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Home My WebLink AboutBLD96-1274 Final Mobile Home Replacement - BLD Permit / Conditions - 6/16/1997 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 B LJ I t._ 0 1 N Fa FE IrA tut II .T FOR INSPECTIONS CALL 427 -9670 BETWEEN 5pm AND Sam 427--7262 61- 096--1274 PARCEL : 123162290081 PLAT . DIVI BLK a I_OT o JOB ADDR SS r NE 60 PONDEROSA RD RE LFA I R OVINF..R : RANDY S E MS 275--6349 CONTRACTOR ; LEGAL r TA 11-A OF III WW TR R Of SP Tt3 ' ::'S«".'f.:.�S`Li^ L.L'..yRR'S'a%141C'..A"1lG':�'.5'CYST_�.:3:.:X43"�F.L.4�.'"SS'»`.G:t4^.CC'a3�:,ir';:•"'£.'SSIIA Ki.".X:ai.:i:S:<`� CLASS OF WORK . - !NEW BEDR : 2 .BATH t 2 Tvpf AMOUNT BY DATE NfCtIFT 'tYPE ANOUNT ftt DATE Of GE;P1 � TYPE OF USE . . . . sMH STORIES . . . . . . . . 1 OCCUP . GROUP . . . t7 BLDG . HEIGHT . . : 0 .Of t NNOf 1t 1SO.## CPO 10124196 0006 TYPE OF CONST . . :7 FIREPLACES . . . . 0 Siff 1 4.5f CPO 10124196 0091 T OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . a 0 FNCP 11 46.00 CPO '0124196 A008 DWELL .UNITS . . . . .. 0 PARKING SPACES z 0 INSPECTION AREA : 1 SHORELINET . . . . :N TQTAL� � 180.50 V1KIUlA.T!ON: 29500 SETBACKS--_____. _______..__ TOILEwTS . . . . . . . . . . g 0 FUFA. TY'PES_________ __. BOILERS/CUMP -_-- MOBILF HOME..._ FRONT . ., .S 80 .0f t BATH BASINS . _ _.,. . 0 : 0- 3 HP . : 0 REAR . . . .N 30 .Oft . : - '1 SIDE ( 1 ) .E 75 .Oft BATH TUBS 0 F'URN 1001C RTU : 0 13-30 HP . : 0 -MAKE .e--n - -EIVWES SIDE (2) .W 1 15 .oft WATER HEATERS . . . . : 0 FORK >-100K BTU : 0 30--60 TIP . a 0 MANOR It 1 SHRL I NE . 0 .Oft CLOTHES WASHERS . . r 0 FURN _. FLOOR — : 0 50+ HP . : 0 - YE AF;.. AREA ------------------ KITCHEN SINKS . . . . . 0 HEAT PUMP . . . . . . : 0 96 LOT SIZE . . z FLOOR DRAINS, . . . . : 0 VENT SYSTFIVIS . . . . O EVAP COOLERS s 0 LENGTH s 48 BUILDING . . . : Osf DRINKING FOUNT . - 0 VENT FANS . . . . . . a 0 HOODS . . . . . . . m 0 WIDTH . :2.8 BASEMENT . . . : itst LAUNDRY TRAYS . . . . ; 0 DOMFS : INCIN :0 -SERIAL.#_ BECKS . . . . . . s Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS--- COMML . I NC I N :0 N 161 GAA/CARP :? Osf GARB DISPOSALS . . . a O <— 10000 r.fm . : 0 RFLOC/RUPAIR : 0 AT/DT . ,? URINALS . . . . . . . . . . . 0 a 10000 c:fm . a O OTHER UNITS . : 0 MISC PLM FIXTURESr 0 GAS OUTLETS . a 0 SC.:.]CTJ.":eY.'9S47ftt'Y6}CS3G'%S.G.�. •'CX 1C}":;°k%.'^L4SR'«S..:.'nCk�CK^^:YS.'�`—'.$:.Z'R'�' 'KYT�^},....�L^.`R:�GM�K''S:S-::..TMJ.'y'if3'LS"sRA4S.G.ffi:.1.P^.�NOI'.c:95 . '.:T..:"''9'M4�i.4Y'.^...-:__'X-A:t PROJECT IIONE REPIACENFNT PROJECT LOCATIO0o2 112 3.0 1111ES, NORIN FAON B€1fAIR ON OLD RELFAIR NWY., TURN 11. O110 PONDEROSA 80 FOR If#', PROPERTY ON 10110 SIDE OF ROAD. fOIS PF1VH BFCONFS 0011 ANO VOID IF 100t 09 CONSTRUCTION AUTHQAIZES IS Not CON#FNCf$ 1110111 169 MAYS OR If CONSTRUCTION OR WORT Is SUSPEAPEO FOR A PkAIOD Of 140 DAYS AT ANY Tlf AFTER WORK IS CONNENCED. EVIDENCE Of CONTINUATION Of WORK IS A PROGRESS 1115PHT 10N WITHIN THE 180 DAY PERIOD. FINAL INSPfCIION MUST B APPIOVFD BEFORE BUILDIN& CAN Of OrC4P1F1, i 4 OWNER 09 AFfNT: S19_flif, rev, 03131 191 ._._� . COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED r— 1 CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date - Gas Piping date - ") -9.6 b Foundation Walls date by Set Up date by INSULATION date l-21J—`I 7 by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic d date by ate by S- 9 .W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by �✓l$ I Un •^�I g d- I I A I I MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 PF- RMI -r C, 0NO ! 'T140NI�> Case No . : BL.D96-1274 For : RANDY SIMS Page : I 1 ) This application is subjeot to Buffer and Landscaping requirements as established linder Mason County Ordinance 1 .03 .036 . X--- 2) The use , handling and storage of hazardous m.-iterials or flammable and combustible liquid$ In excess of 10 gallons Is not allowed without the approval of the Mason County Fire Marshal . X 3 ) Proposed structure or any portion thereof greater than 30" In height from grade line , must maintain a minimum of 5 ' setback from all property lines , easements and 10 ' from alL, County and State Road right of ways . X 4 ) Approved per dimensions and setbacks on submitted site plan , X 5 ) PURSUANT TO 1994 UNIFORM BUILDING CODE SECTION 305(C ) AND SECTION 513 ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PR6VIDED IN SUCH A POSITION AS TO Bt PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPtETED PRIOR TO CAL-LING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE BASED ON RATES IN TABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNFAIICONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . X 6) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIRE"ENTS . 7 ) RFOUIRED INSPECTIONS ( Footing Int.pection-,prior to pour , Set--up Inspection-pulor to skirting Ins ect,lon-prior to occupancy) I have received a copy of the General Informa .n and Guidelines-Mobile/Manufaotur-ed *Vfousing Installations Handotit for. r CONCRETE MECHANICAL MOBILE HOME I Footings-Setback date by Ribbons II date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by f BG/SLAB Insulation Floors Final date by date by date by FRAMING j Walls FIRE DEPT. !I date by date by date by PLUMBING OTHER Groundwork Attic date by date b D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I I I I �I i MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O, Box 186 Shelton, Washington 98584 I a t I ed desci t 1 vits r, ��Jv I I i n Z3 t a I I at I on . I hereby a�,,;umt; a I I 1'e a�qnt'� ibj i Ity lot trio pohedu i i 1-j of Liik:�-e, f equ I red Inspections , It these required inspections are not requested. Inspected and signed off (approved) by the inspector In the prescribed order l understand that retrispeotloo fee: and an hourly investigation fee pursuant to the ,.91 UBC, Table 3A will be assessed in addition to my original permit fees to resolve any questionable practices or roblems that have been discovered . I further understand that this investigation will o scheduled as time allows . Until resolution of anylall problems no occupancy ( Final Inspection ) will be granted for the residence . OWNER/CONTRACTOR( Indicate which) Signature X 8 ) All mobile/manufactured home landings or decks must be freestanding ( self supporting ; . The largest landing or deck permitted without drawin r, or a building permit is 16" x 36" . Any landing or deok that is 30" or more in heig9t from walking surface to finish grade requires a guardrail . Any l and inq or deck that has 4 or more risers requires a andrail . Any landing or deck lartler than 36" x 36" must be permitted which requires . structural drawings and a building permit application . This Installation Permit doer� NOT Include any landing or desk larger than the 36" x 36" size . X. 9 ) Proposed structure or portions -thereof with an projection over 30" in height from grade line must maintain a 5 separation distance t)etwean adjacent structures and that furthest project I on . X—��411'-�.