septic t-' Connect to Water System _Name of Water System /fit Well L0004 Sewer Syster ' A Name of Sewer System h4j,±� PARCEL INFORMATION - 12 Digit Parcel No. z-1 aC 1 ®O Fire District Legal Description--A,* l'e V-LdoZ' *_4 A e CA-t-VACA.,.WCA1 Site Address (Please include street name, street number and city) t6 1 /.l.IS-, 00tT*4 tom / / Directions to site c -% So�T k L 15a "%L ws �J�sST L Qe-004 S O K,wu L ► Ii 1 a uetrk 1 Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement acti Y o TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENC EASONAL L] Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACT}JRED HOMF INFORMATION - Make A'y14, h Model A{!Ql %6 Year2O06 Length4 �/Vidt 11t��Serial No�.1 o. of Bedrooms No. of Bathrooms / Type of Heat Pd`'L� ��rW#.e ( e$ -4 ti©OOe Replacement Unit? Ye No 4 Installer Name ''_' mow— C!AQG►� 'R-V �&4"L1 Certification No. �� 91 OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEA APROGRES INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X Date: '7--:2 4 Owner/Owners Representa /Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: ' Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION - •' t i 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 i (,t( Selton (360) 427-9670 • Belfair(360) 275-4467 • Elma (360) 482-5269 r On the web www.co.mason.wa.us APPLICANT I ORNfATION CONTRACTOR INFORMATION Owner,!:' f, Company Name Mailing Address / <` _ Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Contractor Reg. # Exp. E-4a44ddress E Mail Address --B@g- Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic � Existing Septic y' Connect to Water System °A Name of Water System A Well_ Sewer Syste►aT Name of Sewer SystenLN/�r� PARCEL INFORMATION - 12 Digit Parcel No. Z.I CIO 1 0 Q Fire District Legal Description An 4 e'_ 4'L.0--r T-A WCjZ Site Address (Please include street name, street number and city) e I h.!• M i4d. Directions to site �"r% '+ +it�"i" t `', C I -rtrzq 1 5 }ti.. %.- rr.K t,4c C--r' S 4 1 v Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?t Ygs No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make AT�4lSus p _�Model Q1 tO Year2 Length�Widt 11h Serial No. 5 Ia Q o. of Bedrooms NNo. of Bathrooms / Type of HeatPIZA'p �_q�'rfr Ae rife$ At 1C.,C- Replacement Unit-AMN No Installer Name c' C WGG;k R.V. C-4Z4 ->-S-- Certification No. 0 - - °`b' OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OFAPROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X :. Date: 7 Owner/Owners Representative'/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: .... X > Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department .A' Planning Department © fl Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State,Fee Violation Fee Pre-Paid at Submittal Valuation $ ,. TOTAL FEES ,. MASON COUNTY PERMIT NOAW Q( ) -' JJ 1�J BUILDING PERMIT APPLICATION 1 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 [ton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT &FORMATION CONTRACTOR INFORMATION caner':%%'©z--- Company Name Mailing Address Pe l-:�O u -76 Mailing Address City -F Staten; Zip Code X5!'� & City State Zip Code Phone 340 -2 75 L97vt;57 Other Ph��IL561- o �b 6 Phone Other Ph. Contractor Reg. # Exp. E Mail Address z4vaw'.I ..# fig- Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to,New Septic- ''46t Existing Septic 4� Connect to Water System Name of Water System Well ✓ Sewer System N A Name of Sewer System ILDirections NFORMATION -12 Digit Parcel No. Z I CEO t O Fire District ption ,* �'e- i'L'0-r " < ---C-AC.�W (Please include street name, street number and city) 0 I l•1•Is• t7�SF/O� /9` site e-'t"� So�T ! 1.. t k' t 'S1t-rrs IaST-e. P•1C++�fi-+ 5 ®�2 " a A txd6--t_ Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement acti No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENC EASONAL ❑ Use of Building Describe Work N6. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOMP INFORMATION - Make krl- GM.s Model pq.% ZC Year2O0b LengthS4-9S%idt II In LA' Serial No. o. of Bedrooms No. of Bathrooms Type of Heat hVP,'0�'4"1 W ° taKAe i e$ 'd k 0� Replacement Unit? e o Installer Name c L-ftdR-� �-'�riek R•V � Ike- Certification No. ��-R- *�� OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS9fAPROGRESS_INSPECTION.INACTIVITYOF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. f d ' X _.__,� n t ..z..�-� .�z Date: Owner/Owners Representat'v /Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW AP ROVED DENIED NOTES Building Department a Planning Department Environmental Health Department Fire Marshal `` FEES Building Permit Fee . NO Site Inspection Plan Review Fee oZ - EH Review Fee Plumbing & Base Fee — PlanningReview Fee Mechanical & Base fee Other i Wood/Gas/ Pellet Stove Fee Statef ee Violation Fee c;.q 2• 010 Pre-PaN at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. i BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 \S.helton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien[Title Holder Contractor Reg. # Exp. E mait.addreYss E Mail Address 0rugs-,L4G_# pry Drivers Lic.# DOB it SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System _Name of Water System_ i A S Well w� Sewer Systeml)LA_ Name of Sewer SystemE-+ PARCEL INFORMATION - 12 Digit Parcel No. I Z'Z--,L .. Z-1 QQ 1 0 Fire District Legal Description A . t €' + ;" `tt.� Site Address(Please include street name, street number and city) i �5; 1 E:. I t,3, Directions to site i, ., .' 7-i C. t..x .. iGr i 1 `.: C' l L"" I -5, v_-t% i.. �,.' A ;C,..Y'.. t\.-t It_..aa4x.L.Y., Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE` < SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached E MANUFACTURED HOME INFORMATION - Make A'T'"G, Model ► Year� � C Length %idt the"Serial No., 5! 8 —No. of Bedrooms ' No. of Bathrooms / Type of Heat '`' : `"I u1't'fi� e"f''r e $ �' C. ? �- Yp ,�. Replacement Unit. 'ems No Installer Name k _. = -+ . v! te,a-1 '"-_�. Certification No. ''` "4 OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted b : `'. Date r P Y DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department >, Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES . I u Z C, ¢ j Ld J ►- m ZD LU LLJ J �i 4, ti- a <u1D z n •c Ilk t w i zo p CL CL c � M � 0 � ¢ Vj %A LLJ - � u to .N 4 7 w ;t � a • 7i.- iva O Zw Z a O w Cn F- U K � � robes 1 V+ - ArcIMS Viewer � � �i4iN1 no ste sass 3n2= =N suQtE r r http://mapmason.co-maSOn,wa.us/webiitp.ttqa§(Inl ilgi frq,.nl� lit ! 1AR8 hltp://maptnasame+�:ma�:v�:tisJ�tb biteJeS� raxne:ti i i i } 1\ � i 1 6 !i f I 3 t MASON COUNTY DEPARTMENT OF HEALTH SERVICES July 30, 2008 PO BOX 1666 Shelton WA 98584 Shelton (360)427-9670 Fax (360)427-8442 Elma (360)482-5269 Cgrz,ul C�rv'-y Belfair (360)275-4467 Case No.: BLD2008-00925 Parcel No.:322282100100 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: I r Please see comments at the end of this letter. Please call me at (360)427-9670, ext. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services Comments: There is one drainfield on the non shoreline side. It has two tanks, one on each end. I am enclosing the as built for both of the systems on this property. Both tanks will need to be pumped for maintenance of the drainfield the building permit . The pumper is required submit a report to Mason County Public Health and give you a copy. Both of these systems are community drainfields and require annual maintenance. i i 7/30/2008 1 of 1 BLD2008-00925 t i i MASON COUNTY DEPARTMENT OF HEALTH SERVICES July 30, 2008 PO BOX 1666 Shelton WA 98584 Shelton (360)427-9670 Fax (360)427-8442 Elma (360)482-5269 Ala`v Belfair (360)275-4467 -7 F W { —r-�-h Case No.: BLD2008-00925 Parcel No.:322282100100 E E Dear Applicant: k Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Please see comments at the end of this letter. Please call me at (360)427-9670, ext. 353 if you have any questions. Sincerely, CVY L" Cindy Waite Environmental Health Mason County Health Services Comments: There is one drainfield on the non shoreline side. It has two tanks, one on each end. I am-enclosing the as built for both of the systems on this property. Both tanks will need to be pumped for maintenance of the drainfield the building permit . The pumper is required submit a report to Mason County Public Health and give you a copy. Both of these systems are community drainfields and require annual maintenance. 7/30/2008 1 of 1 BLD2008-00925 ' MASON COUNTY DEPARTMENT OF HEALTH SERVICES - Environmental Health _ - Personal Health PO BOX 1666 SHELTON, WA 98584 LOCAL(360)427-9670 (360)275-4467 Application for Determination of Adequacy BEL AIR FAX(360)427 7798 Instructions �� "' � �' a=F art 1.:f�z >� n=1be m�';. u>� 1�;� 'i.