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HomeMy WebLinkAboutBLD99-0293 Final Mobile Home - BLD Permit / Conditions - 7/9/1999 - --- T - MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 " U I L_ 0 1 N C3 PERM 1 T FOR INSPECTIONS CALL. 427-9670 BETWEEN 5Rm AND Sam 427-7262 BLD99-0293 PARCEL : 123305200054 PLAT :BEPI.O DIV : BLK : LOTt 54 JOB ADDRESS : 120 NE HARPOON DR BELFAIR OWNER : DONALD CLARK 360--275-2214 CONTRACTOR : LEGAL : BEARDS COVE DIY 5 BI-K: LOT: 54 CLASS OF WORK , :NEW BEDR : 3 BATH : 2 TYPE AMOUNT BY OA'E RECEIPT TYPE AMOUNT BY DATE RECEIPT TYPE OF USE . . . . :MH STORIES . . . . . . . : 1 _.- OCCUP . GROUP . . . :7 BLDG . HEIGHT . . t 0 .Oft MNSF $ 175.00 KI 04?20199 50018 ! TYPE OF CONST . . :? FIREPLACES . . . . : 0 MHBL 1 175.00 KS 05105199 50172 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 ISTFE 1 4.51 KS #5105199 50172 DWELL .UNITS . . . . : 0( PARKING SPACES : 0 EHCP 1; 50.01 KS 05105199 50172 1 INSPECTION AREA : 2 SHORELINE? . . . . :N TOTAL: 404.51 VALULATION: 35445 SETBACKS--------------- TOILETS . . . . . . . . . . : 0 FUEL TYPES----------- BOILERS/COMP--_.- MOBILE HOME-- FRONT —S 60 .Oft BATH BASINS . . . . . . t 0 0-3 HP . t 0 REAR . . . .N 25 .Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL :FLEETWOOD SIDE ( 1 ) .E 50 .Oft SHOWERS . . . . . . . . . . : 0 FURN - 100K BTU , 0 15-30 HP . : 0 --MAKE------ SIDE (2 ) .W 15 .Oft WATER HEATERS . . . . : 0 FURN >-100K BTL) : 0 30-50 HP . : 0 BERKSHIRE SHRLINE .N 0 .0ft CLOTHES WASHERS . . : 0 FURN -- FLOOR . . . t 0 50+ HP . - 0 -YEAR---- --- AREA ---- _----------- --- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 99 LOT SIZE . . : FLOOR DRAINS . . . . . t 0 VENT SYSTEMS . . . c 0 EVAP COOLERS : 0 LENGTH :48 BUILDING . . . : 0,;f DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . 1 0 WIDTH . :25 BASEMENT . . . t 0yf LAUNDRY TRAYS . . . . : 0 DOMES . 1NCIN :0 -SERIAL #---- _ DECKS . . . . . . . Osf DISHWASHERS . . . . . . . 0 AIR HANDLING UNITS-- COMMI.. . INCIN :O GAR/CARP :? Osf GARB DISPOSALS . . . : 0 +R 10000 cfm . : 0 RELOC/REPAIR : 0 AT/DT . :? URINALS . . . . . . . . . t 0 > 10000 ctm . : 0 OTHER UNITS . : 0 MISC PLM FIXTURES : 0 GAS OUTLETS . : 0 PROJECT DESCRIPTIO11:111061LE HOVE PROJECT LOCATION:GO OUT P SHORE RD FPOM BEI-FAIR TO SAND HILL RD TAKE RIGHT GO APPROK 1(2 MILE TO tARSON BIVD TAKE LEFT, GO 314 NI!E TO SECOND SCH0@NER LP TAKE RT GO I BLK TO MARROON TAKE RIGHT CLEARED LOT ON LEFT, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR12E0 IS NOT COMMENCED W!THIN 180 DAYS, 01 'IF CONSTRUCTION OR WORK IS SUSPENDED IOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIOENCE.OF CONTINUATION OF WORK IS A PROGRESS INSPECTION 19TNIN THE 180 OAY PERIOD. FINAL INSPECTION MUST BE APPROVED BEFORE BUILDING CAN BE OCCUPIED. , OWNER OR AGENT, UAT: 8L0 PRMT, rev 13131191 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Final Floors date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date b I D.W.V. WALLBOARD NAILING date by date by I Water Line FINAL INSPECTION date by date by date by I I - - I I �I MAS ON COUNTY �\ Mason County Bldg, III 426 W, Cedar P,O, Box 186 Shelton, Washington 98584 PFF2M 1 T CCDND 1 1 I'A : .> Case No . : BLD99-0293 Fors DONALD CLARK Page : 1 1 ) Approved per dimensions and setbacks can submitted o l to i I Lin . X Yam r" 2 ) Temporary erosion control measures must be implemented to prevent water quality degradatyon of adjacent wagers or properties . Silt fencing or straw matting must be installed and maLgtained until upland vegetation has become established . X 3A 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 an-d State Road right of ways . ,:. X - -�- t'r4 ) The use, handling and storage of hazardous materials or flammable and combustible liquids in excess cf 10 gallons is not allowed without the approval of the Mason County Fire Marshal . X 5 ) Owner / builder assumes all responsibility if drainfleid area is encumbered . 