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HomeMy WebLinkAboutBLD93-1305 Mobile Home - BLD Permit / Conditions - 9/1/1993 MASON COUNTY Mason County Bldg. III 426 W, Cedar P.O. Box 186 Shelton, Washington 98584 I.N F'1 1:1 1.1)N I. A! 1 427-•961* fi1.093--130h PARC1 1 ; '3:;,:f34 f ts1401 o.' f°! r, 1 1f f V, 1()H 1A1)1)1-F ; NF_ ;?** C ISS1f1 TILE E 1 N I A110YA OWNI k GF_01 61' SPIAW :i:'A 1 1.4 0 1-.IlN_lk,r t I 'll( 60 IRS l I..ANT1 $IF_-VE;I..0P'14.N.1' '1!`i--S001 1.1 ('aA! Ip 11 1 r1C SMIiYI'1 SP ii3'l IS olksoll I A N1 114 •' t. 1 A tie i 1s l I � ' V? I i�L.�1 x-..A�'.�"-:unrc�,�. �.-�+��rs.�narmmc+„�sacrs�e� •:-sn+m�•w�,rxna+.�m��ca;xe,��,� `��°°� !-,, Ell WOR1, 141.. . ^ ,W ki i+i' 0 "Ill 11`; 4AiE 9F(kIT'1 IYP1 AMIINNI III RA1F kf(•f1Pf1 1 'YP1. 0I 11,3E . . . . : Mii Ili:(;lii' , 1,17r1ifi' rs! 0f1 Ffk t (tii# 1 Of 0 •r1... jNAf)( 1i11.111. lip A?1tl1" 1 11(its t f Yf'F ►it= t f)N�;T 1 2 11+t' F-'I A1,,1 'i 0 1ti1Ff 1 4 (,1 M1!* eal li"i1 ;itNe, lit lip 1 (1AI1 0 i f)VI - tfIIFII . 11M1: 1 `:ti . 0. 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' ' �—' YAW BID_PkN1, 1(?u: 1sj 1)')1 t;fskl}' H1;t I41 ilk 1'Ac11f FI C.U1FMM.,1..-1ON`: IS. Rt QuIRLU CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b L, Foundation Walls date by Set Up I date by INSULATION date ' - - by BG/SLAB Insulation Floors Final date by date by dateol/- by FRAMING Walls FIRE DEPT. date by date by PLUMBING Attic by OTHER Groundwork date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 C a k., No . H L D 9 i .1,3 0 b f or (iCORM-_ :.)HAW I. ) I tip uce. lirind L i nq An(I f�S Cot a qv I i * a(I rl collib I It, I" I'b I.ve q I I d*a i n 'R X c o cl �j I f 1':, 11 to(I tj i.th o it 1 1.hr. 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( 11 11 r I-Ii.0"?i. I I I 101 1,r 1, ; i vzi i I(I I IIAI I It i in•/c>v. I I q o t e schedtjl -cl -is tiniv AI I ows . 011 t i I v e c�() I it t j.o it o I rPliy /,1 1, 1 pr fill i 1, I)() jlj;.ltjf V i t itia ln,spec t i ort It wl.I I by qrmn 1.ell f(it h 0. r A 41(4 1'$,,o OWN t R/C 0 N I R A C 1 0 R( i n d i c.a t#4 wh i t,h no p I n n§, stitimi, C ted for any dpi- i: t it t 0 kt, I'll i I I 1 0 i i hol.1 I a 1­4 till than Lhat needti. 6 pvriwi I CONCRETE MECHANICAL MOBILE HOME Footings-Setback date y 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 Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by MASON COUNTY BUILDING IR 426 W. CEDAR SHELTON, WASHINGTON 98584 (206) 427-9670 CORRECTION NOTICE Job Location 20 O ; ; -, 4 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 I. `�L,,�� ►-�,cti � `�-Imo,� �� r-4 ...�cam, � l� � �. -� � e� -�'r d„1� �� � t-�-C_ /A/�--Z ►��1 v- II YA D /z;1L r v r M �r S 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 l Date j 19 _�y Inspector ,CAj-t t ^s ■ �� 0 No OT MOV 1H1 T LOW' MASON U��U�4���K �U�� COUNTY . ° .^ ^�� ~~� . ~ K� County P(|r1 ||| ���� \�/ Cedar ...CJS��[l �^C)U[l. y ^^.^^��. ... -,.�^^ W. ~^��^^ar P.O. l A/\ Shelton, Washington f OA��� . �^ "C]�K ."" `,. .��..C}[l, ""^^0 .|[l��.C)�l ,"""-, F3 LA ][ U_ C�) ][ �� (m:!ii �� 11::::: jj::;j!: 11,111 ]:� 'U FOR INSPECTIONS CALL 427-9670 BETWEEN 5pm AND Oam 427-7262 0LD93-1305 PARCEL : 323347590102 PLAT ; DIV: BLK : LOT - JOB ADDRESS ; NE 200 KISSIN TREE LN TAHUYA OWNER ; GEORGE SHAW 324-7140 CONTRACTOR : GDRST LAND DEVELOPMENT 373-6001 LEGAL : TN 10-8 OF SURVEY 8/10 TK 8 OF SP 01335 [S 05888:1-& UK 0/4 CLASS OF WORK , . ; NEW B E D R : 0 , DATH : 0 T Y P E AMOUNT BY DATE R E C E I P T T Y P E AMOUNT BY DATE RECEIPT TYPE OF USE ' ' ' ' ; MH STORIES ' ' ' ' ' ' ' ; 0 0CCUP , GROUP . . . 