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HomeMy WebLinkAboutBLD2015-00865 Replace MFG Home BLD4264 Mobile Home - BLD Permit / Conditions - 12/2/2015 Inspection Line(360)427-7262 0N CO MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III _ 426 W. Cedar Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2015-00865 OWNER: ROBIN HOOD VILLAGE MHC LLC RECEIVED: 10/5/2015 CONTRACTOR: BERWICK'S MOBILE HOME SERVICE 253-606-9323 LICENSE: BERWIMH865LP EXP: 6/17/ ISSUED: 12/2/2015 SITEADDRESS: 6780 E STATE ROUTE 106 SP 27 UNION EXPIRES: 6/2/2016 PARCEL NUMBER: 322325093001 LEGAL DESCRIPTION: UNION HOOD CANAL LAND & IMP CO BILK 93 LOTS:1-30 &VAC STREETS S 33/205 PROJECT DESCRIPTION: DIRECTIONS TO SITE: REPLACEMENT MFH - 1969 ONE BED, ONE BATH, 12 X 50' - General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: Mobile Hom Type of Use: MH Insp.Area: No. of Bathrooms: Occ. Group: R Lot Size: Deck: Type of Work: MOV Fire Dist.: 6 No. of Stories: 1 Occ. Load: Building:600 Valuation: Building Height: 13 Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:Skyline Length: 50 Ft. Front: S 16.0 Ft. Shoreline: Ft. Water Body: Rear: N 13.0 Ft. Slope: Ft. SEPA?: No Model: Width: 12 Ft. Side 1: E 55.0 Ft. Shoreline Desig.: Not Applicable Year:1969 Serial No.: S 1644 C Side 2: Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Manufact. Home Submittal JBN 10/5/2015 $264.25 S2201500000001 EH Minor Plan Review JBN 10/5/2015 $ 100.00 S2201500000001 Planning Review Fee JBN 10/5/2015 $205.00 S2201500000001 Manufact. Home Issuance CRE 11/3/2015 $264.25 S1201500000001 Total $833.50 BLD2015-00865 Please refer to the following pages for conditions of this permit. Page 1 of 5 CASE NOTES FOR BLD2015-00865 CONDITIONS FOR BLD2015-00865 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. XC �7 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. XCi2a 4) Approved per dimensions and setbacks on submitted site plan for replacement mobile home. Setbacks are measured from the furthest projection of the structure. X 5) 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 Buildi a artment prior to any further inspections being performed or approvals granted. X 6) 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 BLD2015-00865 Please refer to the following pages for conditions of this permit. Page 2 of 5 7) 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 �= 8) 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. X cm 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 10) Applicant has indicated this is a replacement unit. Prior to Mason County�IjQwjng 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 o��� 11) This permit is for the placement and i lation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X BLD2015-00865 Please refer to the following pages for conditions of this permit. Page 3 of 5 12) 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 13) 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 sha ade prior to requesting additional inspections. X 14) MOBILE HOME PARK SETBACKS SHALL BE 15' FROM NEIGHBORING ACCESSORY STRUCTURES, 10' FROM PROPERTY LINES AND 5' FROM RIGHT-OF-WADS PER MASON COUNTY ORDINANCE#118-91. x 15) 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. X BLD2015-00865 Please refer to the following pages for conditions of this permit. Page 4 of 5 16) All property lines shall be clearly identified at the time of foundation inspection. X 07c: 17) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure these structures meet the setback conditions listed. X 18) 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 C ordinances and building regulations. X 19) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectbts� nd flashing. Install metal connectors approved for contact with the new types of pressure treated material. X 20) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv ite Plan"to ensure these structures are shown and meet the setback conditions listed. X J� 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. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. - /__-� ,a, -/S Signature I Date I OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2015-00865 Please refer to the following pages for conditions of this permit. Page 5 of 5 .yON COLN BUILDING ! _ . MASON COUNTY PERMIT NO. DEPARTMENT OF COMMUNITY DEVELOPMENT 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. 352 PO Box 279, Shelton,WA 98584 (360)482-52699 IElma ext. 351 BUILDING PERMIT APPLICATION 1� lla'� EjVE� OC OWNER INFORMATION: CONTRACTOR INFORMATION; ,6 W. CEDAR NAME: IQ u b "n r„A L/r I lane N1 H G Lt_G NAME: _. 2�( w, k s /� o b i 1 e rn Q SAY viAc-, T. MAILING ADDRESS: P.0. 1 �,� Z MAILING ADDRESS: p. p r3 y-A t S 3 CITY: Lame y STATE: WA ZIP: * 0 CITY: a 1 STATE: 14_j f} ZIP:$PY-7/ PHONE:3 b O-"9, 8-0785 CELL: PHONE: z�3-60(0-,7 323 CELL: EMAIL: + C EMAIL : ic; bcx w Eck C��►��ury !i'nk.r,� L&I REG# .?