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Home My WebLink AboutBLD96-0655 ATF MFG Home - BLD Application - 5/31/1996 Permit No. MASON COUNTY PERMIT APPLICATION BUILDING o 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Owner Rickc4 'K 9ey-tn.<Je 3 x4��1 k S Phone# 3C� Z 7- "Z))b Site Address N1 2-1 01 1D gin 4';L — gwij Fire District# City lu I e- St W14- _Zip cS Directions to Job Site [ Tw Owner Mailing Address City St Zip Lien/Title Holder _dfzw Address Clty St Zip #2 Contractor Name &JYn a, Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic?--s,/' Public Water Supply Well NZ" Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 arcel No. -L4- 0(0! Legal Description 74 1OP Sr A(6- & -SW N W SEC 1 L #5 Building Square Footage: (existing/proposed) 1 st FI '5'0 / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building Describe work #7 Type of Job: New \/ Add Alt Repair h r� L°FI IS D #8 MOBILE/MANUFACTURED HOME INFORMATION MAY � � ��6 Model Year�Make REV— Model Length Width i(% Serial No._ LlAtn # Bedrooms � # Bathrooms Type of Heat �� FAI T}-� ��c Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Directional by (N, S, E, W) Name of Flanking Street Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW NV n„ D zO J 5 SB � 1 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3.25 each) Fee Mechanical Fixtures ($6.50 eachl No. Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs No. Units Fees Showers Furn BTU _Hot Water Htr _ Heatpumps _Laundry Washer _ Vent Systems Sinks _ Spot Vent Fans _Floor Drains No. Boilers/Compressors _Laundry Basins _ HP _Dishwasher No. Air Handling Units _Disposal _ cfm# _Urinals No. Fire Protection Systems _Other_ _ Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 16.25 _ Auto Fire Sprink Sys 35.00 TOTAL PLUMBING $ No. Other Gas Outlets o�Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 16.25 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTKNT. DEPARTMENT. X OWNER X BY DATE — DATE Z/7 ,.-- FOR OFFICIAL USE ONLY: Accepted by: Date: �1 DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE I Building Permit # MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location ale This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code coz" 171� mmpliance .117 You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OKto Department Date I&Z2y Inspector non NnT Mnif lul ; r" Low MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W.Cedar P.O.Box 186 Shelton,Washington 98584 (360)427-9670 BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION July 18, 1996 Richard and Gertude Medeiros NE 2481 Old Belfair Highway Belfair, WA 98528 RE : Mason County Parcel 12317-14-00010 Building Permit : BLD96-0655 Dear Mr. and Mrs . Medeiros : Under title 14, chapter 20 of Mason County Ordinance 37-96 manufactured homes assembled prior to June 15, 1976 must comply with portions of the Department of Housing and Urban Development (HUD) Fire Safety Standards AND bear the State of Washington, Department of Labor and Industries, Factory Assembled Structures Division, Alteration Fire Safety Insignia before a permit will be issued. Your proposal, to install a 1965 manufactured home at NE 2485 Old Belfair Highway, requires compliance to the HUD guidelines. A procedure list and alteration fire safety pre-inspection checklist from Labor and Industries is enclosed for your information. When we receive the documentation indicating that Labor and Industries has approved the manufactured home is received in our department, we will continue reviewing the permit application. Until the documentation is received, the permit application will be placed on hold pending future actions by our department . If you have any questions, please contact me or Tami Griffey at (206) 427-9670 ext 356 . Thank You, Deb era Coker M on County Building Dept . CC : Property File encl : Procedure, Obtaining installation permits for mobile homes assembled prior to June 15, 1976 .