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BLD2015-00414 Replace MFG Home BLD2008-01201 MFG Home BLD2005-01977 Final MFG Home - BLD Permit / Conditions - 10/5/2015
f o-%oDy REVIEWED FOR CODE COMPLIANCE MASON COUNTY 1 DING DEPA E Date `3 Documents atiacneii to approved plans: Site Plan Plan review. checki• Engineering: y N Pages La eral Vertical Num Pr n# gapes_ THESE PLANS POUST BE ON THE JOB SITE FOR INSPECTION CHANGES MUST MEET ALL CUI2l2!_I`•? SUBMITCHANGIS I OR APPROVAI WASHINGTON STATE CODE PRIOR TO PERFORMING WORK n,.rmme CHANGES THESE PLANS MUST BE SUBIVIf T C_OIANGES FOR APPROVAL ON THE JOB SITE PRIOR TO PERFORMhvG WORK FOR INSPECTION Off' C _ 7 o0 Q11k � � r G � rn S rn �� D N Zoa � ;u • cn L�7 SZ S3 SSA MUST MEET ALL CURRENT yCf 1 WASHINGTON STATE CODES BUILDING 6L02,015 -OOL11 rV Wu i J I E c 3 j TTE. 1 E P 33 ►�.b I e- p -- - Tf rah. del i I TOPOGRAPHY PROFILE: RECEIVED Lane S MAY 2 9 2015 = M F A l oc"On "1 C_^ " ` T o� S_ may, L / Direction: Scale: Approval: for office use Building Permit number: ? I'' 2c'>I Building: f^Owner/Applicant: Ko to;n �--4o L,0- V 11��e M-W-� 1 I Date of Planning: Parcel Number: 3ZZ 3 L U ,�13�D I application: Env. Health: 6/30/2016 Case Activity Listing 8:29:48AM29:48AM Case #: BLD2015-00414 Parcel #: 322325093001 Description: REPLACEMENT MFH IN ROBIN HOOD VILLAGE PARK Assigned Done -- Acttvf{j+ lai orgy Date Z Date 3 Bold llisp To By Updated Updated By BLDA010 Application Received 5/29/2015 6/1/2015 None DONI" JBN WI/2015 JBN BLDB201 More Info Letter-EH 6/1/2015 None DONE ALP 6/1/2015 ALP This property is served by a community septic system that requires annual maintenance. We will need a satisfactory maintenance report for the drainfield. BLDB 130 Planning Review 5/29/2015 6/22/2015 None DONE AHB AHB 6/22/2015 AHB Proposed with proper setbacks from space boundaries.AHB BLDB110 Building Plan Review 5/29/2015 7/13/2015 None DONE RTB 7/13/2015 RTB review complete sent to case manager 7/13/15 RTB BLDB200 Environmental Health Review 6/1/2015 10/1/2015 None DONE ALP 10/1/2015 ALP Maintenance submitted BLDA100 Approved for Issuance 10/1/2015 None DONE JBN 10/1/2015 JBN PERMIT READY FOR PICKUP-LMOM FOR APPLICANT 2:45PM 10-01-15—JAHANEL BLDA500 Issue Building Permit 10/5/2015 None DONE JBN 10/5/2015 JBN BLDA540 Print Inspection Card 10/5/2015 None DONE JBN 10/5/2015 JBN ILDA510 Reprint Building Pemiit 6/28/2016 None DONE GMI i/2.8/2016 GMM Page 1 of 1 CaseActivity xpt SON 78 BUILDING I ,n U54 , MASON COUNTY PERMIT NO.DEPARTMENT OF COMMUNITY DEVELOPMENT �� `JBUILDING-PPLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 q rMason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext. 352REC� k Lj D PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext. 352 BUILDING PERMIT APPLICATION IrIWA 9 5 MAY 2 9 2015 OWNER INFORMATION: CONTRACTOR INFORMATION: ST. NAME: P o b;n �-6 oek V; Ha t_ A4 RCJ AME: �vrw ►dt!S 1\-1 u b►^fie MAILING ADDRESS:Qp ►30* k 3 MAILING ADDRESS: po 1�o x 1 S 1,3 CITY: STATE: WA ZIP: %5DI CITY: e,, 4All--a STATE: WA- ZIP:mid'3-7 1 PHONE: o- 38-pjj CELL:36b--I8 •16,9 PHONE:-Z53 -bo.6-VZ3CELL: EMAIL: 'q y�sQn wt CaS , ►-Lefi EMAIL : w b2r w tc-1ceX)C }Lw� i Ytk-•ntt L&I REG -7$U E P 1�- PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) ZZ 3 2 5 U - 3 O U FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED):Un ion flvoA Ce.v►a1 ar+d `Zn. Ce3 LIB' 4�LbT5: f A SP 75 SITE ADDRESS 12_e ��t L d _FF 3 'q CITY LA.n 1 o r� S os- DIRECTIONS TO SIF ADDRESS Y,t tA r lob r. o�- IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YESK NO ❑ TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER K R F_PL A C F_Mi EN USE OF STRUCTURE(;ZESIDENCE,GARAGE ETC.) N1 o b 0 e_ H-v ",x_ l�.cs I dery c e IS USE: PRIMARY[SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS DESCRIBE WORK R P lacy— y,ti,, b 11e, in b ene- SQUARE FOOTAGE: 1ST FLOOR t 1 S2 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq. ft. BASEMENT sq.ft. DECK sq. ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq. ft. GARAGE sq. ft. ATTACHED ❑ DETACHED ❑ CARPORT sq.ft. ATTACHED❑ DETACHED ❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN MAKE S o Mf-P- MODEL YEAR III IS LENGTH qd' WIDTH -2-q BEDROOMS 3 BATHS SERIAL NUMBER DD 1 9!f OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVI.TY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signature of App i ant b o L►t Date X `i {A rGSa OWNER REPRESENTATIV /CONTRACTOR Print Name (CIRCLE TO ATE) DEPARTMENTAL REVIEW APPROVED .D TE DENIED DATE TA.GSNOTESlCONDITIONS BUILDING DEPARTMENT f 3 PLANNING DEPARTMENT FIRE MARSHAL PLANNI � oN iCo . � MASON COUNTY w PERMIT NO. DEPARTMENT OF COMMUNITY DEVELOPMENT �� I BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext. 352Ej C �JED PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext. 352 BUILDING PERMIT APPLICATION ,qI(Qn fLI�S MAY 2 9 2015 OWNER INFORMATION: CONTRACTOR INFORMATION: ST. NAME: IQ o b i n 43 n d- 11), HQAt A4 H-CJ AME: _ax w,cAeS P-i u b,'IG MAILING ADDRESS:Fa"30yL g 3 MAILING ADDRESS: Po 1 >o-x I S b 3 CITY: La_c e" STATE: WA ZIP: %S-DI CITY: ,� a11-- STATE: W,+ ZIP:gd'3-7 I PHONE: o• 18 g4 PHONE:-z 53 -&4-43Z.3CELL: EMAIL: AM'OLY%_L n C.n Wk CAS , rtefi EMAIL : w b2r w lc.