HomeMy WebLinkAboutBLD2023-01527 MFG Home - BLD Application - 12/20/2023 COM41MASON COUNTY Permit No: ��J � F."-
MUNITY DEVELOPMENT RECEIVED
Permit Assistance Center, Building,Planning DEC 2 0 2023
BUILDING PERMIT APPLICATION 615 W. S
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PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:e-e< 04A,- NAME: }-fZ�v��l�rvv� (pv+5"ycocN,o
MAILING ADDRESS: MAILING ADDRESS:p 34)Ic SI?CO
CITY: STATE: ZIP: CITY: - c e nv STATE:W A:_ZIP: a!g 15'0
-^� PHONE#1: PHONE: - Z-1A3 CELL:
PHONE#2: EMAIL: *'11tag
EMAIL: L&I REG# EXP. /3V 1_Z_j' C
PRIMARY CONTACT: OWNER❑ CONTRACTOR��_ OTHER❑ �•
r L-L C(e!jV'1A I
NAME EMAIL rUrtKl-Yitr�
MAILINGADDRESS (5 biC 5-5'00 CITY LaCTSTATEIei ZIK$54_
PHONE 'Sto---?47-G!i_T CELL
PARCEL INFORMATION:PARCEL NUMBER(12 Digit Number)q i q D3 -34 -50o-5( ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT j
SITE ADDRESS CITY q?- --O vq �- A
DIRECTIONS TO SITE ADDRESS
ACJ LA)
IS THE PROJECT WITHLN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NO SNOW LOAD:2tpsf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW N�'ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Res' ire.Garage.Commercial Bldg.Etc.) V ,PS r A tr e k-
IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_?
HEATED STRUCTURE? YES OYhole BUZ bl"YES(Pant cJ ojBldg)❑ NO❑
DESCRIBE WORK ,/e
SQUARE FOOTAGE:tpvpased)
1ST FLOOR 1, (Z- sq-ft. 2ND FLOOR s sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK__?Z sq.ft. COVERED DECK.— sq.ft. STORAGE — sq.ft. OTHER. — sq.ft.
GARAGE -Sq fi. Attached❑ Detached❑ CARPORT��sq.ft. Attached❑ Detached❑
MANUF�ACTU M RED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
/
MAKE l jMa V\ MODEL 57&z 15�' YEARZV Z--LENGTH
WIDTH_ BEDROOMS BATHS - - SERIAL NUMBER -T 8D
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTICkr— SEWER❑ NEW( EXISTING❑
PLUMBING IN STRUCTURE? YES b---- NO❑ ljyes,attach completed WaterAdequacvForm
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOk�-- EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER 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 and 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 legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and at 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 ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED: DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
Aft OMNI t"N 1"J"'N" DENTLOPMENT MASON COUNTY rertakt l RECEIVED
DEC 2 0 2023
BUILDING PERMIT APPLICATION
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PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF iNSPEC"JON. iNACTIVITY OF THIS
PERMIT APPLICATION OF 180 GAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
_y COUNTY CODE 14.D6.411)
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Mason County Building Division
MANUFACTURED HOME PLAN REVIEW SPECIFICATIONS
UNIT INFORMATION: *****Snow Load Z<_
Make Model 5-co Z (- Year 2ti 23
Square feet Width 2:D Length
Single/Double/triple-wide(indicate) NEW or Replacement(indicate)
All footings must be min. 12"below natural grade within 24"of the skirting when perimeter blocking
is required.
When a relocated unit AND the manufactures specification are not available the HUD 24 CFR 3285
must be used for required pier plan,standards and set-up.
Allowable Pressure(Pound Per Square Foot)No Allowances made for overburden pressure,embedment
depth,water table height,or settlement problems
Soil bearing is assumed at 1500 psi If set-up is using a greater soil bearing capacity a soil
report from a design professional is required
Fill(compact or uncompacted) Compaction Report required through Special analysis
Peat or organic clays Compaction Report required through Special analysis
SET UP SPECIFICATIONS:
Manufacturer's Pier Plan
'l HUD24 CFR part 3285
FOUNDATION:
Check the type of foundation and attach detail plans from manufacturer's or the ANSI
A225.1/ HUD24 CFR part 3285
-1 Pads
O Concrete(pre-cast)
Cl ABS Pads(Poly)provide manufactures specification with capacities.
OCo uous concrete footing(runners)
rl Slab
ANCHORING:
M Ground
LGr Magnum
77 Concrete-2500 PSI
-1 1-bolt
7 Expansion bolt
For new units,this information can be obtained from the home retailer or contractor. Previously
owned units,which manufacture's instruction are not available must utilize the HUD24 CFR part 3285
code for installation.Washington State law requires that a certified installer install manufactured
homes.
The undersigned I hereby acknowledge he/she does understand that the Mason County submittal and
review processes will be based on the information provided herein and will be verified at time of
inspe
X Applicant/Dealer/Installer(indicate) Date
EH Setbacks
A.) Drainfield/Reserve requires 10'setback from footing/foundations
(I B.)Septic tank(s)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of
Drainfield/Reserve area
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
50ft,down gradient of Drainfield/Reserve area
_ Auc.ia- isual Alanr
1 a
Cleano'jt
S EH APPROVED
7 Rhonda Thompson 03/01/2024 I 3 1200 Galion Septic Tank;
2-Campartrnent with
.- Effluent Filter WELL.
1000 Gallon '-IL1*np Chamber
0 Vah,e Control Box
fa-1V i
H SLOPE 'f id t �\��;N
'"oast?
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Name:71y� W V, gvU,0 Parcel# I (�0 —�`�' S�� BLD#��,�j
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 Compl.
Surface Type Length I X Width = Area *All dimensions in feet
Buildings S(P X L7 = I,S/ z
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 = ,jf the total impervious area of the proposed site
X = evelopment 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-
de roperty for review and inspection as may be required.
Owner/Agent/Contractor(circle one)Date:
If t e To a us 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 Parcel# BLD#
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 IN61AL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) Z
he relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in th it 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 re ' d inspection as may be required.
X Owner/Agent/Contractor(circle one)Date: J ' 60
Page 2 of 2