HomeMy WebLinkAboutBLD2022-00732 Final MFG Home - BLD Inspections - 6/18/2024 MASON COUNTY 615 W.Alder St.Bldg 8,SHELTON,WA 98584
COMMUNITY SERVICES SHELTON:360-427-9670,EXT 352
BELFAIR:360-275-4467,EXT 352
Buildin%Planning,Environmentalliealth,CommunityHealdi ELMA:360-482-5269,EXT 352
www.co.mason.wa.us
INSPECTION CARD AND CERTIFICATE OF OCCUPANCY`*
To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bid-inspection.
Permit Number BLD2022-00732 Date Issued 08/12/2022 Iss By
Project NEW MFG
Site Address 50 NE Schooner Ct
Applicant CUNNINGHAM JOHN HOWARD
Contractor FUTURE HOMES OF BREMERTON
Contractor Phone 1.360.479.4663
Primary Code UPC IBC,IRC,IFC,IEC,IMC,& Type
Permit Type MANUFACTURED HOME Occupancy
-APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS.
-DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED.
-THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION,FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY.
-ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION.
-OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION.
"THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.—
PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET
Public Works Access/Driveway Other
Health Septic Well
Deptartment
Planning Site Inspection
Department
Fire Marshall Fire Apparatus Access Fire Sprinkler
Auto Fire Alarm Hood and Duct
Other Final
Building
Department Building Official: Community Services Designee
Concrete Setbacks Slab
Footing Perimeter Point load Footing
Footing Interior Footing Decks/Porches
Foundation Stem Walls Other
Rough-In Groundwork Plumbing Framing
Groundwork Mechanical Plumbing
Groundwork Gas Pipe Mechanical
Gas Piping Shear Wall Nailing
Underfloor
Other
Insulation Slab Ceiling
Floor Vaulted Ceiling
Walls Vapor Barrier
Other
Wallboard Interior Wall Brace Panels Fire Walls
Nailing
Other
Final Building
Manufactured Setbacks Setup
Home Ct-210-7,Z rT7— s'23 �J
Concrete Foot/Runners q�Lto-ZZ J-I-L Final
Other
f t-e- ( s- rq 13 �a I'
iF,.( Fa�C6-1 d a3 ��
�FtrlcC fA(L.6-;-rr a3 ,P0 s" A-h'-
MASON COUNTY 360-427-9670 Shelton ext.352
. COMMUNITY SERVICES 36 60-482-52 Belfairext.352
360-482-5269 Elma ext. 352
Building, Planning, Environmental Health,Community Health
615 W. Alder St. Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov
CORRECTIONANSPECTION REPORT
PERMIT/CASE NUMBER:
ADDRESS/LOCATION: sp A-) cr' St yvy n/ER C%
FINDINGS:
G
C t f'C 7O 3E (.W OTC �'�.�i'ro'7 x�►te l
ai..CS �uF -)o l� ►oac�� �-� ��c ros�
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1 to� 6L �e•Q ;
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Items listed above must be corrected to p_ain compliance.
[1 THIS IS NOT A COMPLETE INSPECTION
This 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: - - ❑ Please contact our office regarding possible
Department: LD structural damage incurred by recent
Inspector: "natural/man made"disasters.This is NOT a
CORRECTION NOTICE.
DO NOT REMOVE THIS TAG
MCC14.12
MASON COUNTY 360-427-9670 Shelton ext.352
360-275-4467 Belfair ext.352
COMMUNITY SERVICES 360-482-5269 Elma ext.352
Building, Planning,Environmental Health,Community Health
615 W.Alder St.Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov
CORRECTION/INSPECTION REPORT
PERMIT/CASE NUMBER: &D20aa-GO-73e2
ADDRESS/LOCATION: S0 /UE 0C41QOA)E2 C.i
FINDINGS:
4aS A0 62
En���•nui-�s � ��tLT� 7eo�. V
oorck
d
.1 __/14SOA)Co cJNTYtj .a
Items listed above must be corrected to gain compliance.
❑ THIS IS NOT A COMPLETE INSPECTION
❑ This 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 -5-wD S,y
Date: 6 16',23 ❑ Please contact our office regarding possible
Department: Bur) structural damage incurred by recent
"natural/man made"disasters.This is NOT a
Inspector: ,�� CORRECTION NOTICE.
DO NOT REMOVE THIS TAG
MCC14.12
MASON COUNTY
360427-9670 Shelton ext.352
COMMUNITY SERVICES 36 60-482-52 Belfair ext.352
360-482-5269 Elma ext.352
Building, Planning,Environmental Health,Community Health
615 W.Alder St.Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov
CORRECTIONANSPECTION REPORT
PERMIT/CASE NUMBER: FID20,22—60`73 a
ADDRESS/LOCATION: SO /UE 5-01WA)EK
FINDINGS: /
D►not' COMI-4 s 4 '-o 6ockinj un,1t!e� Gka�c .GIo�C,� I
rL n \j e-,Itj al-ov, c�, !K ora,W1 a-01U+110(
C $ �� �=n ;.• vc� fir,
D pJufts Wt r rCcci fO nmi eA-,kl I cLi4 ,T4V- CS,T
,r -k 44is 4a-iAkd lo� 6ef� Co,mc:A ,
J-)MRSOA/W MRJp4)C-00NTYQA•6dV
Items listed above must be corrected to gain compliance.
❑ THIS IS NOT A COMPLETE INSPECTION
❑ This 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: Please contact our office regarding possible
Department: &D structural damage incurred by recent
Inspector: .DCD "natural/man made"disasters.This is NOT a
CORRECTION NOTICE.
DO NOT REMOVE THIS TAG
MCC14.12
` Mason County
I Mason County - Division of Community Development
615 W. Alder St. Bldg.8
x�,vati'c� Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
B DD2022-00732 MANUFACTURED HOME
PROJECT DESCRIPTION: NEW MFG ISSUED: 08/12/2022
SITE ADDRESS: 50 NE SCHOONER CT BELFAIR
EXPIRES: 02/08/2023
PARCEL: 123305200035
APPLICANT: CUNNINGHAM JOHN HOWARD OWNER: CUNNINGHAM JOHN HOWARD
13639 COHO RUN NW 13639 COHO RUN NW
BREMERTON,WA98312 BREMERTON,WA98312
360.440.5124
GENERAL CONTRACTOR'S LICENSE: FUTURE HOMES OF BREMERTON License: FUTURHB812JS
4021 W STATE HWY 15 Expires: 07/30/2023
BREMERTON,WA98312
1.360.479.4663
FEES: Paid Due
Modular/Manufactured Home $275.00 $0.00
Fee-2nd half collected at ready
to issue
Technology Surcharge $11.00 $0.00
Planning Review Fee $240.00 $0.00
State Fee-Residential $6.50 $0.00
Modular/Manufactured Home $275.00 $0.00
Fee- 1 st half collected at
submittal
Building Plan Review/Change of $125.00 $0.00
Use- Onsite Sewage
Totals : $932.50 $0.00
REQUIRED INSPECTIONS
Setback Inspection Connection has been verified by Health or Utilities
Footing Inspection BLD-Final Inspection
Set-Up Inspection
Printed by:Amber Selby on:08/12/2022 09:42 AM
Page 1 of 5
Mason County
Mason County - Division of Community Development
''�'��*• 615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
MANUFACTURED HOME BLD2022-00732
CONDITIONS
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. Support configuration shall be clearly marked in the installation instructions.
* 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).
* The foundation/footing must be placed on undisturbed, firm-native soil. Proper frost depth shall be observed below grade
in undisturbed soils.
* 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.
* All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor
increase the velocity flow entering or abutting to any state or county culverting/ditching system or road way.
* 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.
* All RED stamped 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.
* 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 and 14.17.
* 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.
* REQUIRED INSPECTIONS (Footing Inspection-prior to pour(set-up manual must be on-site), 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. Until resolution of any/all problems no occupancy (Final Inspection)will be
granted for the residence.
OWN ER/CONTRACTOR(indicate which)
Printed by:Amber Selby on:08/12/2022 09:42 AM
Page 2 of 5
Mason County
X
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
MANUFACTURED HOME BLD2022-00732
" 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 feet 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
* 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.
* When parcel development requires direct access to county road(s), a Road Access Permit or Approval must be granted by
the Mason County Department of Public Works. For more information contact Public Works, at (360)427-9670, ext. 450 or
100 W Public Works Dr. Shelton. The building permit will not be finaled until the permit holder can show proof that the
access permit from Public Works has been finaled and approved.
* 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 (NCSBCS/ANSI A225.1).
* 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.
* The stamped 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, 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.
* 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/age nt/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.
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 stormwater 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.
* This permit is for the placement and installation of the manufactured home only and does not imply approval or review for
any other items indicated on the plot plan.
Printed by:Amber Selby on:08/12/2022 09:42 AM
Page 3 of 5
t
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
MANUFACTURED HOME BLD2022-00732
Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the
structure.
* All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building
Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration.
Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No
more than one extension may be granted.
* The plan review check list and corrections are part of the approved plans and must remain attached. It is the responsibility
of the applicant, owner or contractor to make the required 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.
* 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.
* All building permits shall have a final inspection performed and approved by 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.
* 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.
* All property lines shall be clearly identified at the time of foundation inspection.
* All construction must meet or exceed all local and state ordinances in addition to 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.
* On-site Septic System final installation approval required prior to temporary/final occupancy of the residence.
* Applicant/Owner assumes all responsibility if On-site Sewage Components are encumbered.
A.) Drainfield/Reserve requires a 1 Oft setback from all footing/foundations.
B.) Septic tank(s) requires 5ft setback from all footing/foundations.
C.) No foundation/ Perimeter Drains within 30ft, down gradient of Drainfield/ Reserve area.
D.) No Cut Bank(s) (greater than 5ft and over 45 degrees)within 50ft, down gradient of Drainfield/Reserve area.
* PLANNING SETBACKS
Front: 25', Rear: 20', Side: 10'
Measured from furthest projection
Subject to EH Setbacks
* Approval for residence only
Printed by:Amber Selby on:08/12/2022 09:42 AM
Page 4 of 5
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
,uava� Shelton, WA 98584
360-427-9670 ext 352
www.co.masonma.us
MANUFACTURED HOME BLD2022-00732
I hereby certify that I have read and examined this application and know the same to be true and correct.
All provisions of Laws and (Irdinances gov rning this type of work will be complied with whether
specified4hereint. The granting �rmit does not presume to give authority to violate or cancel
the proviof r state/lo al I r gulating construction or the performance of construction.
Issued B
Contractor or Authorized Agent: Date: r��
Printed by:Amber Selby on:08/12/2022 09:42 AM
Page 5 of 5
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APPROVED
A^.QAetrnfpYmMlaxllWXNAa:m.vnmwamwAam..' amgrJanT ® °/a2,T w sa:aeaxrmanrrv�.cea� MASON COUNTY DOB PLANNING
' SITE PLAN REQUIRED TO BE ON SITE
11NSISNOTASURVEY CHANGES SUBJECT TO APPROVAL
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Note:Approval for residence only
County Review
e
EH Setbacks ,, �►
A.)Drairf"Reseme requires 10'setback from toottngRoundalions • 1
8.)Septic tanks)requlras 5'setback tram all footingloundatbM
- C.)Nd totmdaliom4 e&imeler Drains wdhin 3(Ht.downgrade l of • - - - t,9
Drat nfielyEteserw?area
S No Cut Banks)(greater Lhan 511 over 45 degrees)within
50h N� APPROVED
P P O Y j�`L D
down gradterd of Drainneld?Resewerve araa A� •per a
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EH APPROVED ' ryCO tYc
Rhonda Thompson 07/07/2022
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W.A�n�ion Da�lA'1�P2
Name Parcel#�`d �^ �_ �15 BLD#VECCEIVED
�ao�—QD73GC
Mason County
BUILDING Department of Community Development ,JUN - 8 2022
Small Parcel Stormwater Management Application/Workshsgt (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 X
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections (example:
eaves/gutters)
X =
Driveways Q 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) /l ,�
If the 'I'otal Impervious Surface Area is LESS THAN 2000 Sotiare 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 ope for view and inspec ion as may be required.
X w gent/Contractor(circle one)Date:,�`���
f the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
the information provided on page 2 of 2.
Pagel of 2
MASON COUNTY COMMUNITY SERVICES Permit N - L,020=-0073a
PERMIT ASSISTANCE CENTER: R CE�VE
•BUILDING•PLANNING•PUBLIC HEALTH.FIRE MARSHAL ■ E
615 W.Alder Street,Shelton,WA 98584 JUN - 8 2022
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
Belfair(360)275-4467•Phone Elma:(360)482-5269 615 W. Alder Street
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
—
NAME:�IfAf t�l/sU,�l NAME:
MAILINGAODDIRESS: MAILING ADDRESS:_ /��f�j!
CITY:_/g,-G�, X' j,�l STATE: ZIP: �CITY:,ot- 97ej?� STATE: A ZIP:4 %Z
PHONE#1:�36p..- 72y PHONE: �� �ELL:
PHONE#2: EMAIL :
��
EMAIL: L&I RE EXP.
PRIMARY CONTACT: OWNER[ram CONTRACTOR❑ OTHER❑
NAME / EMAIL
MAILING ADDRESS CITY Ai�'��s-�./STATE ZIP
PHONE CELLT��� T��Z�� 4=
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS �'- CITY�/�� �f s--
01RECTIONS TO SITE ADDRESS gjy,6f,2
S THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO J5—
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 gr ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) jj10 Ad*g..�e-tom
IS USE: PRIMARY 2-- SEASONAL ❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(Whole Bldg) 93-' YES(Part[,,]of Bldg) El No ❑
DESCRIBE WORK L 44gL;- P s!!J.
SQUARE FOOTAGE: (proposed)
1ST FLOOR l�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 REQUIRED*
MAKE t6 90&� MODEL eZ;gr4 YEAR-Z LENGTH
WIDTH BEDROOMS BATHS .2+ SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 91"', SEWER ❑ / NEW 910' EXISTING ❑
PLUMBING IN STRUCTURE? YES P NO ❑ Ifyes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NOff' EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS- ,g —
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by
signature below.1 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&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)
ignature of OWNE st be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
01,0022-(073a
BUILDING RECE1v/E0
Mason County _ g NU
Community Services-Building Division �UN
MANUFACTURED HOME PLAN REVIEW SPECIFICATION505 W• A►der Street
UNIT INFORMATION: Snow Load v
Make fL1��t Model Year 2
Square feet Width �ly/7 Length
❑Single/Double/❑Triple-Wide (indicate) [ NEW or❑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:
Ef Manufacturer's Pier Plan
❑ 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
❑ Pads
Continuous concrete footing(runners)
❑ Slab
ANCHORING:
❑ Ground
❑ Magnum
❑ Concrete-2500 PSI
❑ 1-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
review processes will be based on the information provided herein and will be verified at time of
inspectic
X Applicant/❑Dealer/❑Installer(indicate) Date -