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Home My WebLink AboutBLD97-1122 Cancelled Mobile Home - BLD Permit / Conditions - 9/18/1997 n 6� ^z X o x � tt ODSi 0 0 C - - cn ITV OC) 00 01 -1 t w I a (ICONCRETE MECHANICAL MOBILE HOME iFootings-Setback date by Ribbons Edate --Z5—J'r by �,/C Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB insulation Floors Final date FRAMING by date by date by Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING I date by date by Water Line FINAL INSPECTION date by date by date by 1117 v T w 4 27, OQ w. a X ^ V' � ZZ � cn N 1 Q j ODOl 00 Q _. L >, v_ z _r 'I f I t f i 1 Fit 00 OD 0 ol 3 � �= - Q � z cn z ol 4 00 10 C)L OD Building Permit # ,�G � MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 6<: > z� 17,e 5 2. This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance f.Allv, `:'_ -7 G /xiew /"s/ram,✓� ,..� c�� T%r7 s _ _ o — G �S cG _ T �✓ �i.-� You are hereby notified 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 OK to p cc ;5 ❑ This is not a complete ins ection Department ?� Date ,,,, Inspector , DO NOT REMOVE THIS TAG ,wilding Permit # MASON COUNTY• BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location �� _ This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: items Listed below must be corrected to gain code compliance ;� You are hereby notified that the above corrections shall be made BEFORE PR OCEEDING WITH ANY FURTHER WORK ❑ call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection OK to ( f • G� Li This is not a complete inspection Department �� _ Inspector Date DO NOT REMOVE THIS TAG _ Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 28 a�. 426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-800 562 56 � (Calling From: Seattle 464-6968, Belfair 275-4467,'Elma,482-5269) (9 PLEASE PRINT #1 0 ner Phone#--4'7 ` Fire District# z iteAddress �E 60 45aA � z d St w Zip s ityE Directions to Job Site Lc)&-s7' FigaV"7 Owner Mailing Address ` City Lien/Title Holder - L 7 Address StZip_22 — city r= 4 1 Contractor Reg - #2 Contractor Name Expiration Date Address J St r;rt _Zip Phone# city .y P 'a #3 If septic is located on project site, include records. Connect to Septic?a Public Water Supply Well Connect to Sewer System? Name of Syste (If residential, proof of potable water is required) I-le N"� #4C Parcel No. ! / z Z) - 20 i -S egal Description 1 ,i #5 Building Square Footage: Loft Basement 1st FI 2nd FI 3rd FI # Bedrooms #bathrooms Deck Other Garage Carport (Circle:Attached or Detached?) Describe work_,N�G(� #G Use of building ✓ Add Alt Repair Other #7 Type of Job: New_ .--- #8 MOBILE/MANUFACTURED HOME INFORMATION RECEIVED Model Year Make c� > Model n f/ - Sf P 18 1997 Length � Width Serial No. #Bedrooms — #Bathrooms_--!,:.--Type of Heat Purchase Price$ �n #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 Na�t Show following on the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Drainage Plan Wells Septic Systems Easements Proposed Improvements Name of Side Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW 7 ,� ,� fie• � � -___ 14 1 C��Z b APPLICANT TO DRAW TOPOGRAPHY PROF"ILE BELOW � irk Ea'. Mechanical Fixtures 0.75 eachl Plumbing Fixtures ($3 35 each Fee CIRCLE FUEL TYPE: Gas, Electric, No._Toilets _Bat Basins eatpump, Other _Bat Tubs N Units Fees Show rs Furn BTU -- —Hot W er Htr — Heatpumps — ent Systems Laundry asher — _Sinks — Sp t Vent Fans Floor Drains No. Boile Com ressors HP _Laundry Basins — Dishwasher No. Air Handlin Units cfm# _Disposal — Urinals No. Fire Protection stems Auto. Fire Alarm s 50.00 Other —' _ Fixed Fire Supp. S 50.00 16. Auto fire Sprink Sys 35.00 Permit Basic Fee — 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- Permit Basic Fee 16. 5 MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR 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 ENTLY REGISTERED I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- CONTRACTOR T THE STATE OF WASHINGTON AND I MENTS OF THE CONTRACTORS REGISTRATION LAWREME RCW 18.27, AND AM AWARE OF THE MASON COUNTY ALAM AWARE OFTHE TING TTHE ORDINANCE WH CH THE PIERM TNS SSUED REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- MIT IS ISSUED AND THAT ALL WORK DONE WILL BL BE THEREWITH NO CHANGESE IN AND ALL WORK DONE WILL SHALL IBE MADE WIN THOUT CONFORMANCE THEREWITH.NO CHANGES SHAL MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. X BY X OWNER DATE DATE FpR aFF�C1�1L I�SE;�NI.Y„, P y. ., DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: G o Environmental Health: Building Plan Review v 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 Site Inspection Building State Fee Other jq 1,771 Other Other E ilding Valuation: TOTAL FEE Z� OO'd 7H101 — 1 ib � I US'i ' I � • � GG l instoo N: Pi I � if i 4 i 1� I -lot I . ;I I i i i I I i t0'd 3anina Ol ONI S3WOH lla3HI-I WOad WdTZ:£0 866T-va-L0 Show following on the site plan ---®- - Lot F Dimensions Fencesi f Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Drainage Plan Wells \ Septic Systems Easements Proposed Improvements Name of Side Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW 1400 Y I\ F r � I \ w,Jcc�ds jAPPCICANT TO DRAW TOPOGRAPHY PRQFILE BELOW yG rrE_ sl\ JL- ., o �A !trr? r„ Arj leT_X a� - APPLICANT NAME: ( Gt gftejDATE: BUILDING PERMIT CHECKLIST (� SITE ADDRESS If site