HomeMy WebLinkAboutBLD95-0050 Mobile Home #12 - BLD Permit / Conditions - 2/21/1995 LAC W Wrm (n2 w- 00 -i01A O R7p C
m D c O.D S - -
rff W 2 x A < A K r Z
a oes D9ACn - -i 9ggDOD ymA 'OA � D -i ➢ CA
rf f „'� o e -i � 7cmr rTm37ZA OrCrn 9 O I
Tom - I ZNv
-40M . y A O . p m A EAm _
IJp 2ZN 1 m - -iC T O -12 mq C7
1 i - 2r G'7 rn D O mCA@
Z (n 1 0 - 0 n A C r m, r 0
$ t!) 0 za m O D
D rp 9 S a 2 (n 2 2 Z
D . . . . . SN r
r@ -
P sav e o N 1 1 NNLZ s Am
r'^ = o..
w
'. oaw s @ y1 t rt rt rt rt rt 1 s E/1 -4 T W
..INN -'
e i'. � COOr Om �CA � fAWLD1 V1v $ m W CJ W @
S D - D w r - r D 2 ➢ D O S ➢ C — r r.l ➢ @
sm o y - W 9, C - 0 1 0 -4 0 -4 -1 - O 2 0 S G O q " - IZ a@
ozm = Z20A -Im f SSr SRO m a) w ma O ul
m b xc7r2xS9m m m - - r 'sZ @
Oe -of- D > W - mm S -im -i rZ r T Cf
� 032j0 Rrn W W 20OAm . N w @A7
a .
0m30 —n a -➢i : to N a (n s V N
W 0 D O Z x co m : D - s 1 0 —
�o X ➢ . -t c CM X S W . - A . -iv Q1 i m ® 0 Q
r . fn2 • � m (n T . : . D tOaV+ -
I .. N - .. r . � O O
co
eo _ •� s N x/�
ye - j W W O
r O\ Z
y T
x
A a O s N n - O W n
mmmccc c O CL O
-{ m` = v h x ZzDaaa m
.. rT rngj Zt i '1 i ca Wes'
� m -90m@@ � -
x m= Z = - 0x 7 i "• o s 'Inz
m T= a o 0 o v� • azo
v CQ
Z z N ,s, a O -0 Q
= 19@ I i9@@9 S1@ ! - c�2 Q
mcn
e e m I I v q U: C
m , .p
a
en va D -im 00 < O
_ YnSr ; 0D cnW _<
s� T O m 0 -0 @ 9 C71} j@ m y A A C
aw c) a o y � m
t71 � ISO ul 0)
m Cr S S x x S Cl) r -i td
MZZ . V1
I �
i J
av � cr n: W < fn 90 O m X
�z aomgz A, M 0 vD e T
@x � v ➢ Zxm -
a d - 2 -1 S g m r r D,
03> . x c 1 T
a v Z l m °� Z
o' m 1 m e
m l -i In a
'fry p
O
P
Pdateby
CRETE MECHANICAL MOBILE HOME
ngs-Setback data b5' Ribbons
by Gas Piping date b
etion Walls
�, date b Set Up
FBGtSLABInsulation INSULATION date C� 3'7-gS by
by Floors Final
ING date by date by
by Walls FIRE DEPT.
BING date by date by
dwork AMC OTHER
date by
. WALLBOARD NAILING
by date by
Water Line FINAL INSPECTION
date by date by date by
7 cl,I IO nf � �c y 6n nreSs�r � ✓ e / c a ��
J44& f/
f
00 x m aD
mo
az K m C
DO E
M1 ( -�
�C r- 7107 -
mo ama
Z-f
IQ zio
DZ I a
Z O O
9
CO apa
zo me*
-m o-o
1.10 r—ar
OW a
a —
i-i
CCD OVO
—m
r �
o�+ rta rt
—z
2m m rtm
v m O Q
OCR so 0) O
mm
xm
O (n CDs X n O
x0 U C
0 . :5
a c �
m (D W
m m�
s m o (Q
rta o n
D OE
O -O Q
Z QO OD Q
q=r UI
0 9 �p
C -O
z ,+a
K n-
0 -5
W qq
C P N
r' Zq
O Ort
Z c
D -O
zrt
Oc
-•7
G Oi
n-
m rA
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date r' by Ribbons
date I by Gas Piping date b
Foundatlon,Walls date by Set Up
date by INSULATION date by
BG/SLABinsulation Floor. Fnai
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attio OTHER
Groundwork
date by
date b
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date y� by q' L date by idate, by
l J n7'c 11117`G Do --5� °P �YbAk l
o
D-In O 40mpO--'+7'a-ma xOb X -DaODZV X T-y Z T TT
77'- `j. Z---137 Jm 07 xrn mr Z(nmmZAC
0z 00 nC Ord OIVi--00<a �� 0 m 7001C00090O9C C - •omzb m(n - OOJ .