��°�c�n}�try i hk•n�# L&I REG# ,Q'I$U EXP. -lb- PARCEL INFORMATION: 7 �1 v1 ��cj�- 6211 PARCEL NUMBER(12 DIGIT NUMBER) 5 O FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED):u»tonflyoek RY--.A `Zr►� Cep(r1Z' 4�Lp75: f R SP 7'� SITE ADDRESS �,18 b Ir c, 4-a.+-e k ip L,_ e J D -F-3 y CITY r-I I rI .S os- DIRECTIONS TO SI ADDRESS tA 1 (fob IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE❑ RIVERJCREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YESK NO ❑ TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER K k F_PL H C Ewt E w USE OF STRUCTURE SIDENCE,GARAGE ETC.) Nl o b �� H e_ -D 1 Y`4 k-f s i oler-)C.F_ IS USE: PRIMARY X SEASONAL❑ NUMBER OF BEDROOMS Zi NUMBER OF BATHROOMS DESCRIBE WORK R e-p l61c2. VW0 b 1 1C p ►-me_ SQUARE FOOTAGE: 1ST FLOOR 115Z sq. ft. 2ND FLOOR sq.ft. 3RD FLOOR sq. ft. BASEMENT sq.ft. DECK sq. ft. COVERED DECK sq. ft. STORAGE sq. ft. OTHER sq. ft. GARAGE sq. ft. ATTACHED ❑ DETACHED ❑ CARPORT sq.ft. ATTACHED❑ DETACHED ❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN MAKE 5 o W1t: P- MODEL YEAR 1 q 1-9 LENGTH �# WIDTH -Lq BEDROOMS 3 BATHS SERIAL NUMBER Oo OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIV TY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. x 6LInI,___r sa� I Signature of App i ant b►n o LLB Date x j kut-re-s- 'rriz-a--, OWNER REPRESENTATIV /CONTRACTOR Print Name (CIRCLET ATE) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS OTESLCt)NDITI0NS BUILDING DEPARTMENT PLANNING DEPARTMENT 2-7- FIRE MARSHAL PL ": g U0201� -00�/ a tg a EL _..3.... �....—.._ —' . � � 1 ° ZZ - ::77 ef ! #t - 1 I f i i IV IT € E ' I I € tiWi L , zl5 r -- €T SI E . PE Ulr FG — -- �� .0\41 L a TOPOGRAPHY PROFILE: RECEIVED L;ne S MAY 2 9 2015 = MF 4 l ocrfw) 42c Vtit. CE^AF-I "T. ��D2�, �_ ��` � Direction: Scale: Approval:for office use Building Permit number: 11 1 )-b Building: Owner/Applicant: Kcb;n � V 11°�q� Mac LIB �� l Date of Planning: Parcel Number: zZ 3 5 0 �13 1 V application: Env. Health: L c,o► COMMUNITY DEVELOPMENT ENVIRONMENTAL HEALTH REVIEW Mason County Public Health Official use only 415 N. 6th Street Permit Number: BLD-X)5--©d q PO Box 1666 Shelton, WA 98584 Date Received: Shelton: (360) 427-9670, Ext. 400 Amount Received I O� Belfair: (360) 275-4467 Ext. 400 Elma: (360)482-5269 Ext. 400 Receipt Number 5ZZ01 — S Fax (360) 427-7787 Applicant Information LAC Type of Review Applicant 4,,,u A V i I fgge /1/I f4e,Date ] Building Per t k Mailing Address PO _&v ❑ New W Replacement L_&_ WA I b 5o 9-j3N I- ❑ Commercial Building Permit City State Zip ❑ New ❑ Replacement 3'I90-q3s— 3 Lo0 --7c?q" ❑ Building/Commercial Permit Revision Daytime Phone c>7SS Other Phone [ 85y ❑ Tenant Review E-Mail Address 06 a►'ti "'&4 r�ct ❑ Pre-Application Parcel Information 12-Digit Parcel Number 32-2 3 7- - 5 o - 9 3 o U l Site Address (o'7t0 F- S -Lekk (Zr- Ait_ t D ,. }!E 3-!4 to n ►'t r1 Street Number Street Name City Tjpe of Job Please submit a scaled plot plan Describe work ���,I e`c C rvLa b1 IC "me, showing all existing and proposed building, on-site sewage system, Number of Bedrooms and well. On-Site Sewage Information Water System Information 0 On-Site Septic System ❑ New Existing Plumbing in structure? Iz�Yes ❑ No ❑ Sewer Name of Sewer System If yes: Using an existing on-site septic system will require a current please submit a completed Water maintenance report and a Record Drawing (Asbuilt). Documents for both of these requirements may be on file with Mason Adequacy Form. County Public Health. Other requirements may apply. Applicant Signature /LV b I gv-rat. V 0IA� M h4Gt-t-0- .1 ►— C')f --�4 Date "lS APPROVED MC PUBLIC HEALT Official use only OCT 0 1 2015 Departmental Review Approved Notes Water Adequacy On-site Sewage System Tenant Review Revision Revised 12/17/09 Case Number: Mason County Investigation Report Form Parcel Number: 52' )' - -':�-O�- -I-J \ Violation Site Address: � -k Property Ovener(s): \'LO����tr�t�c� y��`(7. YWA C, Phone#: Mailing Address: 93 a O �$ K)F- n SAk-"\T i o" F�5Cl(p Tenant/Contractor/Operator on site: \\ Directions to Site: 8��w 1A U k U L \Cn!'VQ Acs� Description of Concern: r N V � tb Under the provisions of the Public Disclosure Law, RCW 42.56.240, the complainant may indicate a desire for disclosure or