-7&D EXP. S/31 l 16 PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 3 ZZ:5 Z" SO - q 3 0 0 1 FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED):l,-nt o n 4o n ck LEA` — Co LK I c, e}s SITE ADDRESS 6-180 f=: . S-}&fie- 101, f L o-f---W a 77 CITY S 3 2 DIRECTIONS TO SITE ADDRESS b 0 h L--P 1101 d V ll cone, I\A Vt P , 76 Lst `41P ,71 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% YES[] NO JA TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER )J R-E-PL 01}CEfh C--tv USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) D ; 12 IS USE: PRIMARY)R SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS I DESCRIBE WORK IQe p lo�c� Yv�O b I ►e k n rnL SQUARE FOOTAGE: 1 ST FLOOR �0 d 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 MODEL LENGTH S U WIDTH Id BEDROOMS I BATHS I SERIAL OWS 16 yyC, 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.INACTI ITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signature of licant be Date X ��"CS" o�o.nzszv� OWNER/ REPRESENTATIVE /CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT n l� PLANNING DEPARTMENT FIRE MARSHAL - � RECEIVED _ _� . �RENT L � L ¢ ; i O _.� St�1TE'C DE i 42 C D R STJ I E ' bONSPECTI©N: '� f 1 — 7vrrcF FT : 1 i 3 i q f-- - - ' f i n f - i _}__ TOPO , r D� ) Direction: .Scale: Approval: for office use Building Permit number: ��V (� (' - Z U Building: Owner/Applicant: jQ_,j:)`,r, 4J-o oA U ; l la4g_ M HC_LLC Date o Planning: application: Env. Health: Parcel Number: 2-2—3 2 '- SO- 1i.3 o0 I PRIBBER MARNMIRM-M O%A ST R.A -r AH riig212F:K1T . . I 4 I I I IIPW WWI-JW WM!OPOPI W In IM IWM i CC DFI; r —T 426 0J C D . S T. AS! tvi 1W.7 I r TLAPZ07 '04 INSPECTION if MM --4 SL BMI T CHANGES O,OR PP'OV L I PEqFO"ING VJPRK It I hs. T, I n I L —4 /{ i = i i ��} I ! i Jr GD 771 7 -h A -4- 41-4 -A I I Vi II U I I I TOP y Direction: Scale: Approval: for office use Building Permit number: 00 Building: Owner/Applicant: 44zA UIlane MW-LLC, Date of Planning: IN application: Env. Health: Parcel Number:. 31 Do) 10-s-i S I Lv cQ �► Ad 0O 3113 ONICrune t A •�� � , V�•'•_' nv+� �w.�1.i• fJ am - Io za , REVIEWED FOR CODE COMPLIANCE 1. MASO.N COUNTY UILDING DEPART N gate <I Documents at ached to approved plane Site Plan Plan review checkli t: 13 Pages Engineering: Y Lateral VertiCAl Number of pages_ soN co N PLANNING MASON COUNTY PERMIT NO. DEPARTMENT OF COMMUNITY DEVELOPMENT `J 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.352 1854 PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext.352� BUILDING PERMIT APPLICATION OCT OWNER INFORMATION: CONTRACTOR INFORMATION4 2s W CED NAME: iQ a b,"., A 1/;)laa a LI.- M H C. CI NAME: �Y'v',c A lU)obi)a -�-�►-n o_�eY y!ti T MAILING ADDRESS: :P 0- $ 3 4 Z MAILING ADDRESS: P U ey-A►S b 3 CITY: l Ac,e-y STATE: WA ZIP: * p CITY: cll STATE:_ZIP:1t9-7/ PHONE:3 b b r q 8-o'T 85 CELL: 31,o-°l99-18Sq PHONE:2 t 3-6o q 323 CELL: EMAIL: EMAIL: be r w A k co-erkLnJ Un k.."et L&I REG 7 8 0 EXP. S/31 PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 3 Z2 3'Z-- S 0 " 9 3 0 0 1 FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED):l-nto n A noa.l UxnA` —' Co ILK LG - o ` S SITE ADDRESS 6-180 V=. &+&-t - P�h u+e, 1 G t, i L off"� � ']- g CITY S 3 2 DIRECTIONS TO SITE ADDRESS 1. 0 k hW i A IS PROPERTV 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% YES❑ NO TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER � R.E pI--�F—Y-A USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) M D}j► c 7te w" IS USE: PRIMARY,q SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS I DESCRIBE WORK W'c 6;)e ti► r.rn� SQUARE FOOTAGE: 1ST FLOOR �00 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 le-!J I'',r-%e- MODEL LENGTH SO WIDTH i d BEDROOMS I BATHS I SERIAL NUMBER S 16 414C, 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/appl!cation 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.INACTI TY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. x iC� -IS Signature of d licant IP iccLC Date X `T�ercS�� ��+nzs�►'� acL OWNER / REPRESENTATIVE /CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT Z FIRE MARSHAL PLANNI !, G RECEIVED It f 1-�- - �--- - -- 'c ' c TE HA GE - _ i ! By. D t8 i } ' � t 1 i s f t b " .j 117 I t I ` I f i _--4-_.—--i---1 — -—1--- �-- 3 E I i i I TOPOGRAPHY PROFILE:y Direction: Scale: Approval: for office use Building Permit number'. 1(1 ✓ I" :--z ZU, Building: Owner/Applicant: 400ek U f lla Q M NCjU C- Date of Planning: �V application: Env. Health: Parcel Number: � Z o U,-/ 11 Pfic uC. RECEIVED OCT 0 5 2015 426 W, CEDAR ST. n L i V L n c� PLANNING 170b-Y Q � F-DI �ti b �e �-6 r,-i..e �� ( _ t . t � i RIECEIVED tE � '1Y'K� j 3 ! --- -t-- PU I 1 ( -T- TOPOGRAPHY! PROFILE: �LIC HP A 1 14 i V 1 2 2015 CEW 0- or c"'� Direction: Scale: office Approval: for oce use Building Permit number: Building: Owner/Applicant: IQ �,;n 4�o o c� �/ ! 1la a,e IL1}�_>_� � Date of Planning: !y application: Env. Health: Parcel Number: ?, z 2 32 - �" C7 00 1 BUI LDING, Name h" ' A,3d MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT FEE CALCULATION O- 09/01/2015) VALUATION DETERMINATION r-775727i)-� � Occupancy Type Square Footage Valuation Total Valuation Amount (sq. ft. x valuation) Residence /Addition /Basement $112.65 $ Garage /Storage $44.63 $ Unfinished Basement $15.00 $ Deck $14.34 $ Carport /Covered Deck $20.38 $ Other _ $ TOTAL VALUATION $ Estimated Plan Review Fee: $ Planning Dept. Review Fee C$2053�30,$70): $c� U GEO - Geo-technical Review Fee ($255.00): $ Addressing Fee ($173.50): $ Rom:CEIVED Fire Access & Grade Revi w Fee ($73.00): $ OCT 0 5 2015 Other: t1a $ r TOTAL DUE WHEN PERMIT IS SUBMITTED: $ G 9. d The estimated plan review fee is based upon information provided at the time of application and is subject to change. Planning Department fee is a flat fee which is due when permit is submitted. Building permit fee, mechanical, and plumbing permit fees will be calculated during plan review. The balance of all other fees will be collected when permit is issued. ESTIMATED BUILDING PERMIT FEES Building Permit Fee (ICC, Table 1 - Building Valuation Data) Estimated Mechanical Fees (U.M.C. , Table 1-A) $ Estimated Plumbing Fees (U.P.C. ,Table 1-1) $ State Fee: $ Other: $ Estimated Building Permit Fees WHEN PERMIT IS READY $ GRAND TOTAL $ 2 Name P.103i n V�o-o d1 V►'1�alrt►� Parcel# 3 ZZ3Z--SO `Cl3o p I BLD# ti c u Y4 em - J BUILD 1 N G Mason County Department of Community Development 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. 2Common 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 C- X I�— _ (,�OU 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 r = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X� C = Any paved, gravel or packed area per definition X _ above table 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 review and inspection as may be required. R u b►n +}a-o A �/'i 110.0 M"Q-CLC-- X '�— -� v Owner/Agent/Contractor(circle one)Date: 16—S')S 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 �► Name l.0 b n 44v-oA V� J)oki- Parcel# 3 ZZ 32-- 50 - 1300 1 BLD# 1'ti 4� L-LC Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa-us/code/commissioners/index.htm Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details*are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT.450 Mail: P 0 Box 1850, Shelton WA 98584 Physical:415 N 6th St, Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact 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.Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT. 352 Mail: P 0 Box 1666, Shelton WA 98584 Physical: 426 W Cedar St,Shelton WA 98584 A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. 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 review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 (10/19/2015\Trish Woolett- Robinhood Village Mobile Home Park- Mobile Home Page 1 7 From: John Woodring <johnwoodring.law@g mail.com> 0 To: "JNeal@co.mason.wa.us" <JNeal@co.mason.wa.us> D 0 CC: Theresa Janzen <tajanzen@comcast.net> �:a M Date: 10/19/2015 1:44 PM 0 -w,- Subject: Robinhood Village Mobile Home Park- Mobile Home Siting Permit ("n m "U Hello Ms. Jahanel Neal, Mason County Permit Tech, r —I I am responding to your e-mail of October 14, 2015, regarding our request for a siting permit for a 1969 Z single-wide mobile home located at Robinhood Village Mobile Home Park in Union, Washington. Thank r-- you for your response. Let me address your questions. m = Th home was purchased from King County out of Riverbend Mobile Home Park located in Renton, M Washington, by Robinhood Village MHC, LLC, the owner of Robinhood Village Mobile Home Park in Union, Washington, for re-location to Robin Hood Village. I am the sole member of the ownership LLC. Riverbend was closed and the tenants, after receiving re-location assistance, vacated with most of them abandoning their homes in the park. King County has held several home sales for the general public in hopes of these affordable housing units being saved and successfully re-located. Prior to the home being moved, to meet the requirements of the Washington Department of Labor and Industries and King County under RCW 46.04.622 and obtain a moving permit, approximately $2,000 was spent on safety up-grades such as installing windows large enough and close enough to the ground for a person to vacate the home in case of emergency; reinforced walls near a stand alone wood-burning stove to address fire safety concerns; and other safety modifications. Theresa Janzen, the Robinhood Village manager, is sending to you the certificate issued verifying these upgrades as indicated in her October 15, 2015, e-mail to you. The subject home has presently been located in Robinhood Village for several months awaiting the siting permit from Mason County to enable finalizing its installation. It is necessary that the electrical hook-ups and other buttoning-up maintenance be completed as quickly as possible to prevent weather damage in the upcoming fall and winter. The home is located on a lot that had been vacant for some time that can only accommodate a single-wide home. These are not easy to find and are generally older pre-HUD homes. With this background information that I trust adequately addresses the questions in your October 14, 2015, e-mail, let's talk about the issue at hand. Ms. Janzen reported to me several days ago that Mason County had denied the siting permit for the home because"the County did not allow pre-HUD (1976) homes." She received this denial from you. You agreed to provide her the legal basis for the rejection via e-mail. We have not received this information. The denial based on not allowing pre-HUD mobile homes in Mason County is illegal on several grounds. State statute expressly restricts a county from denying the location of a mobile or manufactured home in a mobile home park based on the home's age or dimensions. RCW 36.01.225 states, "A county may not adopt an ordinance that has the effect, either directly or indirectly, of restricting the location of manufactured/mobile homes in manufactured/mobile home communities, as defined in RCW 59.20.030, that were legally in existence before June 12, 2008, based exclusively on the age or dimensions of the manufactured/mobile home." Further, the home was moved into Mason County from a closed community. RCW 59.21.105 provides in the legislative intent section that"existing older homes provide affordable housing to many persons." Therefore, the statute continues, "Mobile homes relocated due to either the closure or conversion of a mobile home park, may not be required by any city or county to comply with the requirement of any applicable fire, safety, or construction code for the sole reason of relocation." We are requesting that Mason County issue the requested permit for the reasons provided herein. To (10/19/201%Trish Woolett- Robinhood Village Mobile Home Park- Mobile Home Page 2 i deny the permit would be a violation of state law. Thank you for your consideration. John Woodring Attorney at Law 2120 State Ave. NE, Suite 101 Olympia, WA 98506 (360) 224 4647 johnwood ring.law@g mail,com D ;:0 M C ) :rz M m r � nz r M m Page 1 of 1 Trish Woolett - Fwd: Robinhood Village Mobile Home Park - Mobile Home Siting Permit From: Jahanel Neal To: Woolett, Trish Date: 10/19/2015 2:30 PM Subject: Fwd: Robinhood Village Mobile Home Park - Mobile Home Siting Permit Attachments: Robinhood Village Mobile Home Park - Mobile Home Siting Permit; Neal,Jahanel.vcf Hello Trish, please see email attached from John Woodring RE:the 1969 Mobile Home located at Robin Hood Village BLD2015- 00865. Please advise me of the next step of where we go from here. Thank you. Best Regards, Jahanel Biscay Ned Mason County Permit Tech 426 W.Cedar St-Shelton, WA 98584 (360)427-9670 ext 408 O W �^ J M M r � �nz r-- —I rn s m file:///C:/Users/TrishW/AppData/Local/Temp/XPgrpwise/5624FE7AMasonmai11001626B6E 15691 D 1... 10/19/2015 Page 1 of 1 Jahanel Neal - FW: Invitation to Bid: Riverbend Mobile Homes .� From: "Theresa Janzen" <tajanzen@comcast.net> RECEIVED To: "'Jahanel Neal"' <JNeal@co.mason.wa.us> Date: 10/22/2015 9:10 AM OCT 2 2 2015 Subject: FW: Invitation to Bid: Riverbend Mobile Homes CC: "Johnwoodring law"' <JohnWoodring.Law@Gmail.com> 426 W. CEDAR ST. Attachments: Bid 1508 Riverbend ITB.docx Hi Jahanel - Attached is the original information we received on the Riverbend Mobile Home Park closure. They are closing down the park in phases. We will be looking at one more home to put on our last vacant lot at Robin Hood Village. Let me know if you need any further information. The on-site manager did give me the L&I and Fire Safety certifications, which I will scan to you today when I return from meetings. We appreciate Mason County's reconsideration of this issue. Thank you! 'Theresa Janzen 360-438-0785 tajanzen@comcast.net file:///C:/Users/j neal/AppData/Local/Temp/XPgrpwise/5628A7EEMasonmai110013 9783... 10/22/2015 RECEIVED OCT 222015 426 W. CEDAR ST. King County Invitation to Bid and Public Auction Bid No. 1508 King County Surplus Personal Property Sale Conducted by the Fleet Administration Division In accordance with King County Code 4.56, sealed bids will be accepted for the following County surplus personal property: (22) Separate Mobile Homes located at 17410 Maple Valley Highway,Renton, WA 98058. Lot 1. Unit#4 1966 New Moon Single Wide Lot 2. Unit#8 1963 Anderson Single Wide Lot 3. Unit#9 1967 Detroit Single Wide Lot 4.Unit#10 1970 Fleetwood Double Wide Lot 5. Unit#26 1966 Elcar Classic Single Wide Lot 6. Unit#29 1971 Shelby Single Wide Lot 7. Unit#37 1958 Anderson Single Wide Lot 8. Unit#47 1968 Kit Double Wide Lot 9. Unit#501963 Anderson Single Wide Lot 10. Unit#55 1975 Broadmoor