6 ) PURSUANT TO 1994 UNIFORM BUILDING CODE , 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 FRCNTING 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 JABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF' OWNER/CONTRACTQR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . X 7 ) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOLI . _ t MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 X 8 ) REQUIRED INSPECTIONS ( Footing Inspection-prior to pour , Set- up inspection-prior to skirting Final Inspection-prior to occupancy) . 1 have received a copy of the General Informa � an and Guidelines-Mobile/Manufactured Housing Installations Handout for detailed descriptions of all required Inspections on my mobile/manufactured home nstallatlon . I hereby assume all responsibility for the scheduling of these required inspections . If these required inspections are not requested, Inspected and signed :fM pproved ) by the inspector in the prescribed order , I understand that reinspect. ion fees and an hourly investigation fee pursuant to the 1994 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 oc:ccrpancy ( Final Inspection ) will be granted for the residence . OWNERICONTRACTOR ( indicate which ) Signature }(__ { P. 9 ) 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 120 sq ft or less AND MUST be under, 30 . in height from surrounding 3radea . NO second story decks , or decks abrivf 30" can be built without a permit . Any Iancing or deck that is 30 , or more in height from walking surface to finish grade requires a Permit . Any landing or deck that has 4 or more risers requires a handrail . 10) This application is su�Ject to Buffer and Landscaping requirements as established under Mason County Ordinanoe4 11 ) 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 Lie 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 Instailation/construction of a driveway or access connecting from a Mason Count Road, Contact the Mason County Public; Works Department prior to construction at Ext 490 . 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 . PERMIT NO.: BLD 1 W90UNTY BUILDING PERMIT APPLICATION �( ' 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275.4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICAV INFORMATION CONTRACTOR INFORMATION Owner .&_ glCZ ! Cd. le*- Contractor Name II' Mailing Address F - -2/ 8/ o HY 3 Mailing Address 41 5,,C, City ,aeh�s,,p State W,4 Zip Code 2dS-z City J"dC1t6A.J State A;,#. Zip Code 9,,P5F Phonk 36o ,27s'-Z.Zf-90ther Ph. Ph.( Other Ph.(� Lien/Title Holder A/o�✓G Contractor Reg. # WASH I-)t- O 7'7 Q R Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic_ Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System Be.�.��/,T C`e�Y..: WAtErr S ��� -at (�o&%n/ PARCEL INFORMATION-12 digit Tax Parcel No./.2 O/© Fire District Legal Description /-c T .e)"v-. * S Site Address(Please include street name, street number and city) /Z .L- Directions to site f c ou T` 41,, .f4a1z s � ,/ 7�• .An de/,69//z .te�,,rd/,l,'i/ ��(� ySy,k-,� &'4 a x, �,, o / 1 a L Vc1 f c 6E7Gj� u j/ h, " to ill itle " d In p �.� per t, Is your property within 200' of the following: Body of Water(Name) n o6 Saltwater A10 Lake Alo River/Creek,Vc Pond Al-o Wetland IYa Seasonal Runoff /V o Stream &&A845pes or Bluffs /o, TYPE OF JOB NeW Add Alt Repair Other Use of Building Describe Work S/,*& 1,,24 fJ a 01C No. of Bedrooms_a__No. of Bathrooms 2- SQUARE FOOTAGE-1st Floor��2nd Floor 3rd Floor Loft -U - Basement iVurJ-- Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make _4eJ*two44(ModeI Model Year. 192 l Length W" Width�y'By Serial No. No. of Bedrooms 3 No. of Bathrooms Z. Type of Heatrt'•Ket 4;4 S45c,Purchase Price $ 3 S, y'/S=o Replacement Unit ?(Yes/No) Nv Installer Name /K,, ►t a eNi/ Certification No. W A i u.1�,- bU Z._ NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without ap al. first obtaining approval. ate X Date FOR OFFICIAL USE BEYOND LTHI Tot - Accepted by ( Date- Submittal Amou eeceiptt No. U� DEPARTM NTAI» EVIE ROVI=p DENIED Co(IDITIirJ!N �QI7 S Building Department u,�c Occ Group Type Constr. 