7 BLDG , HEIGHT ' . ; 0 , 0 It:t TYPE OF CONST . . ; ? FIREPLACES . . , . ; 0 UCCUP . LOAD , , , , ; 0 W00DSTOVES . , , , : 0 DWELL . UNITS . . ' ' : 0 PARKING SPACES : 0 INSPECTION AREA ; 1 SHORELINE? . . ' , : N � SETDACKS-------------- TOILETS . . . . . . . . . . ; 0 FUEL TYP[S---------- BOILERS/CUMP---- MOBILE H0ME-- FRUNT . . . E 90 . 0ft OATH BASINS ' , , , . , : 0 : ? 0-3 HP . ; 0 REAR . . . .W 5 , 0ft BATH TUBS . . . . . . . . : 0 3-15 HP . ; 0 MODEL ; FLEETWOOD SIDE ( 1 ) , N 50 ' 0ft SH0W[RS , , . ' ' ' ' ' ' , . 0 FURN < 100K BTU : 0 15-50 HP , : 0 -MAKE------ SIDE ( 2) , S 60 . 0ft WATER HEATERS . , , ' : 0 FURN )=100K BTU : 0 30-60 HP . ; 0 7553L SHRLZNE , % 0 , 0ft CLOTHES WASHERS . . : 0 FURN - FL0UR ' ' ' : 0 60+ HP ' : 0 -YEAR------ AREA ---------------- KITCHEN SINKS , , . , : 0 HEAT PUMP , , , . . ' ; 0 93 LOT SIZE ' , : ? FLUOR DRAINS . . . . . : 0 VENT SYSTEMS . , . : 0 EVAP COOLERS : 0 LENGTH : 56 BUILDING , , . : 1792af DRINKING FOUNT . . . : 0 VENT FANS , , , . , ^ : 0 HOODS . . . . . . . : 0 WIDTH ' : 40 BASEMENT . . . : 0af ' LAUNDRY TRAYS . . . , ; 0 DOMES ' INCIN : 0 -SERIAL#---- OECKS ' , , . . , ; 0ef DISHWASHERS . . . . . . ; 0 AIR HANDLING UNITS-- COMML , INCIN : 0 16037 GAR/CARP : ? Oef GARB DISPOSALS . . . ; 0 (= 10000 ofm. : 0 RELOC/REPAIR : 0 AT/DT , : ? URINALS . . . ' , . . . , . : 0 ) 10000 ofm. ; 0 OTHER UNITS . : 0 MISC PLM FIXTURES : 0 GAS OUTLETS ' : 0 P8UJ[CT 0[SCKlPT0N:N80i[ U88[ PROJECT i00T0N'T LAKE TO UAHU8AS CAMP THIRD U0V[ PAST ON 06HT, SIGN SAYS 2700 THIS PERMIT BECOMES NULL AND Y0IU IF U88K OR CONSTRUCTION AUTU88D0 IS NOT C0NN[NC0 NlTHlU 180 UmS. 08 IF CONSTRUCTION OR WORK IS SUSPENDED 08 A P[0V0 OF 181 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A Y80SRBS INSPECTION AITUlK THE 180 DAY y[0U0. RHAi INSPECTION MUST BE APPROVED BEFORE 8 liUl CAN BE OCCUPIED. 8UKEK 08 AGENT 0AT[' 8iU_pKMT. rev' 03/31/91 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O, Box 186 Shelton, Washington 98584 IF> N::'.::: p'm" M'MI :::M::. ...M..' 1:::: (:11 li''II N::b :::M::: ...II.._ ::II:: li:::U Case No . : BLD93-1305 For : GEORGE SHAW Page : 1 1) 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 Fi ar 1 . X 2) Propos d structure or any portion thereof greater than 30" in height from grade line , must m ntain a mum of 5 ' setback from all property lines , easements and right of w 3) PURSU4T TO 1991 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 1991 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER /CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECT NS . X 4 ) REQUIR D 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 detailed descriptions of all required inspections on my mobile /manufactured home 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 /all problems no occupancy ( Final Inspection) will be granted for the residence . OWNER/CONTRACTOR ( indicate which ) Signature X 5 ) no plans submitted for any decks . largest to be built without a permit is 36"x36" , other than that needs a permit. Permit No. MASON COUNTY BUILDING PERMIT APPLICATION t p� 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �t9 PLEASE PRINT #1 Owner ShAL', Occ�Agc - - mARr Phone# 7Ayo Site Address N.E-1cri KisszA,-TRcc MCA.. 'ra Y'4 wA. gjg5e'P Fire District# CQ City TAA,V a wA St Zip Directions to Job Site '7-' t A K< 'To i4 R h c,bas C ib-P, n Owner Mailing Address /1.97 6797;� Au--e. City 5 c'A'71/e St L,-A. Zip Lien/Title Holder —`s — Address Clty St Zip #2 Contractor Name Asvd Ve-0 ,:;f Contractor Reg#Cbar400-r^l Address 0 AOX 24 Expiration Date/ 9 q3 City CoC%04T St Lv A- Zi Phone# -- #3 If septic is located on project site, include records. Connect to Septic?