----- 10) ALL CONSTRUCTION MUST MEET OR EXCEED LOCAL CODES . IF ANY QUESTIONS, PLEASE CALL THIS OFFICE BEFORE CONSTRUCTION . X- '�L�! ---- 11 ) CONSTRUCTION PROCESS TO BE FIELD CORRECTED .AS REQUIRED PER MASON COUNTY BUItDING DEPARTMENT AND UNIFORM BUILDING CODE r— CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING b Walls FIRE DEPT. daty date by date by PLUMBING OTHER Groundwork Attic date by date by te V WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Building Permit # MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHtNGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location �o fr,,,�er ac% 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 compliance ✓— ov— r - _ 1m4 44- 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 ❑ OK to / Department Date t ( —2 ? Jk Inspector ■ oo * No *T MnV THI, T'" * w I MASON COUNTY - Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 B U I L_ U I N C3 PERM I T FOR INSPECTIONS CALL 427-9670 BETWEEN 5pm AND 8am 427-7262 BLD96-1274 PARCEL : 12316229OO81 PLAT : DIV : BLK : LOT : JOB ADDRESS : NE 60 PONDEROSA RD BELFAIR OWNER : RANDY SIMS 275-6349 CONTRACTOR : LEGAL : TR 8-A OF NI NI TR B OF SP 713 CLASS OF WORK NEW BEDR : 2 BATH : 2 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT TYPE OF USE . . . . :MH STORIES . . . . . . . : 1 OCCUP . GROUP . . . :? BLDG . HE I GHT . . : 0 .Oft MHOF $ 150.00 CPH 10/24/96 0000 TYPE OF CONST . . :? FIREPLACES . . . . : 0 S T F E $ 4.50 CPH 10/24/96 0000 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 E H C P $ 26.00 CPH 10/24/96 0000 DWELL . UNITS . . . . : 0 PARKING SPACES : 0 INSPECTION AREA : 1 SHORELINE? . . . . :N TOTAL: (180-50) LLULAT ION: 29500 SETBACKS-------------- TOILETS . . . . . . . . . . : 0 FUEL TYPES---------- BOILERS/COMP---- MOBILE HOME-- FRONT . . .S 8O .Oft BATH BASINS . . . . . . : 0 0-3 HP . : 0 REAR . . . .N 3O .Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL :GOLDENWES SIDE ( 1 ) .E 75 .Oft SHOWERS . . . . . . . . . . : 0 FURN < 1O0K BTU : 0 15-30 HP . : 0 -MAKE------ SIDE (2 ) .W 115 .Oft WATER HEATERS . . . . : 0 FURN >=1O0K BTU : 0 30-50 HP . : 0 MANOR II SHRLINE . O .Oft CLOTHES WASHERS . . : 0 FURN - FLOOR . . . : 0 50+ HP . : 0 -YEAR------ AREA ---------------- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 96 LOT SIZE . . : FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH :48 BUILDING . . . : Osf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . :28 BASEMENT . . . : Osf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN :O -SERIAL#---- DECKS . . . . . . : Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS-- COMML . INCIN :O N 161 GAR/CARP :? Osf GARB DISPOSALS . . . : 0 <= 10000 cfm . : 0 RELOC/REPAIR : 0 AT/DT . :? URINALS . . . . . . . . . . : 0 > 10000 cfm . : 0 OTHER UNITS . : 0 MISC PLM FIXTURES : 0 GAS OUTLETS . : 0 PROJECT DESCRIPTION:MOBILE HOME REPLACEMENT PROJECT LOCATION:2 1/2 3.0 MILES, NORTH FROM BELFAIR ON OLD BELFAIR HWY. , TURN W. ONTO PONDEROSA RD FOR 300', PROPERTY ON NORTH SIDE OF ROAD. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD Ot 180 DAYS Al N ,, OL A� ILR VORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 180 DAY PERIOD. FINAL INSPECTION MUST BI APPROVED BEFORE BUILDING CAN BE OCCUPIED. C� / OWNER OR AGENT: ` DATE: ___( - � BLD-PRMT, rev: 03/31191 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 P E R M I T C O N C I T I O N S Case No . : BLD96- 1274 For : RANDY SIMS Page : 1 1 ) This application is subject to Buffer and Landscaping requirements as established under Mason County Ordinance 1 .03 .036 . X �V3 2 ) The use , handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal . X C l4-S 3 ) Proposed structure or any portion thereof greater than 30" in height from grade line , must maintain a minimum of 5 ' setback from all property lines , easements and 10 ' from all County and State Road right of ways . X I k.S 4 ) Approved per dimensions and setbacks on submitted site plan . X 5 ) PURSUANT TO 1994 UNIFORM BUILDING CODE , SECTION 305 ( C ) AND SECTION 513 ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES IN TABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . X c li ? 6 ) XLk CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS . 7 ) REQUIRED INSPECTIONS ( Footing Inspection-prior to pour , Set-up Inspection-prior to skirting , Final Inspection-prior to occupancy ) . I have received a copy of the General Information and Guidelines-Mobile/Manufactured Housing Installations Handout for II L_ II MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 installation . I hereby assume all responsibility for the scheduling of these required inspections . If these 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 1991 UBC , Table 3A will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered . I further understand that this investigation will be scheduled as time allows . Until resolution of any/ all problems no occupancy ( Final Inspection ) will be granted for the residence . OWNER/CONTRACTOR ( indicate which ) Signature X L<<-s 8 ) All mobile/manufactured home landings or decks must be freestanding ( self supporting ) . The largest landing or deck permitted without drawings or a building permit is 36' x 36" Any landing or deck that is 30" or more in height from walking surface to finish grade requires a guardrail . Any landing or deck that has 4 or more risers requires a handrail . Any landing or deck larger than 36" x 36 " must be permitted which requires structural drawings and a building permit application . This Installation Permit does NOT include any landing or deck larger than the 36 " x 36 " size . X > IDS 9 ) Proposed structure or portions thereof with an projection over 30" in height from grade line , must maintain a 5 enaration distance between adjacent structures and that furthest projection . X 10 ) ALL CONSTRUCTION MUST MEET OR EXCEED LOCAL CODES . IF ANY QUESTIONS , PLEASE XALIFl g IS OFFICE BEFORE CONSTRUCTION . 11 ) CONSTRUCTION PROCESS TO BE FIELD CORRECTEKtS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE . x }}�� 14C.e W)chY �„`� � Permit No. MASON COUNTY lam`' BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 n PLEASE PRINT `�✓ #1 wne Phone# ,(y - '( 634G1 e Address 1� Fire District# Z City tP1 fa1� St [��as)18 Zip d1cs�a Directions to Job Site 2 %2. 3,0 rn IVo QTV\ F SRO Vlo-It ELEA I►Z, c r. 0 L D 'K'et- Owner Mailing Address- WA 16 4-5 City St(aaI Zip Lien/Title Holder Address Clty i�e-k k—C., St Zip #2 Contractor Name S IF7L t Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic? LX Public Water Supply Well Connect to Sewer System? Name of System S (If residential, proof of potable water is required) rip- wtvyn ev�� m O);�k. OP*Ae # Par I No. Legal Description #5 Building Square Flo,,age: (existing/proposed) 1st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / airport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building PISA Aer71VA .k Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year 149k Make Model ; �I Length y 9t• Width_Serial No. 16N q # Bedrooms # Bathrooms Type of Heat E= t yr r. Purchase Price $ Z 9, S O0 1 #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 IV6 �' 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 Name of Flanking Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW , Zoo a i Home - 15. �J n LacW, �c IS 2Bx46 W w R ELF DAY\V E 2'►' V4 Ay 280' �halE�Pas� IPd. r 50' APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures $3 each) Fee Mechanical Fixtures ($6 each) 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 _Disposal _ cfm# r_) Urinals _ No. Fire Protection Systems _Other _ Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 t Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ No. Other Gas Outlets Wood, 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 15.00 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 DEPARTMENT. DEPARTMENT. 6 X OWNER �� X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by. Date: I DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review 't Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit W Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other 26"' Other Building Valuation: TOTAL FEE C I � w � t� ✓�� c�etc e�'� � Y bylf�,C%Af- codu e e"-' v� COYUS, 5lC) V''1 ✓!ems kwtt CQU� foe vk i 1 � 60,L d � i �S (J� t -- MASON COUNTY 5 GENERAL-SERVICES DEPARTMENT Lc) 8g0 P.O.BOX IN-303 PI`ORTH 4th STREET-SHELTON,WA 98W PHONE(206)428.5581 RECORD OF FINAL INSPECTION OF YOUR SEWAGE DISPOSAL SYSTEM OWNER....�r � - 1. 'r '�L ADDRESS 1 i THIS RECORD IS NOT A GUARANTEE OF PERFORMANCE. CITY ZIP - GG A SEPTIC SYSTEM IS NOT A MUNICIPAL SEWER. HOWEVER . L 2- 6 , (_ � WITH PROPER MAINTENANCE AND CAREFUL USE OF LEGAL DESCRIPTION 7 WATER IT CAN GIVE MANY YEARS OF TROUBLE FREE SER- k "I!° VICE. MANY.PROBLEMS WITH SEPTIC TANKS ARE CAUSED SOIL BY FLUSHING EXCESSIVE AMOUNTS OF PAPER, CLOTH COMMENTS AND PLASTIC MATERIALS DOWN THE DRAIN, OR BY SITE FIELD X LARGE AMOUNTS OF WATER FROM LEAKY FAUCETS OR NO. SIZE FAULTY FIXTURES. DEPTH TO MONTH THE SEPTIC TANK ITSELF SHOULD BE CLEANED EVERY WATER TABLE OF YEAR TWO OR THREE YEARS DEPENDING ON THE HABITS OF THE INSTALLER _ FAMILY, THE NUMBER OF FIXTURES IN THE HOUSE, AND �"' THE AMOUNT THAT A GARBAGE DISPOSAL IS USED. CLEAN- SIZE ING AT THE RIGHT TIME WILL AVOID THE RISK,OF INJUR- SEPTIC TANK (S) 0 o ING OR DESTROYING THE-DRAINFIELD .DUE TO SOLIDS DRNGTHIELD � . � FEET CARRYING OVER INTO THE DRAINFIELD. CALL,.,THE TRENCH AREA