non-disclosure of their identiy ff non-disclosure is chosen, this portion of this,form will not be released to the public unless this case is filed in court. Iffiled,your name will be disclosed ifyou are a witness in the case. Mason County-investigates possible violations on a complaint basis only. Therefore,the name of the person filing the complaint should be provided. Pl se check one of the following: Please do not disclose my identity. I understand that disclosure may be required by court order or if this matter goes to court. ❑ You may disclose my identity. Name(please print): Phone: Address: Street City- State Zip Signature of Complainant: Date: THIS SECTION FOR XIASON COUNTY tTSE ONLY ( � p Complaint Received by: Date: Complaint Received by: .Phone ❑ Email ❑ Web Site ❑ In Person Department of Concern: X Building ❑Planning- ❑Fire ❑ Public Works Environmental Health: ❑ Solid ❑ On-site ❑ Wells ❑ Food ❑ Other Investigation Date and Findings: jz'41«o t>eJ*a'Ej�• � -ToL4C) 41�c -u`. C!►t.L. l� AJa' �G(rC[Dt�t-� tt..�E>t Cr"C6�L� �►��-�PCL'Cco.•� . �-C i►Q4fr.�t..5 K*- tg Amµ-�'rY C�£.�.a't 6'4- ?&(part 1+�5Pcc( Date Closed: i— Reason Closed: 062! _ Initials: vlD .-A' P,60 cov4r MASON COUNTY (360)427-9670 Shelton ext.352 DEPARTMENT OF COMMUNITY DEVELOPMENT (360) 275-4467 Belfair ext. 352 BUILDING•PLANNING•FIRE MARSHAL (360) 482-5269 Elma ext. 352 Inspection Hotline (360)427-7262 ,t Mason County Bldg. 8, 615 West Alder Street Shelton, WA 98584 www.co.masonma.us CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: 7-01(l - CM F�( ADDRESS/LOCATION: 6-Ren 6-rA-m- k., r-rf, a FINDINGS: SL-@�CDyL,9;- �- t7PFIL J`l�J CST t B•J S �c S I r•�Dtc�-tL� ►.r� CsvNo�-t I o�`7 ��C��4U�C�p �o L�-� � t,�l 1 w•J w. Orr � u-�.�oQ.t(L'j �`%4C-C�(J�)�,J C�`'( �c t�5 Z � o�7�t�� (, � T� o Lc.�Q�J�i Zwc IE 5�•�-c.� v oC -7- 1 p.rlf�z -v;> Go t-je ,�r wtrtal fib r S �TcC "01AD�2 Wo.e-� "�v 1 A w-'�17 -St4L '4*,- C-11S-(ff-ATIo---) � C>Ocj -'O y' ,-X t U-1.1a7 C,Fr..r �� �.��—C i o r-c> . Items listed above must be corrected to fain compliance. ❑ THIS IS NOT A COMPLETE INSPECTION his structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. ❑ Call for re-inspection when corrections are made before proceeding with any further work. ❑ Make corrections, items will be checked on the next inspection. ❑ OK to Date: V 12`i��r}o ❑ Please contact our office regarding possible Department: Q LAO structural damage incurred by recent Inspector: `j(ZZi "natural/man made"disasters.This is NOT a CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 ��DZo15- oo'// PLANNING r , 1 O i -- � I I RECEIVED MAY 2 9 2015 426 W. CEDAR ST. 56 0Z s-may Name `ZO b J Vn U i I1 9arcel# 3 2Z3 2. -,SD- 113 o o I BLD# �- O t i5 Mason County MAY 2 9 2 Department of Community Development 426 W. CEDAR ST. Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface 2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area * All dimensions in feet Buildings y 8 X 2-,4 _ _I I S 2- X = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X X = Any paved, gravel or packed area per definition above table X = Others X X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read, acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for reAiew and ection ap ay be re"qqu' ed. X LLe— Owne Agen ontractor(circle one)Date: a d^I If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 Mason County Map Output Page Page 1 of 1 Mason County Map 922325090001 322325010339 322325010303 322325010307 322325010308 322325010309 322325079018 E MASON AVE 322325010943 322325010203 322325011001 322325010201 322325010202 322325010204 322325010205 r��,r 922325078001 322]]9999999 32232.10206 I 322325091001 I 322325010218 322325010208 322325011002 322325010215 322325010213 722325010214 322325010211 322325010209 322325010207 722325011004 322329999999 E ORRE NOBLES RD_ _._ 322725092902 322325010905 322325010103 322325010101 322325011101 322325010102 322325010105 322325010106 322325010104 p 322325092001 322325092900 322325011102 322338886688 322325010109 322325010108 4 322325011103 tiQ q 722325011104 tU 322325010033 3223250 lea 11 322325010010 322325010002 322325010030 322325010019 32232501009 322330050000 7T2]-7" 3T2335000004 32232 222335000003 322325094000 322335000002 722325094010 722325098070 Qv 322325094021 322325029000 322326094007 322325094015 0 322325095011 D W 322325098001 322325094011 322325094001 322335000001 322325094009 /// 322325024002 322335000906 322325094006 322325094005 322325094003 0 331tt DISCLAIMER AND L,IMITA"1•ION OF LIABILITY: The data used to make this map have been tested for accuracy,and every effort has been made to ensure that these data are timely,accurate and reliable.However,Mason County LEGEND makes no guarantee or