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HomeMy WebLinkAboutMIS97-0217 Mobile Home Storage - MIS Permit / Conditions - 4/21/1997 -a cat -i *% z z *0 o - c --Ix -C 0 go Cn Into V G — C- m CD m rn on r- m r a •i I Qa +w -� -n � _ "' Arens = " IC 00 �' m QE► 2 9-4 "'@" tom" ty .6 C3 a 30 d 7e R to C m © sr z I Isis 0 40 GaCQcis ]► I • N N C. tx cox I to CACS i # f M co �r O , y I F CD x n ?.Z m O coo 1 � y i ra V i �91 .I 17c11 a * xaov0z" aTla �+z7 — oaa — cam 0 .. � 3e ao rr -- m v .+ o ib 'v !� 00 co r: '7 o — 0 as t* a m to = 0 r} r- -4 r+ !p rt a s C O Ocr C 0. - 0 3B � O "7 too G9 P+ fa ? -- as 0 w .. 4 n! O WC ®D rt cr i ai �► 0+ 0 0 .+ — 4 0 p m co G 1 a to 0 00 r *77 — = -{ O At r+ r+ T 's r+ 3 r+ O of zr Q or 0 e+ t► r+ 4 O t3 t3 .. C.V x "� "� -• J A C3 C 'O � 0 O age 4 Olv m la 4 V — 0 A A C w { a Q O V zr -i O O O G 4 9A O 0 O � zr Q ^ r- 3 r+ as tr t8 0+ f+ a { a * � 1 °a 02v001)) a' --07 00 IE rn as zr ... � � v ea o -- a► m Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O. Box 186,Shelton,WA 98584 427-9670/1-WO-562-5628 (Calling From: Seattle 464-6968, Belfair 275-4467, Eima.482 5269) �l O j PLEASE PRINT I /J #1 owner p n ex PSel��q v n oet Phone# 36 �'J .2 CJ 1 s Site Address --IYIvy 3 Fire District# City 121&n St W4• Zip ly Directions o Job Site O O O 1VA Owner Mailing Address 4—F, 16 9 9 1 #W V, ,3 -A& I city St A1,051. zip�� Lien/Tdle older Address City St zip #2 Contractor Name fit/ n Contractor Reg# Address Expiration Date_ __J� city St Zip Phone# #3 If septic is located on project site, include records. D R I R 0 FS La Connect to Septic? of Public Water SupplyJ�(�Well i D nn Sewer stem? Name of S Connect to y stem Y (If residential, proof of potable water is required) #4 Parcel No./ 2 3 D - 12 - 0006 o HEAk.TM--SERVICES Legal Description Tr i9f S U S ! 2 S I . #5 Building Square Footage: 1st FI 2nd FI 3rd Fl Loft Basement #Bedrooms-2 #bathrooms / Deck Other Garage Carport (Circle:Attached or Detached?) I #6 Use of building A e-,� �4 m L°_ Describe work eA #7 Type of Job: New Add Alt Repair Other M e✓ti nb, #8 MOBILE/MANUFACTURED pMEw IRMATION Model Year 1 g Make �tct Model 9 //►fi f Length width I Serial No. #Bedrooms Z #kthrooms I Type of Heat �: GG�/Yc Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the sits plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Drainage Plan . Wells Septic Systems Easements Proposed Improvements Indicate Directional , Name of Side Street by (N S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW AOhIC' WTTO=DRAWTOPOPRAPHY PROFILE BELOW Plumbing Fixtures(S3.35 each) ,Egg Meal Fixtures($6.75 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other Bath Tubs NgL Units El3Sg _Showers _ Furn BTU _Hot Water Htr _ Heatpumps _Laundry Washer _ Vent Systems _Sinks _ Spot Vent Fans _Floor Drains Ng, Boilers/Compressors f _Laundry Basins _ HP _Dishwasher No. Air Handling Units _Disposal _ cfm# Urinals Ng,, Fire Protection 5ygerns _Other = Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50-00 Permit Basic Fee 16.75 _ Auto Fire Sprink Sys 35.00 TOTAL PLUMBING $ NQ Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL,AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 16.75 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED.PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27,AND AM AWARE OF THE MASON COUNTY AM AWAREOFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER LATING THE WORK FOR WHICH THE 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 THEREWITH.NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. y -Per,�7m e-1 �Qt� X OWNER �/`•�dL X BY DATE 7' ` ` DATE DEPARTMENTAL REVIEW FOR OFFICE USE ONLY [AWO"d Coed. Had AWovW Planning: Environmental Health: Building Plan Review�A�a_7) CKW-et---� 44 Occupancy Group: Type of Const: Fire Marshal: Other. Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee i Site Inspection Building State Fee Other Other Other Valuation: TOTAL FEE (14 DIRECTIONS TO JOB SITE r PARCEL NUMBER A • •. • rs MEN■■■■■■■■■■■■■■■■V,I■■■■► ,?AR4 W. ■■■■■■■■■■■■N"■■■S WIN 9 • GARY YANDO,DIRECTOR Ms DEPARTMENT OF COMMUNITY DEVELOPMENT N PLANNING-SOLID WASTE-UTILITIES Y �°► BLDG. I . 411 N.5TH ST. * P.O.BOX 578 0 SHELTON,WA 98584 • (360)427-9670 1884.. DISCLADMUWAIVER OF COUNTY LIABILITY:PERMITS ON EXISTING LEGAL LOTS OF RECORD, LAND DMSION APPROVALS,SHORELINE PERMM,VARIANCES,AND SPECIAL USE PERMITS: The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by that Order,the undersigned property owner hereby agrees to waive any lawsuit, action,or claim for damages against Mason County which may arise out of Masan County's actions in acceptance,processing and/or issuance of such permits or approvals(hereinafter"permitting actions'),which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid. D (Parcel No. or Legal Description) owner's si (N ) (or th may accept the signWure of the owner's authorized.agent upon proper proof of authorization) ACKNOWLEDGEMENT CERTIFICATE(INDMDUAL) STATE OF COUNTY OF On this day of ,in the year ,before me Notary Public, personally appeared personally known to me to be the person whose name is subscribed to this instrument,and acknowledged that he/she executed it. WITNESS my hand and official seal. -For Camty use only- Reuie►v�d p t �j (D ) Notary's signature Staff Initial. My Commission Expires: /'p OU 1 /11/-fie r l o, 0, e S e G y cAF\I=�/f�` -e u, ,,( ferm ; f # t Ix y A6644 `r r ,r < i o 11 f-e f Y, � •3 eSe/`f� �j `y Y, 4:17_3 All Y/V APR 3 01997 r ar-A I •rU 0CQ1/10-1:0 s � GUNDERSON SITE 1) Pole Building BLD93-00075 Expired/No final. Framing OK without skin by PH 6/3/93 2) Mobile Home 55x12 Permit#26267 issued 7/25/90 Expired/No final. Setup OK 1/7/91...This unit should not be on site as BLD97-00429(4)was issued as a replacement unit. 3) Mobile Home,1344SF,Permit 27187 issued 11/27/90 Temp Occ approved with setup on 1/7/91. No Final. 4) 197714 x 66 BLD97-00429 issued 5/28/97 and finaled 12/1/97. WS97-00217 was storage for this unit until BLD was issued. 5) Addition/porch permit#27453 issued 2/5/91 Expired/No Inspections. Was not there when LW inspected BLD97-00429. Should have left with(2)