address has not been issued refer the customer to Community Dev. ext 291. FIRE DISTRICTS Please make sure the fire district is included in the application information. Refer to map located at counter. DIRECTIONS TO JOB SITE Needs to be as complete as possible (i.e. major roads, is house on left or right side of road, etc.). Be sure to read for clarity (Landmarks, signage, owners name on mailbox, etc.?). LIEN/TITLE HOLDER Who holds the mortgage (Bank or name of private owner holding contract)? Ile CONTRACTOR REGISTRATION # AND EXPIRATION DATE This information needs to be provided. The Building Department may be able to research expiration information if customer does not know it. We must have a signature in 1 of the 2 boxes, either the applicant or the contractor. SEPTIC RECORDS New systems must have test holes dug prior to submission and Septic Application must be filed and paid in full. A B WATER COMMUNITY PRIVATE SEPTIC EXISTING DESIGN APP. DEV REMODEL NEW STATUS IS THIS A REPLACEMENT UNIT? YES NO IF SO: MASON COUNTY BUILDING PERMIT APPLICATION SECTION #5, BUILDING SQUARE FOOTAGE, MUST BE FILLED OUT COMPLETELY. AND: SECTION #6 MUST CLEARLY STATE, "REPLACEMENT UNIT" rQ PARCEL #/LEGAL DESCRIPTION Parcel # must be included. If number is not available contact Addressing at Ext. 291 El BUILDING SQUARE FOOTAGE kJ AClearly show existing square fo to a and that of which is proposed. If there is a garage, verify whether it is attached or detached. Include square footage information for mobile homes.lie. 10X20=200 square feet.) USE OF BUILDING Residence, garage, greenhouse, designate if it is commercial. EY DESCRIBE WORK (i.e. mobile home addition, addition to a house, etc. . .) TYPE OF JOB Verify appropriate boxes are marked. 1 MOBILE HOME INFORMATION Verify appropriate boxes are marked. If factory order, please put factory order#in mobile home serial #. If unit was assembled prior to June 15, 1976, refer to procedures handout for "Obtaining Installation Permits for Mobiles Assembled Prior to June 15, 1976." ❑ SHORELINES/CREEK/WETLAND N If property is within 200 feet f fld dins adjacent propertiesl of Shorelines/Creek/Wetlands, #9 must be complete. If none of the conditions are present please enter "na" or "none". SITE PLAN DRAWING MUST SHOW THE FOLLOWING. * LOT DIMENSIONS * DRIVEWAYS * EXISTING STRUCTURES * SHORELINES * STRUCTURE SETBACKS * WELLS * WATER LINES * SEPTIC SYSTEMS * PROPOSED IMPROVEMENTS * EASEMENTS * NAME OF FLANKING STREET * NAME OF FRONTING STREET ALSO PLEASE MAKE SURE DIRECTIONAL IS FILLED IN ON APPLICATION TOPOGRAPHY DRAWING If property is flat write "flat" on the topography section. If house or structure is near a slope or hill, drawing must reflect this. This should show n accurate side view of the property. ❑ PLUMBING/MECHANICAL P This form must be completed or any structure with plumbing and mechanical excluding mobiles/modulars. OWNER OR CONTRACTOR AFFIDAVIT Owner or contractor must sign affidavit statement and date it. ACCEPTED BY Whoever is accepting permit information must sign your initials and date form on the bottom of page 3 or use date stamp and ir itial on back of permit. ❑ PRINTS 0 k Need two sets of prints unless it is a stock plan. For stock plans, we only require one copy, Commercial oroiects require four sets of plans. ❑ WATER ADEQUACY For new residences and obites. PRIVATE WELLS MUST HAVE WELL LOGS OR CAPACITY TEST AND BACTERIAL TEST. If they are on a public water system, check for signature to verify that the system is not on the State's "out of compliance list" ❑ WSEC &V & IAQ CODE Required for all residential, additions and commercial buildings. Energy Code compliance form needs to be COMPLETED. Verify heat source(no wood or pellet stoves are permitted as primary system). Window schedule must be filled out and reflect what appears on submitted building plans. If applicant has decided to go with the PUD in a Long Term Super Good Cents program, we require a copy of the signed agreement with the utility. ❑ ROAD ACCESS PERMIT A If you will be accessing you driveway from a County road, contact the Public Works Department in Mason County Building 1,427-9670 extension 450. Access from State Highways requires Department of Transportation approval. Contact office (206)895-4753 (Port Orchard). "Notarized statement for GMA" Checklist.2 2-5-97 Trish 2 GARY YANDO,DIRECTOR P�Ot% STA s U N DEPARTMENT OF COMMUNITY DEVELOPMENT N z PLANNING -SOLID WASTE- UTILITIES �o N Y O~ BLDG. I * 411 N. 51 ST. 9 P.O. BOX 578 SHELTON, WA 98584 • (360) 427-9670 1864. DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD, LAND DIVISION APPROVALS, SHORELINE PERMITS, 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 Mason County's actions in acceptance, processing andlor issuance of such permits or approvals (hereinafter"permitting actions'),which damages are atfnbutable 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. qo 3 I Date (Parcel No. or Legal Description) Property owner's signature(Notariz (or the County may accept the signature of the owner's authorized agent upon proper proof of authorization) t ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL) 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 County use only- Reviewed by applicaru on (Date) Notary's signature Staff Initial: My Commission Expires: