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BLD7662 Mobile Home - BLD Permit / Conditions - 10/18/1978
Collum, Barry L. _ #7662 10-18-78 SE 1/4 SE 1/4 17-20-4 Mobile Home BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 DATE ISSUED PERMIT NO. OWNER NAME _ MAIL ADDRESS CITY&STATE ZIP PHONE wtr+'t T t b ► v .e rx WA 17o DIRECTIONS TO JOB SITE /!71/e5 OGcfof jgoI,, OA/ jrJArZOC 2oe- .S/D4?- LEGAL 1/ / (❑ SEE ATTACHED SHEET) DESCR. S E y -7 -20 0 G/ W W. NAME V MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR Chi,►�/,`e S USE OF BUILDING Class of work: )0 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: Valuation of work: $ 0-4 PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: 40, BEDROOMS D KS CARPORT ❑ NOTICE BATHROOMS TOTAL SO. FT. GARAGE LI ATTACHED L' SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT ❑ OR AIR CONDITIONING. TOTAL SO. FT. FIREPLACE ❑ DETACHED L 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 P+r 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�( SHORELINES i SEASONAL [ i FLOODPLAIN i 1 Firm E.D. NO. S.E.P.A. I j By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. 91 NO' 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 of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance the t MOTOR VEHICLE PERMIT l 6 Iq� APPLICATION ACCEPTED BY PLANS CHECK BY A PROVED FOR ISSUVCE Owner rDate_ , PL N CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH -40. PARCEL NO. RECEIPT THORSTO,N:MASON HEA-LTH DISTRICT DATE BASIS FOR FEE AMOUNT NUMBER DIVISION OF ENVIRONMENTAL HEALTH 2000 LAKERIDGE DR.S.W. FIFTH&BIRCH ST. PHO14E 753-8073 PHONE 426-5561 OLYMPIA, WA 98501 SHELTON, WA 98584 APPLICANT r ; ADDRESS PHONE DATE APPLICANT MUST CALL FOR INSPECTIONS LISTED BELOW SITE: ❑ APPROVED ❑ NOT i APPROVED SEWAGE CONTRACTOR BY: NAME OF PLAT LOT NOT NO. SEWAGE: ❑ APPROVED ❑ APPROVED SEC. TOWNSHIP RANGE rj BY: DESIGNER: TYPE OF /I ✓ NO.OF LOT i 1 SOIL TYPE BUILDING /__BEDROOMS- SIZEi X' WATER GARBAGE DEPTH TO WATER TABLE FT. SYSTEM DISPOSAL PERC TESTS INCHES PER HOUR LIQUID WASTE G.P.D. BY DATE PRIMARY NORTH - SITE PLAN AND SPECIAL STIPULATIONS: SEPTIC TANKISI ,, GAL. PUMP REQ. (INDICATE DIRECTION OF DRAINAGE) - "" --'- -' DISTRIBUTION TILE TOTAL FEET FILTRATION AREA SQ. FEET QUANTITY OF t< APPROVED STONE CU. YD. SAND CU. YD. FILL REQUIRED CU. YDS. SPECIAL SYSTEM REQUIRED THE ELEVATION OF THE BUILDING SEWER SHALL BE SUCH THAT THE MAXIMUM DEPTH OF THE DISTRIBUTION TILE SHALL BE BE- TWEEN 12 INCHES AND 36 INCHES FROM FINISHED GRADE TO TOP OF TILE UNLESS OTHERWISE STIPULATED BY THE HEALTH OFFICER. IF THE ELEVATION OF THE BUILDING SEWER IS TOO LOW TO MEET THESE ELEVATIONS, A SEWAGE EJECTOR MAY BE Jb REQUIRED. ISOLATION STANDARDS FOR PRIVATE WATER SUPPLIES: BETWEEN WELL AND TANK OR ANY PART OF THE TILE FIELD, 100 FEET FOR SINGLE RESIDENCE, MOBILE HOMES, DUPLEXES AND MULTIPLE DWELLINGS. NO DRAINFIELD WITHIN 100 FEET OF ANY WELL, FRESH WATER LAKE OR STREAM; 100 FEET FROM ! ANY SALT WATER BODY. NOTE: "FOOTING DRAINAGE, DOWNSPOUTS, WATER SOFTENER AND ANY OTHER WASTE WATER NOT DEFINED AS SEWAGE SHALL NOT BE CONNECTED TO OR DISCHARGED INTO THE SEPTIC TANK SYSTEM OR THE SEWAGE DISPOSAL AREA'. ALL SEWAGE, INCLUDING SINK AND LAUNDRY WASTE, MUST BE DIRECTIONS TO SITE: CONNECTED TO THE SEPTIC TANK. FINAL INSPECTION REQUIRED BEFORE BACKFILLING TO " BACKFILLED AFTER INSPECTION 12" TO 24" Ei 2" STRAW E STONE OOVER TILE F� STONE UNDER TILE THIS SITE PERMIT EXPIRES I F CROSS SECTION OF TRENCH ©w