0a Planning Department Environmental Health Department Public Works Department 4 Fire Marshal Valuation $ FEES Building Permit Fee Site Inspecti 11 on Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other i Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) :::>::>>.E:.:: :>::: .................... :::::.:.:::.......... TOTAL FEES FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name /� o /u r1/r Ci CLIP PARCEL NUMBER / a33 o s"-Z0,00a Date V—1?— 9g SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences IN Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography 't'`t iE Well Location (including adjacent) Drainage Plan Names of Streets Easements Names of Fronting Streets Septic System S DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line- , , E-adjacent property line 1 1 I I I 1 �7 r�6;,X� 2-0 Aft r I / I I B/ b C I a � I 1 7, 8 I I 1 I I I adjacent property lined I ' <-adjacent property line SAMPLE SITE PLAN adjar�nt Cru�K property line II £ .pI• aioE _ _ ge��il FadjacCienu6t Esp�ar1 o perty line v 30• F rv& HOM j PO NO-% 0d 1 R sQ.pt:G I If— 6 c' --/50 I � VAGn,T ' 7 C,nrt�acs TA&R=LLLrU So � I • � ' k--eo' I � I /oo' I 1 1 L_.eLL 1 � I I � /DO• —� I adjacent property line-> E-adjacent ro ert' line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE Sr►ru,Gt6�Y� Slops f-o¢ Signature Date RETURN ADDRESS LAND TITLE COMPANY 1140 BETHEL AVE SUITE 202 P 0 ROX 1429 PORT ORCHARD, WA 98366 —f TON MANUFACTURED HOME APPLICATION TITLE ELIMINATION Iunsim ❑TRANSFER IN LOCATION Anyone who knowingly makes a false statement of a material fact is guilty ❑REMOVAL FROM REAL PROPERTY ! of a felony, and upon conviction may be punished by a fine,imprisonment,or both.(RCW 46.12.210) MANUFACTURED HOME T VL8TE N R I YEAR� MAKE4ec+ �`lj LENG'H X 'D VEHICLE IDENTIFICATION NUMBER(VIN) GJ� _•JL It C0/ _�j`' tr+"lj OQ f/LJ, C LAND LEGAL DESCRIPTION ON PAGE MANUFACTURED HOME WILL BE AFFIXED ❑ REMOVED UA WRI1 TAX PARCEL NUM LOT BLOCK PLAT NAME OR SECTION/TOWNSHIP/RANGE OUARTER/OUAnTER SECTION GRANTOR(S)REGISTERED/LEGAL OWNER(S) ADDITIONAL NAMES ON PAGE COUNTY NUMBER NUMBER OF REGISTERED OWNERS NUMBER OF LEGAL OWNERS` NAME OF REGISTERE OWNER DOL CUSTOMER ACCOUNT NUMBER S � I+7- NAME OF ADDITIOQ AL R�G ERED OW E \�� y 1�(4� ADDRESS � DOL CUSTOMER ACCOUNT NUMBER STATE ZIP CODE q NAME OF LEG ALOWNER DOL CUSTOMER ACCOUNT NUMBER NAME OF ADDITIONAL LEGAL OWNER DOL CUSTOMER ACCOUNT NUMBER AD pRESS 0 I �I + CITY�aA 1 STATE ZIP CODE GRANTEE NAME I DO SOLEMNLY ATTEST UNDER PENALTY OF PERJURY THAT I/WE AWARE THE REGISTERED OWNERS F THIS VEHICLE AND THIS INFORMATION IS ACCURATE: Signature of Registered Owner and Title, IF APPLICABLE • ' ' Signature of Additional Registered Owner and Title, IF APPLICABLE NOTARY SEAL OR STAMP NOTARIZA a X/iS RN/CERTIFICATION FOR REGISTERED OWNER(S)SI ATURE State of Signed or attested �.1S County of �Yt)VSS'd ala before me on 5/027 1O 6 PM Pue� i � Mr COMMOS t %?% I by �c S L -7- �. �:�-��z Signature&fd&a� � ' 2007 PRINT NAM OF REGISTERED OWNER NOTARY OR A%U;rr �JG�51 i by 1 C— �� ��� i. � t . IryL k W PPAINT NAME OF REGISTERED OWNER PRINTED NAM OF NOTARY County/Office No.OR Title AND: Dealer No.OR DEALERSHIP POSITION/AGENT/NOTARY Notary Expiration Date TITLE COMPANY CERTIFICATION I certify that the legal description of the land and ownership is true and correct per the real property records. NAME(TYPED OR PRINTED) TITLE COMPANY/PHONE NUMBER SIGNATURE/POSITION DATE Finalize this application with a Licensing Agent within 10 calendar days of the date Title Company Representative signs. BUILDING PERMIT OFFICE CERTIFICATION I Certify that: 'Vilthe manufactured home has been affixed to the real property as described. a building permit has been issued for this purpose and the attachment will be inspected upon completion. NAME(TYPED OR PRINTED) BLDG PERMIT OFFICE/PHONE# ( �7_Y 6 7JD BLDG PERMIT# ,r" LI D�,�� �J ISIG A E/POSITION DATE 7-46 TD-420-729MANUFHOMEA (R/2/02)OR(W)Page I of2