Single Wide Lot 11. Unit#571982 Kentwood Single Wide Unit#67 1969 Sky Singid Lot 13. Unit#68 1965 Vanderbilt Single Wide Lot 14. Unit#76 1968 Elcar Double Wide Lot 15. Unit#77 1969 Van Dyke Double Wide Lot 16. Unit#82 1978 Gold West Double Wide Lot 17. Unit #83 1974 Glenbrooke Single Wide Lot 18. Unit#86 1963 Anderson Single Wide Page 1 Lot 19. Unit#87 1969 Buddy Single Wide Lot 20. Unit #98 1967 Elcar Single Wide Lot 21. Unit #104 1970 Tamarack Single Wide Lot 22. Unit#108 1981 Kentwood Double Wide TITLE: Riverbend Mobile Home Park SALE TYPE: Sealed Bid MINIMUM BID: $ 100.00 DATE ISSUED: April 15, 2015 OPEN HOUSE: Week of April 20, 2015 by appointment only(refer to Section IV 45) BID OPENING DATE AND TIME: 10:30am Wednesday, April 29, 2015 Sealed bid proposals are hereby solicited and will be received at the King County Fleet Administration Division, 201 South Jackson St.,Room 822, Seattle, Washington, 98104, for the removal and relocation of the 22 mobile homes located at the addresses above. This sale shall be conducted in accordance with the following instructions, requirements and specifications: All bids received will be opened in public at the time and place stated above and all bidders and other interested persons are hereby invited to be present. To submit a bid you must complete the SEALED BID FORM (Attachment A) SECTION I -GENERAL INFORMATION A. All bids submitted become public information and may be reviewed by appointment by anyone requesting to do so at the conclusion of the bid evaluation process. B. All mobile homes shall be offered on an"AS IS, WHERE IS"basis without warranty or guarantee of suitability or,$tness for the purpose for which it was intended. King County reserves the right to reject any or all bids. C. In the event it becomes necessary to revise any part of this Invitation to Bid (ITB), addenda shall be provided to all prospective bidders who received the initial ITB. D. King County is not liable for any cost incurred by prospective bidders prior to awarding the Bid. E. No bids will be received after the time and date specified on the ITB. There shall be no exceptions to this requirement. Page 2 F. The award will be to the highest bidder. Once awarded, the successful bidder is bound by the bid and obligated to claim the goods. Persons failing to do this may be declared ineligible to bid at all future King County Fleet Administration sales. All bids are final. In case of equal sealed bid offers,the award will be made to the earliest bid received. For purposes of clarity,the successful bidder will be referred to as the"Buyer"from this point forward in this document. G. After bid has been awarded,the property becomes the sole responsibility of the Buyer. Buyer agrees to indemnify and hold harmless Seller against damage caused by the acts of Buyer or any person acting at Buyer's request or on Buyer's behalf in connection with the dismantling or removal of property. H. A contract between the successful bidder and King County shall include the ITB and the bidder's response to the ITB. Failure of the successful bidder to accept these obligations may result in cancellation of their selection. I. The Buyer may not assign any rights or delegate any duties under this contract without the County's prior written consent. Such consent must be sought in writing no less than thirty (30)days prior to the date of any proposed assignment and/or delegation. J. Either party may request changes in the scope of services and performing or reporting standards to be performed or provided herein. Proposal changes which are mutually agreed upon shall be incorporated by written amendment to the agreement by King County Department of Natural Resources and Parks and King County Fleet Administration Division. K. The contract may be terminated at the County's election if for any cause the Buyer fails to fulfill in a timely and prompt manner her/his obligations under this agreement or if the Buyer violates any of the provisions of the agreement. L. Payment must be in the form of cash, certified check or cashier's check made payable to King County Finance for reimbursement to the King County Flood Control District Fund. M. Please direct all questions regarding the bid process to: Ron Mendoza,Inventory Specialist Fleet Administration Division 201 South Jackson Street, Room 822 Seattle, WA 98104 (206)477-3892 ronald.mendoza@kin cg_ounty.gov Page 3 N. Please direct all site specific questions to: Amanda Hubbard, Real Property Agent Department of Natural Resources and Parks 201 South Jackson Street, Room 600 Seattle, WA 98104 (206)477- 4713 amanda.hubbardkk`n cg ounty.gov SECTION II—BID DESCRIPTION King County is seeking a new owner for the twenty-two mobile homes to be relocated to a new location. This effort is being conducted as part of a capital improvement project conducted on behalf of the King County River and Floodplain Management