warranty to its accuracy as to labeling,dimensions,or placement or location of any map features contained herein.The boundaries depicted by these data are Rr,y:r. 1 .J Fodi)ra`Land. approximate,and are not necessarily accurate to surveying or engineering standards,and are intended for informational purposes only.Mason County does not assume any legal liability Higrtnaya tidy of£helten or responsibility arising from the use of this map in a manner not intended by Mason County. ��rr-� In no event shall Mason County be liable for direct,indirect,incidental,consequential, R'""r"� 'tr''a^�� LJ -ovity ecurilCory tiC+4p1 special,or tort damages of any kind,including,but not limited to,loss of anticipated profits pan elp Dstrt•,-.ts or benefits arising from use of or reliance on the information contained herein Sections ',akes *-y m 2009-Mason County GIS Townsh:p5 ' F'ugcd Sound$Malcr Lakes 100 W.Public Works Dr Shelton,WA 98584 ►n n W pLANNNG http://mapmason.co.mason.wa.us/servlet/com.esri.esrimap.Esrimap?ServiceName=amason_... 6/1/2015 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 ir Shelton, WA 98584 flo RESIDENTIAL BUILDING PERMIT BLD2008-01201 OWNER: WILLIAM HAYWARD RECEIVED: 9/19/2008 CONTRACTOR: WASHINGTON HOME/LAND SERV INC LICENSE: WASHIHL938PK EXP: 10/12/2009 ISSUED: 10/15/2008 SITE ADDRESS: 6780 E STATE ROUTE 106 SP 22 UNION EXPIRES: 4/15/2009 PARCEL NUMBER: 322325093001 LEGAL DESCRIPTION: UNION HOOD CANAL LAND & IMP CO BLK 93 LOTS:1-30 &VAC STREETS S 33/205 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Manufactured home (replacement unit) Lot#22, top of hill in Robin Hood village General Information Construction&Occupancy Information Square Footage Information No.of Bedrooms: 2 Type of Constr.: VB Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: R3 Lot Size: Deck: Type of Work: NEW Fire Dist.: No. of Stories: 1 Occ. Load: Building: Valuation: Building Height: Occ. Status: Unknown Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:Palm Harbo Length: 56 Ft. Front: E 25.0 Ft. Shoreline: Ft. Water Body: Rear: W 45.0 Ft. Slope: Ft. SEPA?: ModeI:N4P56S69 Width: 28 Ft. Shoreline Desig.: Side 1: N 5.0 Ft. Year:2009 Serial No.: TBD Side 2: S 12.0 Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee GMM 9/19/2008 $247.00 S22008000 EH Plan Review GMM 9/19/2008 $40.00 S22008000 Planning Review Fee GMM 9/19/2008 $190.00 S22008000 Mobile Home Issuance Fee MAL 9/22/2008 $247.00 S22008000 EH Plan Review ADR 10/10/200 $60.00 S22008000 Total $784.00 BLD2008-01201 Please refer to the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2008-01201 CONDITIONS FOR BLD2008-01201 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X : 2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Department prior to any further inspections being performed or approvals granted. X '?„ `� 3) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X_ �p . 4) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removal of approved documents will result in failure of required building inspections. X- IL�* 5) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X. 6) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X �f if. 7) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or installed. certification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X BLD2008-01201 Please referto the following pages for conditions of this permit. 2 of 6 8) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. X Jk ar; 9) Per 2003 IRC -SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIND SPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X ✓' x i 10) Per IRC -SECTION R905- REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance with the applicable provisions of this section and the manufacturer's installation instructions. X is ,if 11) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of the building permit the owner/agent/contractor is acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 12) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocation. Xl ;l 13) Lake Cushman area is designated with a 551b snow load rating. The owner/agent of this permit acknowledges that if the unit permitted under this permit does not meet the recommended snow load rating, there is a potential for failure due to weight accumulation beyond that of the design criteria. X f. 14) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy (Final Inspection)will be granted for the residence. OWN ER/CONTRACTOR(indicate which) Signature X r: 15) Applicant has indicated this is a replacement unit. Prior to Mason County allowing any occupnacy of the new proposed unit, the existing unit which is on-site and is being replaced MUST be removed from the parcel. X BLD2008-01201 Please referto the following pages for conditions of this permit. 3 Of 6 16) This permit is being issued to the applicant to allow the moving of this mobile home onto his/her private property to perform the necessary corrections to this unit to bring it into compliance with HUD Standards, and get the unit recertified by the State of Washington Department of Labor and Industries. This unit is not to be occupied. No utilities are to be connected. No permanent set up is to begin. This permit is valid for sixty(60)days only. No extensions will be granted. Any violation of the conditions of this permit or the denial of a permanent installation permit will result in the determination that the unit must be removed from the property at the expense of the owner. X ;,4 17) This permit is for the placement and installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X 18) Permanent Address must be posted and visible from the road Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails must be in good condition and meet code for year built or current code if replaced. Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit Gutters and downspouts must be installed with splash blocks provided All exterior penetrations must be sealed HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24" above grade. The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4 panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection. All conditions on the original or issued permit must be met If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available It shall be the responsibility of the person requesting the inspection to provide the manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection. Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an inspection is requested and required items are not completed prior to the inspection being performed ENFORCEMENT PROVISION: Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action and subsequent violation and penalties pursuant to the Mason County Code. X W BLD2008-01201 Please refer to the following pages for conditions of this permit. 4 of 6 19) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the §tormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. r 20) Placement of structure must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X 21) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance,or regulation, must be reviewed and approved by Mason County prior to construction. X rs, :/ 22) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. X _� ✓l 23) MOBILE HOME PARK SETBACKS SHALL BE 15' FROM NEIGHBORING ACCESSORY STRUCTURES, 10' FROM PROPERTY LINES AND 5' FROM RIGHT-OF-WAY AS PER MASON COUNTY ORDINANCE#118-91. x ; )/ 24) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. X4 ',,/ 25) Owner/applicant must obtain a seperate jermit for the placement of any size propane tank serving a fixed appliance within a dwelling structure or unit prior to the placement of the tank. X ,� 7f 26) All property lines shall be clearly identified at the time of foundation inspection. X -L >i 27) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. X BLD2008-01201 Please refer to the following pages for conditions of this permit. 5 of 6 28) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit 15older have prevented action from being taken. No more than one extension may be granted. X_6 --)/ 29) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X .A ,N 30) Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 31) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed. X Jr�= This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. / OWNERORAGENT: -- DATE: i BLD2008-01201 Please refer to the following pages for conditions of this permit. 6 of 6 J MASON COUNTY DEPARTMENT OF HEALTH SERVICES ENVIRONMENTAL HEALTH PERSONAL HEALTH 426 W.Cedar 303 N.Fourth _ PO Box 1666 PO Box 1666 Shelton,WA 98584 Shelton,WA 98584 (360)427-9670 • Fax(360)427-7798 • Elmo(360)482-5269 • Belfair(360)275-4467 www.co.mason.wa.us January 25, 2007 Hood Investments 6780 E State Route 106 Union, WA 98592 Re: Bld2006-00583 Bld2006-00584 Bld2006-00585 Bld2006-00586 The above reference permits are deemed invalid due to inactivity. A letter was sent requesting further information on May 8, 2006. No contact has been made with our department to resolve the outstanding issues. See attached copy of the signed applications stating " Inactivity of this permit application of 180 days will invalidate the application". If you wish to pursuit these projects you will need to reapply for the building permits under the current regulations. Sincerely Tricia Woolett Permit Tech II Mason County Public Health Environmental Health Division 360.427.9670 ext. 554 tw(6-;,co.mason.wa.us Attachments: Copy of signed applications Copy of letter dated May 8, 2006 CC: Case manager Parcel file Planning Department Always working for a safer and healthier Mason County Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 L� RESIDENTIAL BUILDING PERMIT BLD2005-01977 OWNER: HOOD INVESTMENTS, LLC RECEIVED: 11/15/2005 CONTRACTOR: KEN'S MOBILE HOME SET-UP 253-381-0580 LICENSE: KENSMHS984MS EXP: 7/12/2006 ISSUED: 11/29/2005 SITE ADDRESS: 6780 E STATE ROUTE 106 SP 34 UNION EXPIRES: 5/29/2006 PARCEL NUMBER: 322325093001 LEGAL DESCRIPTION: UNION HOOD CANAL LAND & IMP CO BLK 93 & BLK 100 LOTS:1-30 &VAC STREETS EX E OF R/W,EX LOTS:18-22 PTN 23 f PROJECT DESCRIPTION: DIRECTIONS TO SITE: MANUFACTURED HOME Robin Hood Villiage Mibile Home Park and up the hill. General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: Type of Constr.: Type of Use: MH Insp.Area: No.of Bathrooms: Occ. Group: Lot Size: Deck: Type of Work: NEW Fire Dist.: 6 No.of Stories: Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:Libert Length: 48 Ft. Front: N 15.0 Ft. Shoreline: Ft. Water Body: y g Rear: S 10.0 Ft. Slope: Ft. SEPA?: No Model:Oakwood Width: 28 Ft. Side 1: E 8.0 Ft. Shoreline Desig.: Not Applicable Year:1988 Serial No.: Side 2: W 10.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee KKK 11/15/200 $214.50 S22005000 Planning Review Fee KKK 11/15/200 $155.00 S22005000 EH Plan Review TW 11/20/200 $75.00 S22005000 Mobile Home Issuance Fee RTB 11/23/200 $214.50 §22005000 Total $659.00 BLD2005-01977 Please refer to the following pages for conditions of this permit. 1 of 4 CASE NOTES FOR BLD2005-01977 CONDITIONS FOR BLD20 0 5-01 9 77 1) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X •-P,a 2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee(refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Department prior to any further inspections being performed or approvals granted. X 01V 3) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting inspections. X 4) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X �Ao 5) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or installed. certification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X 6) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. BLD2005-01977 Please referto the following pages for conditions of this permit. 2 of 4 7) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X �.� )z 5) Lake Cushman area is designated with a 551b snow load rating. The owner/agent of this permit acknowledges that if the unit permitted under this permit does not meet the recommended snow load rating, there is a potential for failure due to weight accumulation beyond that of the design criteria. X V1S 9) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved)by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy(Final Inspection)will be granted for the residence. OWNER/CONTRACTOR(indicate which)Signature X DJ? 10) This permit is for the placement and installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X 1)? 11) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. X V 12) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. X 12.13 13) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAG 296-150M-655. Support configuration shall be clearly marked in the installation instructions. 14) All property lines shall be clearly identified at the time of foundation inspection. X t�13 15) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. X BLD2005-01977 Please referto the following pages for conditions of this permit. 3 of 4 16) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have prevented action from being taken. No more than one extension may be granted. X aDV f7) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X r A This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied.Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and strUCfV.rle fi rr-reviieew'5dd inspection, OWN ER OR AGENT: DATE: I I Z 3-2 BLD2005-01977 Please refer to the following pages for conditions of this permit. 4 of 4 HOOD INVESTMENTS, LLC 4D2005-01977 1 � ti G W ttJ m im H m .� m r € a a Q lufw � Q W W z .a o n LL 01 U- a ' z m 1 z ^� CL > �. z _ m Q z a ' , c m — V ry � � � L � p � z� � ,,, C3 v C� - a (( .. ... - L •- y " — LC qrN ti MCt a ' 3 W ro CL I t•- w x ,� m z C c °� 3 y m G1 U u n U. n m o U. o a, 0 a a s \4F 3 a t- BLD2005-01977 Please referto the following pages for conditions of this permit. 1 of 1 MASON COUNTY PERMIT NO. ���'c J BUILDING PERMIT APPLICATION A- . 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner _ ;e. .s- ►��.-: _ L C_ -- Company Name r'1�b,�e Nc�►,., Mailing �,Address 4 2 " } ` "- =' Mailin Address ' — v City ' "' ' State '' " Zip Code 7�` City °����j State v J A Zip Code 'P Phone',-I(`°2`t 11 I i " Other Ph. Phone .a S Vs 3 Other Ph. Lien/Title Holder Contractor Reg. <"SMHS'9,YILA = Exp. -I E mail address E Mail Address Drivers Lic.# DOB - i, Drivers Lic.# DOB SEPTIC /WATER SYSTEM_ INFORMATION - Connect to New Septic Existing Septic Connect to Water System '� Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. = l:-' ' ' ' Fire District Legal Description Site Address(Please include street name, street/cumber and city) Directions to site . _"'k V j Will timber be cut and sold in parcel preparation?Yes/:Nco Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs �/o Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor " .- 'x" 2nd Floor 3rd Floor Basement Deck Covered Deck —Other Sq. ft. Garage Attached Detached Carport Attached Detached ! . MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. - No. of Bedrooms o. of Bathrooms Type of Heat ` `- Purr�ha e Price$ Replacement Unit? / No. y Installer Name , . ''a Certification No. "'� -? `�" OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OFAPROGR_ESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department_ Environmental Health Department Fire Marshal FEES Building Permit Fee 41 S-0 Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES VENT AT 1 Sq Ft Per 150 Sq Ft NCSBCS/ANSI FILE <Z- opyion of A225.1-1994 Revision � ANSI A225. ion of THESE PLANo MUST BE ON THE JOB SITE FOR INSPECTION. American National Standard MANUFACTURED HOME INSTALLATIONS Documents attached to approved plans: Site Plan Ce A Plan review checklist: ('-'�Pages G S Engineering: Y N Lateral Vertical SUBMITR CHANGES FOR APPRoyAk Number of pages Jr.°MAG Secretariat National Conference of States on Building Codes and Standards, Inc. MUST MEET ALL. CURRENT WASHINGTON STATE CODES Approved January 4, 1994 American National Standards Institute, Inc. APPROVED MASON BUILDING INSPECTOR CHANGES SUBJECT TO APPROVAL ——DATE .___------- REGISTERED AS PROVIDED BY LAW AS CONST CONT GENERAL aj REGIST. # EXP. DATE CC01 ' KENSMHS984MS 07/12/2006 EFFECTIVE DATE 07110/2002 KEN' S MOBILE HOME SETUP 16501 4TH AVE CT E j SPANAWAY. WA 98387-7895 signuure Issucd by DEPARTMENT OF LABOR AND INDUSTRIES . I Certified Manufactured Home Installer Kenneth J Vetter l W A I N,%348 Mmv4pw_ORk.M Ywajacs .r Hmr fxpires 7/31/2007 Building Permit Information General Contractor: Kens Mobile Home Set Up #Kensmhs984ms wains # 0348 Transporter L&D services George Boren driver wutc # 61273 dot# 213446 set up manual will be Ansi manual enclosed r I f STATE OF WASHINGTON Ikpartmrnt of Corrunuoity,Trade:and Ecaiornic Developmcal Certified Manufactured Home Installer I Kenneth J Vetter WAINS0348 j Expires: 7/3 i/2(K)7 REGISTERED AS PROVIDED BY LAW AS r CONST CONT GENERAL REGIST. # EXP. DATE CC01 -KENSMHS984MS 07/12/2006 EFFECTIVE DATE 07/10/2002 KEN' S MOBILE HOME SETUP 16501 4TH AVE CT E SPANAWAY. WA 98387-7895 Siviustutc Issucd w UFPAkTMENC Of 1 AW R AND iNli11S"IK�l;$ MASON COUNTY DEPARTMENT OF HEALTH SERVICES _ Environmental Health — Personal Health PO BOX 1666 SHELTON,WA 98584 LOCAL(360)427-9670 BELFAIR(360)275-4467 Application for Determination of Adequacy FAX(360)427-7798 Instructions 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water system utilized. 3. Submit completed application,with attachments to the health department for review. PART 1: Applicant/Parcel Identification Name of Applicant /`70o c�, ��h S�►�e s LL Date Mailing Address6 7 9-0 E 5�CLILC I Telephone t�Cv�; fly' LJA 9 9-C'q�.-_ Assessor's Parcel Number `32232. 50 g300I Type of Water System (Check One): Reason for Application (Check One): 0 Public/community water system(2 or more connections) a- Building permit ❑ Individual well(one connection) ❑ Land use application,if so... ❑ Well ❑ Division of land ❑ Spring/surface water #of parcels? ❑ Other(explain) SPH2_- ❑ Boundary line adjustment ❑ Other(explain) PART 2: Water System Information Complete the section appropriate for the type of water system being evaluated for adequacy: Public Water System Name of Water System o Water Facility Inventory(WFI)Number: fz ❑ The water purveyor has filed a letter granting blanket hookups to this water system. 19 I am the manager of this water system. The water syst as been approved for 1/services. There are presently" connections in . . will be the connection. This water system is able and willing to provide water to this(th )co ections ith xc ing the limits of the water system or any limits set by state and local regulation. Signature of Water System Manager Date 10 21 /N G!Sc _ update:March 22,1999 Mason County Permit Assistance Center Planning Intake Checklist Owners Name: 4 J LLL Date: 11 S b5 Project: Reviewed By: Commercial Development: YES Comments: Planner: GBM TSC CMM KJM SNG PBC Site Plan: North Arrow Property Dimensions: X 5 L_5g ta/Streets and Driveways Shown. Road name: -a'-All Existing Structures shown with setbacks Well Location, Septic and Drain-field Shown with setbacks �lI.adentify all surface water (streams,ponds, shoreline, wetlands, etc.) 2-'Topography(slopes) ❑ Proposed Structure SetbackSM ection/Setback): F: 1: M/ 15 S2: _5 / rYUtility and Drainage Easements: Yes No if yes enter condition#5022) .-a-0ther Easements " e- Accessory Appurtenances ❑ E unty-Aeees-Remit Needed4a4d-eendition#0010) ❑ Stan no �*�T�.�..�ad&_wndn 20) S ns�a3d-eU—to all Building permits that planning reviews: #5019 and#0700 Are there any impediments that may restrict access to your site? (dogs/gates)er Shoreline and Planning Info Setbacks: Shoreline: jr� Slope: Sh(reline Designation: Comprehensive Plan: Rural Zonin V Not Applicable ❑ Agricultural �, RR 2.5 n 10 20 ❑ Urban ❑ In-holding ❑ RMF ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy )l Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet ❑ RT ❑ Urban Growth Area ❑ MPR ❑ Unknown ❑ Unknown Water Body(t e of water if unnamed): SEPA: Yes No n Flood Plain: YES O own Map# Aquifer Recharge: YES O Unknown Map# Tags/Cases: RLC/SPI Case: \.. 6-Year Dev. Moratorium: YES Eagle Nest Tag: YES NO Other /�, YES O Addressing: Check box if needed ❑ Reviewed by: 2A,_ Revised: 11-01-2005 1APLANNING\PAC\PLANNING INTAKE Part 1: Earnest Money Purchase Agaement A. Parties Buyer: Seller's:Randy Marsh 253-381-0580 � 6003 98th st east Puyallup Wa B. Agreement To Purchase: Buyer agrees to purchase from Seller under the terms and conditions specified in this document the following d scribed manufactured home together with the,accessories and services Indic ted hereon. Make: �^'��h� length: 1/7 width: Model: New Used y Year model as titled a a ' Serial Number Unit sold inspected by the buyer Factory Order FloorPlan: Bed: C. Record of Transaction: Charges: 1. Agreed base price of property allowances & Specifications Notice: Sale does not include,wheels axles,tires or hanger brackets which by law must be recycled. Homes are Sold As Is,Where Is, unless implied on this agreement,allow 30 days for title transfer. (Vote* there is no Implied warranty on the home. In statement there is no warranty on,I-Beam frames,floor and wall framing,subfloor,lino,carpet,exterior siding, interior wallcovering, trim,electrical,appliances,plumbing,roofing and itoof t, ,mot snow �? loads,insulation,rodent barrier,window ,do rs,toilets,sinks,bathtubs,sheetrock or paneling. 2,Total Adjustments: Home to be broke down,transported to the site,set with blocks, vapor barrier,tie downs, exterior trim, interior trim and ridgecap 3.Delivery to Homesite lot must be level and ready for delivery if the site is muddy,snowy etc. the customer must make arrangements for cat or other assistance. 4.SubTotal: Adjusted Sale Price $ a/ j l�Q 5. Sales Tax not incl, 6. Fees,Title transfer/Licensing not ine 7.Total Cash Sale Price $ 8.Payment—Itemization / Down Payment,consisting of the following: A. Earnest Money Ci;tip: B balance of cash to be paid on a home to the property 9. Balance due before delivery lot ret'ttaLatstorage is$250.00per month,per l section of the home the home cannot be moved from storage without a Tax Movement Permit. 10.Delivery: • rY Date Deli Proposed Delivery 7-dd.� P C�,L l��2. • Place of Delivery f 1A 7 e Address: / City: (,LEI,/0 A / /rj e/ State: Wa. Park: Wf kA,l 41AI 1 ////t!f e- Zip Code 0/U d 1) 11 The Customer is responsible for All Permits. Including taxes current for property either owned ,leased,or rented.the buyer must obtain a tax movement certificate and make arrangements with the treasures office to aquire the permit,the seller will provide the buyer with the necessary information for this procedure.ln pierce county it will be the tax assesors office. 12.Insurance: this agreement does not provide for any casualty,liability,or life insurance except as may be specifically stated and included herein.The seller assumes all responsibility for binding any insurance coverage. * The seller is a certified Manufactured Home Installer,not a general contractor,all work will be performed by licensed bonded contractors,the owner,or the seller assisting the owner with the aid of the installer certification#1523. * All sales are final and deposits will not be refunded if buyer backs out of the agreement. Salesman Sigh " Customer Signature: \ 2nd; n i ro tx -IN (57 - ,aR 1 � 30' -4- ------- ---------- ---- - --- ------ ///o RED) ;E ,/� s� r- � - --- --- ---_--- -- -- --- - - i Iz2 ,�opz� TnA.u51��r - �ERM. v 027 AlZ 9 5 Olt APPROVED y x 1� I nN M,5,SOsll COUNTY UCU PLA`NS"INC SITE PLAN KZQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL