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BLD94-0867 Cancelled Mobile Home - BLD Permit / Conditions - 10/8/1997
_ Permit No. MAS COUNTY BUILDING PERMIT.APPLICATION 4'�1 426 W.Cedar/P.O. Box 186,Shelton,WA 98584 427-9670/1-800-562-5628, LP b$ PLEASE PRINT '' 11 #1 n H er A e.r-r C c p u S \ Phone# 'g �6ite Address E Fire District City St .�►, a Directs to Job Site ; ` A` ti � —�~,, ;rip Voy CF OAS r-���..r -h. cG �1- Cr Rcic � s� �D� Qtu V _A r: v 1 r oG cl fro r kt Ica�"--} ham r;s In-� A��o ro x, i 50 `5 o r` r ��'`—�- ;v s n c t A- r a M 4y--a , e r ;Owner Mailing Address as IoS S . F 10 c„.,e r ,4L.2 n L.-� City Poc- V r-c,G.a c{ St � zip 98 3 fo G Lien/Title Holder _��Wr�rs� I-r'GLr.�t y d— fie_r- r �z Co v s_ �` ; Address Z 2 fo 15 S f co City 124 _ C2c-L -\a r d St WA Zip ,q g 3 e>io #2 Contractor Name ►J�`e.m C � r rkn-n ;M o '�o r e_ lryloJ��Contr�r Reg Address Expiration Da�/ / City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic? C Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) Doa81 Parcel Nc /ana 9 - as - Legat Descdptiop/, -rR 2 o F -S Y z ' s 71 z_7t'4 u}_ S eL- aI 9. #5 Building Square Footage: (existing/proposed) 1.st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms_ _/ Garage / Carport / (Circle:Attached or Detached?) Other sq.ft. / #6 Use of building << Describe work �� GC #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year 90 Make SNoPT Model (o Y Length 40(o Width /� Serial No.o2E qA "73ga5� #Bedrooms_—#Bathrooms Type of Heat Purchase Price$ 30cx:;) coo #9 Indicate by circli the applicable source if any water is on or adjacent to subject property: River Po Creek )tream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the sine plan Lot Dimensions Flood Zohes Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography SePtic SY em. s Wells Proposedtnprovements Easem e- nts- Name of Flank�►g.3ttept Indl=e Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN lkLOW t APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures(S3 eat Egg MgobnkW Fixtures(S6 eachl No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _B Basins Heatpump,Other _ 1 Bat Tubs N , Fees _Show _ Fur - BTU _Hot Wat Htr _Hea umps _Laundry her _ Vent S tems _Sinks Shot Ve Fans _Floor Drains NQL _Laundry Basins HP Dishwasher N.4, _Disposal _ cfm# _Urinals Ng,, Fire Protection Syst Other _ Auto. Fire Alarm Sy 50.00 Fixed Fire Supp. ys 50.00 Permit B is Fee 15.00 _ Auto Fire Sprink ys \. 25.00 TOTAL PLUMBING $ NCL Other Gas Outlets - — Wood, G ,Pellet Stove _ NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTIONI AUTHORIZED IS NOT COM- MENCED VM!'�M 180 DAYS'OR-g-CONSTRUCTION OR Permit Basic Fee 15.00 WORI(IS aDwoe. ORAB FORARERIOD - TOTAL MECHANICAL $ OF a80-DRA1 AT.,ANY TIC _VMK;:IS-f - MENR�F CON�TIN OF WORIsr IS BY MEANS OF,A:PROGRESS OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQL4RE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION;t,AW CONTRACTOR IN THE STATE t�WASHINGTON AND 1 RCW II8.27,)WO AM AWARE OF THE MASON COUNTY AMAWAREOFTHEORDINAN IREMENTSREGU- ORDINANCE REQUIREMENTS FOR WHIW TkMS PER- LATING THE WORK FOR WHICWTHE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH.NO CHANGES SHALL BE TH: EREWITH.NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIASr'OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE fo DATE : o : i< vt r:. DEPARTMENTAL REVIEW �: FOR OFFICE USE ONLY Approved Cond. j Hold Approval Planning: Environmental Health: ©tarur 1` -hift"A 4 1 et 'ea Ae.4y fts-E c.M 6a d'a-w l Building Plan ` Z�► -jr-AA car-,c. na hQ Oh c,nd ktUAeA 7((0t �aC ( 14,r� Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbingefte ... Mechanical Fee Wood/Gas/Pellet Stove' Radon Monitor Violation Fee Site Inspection �1 Building State Fee Other Other Building Valuation: TOTAL FEE Show following on the site plan Lot Dimensions 4,"' ` Flood Zones Existing Structures✓ Fences� Structure Setbacks Driveways Water Lines Shorelines/ Drainage Piano Topograpl�,yv Septic Systems V" Wells �j Proposed Improvements :Easements Na?ne of Flanking Streety� Indicate Direcxion�by (N, S, E, W) Name of Fronting Street n relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW 0 Aj ee Tk-rq�re 1 9rt� oSt4/o Clcetk"�� New Res ProO�"`` J n 4Fe k h Aolcf000 P-/ ,�'' • l APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW A kX • l00 f no � Noy, Ab �- S r r Creek rrr W rrr�i��rrill�ililY�iIMY Department of Labor&Industries _ ALTERATION PERMIT Factory Assembled Structures Section =J Do not complete shaded areas INSTRUCTIONS: ermit#: 1. Complete all spaces to and including the box with the signature X in It. 2. Then draw map on reverse side of WHITE copy only. Invoke# 3. Submit completed permit and fee to the nearest office listed on the back. 4. Contact and schedule the inspection with the office In which you submitted the permit Insignia#> within 15 days. Owner last namF first name Day time phone Date .............. o��.�.-r_ 1 , .Y .. �� ....�5�.---. Gs--------------------.. S...�...- ...-..9y.---. Address / City late ZIP w gel' O/��` . Installer/Contractor/Dealer Phone Contractors regiltradon number ----------------------------------- N ,�.-------..._..........--- e, Sams Address City S ZIP+4 Check the appropriiii boxes In section A and section B. - FEES A ❑ Commercial Coach B Alteration Inspection(check appropriate boxes below) $75.00 Air Conditioning/Heat Pump Serial No.SS Electrical Electrical Appliances AMobile Home Fire Safety Serial No..; Gas Furnace Oir 07/34 08:40 94003218 66. 75.00 Gas Piping. xuDNo. Plumbing, Structural _ -- Serial No. t St ll P/ ee Stove ❑ Recreational Vehicle or ❑ Park Trailer Woo 7 Gi serial No. Plan Review _ __ _ ___ _ _ ___ _ __ ___- $70.00 RV Inspection ----- -- -- -- -- --- $75.00 Model No.or Plan Approval No. Re-Inspection- No Permit —— —— No $50.00 Technical Inspection - --- - - -- -- - - -- $50.00/hr Signature of applicant or authorized representative Make check payable to: Dept.of Labor&Industries X FEES DUE $ artment use only Request APPROVED or ❑ Request DENIED because of Specific Violations Of Washington Rules And Regulations. Violations Must Be Corrected And ReInspection Requested Within 10 Days For Recreational Vehicles And 20`Days For Mobile....., Homes and Commercial Coaches of the notice of violation date. (This does not apply to technical'inspections). It Is Unlawful To Offer For Sale,Rent,or Lease Any Non-complying'Mobile Home,Commercial Coach or Recreational'Vehicle. ❑ Included are forms required which must be completed and fees submitted before reinspection. Date Area office Inspector Total pages ,� F622-012-000 alteration permit 12/91 White-Olympia Green-Contractor Canary-Inspector Pink-Purchaser Goldenrod-Purchaser 3� 7 fro I aTM 3�zw mm�cp ZI mapt arcI . 1 11 1 i :,*,3 t* < j ZbR. 1-6 C,"-J' Ir w iw mc YD W, 'C' 3& :Z 7m #A oft —, So It CD IP 3P U� Z f— ass fS 2 0 > CJ) ww 4b x O AM 4p < < cn rr, fr 2 Z 3� 77 Da If, 7- w 0 - s a _ .. co 2 ea► Owl 3> c OD 144 N dw 10 co A* zw IM Ift f im aAW M x MW V Z: �w > Ito s mi vp 4b. f"I 711 z 3>11: -r rro -T a at c C TJ j� Sm m< Ds -1 M.-T o CL 'n T Z"o 2,0 11 f-931 ok -4.,v t- ZZ! m M X 0 to no T:3 0 --- m lz I -z*O rt Z 77 rv, -0 --4 ZZ V rl �= -L -< 't n z <ft isca > Mr 0 Z 0 Z wo X, .. 2) Ir --t -�', o. ::r 2, -Z&-t X o OD 0, C :3 Z Z rzc,—Zz 2t 0 Z. C/) Z T T z In n-- 0 —IT O fir\ O. en 77, ID =r C> z Z, z j) 10 CIL 00 C) clo Ol 7T, -TIT r!r '• 4a =;^ 711 Zj, z aj All, MI CL A-1 as 0 'D 'T n z 2v =,Q 0-Z T,< o f� 10, 0 D n TI -:r. -Th 0$ CA C, 0 = 0 1+T"r:y 7 w X o VOA cn -7 7 ca =r (> 0 o to -< zz -2 ft 10 OL 00 C) -P tv CA mm 0 XIM CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons /c date by Gas Piping date-)-tl- Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEFT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NMNG 012 �' 1 date by date by K Water Lne FINAL INSPECTION date by date by date by MASON Z TY BUILDING IIICOW. CEDAR SHELTON, WASHINGTON 98584 (206) 427-9670 IF Job Location qg[ D a .This structure has been inspected by Mason County Building Department and the follovving VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code compliance Lfo V19T I-W Y,6,0 You are hereby that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑Call for re-inspection when corrections are made before continuing ❑Make corrections, items will be checked on next inspection M QK to -"L)VA T Department Date 'J Inspector. ir ( TAGNcff- Am"E r11