Section, Water and Land Resources Division of the King County Department of Natural Resources and Parks on behalf of the King County Flood Control District to reduce flood and erosion risks in the vicinity. By relocating this house, the new owner will support the County's goals of: • reducing risks from flood and channel migration hazards, • avoiding environmental impacts, • reducing the long-term costs of flood hazard management, and • providing an overall benefit to the local community. The Buyer will be responsible for coordination and cost of all subsequent actions: • Acquire or determine a new location for the house; • Obtain all applicable permits related to removal and relocation of the structures; • Remove all portions of the buildings down to the top of the concrete foundation. This includes but is not limited to all building systems, framing, siding, windows, roofing, drywall, floor covering, casework, mechanical systems, plumbing systems, deck/porch, and all other components within, or attached to the existing structures; • Remove all debris associated with the removal of the unit. The site must be left cleared and clean; • The Buyer will have 45 days from the bid opening date to move the mobile homes from the County site, unless otherwise negotiated and documented in writing with the County. The County will be responsible to: • Terminate all utilities including water,power, gas, sanitary, sewer and propane tanks (as applicable). SECTION III—INSURANCE REQUIREMENTS A. Prior to awarding this bid,the applicant shall procure and maintain for the duration of this agreement insurance against claims for injuries to persons or damages to property which may arise from, or in connection with the performance of work hereunder by the applicant, its agents,representatives, employees, and/or Page 4 subcontractors. The cost of such insurance shall be paid by the applicant or subcontractor. The applicant may furnish separate certificates of insurance and policy endorsements for each subcontractor as evidence of compliance with the insurance requirements of this agreement. B. Minimum Scope of Insurance - Coverage shall be at least as broad as: 1. Commercial General Liability: Insurance Services Office form number(CG 00 01 Ed.current or its equivalent) covering COMMERCIAL GENERAL LIABILITY. Coverage to include XCU. 2. Automobile Liability: Insurance Services Office form number(CA 00 01 Ed. Current or its equivalent)covering BUSINESS AUTO COVERAGE, symbol 1 "any auto"; or the combination of symbols 2, 8, and 9. 3. Worker's Compensation: Worker's Compensation coverage, as required by the Industrial Insurance Act of the State of Washington, as well as any similar coverage required for this work by applicable Federal or "Other States" State Law. 4. Employers Liability or "Stop-Gap": The protection provided by the Workers Compensation policy Part 2 (Employers Liability) or, in states with monopolistic state funds, the protection provided by the "Stop-Gap"endorsement to the General Liability policy. 5. Contractors Pollution Liability: Pollution Liability Insurance, including an MCS-90 Endorsement. Whenever the performance of this Contract involves the transportation or abatement of hazardous substances,the Contractor shall provide coverage to cover damages sustained by reason of sudden and accidental pollution, including an MCS-90 endorsement, attached to the Automobile Liability policy, covering accidental pollution or equivalent: C. Minimum Limits of Insurance -The applicant shall maintain limits no less than for: 1. General Liability: $ 2,000,000 combined single limit per occurrence for bodily injury,personal injury and property damage and $2,000,000 in the aggregate. 2. Automobile Liability: $ 1,000,000 combined single limit per accident for bodily injury and property damage, 3. Workers'Compensation: Statutory requirements of the State of residency. 4. Employers Liability or "Stop-Gap" coverage: $ 1,000,000. Page 5 5. Contractors Pollution: $ 1,000,000 per occurrence and in the aggregate D. Other Insurance Provisions 1. The County, its officers, officials, employees and agents are to be covered as additional insured as respects: liability arising out of activities performed by or on behalf of the applicant. 2. To the extent of the applicant's negligence, the applicant's insurance coverage shall be primary insurance as respects the County, its officers, officials, employees and agents. Any insurance and/or self-insurance maintained by the County, its officers, officials, employees or agents shall not contribute with the applicant's insurance or benefit the applicant in any way. 3. The applicant insurance shall apply separately to each insured against whom a claim is made and/or lawsuit is brought, except with respect to the limits of the insurer's liability. E. Verification of Coverage The applicant shall furnish the Fleet Administration Division with certificates of insurance and endorsements required by this ITB. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The certificates and endorsements for each insurance policy are to be on forms approved by the County and are to be received and approved by the County prior to the commencement of activities associated with this ITB. The County reserves the right to require complete, certified copies of all required insurance policies at any time. SECTION IV- SPECIFIC REQUIREMENTS 1. The Buyer will provide to the Real Property Agent a plan for the relocation of the mobile homes by Friday, May 15, 2015. 2. The mobile homes must be moved within 45 days of the bid opening. 3. Performance Bond The Buyer will be required to submit a performance bond of $ 5,000 in the form of cash, certified check or in a standby letter of credit at a bank listing King County as the sole signer to release the funds. Such bond or reserve account is to guarantee the performance by Buyer. "Performance" should be considered meeting all provisions listed in Section II of this package. Page 6 4.Start Up Notification The Buyer will notify Linda Holecek,the Property Agent Supervisor, at the beginning of the relocation/movement process 3 business days prior to the start of work at the County site at(206) 477—4712 as well as the property manager(refer to Section IV #5). 5. Access to the Site The Buyer will notify and coordinate with Katie Hall, Manager, when access to the site is requested. Katie Hall, Manager Larry Hall, Onsite Property Manager 17410 Maple Valley Highway Unit#25 Renton,WA 98058 (425)255 - 2613 Page 7 SEALED BID FORM (Attachment A) Sale Name: Riverbend Mobile Home Park Bid Number: 1508 Date: April 29,2015 The following party hereby submits the following bid: (Print Full Legal Name) (Mailing Address) (City, State,Zip Code) (Phone Number) Lot 1. $ Lot 9. $ Lot 17. $ Lot 2. $ Lot 10. $ Lot 18. $ Lot 3. $ Lot 11. $ Lot 19. $ Lot 4. $ Lot 12. $ Lot 20. $ Lot 5. $ Lot 13. $ Lot 21. $ Lot 6. $ Lot 14. $ Lot 22. $ Lot 7. $ Lot 15. $ Lot 8. $ Lot 16. $ Bidder's Warranty and Bid Signature By signing and submitting this bid as an offer to purchase the mobile homes from King County,the Bidder hereby warrants to the County that they have had an opportunity to fully inspect the mobile homes.Bidder further warrants to the County that they enter this bid based upon their own judgments of the value of the mobile homes,formed after their own examination and inspection. Bidder also warrants to the County that they enter this bid without any reliance upon the appraisals,pre-bid documentation, or any other representation by the King County Department of Natural Resources and Parks. (Signature of Authorized Representative submitting this bid) (Date) (Print name and title of Authorized Representative submitting this bid) Page 8 PHOTOGRAPH: � s . , PHOTOGRAPH: 4 • :a PHOTOGRAPH: Page 9 a PHOTOGRAPH: • • y Lot 4 • f f- e PHOTOGRAPH: y Lot 5 S'y. ilia PHOT• • y , X Page 10 ' • • -77 11 a M, PHOTOGRAPH s - y # PHOTOGRAPH PHOTOGRAPH Lot 1 oor i f 4 PHOTOGRAPH PHOTOGRAPH IV T .. .. -7 t y w�+ PHOTOGRAPH _ r PHOTOGRAPH �`� , qw Page 13 PHOTOGRAPH �r r 9 e n , h PHOTOGRAPH Lot 16 s s. i'• �I t PHOTOGRAPH iS `+ Page PHOTOGRAPH Lot PHOTOGRAPH L• 19 tr J ,x�Y%4baR'.YsxU tta. ,...,....:. ..r•^ - ` ,+� ��' 'p�Em. -n,r PHOTOGRAPH • 1 loom Page 15 • a PHOTOGRAPH Lot 21 --E 41 `"`- s k PHOTOGRAPH Lot 22 7-1 Page 16 Page 1 of 2 POST ON JOBSITE PRIOR TO BEGINNING OF WORK Department of Labor and Industries FAS ALTERATION PERMIT #FP2521774 Contractor Name License Number Installation Description: King County Water and Land Fire safety inspection. Resources Services to inspect: Purchasers mailing address Description Quantity Amount 201 S Jackson St#600 Seattle WA 98104 Combination Permit Mechanical Telephone number FAX Number and Electrical- FIR 1 Inspection fee: $181.60 Premises owner's name Additional Fees May Be Assessed Upon Field First Commercial Property Corp Inspection Address of inspection RECEIVED 17410 SE Maple Valley Rd#67 RENTON WA 98058 (253)391- OCT 2 3 2015 7790 426 W. CEDAR ST. This permit expires one (1) year after the date of purchase. Applied: 5/27/2015 Expiration: 5/27/2016 Date Approved By Date Approved By MECHANICAL PLUMBING Type Type ELECTRICAL STRUCTURAL Type Type OTHER _ OTHER dt- Type ` Type Inspection Date Area, Building or Equipment Inspected Action Taken Inspector Property Owner: Retain Permit Number for your records Attention Applicant! The Department will not conduct this inspection if there are unrestrained animals on the premises. Failure to comply with this requirement may result in additional inspection service fees and delay in service. c CHttIsJ� Si-AO .�L/J�j�: l�%C.-'(E-'.�� l�r�7 u✓ft(,lam (� t� IC�i'S 1 �`.!i N Cr6 �.. ��-�-�f�'.