--e �7 .rf0 -mm00'�� 'r- -0 rnV:wmr 0G 7 q -i.
ao .+ ..
a. qm _.»� 'Jm7m m2 -Imm i:� 3C6n m
a'-'- O -`-to 000 n»LO �.VI �.Gi T12 mu; 0 - -cow
-m- Z -vAm-my zr -4
m .21 �1]N--' m-i O -RIDS N- 7
7m� D O »a037�300 I yC i/iTOym0" ?7>' U
�C 1+1 m �7 . O ---C 7 7 T2
2a mA.. m m .-c
O -m A »- 37 00 m7o 00 tA-
Zm7 1 5--- »a 07mm O TTO� xp <m r1
7 c O m rt-6= m ya-A O fTOa to O - y m V
aa-a a s 0 0 -- ZMcoz(0 0- 0 7
0-0 lOCim 7-� 0--' Z Tm-iC� N7 O ym Z
070 - mmn0 0m -c70 ; D n
00 »00 �0n
c --m2 C AOD Vi2mz ND
a --?NrOmm aavl n�*o11 m- acm nwoonom ~ oD ma- +�1* m
mnn + , z ' o Cl' - --mirvl A -
..
»a » Oc -O�c7-�T Z 77QDy0a 190 a OOG m - O m D yaa; » �,0S m 077�= p7m-m 00 m Cy0 m
-0 (-` am r+0 m--1m 7,4 -12ymDQ7 co �•c O
:F xA o a CO I I - m
wrtm y2 -5L-M m-00� _a�'OQ7 a0 xa 00 r -sp 0 z
:Om S 7m0rta »7-0- m Ty amp n
7 f
D rnty £
37 K7 7'm 7<0-�7 �f�rnalAZ m0 0
ort� ma7 m"1"YyOSM7 3 m 1p-ADff}O m7' 7 Q
-»K + o0;0e rn A w 0O IQ t0--1-1 rtm ZOO mFo m» m Cv m -g WOy 0
V,o »c DaOm7cS7{oo 'r X
ammo<• CL
O
OrtNCC00m0c7 r ory=_ m0 m -'
p71 77a T G7r+onWlb 00 i m co-m +m o»me r c�m0—mm -0 z U Z
` om mmo- u037c7� O iwQzoo
f Sc0 x 7 '+aS -70- DDLL7 -I m'�x m -m y m. m9mK0 D O a - EB 3
7 7 m D a<CL - 0 m 9 /'�
m , ` I
oa 7<-aa—c '" v0---+Zo art (D o0
=n g - o m m - -3 z » m-aoz z m m =r Q
»m c m m rtm-0 0 O O 0-/an'C f � 7 p O
fm r Ortp >O7 Cc - CW a 5 (Q
17 co am DrtO --7'O rn O Orno Ozan S- D
GOQ Cm0 »O m7mc D('i Om 7
3 s10 <n D (ODm .� 4 < Q A z
m ---mn»�-q- z o In N
FO -� moo -- :n�Dra-o m 3 P m� � o�m -7m777�U v -ter-lon »' m
� C
_ f C*0 am -r»ryrt —O m — G
70'» --coo mmm0 I A T20�.sly mm m �
T--i 0m 0 --c aTTDom 0a 6 n I
iG c m -- m»—m co m —Oocn2A 0 a. � (D
-0 7 0m -m0 Cm0
0-a 00'•7m 07a '7 rtG- oaao -4 10Q
'a� —mom70cm— aiDzai0 < o O Q
a—aomm �
� 7 0 �WZA z m C
mm 70m00307�ao0 oc<oy _m a A o m S$ 6m -6aO 00 arfn2o n 7 »
m*0 OSm-N � 3��+ MO--qmw Oa
oc»7mm7 2 o
oa-e +_c 70N -ao7 mamla'OD =g 11
y»m oama nloc y -c'-r � o_ oa»a 0m0c v -�Az_nr c
c amoo »»=
mo
-ND Nm » q-_yO0 ZO-aOZL� 21
0 -rt
0 O E < -S60 -O Ornm-r- N_
Sw� -.+0C0 AZKy Op
m)» 7C N » 0 , �yt7 rn 7 -
i0 r- -90' -10- --a70 7 0m »-+< Om0
m xpp C* 001< J -+'7 rZ Cox 0
2 w.✓ m 7 ..- m m m� -c c
aom �
-
D
✓,tt,�a��le i Permit No. --
�� 6r� lN�ASON COUNTY I `
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628(} 1�
PLEASE PRINT
Phone#
#1 wne Fire District#
Ge A ress St-kL'4—zip-T S
City
Directions to Job Site __ u p N , /1�
4 LL �'
T C
Owner Mailing Address
City
Lien/Title Holder
Address St Zip w
Clty
m � Contractor Reg#An1257'W qg�-�
#2 Contractor f�a�me Expiration Date 7 / 9 S
Address f/ U i �ZI Phone# 5VO
City a 2�i`r St P
#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 residentiaf;'proof of potable water is required)
\\�� - S"L7 Sly i3• '� I��G -� -r A� s
#4 -' �lcel No. 1�33 - �a,r'4_t�.>—��
Ligal Description
YItw, k (�aAa�
#5 Building Square Footage: (existing/proposed) 3rd FI / Loft
1st A2nd FI # bathrooms
Basement /
Deck / # bedrooms
Garage Carport - (Circle: Attached or Detached?)
Other sq.ft.-� =1 /
7 Describe work
#6 Use of building
#7 Type of Job: New i/ Add Alt Repair Other
#8 MOBILE/MANU �AyCT RED HOME INFORMATION k
Model Year ! M ake,46_t-CAAXV od)Type
O f S
Length 10 P Width Serial No.
# Bedrooms # Bathrooms of Heat
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 site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street
in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 each) fta Mechanical Fixtures (H each)
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
Fees
_Bath Tubs Units
Furn BTU
_Showers —
_Hot Water Htr — Heatpumps
_Laundry Washer — Vent Systems
_Sinks — Spot Vent Fans
Rnilerc/Compressors
Floor Drains
HP
_Laundry Basins
Dishwasher NQ. Air Handlina Units
—Disposal —
cfm#
_Urinals No. Fire Protection Sv ttem_s
Auto. Fire Alarm Sys 50.00
—Other
_ Fixed Fire SUpp. SyS 50.00
15.00 Auto Fire Sprink Sys 25.00
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- 15.00
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee
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 FHE
S AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- AT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW IN THE STATE OF WASHINGTON AND IRCW 18.27, AND AM AWARE OF THE MASON COUNTY HEORDINANCEREQUIREMENTSREGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- ORKFORWHICHTHEPERMITISISSUEDMIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN K DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT
OBTAINING APPROVAL FROM THE BUILDING
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRSTDEPA OOM
THE BUILDING DEPARTMENT. >
X OWNER
X BY
DATE �'� DATE
Date:
[FOR OFFICIAL USE ONLY:Accepted by:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Appr7Cond. Hold
Planning: �¢ bce�LT" Cc?kCllncl; l {t 5'6m N dam/ IS' 6v
1. awl., qy�
,�'�-�--� �� �'--P��.�� )1'1 Oio r Le � Y
Environmental Health:
Building Plan Review 11214 CWr-p pn � ��7cS . � —T—�— -
LPL -5 C
Occupancy Group:l2 "> Type of Const: ._
Fire Marshal• --�
Other: -- -- — —
Li
Special Conditions: FEES
Building Permit rm
Plan Check (oD v L�
Plumbing Fee - �- --
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee —�—
Site Inspection — — -
Building State Fee �—
Other c --
Other
Building Va�lation: ----- �
TOTAL FEE [ 5 D
Golden Bell Mobile Home Park
NE 20 Roessel Rd. Bel(air, WA 98528r-
Phone (206) 275-4623
Deede Schattenkerk, Manager JAN 1 i S l
1995
,ENERAL SERVICES
To Whom It May Concern 1/13/95
We have a lease agreement with Shirley 0 . Statham. which
takes effect when the Mobile Home arrives on a pre-existing
ot 12 .
ould--you please send the building permit to the sub-station
in Belfair . It will be picked up there.
Thank You
Deede Schattenkerk