(s�" � "°•�;. sit�l tl'i1�9 �� lrrxter� 't�f � �Itl�de PART 1: Applica Parcel Identification Name of Applicant Date Mailing Address —r Telephone 0---Q Assessor's Parcel Number D e of Water System Check One): eason forA lication Check One): ❑ blic/Community Water System(2 or more ❑ Building permit onnections)* ❑� Land use application, if so.. ❑ Individual water source tone connection), ❑ Division of land: if so.. Well #of Parcels? SPL Spring/surface water ❑ Boundary line adjustment ❑ Other(explain) ❑ Other(explain) k"If you have more than one residence ❑ Replacement(please indicate name of water system connected to this well,check the Public box. below if applicable-no signature required) PART 2: Water System Information Complete the section appropriate for the type of water system being evaluated: Public Water System Name of Water System Water Facility Inventory(WFI)Number: (write "none"for two party) I am the manager of this water system.The water system has been approved for services. There are presently connection(s)in use.This will be the connection. I am the manager of this system.This connection will be to upgrade or change the use of an existing connection on this system(ie:recreational to full time).Please indicate on the following line the nature of this change: This water system is able and willing to provide water to this(these)connection(s)without exceeding the limits of the system ov\any limits set byrstkte and local regulation. j• Signature of Water System ManagerA�- CX Date 7 Z009' Update:Apri12006 give my permission for my friend, Norman 5kawstaJ, to act as my agent in regard to procuring the placement Permit for my Athens Park Model in space #9 atjummertide Resort.and Marina. Norman has been a builder developer for the past 40 years, now retired. The Park Model has been in place for 19 months. I Dave received no word from anyone that a building permit was required to place the rarlc Model in 5ummertiJe Resort and Marina. E)ev Voss, owner of 5ummertide Resort and Marina, informed me about a month ago the building department inspector, Terry, was here and told her a permit was needed for my rarL Model. I have received no prior official notification from the Mason County building Department that any permit was needed. There was Plenty of time, with Terry in the area constantly, to notify me that I needed a permit for the park model. I feel a fine for not having a Permit is totally unfair since I was not aware a permit was necessary in the first place. Worm : (2-0(a) 300 y7yf Carol Chaney) Owner RECEIVED July 16 2008 JUL 17 2008 :�: MASON COUNTY Mason County Planning Intake Checklist Owners Name: WPLA"Ck Date: Project 0 Reviewed By: Proposed use(s)of structure(s) Commercial Development: YES O PLANNER: GBM TSW PBC RDH RK JMS S�. North Arrow o Survey required in Allyn UGA — ❑ AF# o Monuments perty Dimensions: X aclo" is and Driveways Shown.Road name: All Existing Structures shown with setbacks and use Location, Septic and Drain-field Shown with setbacks a—Identify all surface water(streams, ponds,shoreline,wetlands, natural or historic drainage,defined drainage ditches) a--Topography(slopes) Minimum Structure Setbacks(Direction/Setback): T F: — . R: `_I Si: _/ S2: —J — �ti� and Drainage Easements: Yes No (if yes enter condition #5022)<My er Easements Accessory Appurtenances: Propane / Heatpump n Vt _ L'(, xi site plan show landing all exits? (L&D � �19� (A ��ariance applied for: Yes No - parking spaces allotted?6YegNo � J "unty Access Permit Need add condition #0010) r\3�i � "Qe State Access Permit Needed"(add condition #0020) , Y-\�o . Standard Conditions to be added to all Building permits that planning r We : #5019 and #0700 bbY 8 1 Site Access: Are there any impediments(dogs/gates)that my restrict access Q ? Is the site dearly marked? How? 11 Address Name r V y Zonin fie:GmA I . Plan Rural Zoninal Zoning: ❑ Rural 0 RR 2.5 5 10 2 T/R p ❑ R-5 0 HC 0 BI 0 RAC 0 RMF 0 n own ❑ R iP -10 0 LT ❑ .Allyn UGA. 0 _RC 1 2. 3 ❑ Agricultural ❑ R-1R 0 T ❑ Belfair UGA 0 RI ❑ In-holding p R ❑ PF ❑ M MHP ❑ Shelton UGA ❑ RNR ❑ LTCFL R 3 ❑ POS ❑ GC 0 ❑ Tribal ❑ GC-a Critical Areal: (streams, ponds,���wetlands,steep slopes) Shoreline Designation: ❑ N/A Urban ❑ Rural ❑Conservancy ❑ Natural ❑. Unkown Water Body of water If Unnamed): c) � - SEPA: Ye No nknown Flood Plain: YES/NQ Unkno Map# .Aquifer Recharge: YES/NO Unknow\ Map# - 'tags/cases: RLC/SPI Case: ' 6-Year Dev. Moratorium Y Eagle Nest Tag: NO Other Y N0 Revised: 02-07-2008 I:VnANM NG\PAG'\PLANMNG IWAKE