_�Public Water Supply Well Y' Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 Parcel No. 3 J33 - 7S - qD/ob—, Legal Description #5 Building Square Footage: (existing/proposed) 1 st FI > / — -1 2nd FI / 3rd FI / Loft / Basement / Deck / c;2V' _#bedrooms - / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq.ft. / #6 Use of building Kesrb— Describe work A.)ei.cu mz,fii'le W-inl— #7 Type of Job: New _Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year- t93 Make F/ec7w,- Model 1,60L/ Length Width Serial No. 1603 7 # Bedrooms—#Bathrooms O.. Type of Heat Purchase Price$ .Zooe. o_ #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 /tl� 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 y , , E, W Indicate Directional b N S Name of Flanking Street ) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW 00 L /6L So 9'e APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW �ow-e- Plumbing Fixtures ($3 each) Fee Mechanical Fixtures 6 each No. Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other Bath Tubs No. Uni s 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 15.00 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 OF THE 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. i X OWNER DATE ATE FOR OFFICIAL USE ONLY: Accepted by: �_T Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: �1n`MS Environmental Health: V-4J S- 4, 1 w f Pt3�C� M� Building Plan Review -:::P N STALL- j2 e 2 VAPC-r Spe c iS Occupancy Group: tACBjL Type of Const: Fire Marshal: Other: Special Conditions: N© IA NS SLtA/m i77eD FEES FbP— f+iu A-ec e, , 36'*-36" 4�S Building Permit LAtZGCIS- 1?--Lkf T° RE AKOC7- Plan Check W,r-i ocx cT fF 2e2m+7". QTTff�2 -'L+t+N Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE ,O APPLICANT NAME: L DATE: BUILDING PERMIT CHECKLIST 1_1 RESOURCE LANDS & CRITICAL AREAS CHECKLIST. i �`z All projects must complete the Resource Lands and Critical Areas Checklist before a building or land modification permit is issued, or before final approval of a septic system. 1. SITE ADDRESS If site address is not listed, customer needs to be given a site address form. (11 U �� 0 DIRECTIONS TO JOB SITE � {��(l U�` < �l L C=- Needs to be as complete as possible (i.e. � ajor1roa-ds, is (use On lei or r ght side of road, etc. ) . Be sure to read for clarity (Landmarks, signage, owners name on mailbox, etc.?) . Q LIEN/TITLE HOLDER Who holds the mortgage (Bank or name of private owner holding contract)? 2. CONTRACTOR REGISTRATION # AND EXPIRATION DATE This information needs to be provided. The Building Department may be able to research expiration information if customer does not know it. We must have a signature in 1 of the 2 boxes, either the applicant or the contractor. 3. SEPTIC RECORDS Septic records should be included. BE SURE TO INFORM CUSTOMER OF $25 RECORD RESEARCH FEE FOR ENVIRONMENTAL HEALTH. If no records are available, make a notation on the form "No Records". If septic application is recent, mark "pending" in the upper right hand corner. 0 EXISTING SEPTIC LkL -�C `� Remind customer ey need to have their tank pumped and determine whether their system meets cod (sanitary survey or parcel review?) . They will probably need to show reserve for their septic. 4. PARCEL # Parcel # must be included or researched through Gateway. Q 5. BUILDING SQUARE FOOTAGE Verify that boxes are filled in. If there is a garage, verify whether it is attached or detached. Include square footage information for mobile homes (you can multiply length X width to determine number) . 6. USE OF BUILDING Is it a residence, garage, greenhouse, etc. . .? DESCRIBE WORK (i.e. mobile home addition, addition to a house, etc. . . ) �] 7. TYPE OF JOB Verify appropriate boxes are marked. f� 8. MOBILE HOME INFORMATION �1�v1 Verify appropriate boxes are marked. If factory order, please put factory order # in mobile home serial #. If unit was assembled prior to June 15, 1976, refer to procedures handout for "Obtaining Installation Permits for Mobiles Assembled Prior to June 15, 1976. " SHORELINES If any water is on or adjacent to property within 200 feet, #9 must be complete. Once permit is entered into Tidemark, it will be routed to the Plar t. If property is not on water, then put "none" or "n/a". R (� ItIL,,. 11gil Nov o L I'6 GENERAL SERVICES 1 400 10. SITE PLAN DRAWING �Z�z �r Must have setbacks frl all property lino,�easeme�t lines aJd structures. Drainfields septic tank location, outbuildings, etc. . . 11. TOPOGRAPHY DRAWING If property is flat write "flat" on the topography section. If house or structure is near a slope or hill, drawing must reflect this. 12. OWNER OR CONTRACTOR AFFIDAVIT Owner or contractor must sign affidavit statement and date it. Lk7 l 13. ACCEPTED BY Whoever is accepting permit information must sign your initials and date form on the bottom of page 3 or use date stamp and initial on back of permit. 14. PRINTS Need two sets of prints unless it is a stock plan. For stock plans, we only require one copy. 15. WATER ADEQUACY For new residences and mobiles. PRIVATE WELLS MUST HAVE WELL LOGS OR CAPACITY TEST AND BACTERIAL TEST. If they are on a public water system, verify the water system is in compliance with State requirements. 16. WSEC & V & IAQ CODE Required for all residential, additions and commercial buildings. Energy Code compliance form needs to be COMPLETED. Verify heat source (no wood or pellet stoves are permitted as primary system) . Window schedule must be filled out and reflect what appears on submitted building plans. If applicant has decided to go with the PUD in a Long Term Super Good Cents program, we require a copy of the signed agreement with the utility. i 17. PLUMBING/MECHANICAL This form must be completed for any structure with plumbing and mechanical excluding mobiles/modulars. 18. FIRE DISTRICTS . Please make sure the fire district is included in the application information. Refer to map located at counter. 0119. ROAD ACCESS PERMIT If you will be accessing your driveway from a County road, contact the Public Works Department in Mason County Building I, 427-9670 extension 450. Access from State Highways requires Department of Transportation approval. Contact office (206)895- 4753 (Port Orchard) . * ACCEPTED BY: ** DO NOT ACCEPT PLaMIT AP ICATION WITHOUT PRINTS AND REQUIRED DETAILED INFORMATION (SETBACKS, ADDRESSES, PARCEL # AND WATER) . "checklst.blg" 10/05/93 checklst.blg 9/20/93 2 f Me h Too of 2 times erV of Structure Slope c a 15, Max.* o fFooting a f— Face CNot to exceed 40'�- of Toe at Structure Slope 33 µu= a E BUILDING OFFICIAL MAY APPROV' TYPICAL STRUCTURAL SETBACK ALTERNATE SETBAGCS a CLEARANCES Scale I" : 20' 'L Sample Site Plan 2 41' ------------- 133' 14 443 32' 20' I PROPOSED n RE510ENCE ,,.,. c 1 nice £DGc OF HANK Septet T4n7tJ o v 24' c • c eO C o ICU IMim S'selbaUt well(see 122 238' I V TYPICAL SITE PLAN I" x 20' _ J. OOE 1406 Ma3on U. Or. N APPLICANT NAME: -S lA «J C BUILDING PERMIT CHECKLIST 1. SITE ADDRESS If site address is not listed, customer needs to be given site address form. / DIRECTIONS TO JOB SITE Needs to be as complete as possible (i.e. major roads, is house on left or right side of road) Be sure to read for clarity. Landmarks - Signage - Owners Name on Mailbox ? _ LIEN/TITLE HOLDER Who holds the mortgage? (Bank or name of private owner holding contract) _Z2. CONTRACTOR REGISTRATION # & EXPIRATION DATE This information needs to be provided. Building Department may be able to research expiration information if customer doesn't know it. We must have a signature in 1 of the 2 boxes, either the applicant or the contractor. 3. SEPTIC RECORDS ' I�1� L S)c a-p( yvU�- A S Septic records should be included or b6 sure to inform customer of $25 record research fee for Environmental Health. If no records are available, make a notation on the form "No Records". If septic was just perked, please indicate in upper left corner. _ EXISTING SEPTIC Remind customer they need to have their tank pumped and determine whether their system meets code (sanitary survey or parcel review?) . They will probably need to show reserve for their septic. 4. PARCEL # Parcel # must be included or researched through Gateway. 5. BUILDING SQUARE FOOTAGE Verify that boxes are filled in. If there's a garage, verify whether it is attached or detached. Include sq footage information for mobile homes (you can multiply length X width to determine number) . 6. USE OF BUILDING Is it a residence, garage, greenhouse, etc. . .? i _ DESCRIBE WORK (i.e. mobile home addition, addition to a house, etc. . . ) s 7. TYPE OF JOB Verify boxes are marked. 8. MOBILE HOME INFORMATION Verify boxes are marked. If factory order, please put factory order # in mobile home serial #. If unit was assembled prior to June 15, 1976, refer to procedures handout for "Obtaining Installation Permits for Mobiles Assembled Prior to June 15, 1976." 9. SHORELINES If any water is on or adjacent to property within 200 feet, #9 must be complete. Once permit is entered into Tidemark, it will be routed to the Planning Department. If property is not on water, then put "none" or "n/a". Page 2 Building Permit Checklist 10.SITE PLAN DRAWING Must have setbacks from all property lines, easement lines and structures. Drainfield, septic tank location, outbuildings, etc. . . ll.TOPOGRAPHY DRAWING If property is flat write "flat" on the topography section. If house or \ structure is near a slope or hill, drawing must reflect this. �12.OWNER OR CONTRACTOR AFFIDAVIT Owner or contractor must sign affadavit statement and date it. 13.ACCEPTED BY Whoever is accepting permit information must sign your initials and date form on the bottom of page 3 or use date stamp and initial on back of permit. 14.PRINTS Need two sets of prints unless it is a stock plan. For stock plans, we only ' 11 require one copy. �15.WATER ADEQUACY For new residences and mobiles. Private wells must have well logs or capacity test and bacterial test. If they are on a public water system, verify the water system is in compliance with State requirements. f16.WSEC & V & IAQ CODE Required for all residential, additions and commerical buildings. Energy Code compliance form needs to be COMPLETED. Verify heat source (no wood or pellet stoves are permitted as primary systems) . Window schedule must be filled out and reflect what appears on submitted building plans. If applicant has decided to go with the PUD in a Long Term Super Good Cents program, we require a copy of the signed agreement with the utility. 17.PLUMBING/MECHANICAL This form must be completed for any structure with plumbing and mechanical excluding mobiles/modulars. 18.FIRE DISTRICT Please make sure the fire district is included in the application information. Refer to map located at counter. * ACCEPTED BY: � MASON COUNTY STAFF PERSON ** DO NOT ACCEPT PERMIT APPLICATION WITHOUT PRINTS AND DETAILED REQUIRED INFORMATION (SETBACKS, ADDRESSES, PARCEL# AND WATER) . "permitck" 07/29/93 2 times the hegtt of S 1ruc:ure Too of pet _/���_ c�"(i.Z1//1= aaca of i�' Max. FaotTg a Nat to exc=eQ 40't- Face cf y Tae of Structure Slape 341 �E BUIUING CFFICIAL MAY APPROV TYPiCAt SinUCTURAL ScTHACX ALTERNATE SciHACKS g CI=ARANC`5 Scd* i" Sample Site Plan 2 a,' I4' . ' 440 32' 20' C11 I C PROPOSED ,On RESIDENCE L� ova.. G ne�a £IIGc OF BANK Septic Tans v 24' c • 4Q O a SLapE Shop ' - - -- - - - - - - - -- - � Mint S'istbccu well(sce 121 238' I U TYPICAL SITE PLAN In = 20� J. OOE 1406 Masan U. Or. N