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BLD2871 Mobile Home - BLD Permit / Conditions - 8/30/1978
41 Leonhardt, Robert W. #2871 8-30-78 NE 1/4 SE 1/4 20-23-1 4th lot on right on Newkirk road, Blue house across Street, Mossy Trailer next door. Mobile Home /t a R BUILDING PERMIT APPLICATION MASON COUNTY P.O. Box 186 Shelton, Washington 98584 DATE ISSUED &&0/7,F PERMIT NO. o2a 7/ OWNER NAME 6.-bur4 MAIL ADDRESS CITY B STATE ZIP PHONE Leo ii Aq V, a 0, e ex I Q 9PS`.?9- DIRECTIONS 23/ue house ctcve"SS St, (lKossy t °�rlerhe�C-f Dom (_�GO00 s'ou74. TO JOB SITE Lu y,K O /ef Eel-ga!r 1 i 0✓L o AJ PCv ei r ,ol y Lofo^ r� LEGAL (❑ SEE ATTACHED SHEET) DESCR. /�J; �� yy E% Secfla Tou / Lv 9S- NAME CONTRACTOR MAIL ADDRESS CITY&STATE LICENSE NO. PHONE USE OF n I BUILDING hphve -t' oP, IUDK eWne1 GC.L�c 'e ren�cL [ O N ! LdLC.c.I 11L/st Class of work: X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: a l a Q X yo Mo b i'l o sn e cc-> c CO ell S,° fi r Q i Pt -a Valuation of work: $ oa rn.Lt� a PLAN CHECK FEE PERMIT FEE Q-d oo, - C- 1 ao. SP VA CONDITION : APPLICATION ACCEPTED BY PLANS CHECK BY ROVED FOR ISSUANCE Type of ��� Occupancy Division Const. Group 40 e s, ' ize of Bldg. No. of Max. (Total) Sq. Ft."?o k q D Stories Occ. Load CONTRACTOR AFFIDAVIT PERMANENT SEASONAL E.D.NUMBER I certify that I am a currently registered Contractor in RESIDENCE the State of Washington and I am aware of the MOBILE HOME ordinance requirements regulating the work for which the permit is issued and all work done will be in Special Approvals Required Received Not Required conformance therewith. ZONING HEALTH DEPT Q Firm PUBLIC WORKS By ROAD DEPT. Lic. No. Date OWNERS AFFIDAVIT I certify that I am exempt from the requirements of the N O T I C E contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. which this permit is issued and that all work done will be in conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS is �� SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER Owne a'� Date. / WORK IS COMMENCED. PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH S EN4. PARCEL NO. DATE BASIS FOR FEE AMOUNT NUMBER . TH.URSTON-MASON HEALTH DISTRICT DIVISION OF ENVIRONMENTAL HEALTH 2000 LAKERIDGE DR.S.W. FIFTH&BIRCH ST. PHONE 753-8073 PHONE 426-5561 OLYMPIA, WA 98501 SHELTON, WA 98584 APPLICANT r ADDRESS 3 PHONE DATE APPLf T UST CALL FOR INS ION h TED BELOW SITE: APPROVED ,NOT APPROVED SEWGE CONTRACTOR /1I E H/E/? cl BY: NAME OF PLAT z LOT ', 1 1 NOT R� NO. SEWAGE: APPROVED ❑ APPROVED SEC. TOWNSHIP RANGE A,i L_i-, BY: DESIGNER: TYPE OF NO.OF LOT SOIL TYPE ' BUILDING A1016L" 6 !�O"tEBEDROOMS SIZE/V X 11U WATER GARBAGE DEPTH TO WATER TPC LE FT. SYSTEM �C L DISPOSAL ✓U LIQUID WASTE G.P.D. PERC TESTS INCHES PER HOUR BY DATE PRIA NORTH - SITE PLAN AND SPECIAL STIPULATIONS: SEPT� A�K(S PUMP REQ. (INDICATE DIRECTION OF DRAINAGE) — '- 2 ,, i DIST TION TILE�T� FEET -- FILTRATIO SQ. FEET QUANTITY J 1 APPROVED S 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 ' 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 i 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. L n )j&1 /'' 4,41 �� nr-" �N�ti�/���� FINAL INSPECTION REQUIRED BEFORE BACKFILLING TO BE BACKFILLED AFTER INSPECTION 12" TO 24" �i 2" STRAW STONE OOVER TILE FI STONE UNDER TILE THIS SITE PERMIT EXPIRES E CROSS SECTION OF TRENCH ©M