� 5/27/2015 Lab Department s e bled Sand Industries 4 �aTATg FIRE SAFETY CERTIFICATE Factory Assembled Structures o PO Box 44430 Olympia WA 98504-4430 Applicant: You must fill out all of the information below to obtain an inspection. Date 6-- z-7 Homeowner(s)name as it appears on title f� Single Wide El Double Wide T Address where home is currento sited County ZIP IIgt0 SE M"l&- Va--)tz. k , nC 9�'058 VIN number of mobile home Year Manufactured Parcel number where home is to be located City County County Treasurer's address where home is to be sited y , r N Sr-, , i ) 1 ; � 0 hex `/2—cl City County ZIP FAX Number \'l a c (Department use only) —' The home located at the above address has Passed ❑ Failed a fire safety inspection 0 N rn o N * Permit Number D c Inspector Phone Number Office Date �a)< qzs z,510 35 r �f A—, 1- G._ s-_ F623-028-000 fire safety certificate 12-2005 z .f(� .. � `�.+ox--N— �.�Cf1+"yT-c-a�P='-•ram'-.-a� _. t �-I�'�'�-- STATE OF WASHINGTON Vehicle Certil5cate of Title Number t - 1 51 520721 5 ` Model Style .: Series/Body :, t Make ��. License Number Vehicle Identification Number(VIN) � b0/12 969 SKYLN 51644C Fuelyp T e Odometer Status Date of Application Odometer Miles lf.< 06/01Y2015 0000� Prior Title State Prior Title Number y"e, Gross Vehicle Weight Rating Code Vehicle Color l 3 Scale Weight 1428909501 • g WA €3s 00000 ;3f �c Comments r�us 206-2015 ^;7 Brands RECEIVED OCT 2 3 2015 f 426:W: CEpAR S.T. f. Sale price$ Date of sale 4 sing off ere+6 or to a hicle licen ce ra = i wneF:To release interest.sign below and give this title to the registered own er/llableft the OW security for pen al ties. LegalO with the proper fee within 10 days of satisfacfton of the security interest;or you may be g f acquiring'the vehicle to avoid a penalty.Take this signed title to a Buyer:You must apply for title within 15 calendar days o +..•, appropriate fees. vehicle/vessel licensing office with the Registered Owner Legal Owner , ' SAME AS LEGAL OWNER of ROBIN HOOD VILLAGE MHC a :. PO SOX 8342ts: LACEY,WA 98509 list � r D ` . .. :.eIs ..:. .... ....... .......a. ..,. . signature of 2 rstered owner releases all Interest in Date Signature of first iecai owner releases all interest in Date the vehicle de cribed above.it signing for a business, the vehicle described above.If signing for a business. include business name.signature and title. 3 include business name.signature,and title. ,icy ..._ .. ....... .. Signature of registered owner releases all interest in Dale 3 � Signature of second legal owner releases all interest in Date l vehicle described above.it signing for a business, B the vehicle described above.It signing for a business. include business name.signature.and title. }� rs; include business name.signature.and titre. H t certify that the records of the Department of Licensing show the persons �:c d named hereon as registered owners and legal owners of the vehicle described. Director.Department of Licensing tti;� t , y ti Federal regulation and state law require you to state the mileage when transferring ownership if the vehicle is less than 10 years old.unless exempt.Failure to complete this statement or providing a false statement may result in fines and/or imprisonment. ft: S s, o + , 2 7 O 1 certify, to the best of rrty knowledge, the odometer reading is:♦ (no tenths) Transfer date__/� Odometer reading in mhos S > a '17This reading is(check one): ❑the ctual mileage of the vehicle ❑in excess OHM mechanic limits ❑not the actual mileage: r a Signature of transferor/seller Signature of transtereeitwyer ' T v a PRINTED name of transteror/seller r g y PRINTED name of transferee/buyer E s n !.. C r Address of transferees buyer Address of transferors seller _ r Q ^i-^s',�- -s'F-r ^.. -..•a `. n. � "!•"4. -c ?�.s G`"r_ ,r„Scy Ya-'4� .r G 1 4� J. n. BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME MAIL A REdSS CITY&STATE ZIP 2 E _ i DIRECTIONS TO JOB SITE r�U ) j�� �, LEGAL (❑ S E ATTACHED SHEE DESCR. ��� �C�w� spy=�C� 72 D'j- 34 •�f�v� rQ NAME MAIL ADDRESS CITY&STATE LICENSE NO. PH NE CONTRACTOR USE OF BUILDING Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: / ;?- ' Q / 1 Valuation of work: $ C2 PLAN CHECK FEE PERMIT FEEaQ SPECIAL CONDITIONS: BEDROOMS Z DECKS CARPORT/< NOTICE BATHROOMS TOTAL SO. FT. GARAGELI ATTACHED ❑ SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT El ATTACHED AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE ❑ DETACHED ❑ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER I certify that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT I_l SHORELINES SEASONAL I ; FLOODPLAIN I Firm E.D. NO. S.E.P.A. C: By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS be in conformance therew'th. MOTOR VEHICLE PERMIT PLICATION ACCEPTED BY PLANS CHECK BY PROVED FOR ISSUANCE Own Date S A AA PLA CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH Oblizalo, James #4264 3-9-79 Lots 1-30 in or Lots 1-30 in Blk 100 Plat of Union Robinhood Trailer Village Space 27 Mobile Home