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O© #+a,--� 0 ,0 o-► cm a- z f+ D Ci a Ow -.6 00, 0 I ca moo ' c''fp � 5 I Z 1 I- ac +o Q ((D vo k --r cars ='+m s =) a O Z� = C Mc e cx o Qpb Z m a .. C � C k. 0 COM o n k $ O OD zr 2 4 10 Q j Ol 0 ttt a -+ f o c C' G) E' R { t I I I MASON COUNTY --permit No.et-D I8-M61 BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton,WA 98584 '427=9670 (Calling From: Seattle 464-6968, Belfc1ir 275-4467, Elma 482-5269) PLEASE PRINT rc{g,- fp 9 7-0,9-7 f #1 er Phone# S wn — 1 Xite A dress S Fire District# CityVV-h-;1z AL St Zp Directions to Job Site Owner Mailing Address city St St Zip Lien/Title Holder Address City St Zip #2 Contractor Name Cj��v-sL- UBI# Address Contractor Reg# City St Zip Phone# Expiration Date__J_1 #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 rcel No. a'�D'R- Legal Description Tk , 13 dyf- C. C. LD r 5 �j ro/�' 1 � #5 Building Square Footage: 1st FI 2nd FI I *Loft Basement # Bedrooms #bathrooms DecOther Garage Carport (Circle:Attached #6 Use of building Describe work #7 Type of Job: New Add Alt Repair Other -U #8 MOBILE/MANUFACTURED HOME INFORMATION D Model Year Make Model JAN 2 7 IN Length Width Serial No. #Bedrooms #Bathrooms Type of Heat PERMIT CENTER 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*k%mhg on the site plan Lot Dimensions Fences Existing Structures Driveways Stnxtxe Setbacks Shorelines Water Lines Topography Drainage Plan Wells Septic Systems Easements Propowd Improverre3nts Indicate Directional by (N, S, E, W) Name of Side Street Name of From Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures .45 each) Fee Mechanical Fixtures(57.00 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs NQ Units Fees _Showers _ Furn BTU Hot Water Htr Heatpumps _Laundry Washer Vent Systems _Sinks _ Spot Vent Fans Floor Drains No. Boilers/Comgressors _Laundry Basins _ HP Dishwasher NO. A1r Handling Units _Disposal _ cfm# Urinals No. Fire Protection terns Other _ Auto. Fire Alarm Sys �• Fixed Fire Supp. Sys 50•00 Permit Basic Fee 17.25 _ Auto Fire Sprink Sys 35•00 TOTAL PLUMBING $ No. 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 17.25 WORK IS SUSPENDED OR ABANDONED-FOR A PERIOD TOTAL MECHANICAL $ 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 LAWCONTRACTOR.IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS,PER- LATING THE WORKFOR 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. X OWNER X BY DATE - DATE DEPARTMENTAL REVIEW FOWOPFICE USE ONLY Approved Cond. Hold Approval Planning: 1�P✓�2 `� Environmental Health: Building Plan Review l q y roe---- Occupancy Group: - i Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit 737,725 Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove - Violation Fee Site Inspection Building State Fee Other Other Other Building Valuation: TOTAL FEE CIO CoxCD r, CO � — _ �✓ X .� f co) es�f � � i Vr j � � k( ti r } , T, rj + I Jon �o.•�orumtc_. n � nE" IjI �Aa 47 v .ed Ao 15+ 1 `TUTU/?mac � 1 f�l :6) PLEASE NOTE THIS MAP IS NOT TO SCALE WE JUST WANTED TO SHOW THE APPROXIMATE LOCATIONS OF EACH ('►t'4 0155 (1Ut� "1 �hCn� �ic�c��{ MOBILE HOME SPACE. �U �.tCj in _+tN Ly 5 q rxl� r .J on X.L.I G rYl 6 b 4,K6 m I��orccmc�. � � rn&� 4 - �p i 4t AA4- �p #to PLEASE NOTE THIS MAP IS NOT TO SCALE WE JUST WANTED TO SHOW THE APPROXIMATE LOCATIONS OF EACH MOBILE HOME SPACE. MASON COUNTY DEPARTMENT OF HEALTH SERVICES March 4, 1998 PO BOX 1666 SHELTON, WA 98584 LOCAL (360) 427-9670 ELMA (360) 482-5269 BELFAIR (360) 275-4467 FAX (360) 427-7798 Steve Hunt 4255 North Shore Road Belfair, WA 98528 RE: Sun Beach Mobile Home Park Water System Parcel Number 22202-31-00080 Dear Mr. Hunt October of last year you were notified that the water system that serves the mobile homes at the above referenced mobile home park would need to obtain approval as a water system. You have not yet responded to that letter. Wells that serve more than one single residential connection are required by regulation to meet certain standards and monitoring requirements. Failure to meet these standards and monitoring requirements is a violation of WAC 246-290 and Mason County Drinking Water Regulations. All violations of State and local regulation are determined to be unlawful and declared to detrimental to public health, safety and welfare, and are public nuisances. You are required to contact our office by March 18, 1998 to work out an acceptable time line for correcting the issue. Failure to do so will result in our office having no other alternative except to start enforcement proceedings. If we have not heard from you by March 18, 1998, then we will have no alternative except to take appropriate enforcement action. Failure to respond can result in criminal and/or civil penalties. Sincerely j Carolyn Jensen Environmental Health Specialist cc: Claire MCElreath, Area Sanitarian Guy Grayson, Area Sanitarian