HomeMy WebLinkAboutBLD2021-00443 MFG Home - BLD Application - 3/29/2021 MASON COUNTY COMMUNITY SERVICES Permit No:'Bjda0al-WgLj3
PERMIT ASSISTANCE CENTER:
•BUILDING.PLANNING.PUBLIC HEALTH•FIRE MARSHAL _ _ 5
615 W.Alder Street,Shelton,WA 98584 ".
• Phone Shelton.(360)427--9670 ext.352•Fax(360)427-7798 Phone
Belfalr.(360)276-4467•Phone Elms:(360)482-5269
`J BUILDING PERMIT APPLICATION MAR 20 2021BUIL®IN I
PROPERTY OWNER INFORMATION: CONTRA
/C
�T
,OR INFORMATION: "-
NAME: B/ O-ar6 SS' NAME: bEr'?A c S t-L d
MAILING ADDRESS: _ MAILING ADDRESS: 2;
CITY: Wpr tl* STATE: ZIP: CITY: 0/1 er2 STATE: CCU ZIP: '�3
PHONE#1: PHONE:-5 0 Sdo CELL:%SD?397Z01
PHONE#2: - EMAIL: R %7 C3 F!cool
EMAIL; y-eQr t-Ced L&I REG
PRIMARY CONTACT: OWNER❑ CONTRACTOR Rr' OTHER❑
NAME &ARSe Dom!",eAAj EMAIL ,440VX
MAILING ADDFISS CITY STATE ZIP
PHONE CELL 360 S-!P`/ 2 20 ly
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number)1`��� ��'— �� ZONING
LEGAL DESCRIPTION(Abbreviated)1+ 7) FIRE DISTRICT
cur fwLicrSS C.:i
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO❑ SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cheek all rhat oppt)):
SALTWATER❑-LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW UK ADDITION❑ ALTERAAT`ION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Connnerctal Bldg,Eta) /C L 5
IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS .:S NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(whole Bldg)F' YES(Part[.1 of Bldg)❑ NO❑
DESCRIBE WORK PI*Ce- /t?oc;0 6�O�6,o ALa-�'l Power
SQUARE FOOTAGE: (proposed)
1ST FLOOR jfV sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.fL OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.& Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE 54r,t 41NE MODEL f Z69-G1— YEAR/ LENGTH 6().r
WIDTH 27 4' BEDROOMS 3 BATHS 2 SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC❑ SEWER[i]� / NEW[ EXISTING❑
PLUMBING IN STRUCTURE? YES(� NO❑ Ifyes,attach completed Water Adequacy Form
PEREvIETERNOUNDATION DRAINS PROPOSED? YES❑ NO®/ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS .--V
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 structure(s)for review and inspection.This permit/application becomes null 8 void ti 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 AFPI IrATInN OF 18Q DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08A2)
x �o —�1
—W Signature OWNER Must bes ed bvthe OWNER Date
DEPARTMENTAL REVIEW, 'APPROVED ':D E , DENIED, 4DATE >;TAGS/NOTESlCONDTTIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
Mason County
Community Services-Building Division
MANUFACTURED HOME PLAN REVIEW SPECIFICATIONS
UNIT INFORMATION: Snow Load
Make Model tASTOMn6f, Year /3D4-o?—
Square feet_ JiJJ�_ Width Z-/ Length
Singl Doub triple-wide(indicate) NEW r Replacement(indicate)
All footings must be min.12"below grade within 24"of the skirting when perimeter blocking is
required.
When manufacture specification is not available use ANSI A225.1 or HUD 24 CFR 3285.Must provide
pier plan with reference sections_
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:
G— Manufacturers Pier Plan
O ANSI A225.1/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
O Pads
i(Continuous concrete footing(runners)
O Slab
ANCHORING:
O Ground
O Magnum
O Concrete-2500 PSI
O -'-bolt
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 ANSI A 225.1/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
revi w processes will be based on the information provided herein and will be verified at time of
in e
X Applicant/Dealer/installer(indicate) Date_
!V ED
2 9 2021 -00041 PL NING MATSON,4
�� THEODORE J & ECHO D
12217-13-90102 N \ 920 E NORM BAY RD, ALL
iric,r C�r�at \
�1 W y., MARKLE, REBEKAH /
95i E NORTH BAY& NJAM R
RD \
ERMA 13-90103 ��n' �, �i o � \ S89 49'04'EE 250.57'
HERMAN, JOHN M c ' y ' `j i t �� 0 6' R=1136.04'
19680 EAST HWY 3 ALL SET ACKS ARE MEASURED SHORT PLAT,#634704 — s,_ \
SHORT PLAT,#634704 LOT 2 �� �- L=109.17' l �� T -I
LOT 3 t=RO THE FURTHEST � � � � » t / l / l
307.10' FROJECTI OF THE gUiLDINC, 16.42' Delta=53021 l I
97.46'— S N \
3' 94.36 108.76' 91.94' 10 12' 107.68' 7 \\ OWNER. MASSEYI7-14-900
SET RIC LS 40520 AT CORNER 41.30'
10.00' L=30.59' i
=2 52'22" (FOUND ILLEGIBLE BAR & CAP 0.5' HIGH S 89 25 08 E 823. \S26 34'09'E 6.0' FROM CALC'D I ^ 1 J � � \\cam S89 49,04 E 267.
CORNER, NOT ACCEPTED) M C' \z
PARCEL NO. 12217-14-90041 \ �� \\ R=1136.04'
9.
71'
Imo N�
I�
41819
�� \ a=N
TANGENT BEARING ` /N 26'16'06" W S 8949'04" E 770.97' 93.38' 63.71'94.15' 109.97 94.74' 97.60' � 108.76' 108. -
\ 400.15' \
\ S89 49'04'E 61.57' ,�I\ ,
12217-14-90042 30
BELL, RONALD F & KAILEN 3\\
\ 1291 E RASOR LN
it SOUTH LINE OF GOV'T LOT 2 IN THE NE 114 OF SEC. 17, T. 22 N.,
W, PER GRAYUM SURVEY AFN 489340, HOLMAN SP 632605
-- —- — REFERENCE ALSO HAMMOND SURVEY AFN 1732185
60 0 60 180
-- - ----------------- ----- -----------
Scale 1" - so ft BASIS OF BEARING: SHORT PLAT AFN 632605, RECORDS S 8949'04"E
APPRUq - :. OF MASON COUNTY AUDITOR
SITE PI-AN
ICA TE CHAN S SU�.IET T O AP'� ROVAL SURVEYOR'S CER TIfICA TEDate q-tg
BY
DRAWING N0. 1204
of As O a V1 asA Poi
DAY OF , 20_`_ AT M, THIS MAP CORRECTLY REPRESENTS A SURVEY MADE BY ME OR e SW 1/4 and
UNDER MY DIRECTION IN CONFORMANCE WITH THE REQUIREMENTS
OF THE SURVEY RECORDING ACT AT THE REQUEST OF 1 N1 6wd ks C;b
V
7n Land 5urveying. RECORDING FEE $075p WILLIAM & DEBBIE MASSEY �0� . 40520 �� Sec. 1
REGISTZO 4y�
sf0A'AL ---- 13512 138th Ave NWLLC
R. 1
Gig Harbor, WA 98329 Mason
Z-�74 I'"j fe� I^Dz (253) 549-3981
COUNTY AUDITOR DAN E. DAWDSON, PLS #40520 DATE