j SQ. FT. MASON COUNTY HEALTH DEPARTMENT FOR A LIST 'OF ,�, 7 0 LICENSED SEPTIC TANK CLEANERS IN YOUR AREA. THE CLEANER CAN SERVE YOU BEST IF YOU SHOW HIM THIS TILE DEPTH ❑ CORRUGATED (,�' RIGID ❑ CEMENT RECORD WHEN HE COMES. DEPTH HEAVY TRUCKS OR EQUIPMENT SHOULD NEVER BE ROCK BELOW TOTAL C11...YDS.. Pie.. DEPTH -. DRIVEN OVER THE TANK OR DRAINFIELD. CONSULT THIS SPACE RESERVED FOR RECORD IN CASE OF ANY BUILDINGS, DRIVEWAYS, REPLACEMENT DISTRIBUTION FIELD: A S SQ. FT. SWIMMING POOLS, OR EXTENSIVE GRADING OR FILLING ARE LATER CONTEMPLATED. f NORTH SHRUBS OR TREES SHOULD NOT BE PLANTED CLOSE TO THE SEPTIC TANK AS THEY WOULD INTERFERE' WITH CLEANING OF THE TANK. THEY CAN BE PLANTED IN THE DRAINFIELD AREA PROVIDING WILLOWS ARE NOT USED. THE YARD GRADE IN THE DISPOSAL AREA SHOULD BE SUCH THAT SURFACE WATER IS NOT POCKETED ON THE - DRAINFIELD. ANY SETTLING OF THE GROUND OVER THE r ~- � TRENCHES SHOULD BE FILLED IN WITH SOIL. DO NOT EX- 1 Q CESSIVELY WATER THE LAWN IN THE DRAINFIELD AREA. ) 0! l I WATER EVAPORATION FROM THE DRAINFIELD IS ABOUT j EQUAL TO ONE HALF INCH OF RAIN PER DAY. FOOTING DRAINAGE, DOWNSPOUTS AND WATER ' SOFTENER RECHARGE WATER .SHOULD NOT BE CON- NECTED TO THE SEPTIC SYSTEM OR DISCHARGED INTO THE E DRAINFIELD AREA. THE TYPES OF BACTERIA NEEDED IN A SEPTIC TANK ARE - t ALWAYS FOUND IN SEWAGE. THERE IS NO NEED TO ADD { YEAST OR OTHER STARTERS TO A SYSTEM. THE USE OF RE- JUVENATORS OR CHEMICALS TO CLEAN A SEPTIC TANK HAVE NOT BEEN PROVEN TO BE BENEFICIAL AND MAY BE r I HARMFUL BY FLUSHING SOLIDS OUT OF THE TANK OR BY {/ CHANGING THE CHARACTERISTICS OF THE SOIL. THE NORMAL USE OF BOWL CLEANERS OR CLEANING COM- POUNDS WILL NOT KILL THE BACTERIAL ACTION OR SLOW h--- SOUTH DOWN THE OPERATION OF THE SEPTIC TANK. THIS IS AN IMPORTANT DOCUMENT DATE SIGNATURE OF INS LLER KEEP IT WITH DEED OR OTHER ESSENTIAL PAPERS. DATE , "SIGNATURE OF INSPECTOR /Z gg ?��L ��ps pre►�vjA , . 70 o SEPTIC TANK MAIN OFFICE 6023 ROSEDALE ST. N.W. CLE'%NING GIG HARBOR, WA 98332 PIERCE COUNTY KITSAP COUNTY MASON COUNTY JEFFERSON/CLALLAM GIG HARBOR LAKEBAY TACOMA PUYALLUP PORT ORCHARD BREMERTON SILVERDALE POULSBO BELFAIR SHELTON PORT TOWNSEND PORT ANGELES 851-3432 884.5013 627-0826 841.7171 876.5829 373-0821 692.7432 779.1507 275.7134 427-8282 379-8422 or 1-800-533.8422 CUSTOMER NAME JOB ADDRESS CITY PHONE DATE OF SERVICE CLEANED SEPTIC TANK: APPROX.TANK SIZE �I sr� GALS. ACTUAL CHARGES ESTIMATE LIQUID LEVEL APPEARED: NORMAL ❑ HIGH ❑ LOW ❑ FLOODED SEPTIC TANK CLEANED D HOME VACANT El PUMPSYSTEM SEPTIC TANK CLEANING ... . UNCOVER TANK BAFFLES INTACT: x YES ❑ NO ❑ REPLACED DIGGING/COVERING........ SEPTIC TANK CONSTRUCTION: CONCRETE ❑ FIBERGLASS ❑ METAL TRUCK TIME..® HR INFO FROM MAP EXTRA GALLONS HOMEOWNER PER GAL YEAR BUILT 19 LAST YEAR PUMPED 19 gg per I GARBAGE DI P. ❑ YES NO q0m 144 NO.IN FAMILY 0%1 i OVERDUE FOR CLEANING ❑ YES er NO—.—k 1150 1 4004 D� Recomend SUB TOTAL m Cleaning Every H 5 x Years t0 CUSTOMER SIGNATURE Prevent Failure SUB TOTAL �i � TYPE OF PAYMENT THE TERMS AND CONDITIONS ON THE REVERSE SIDE LIMIT OUR LIABILITY AND CREDIT CARD FEE % ❑ CASH V CHECK ❑ VISA PROVIDE GENERAL INFORMATION. PLEASE READ THECA. ❑ MASTERCARD ❑ DISCOVER TAX 0 ❑ PREPAID ❑ OTHER X L1 $2&00 RETURNED CHECK FEE 4 n PROPERTY OWNER or AUTHORQED REPRESENTATIVE TOTAL AMOUNT DUE