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Home My WebLink AboutBLD2004-01585 MFG Home - BLD Permit / Conditions - 11/10/2004 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 'E1son County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2004-01585 OWNER: JULIE DOMBROWSKI RECEIVED: 10/5/2004 CONTRACTOR: FUTURE HOMES CONST (360) 754-3695 LICENSE: FUTURHCO05PE EXP: 10/15/2006 ISSUED: 11/10/2004 SITE ADDRESS: 11 NE LARSON BLVD BELFAIR EXPIRES: 5/10/2005 PARCEL NUMBER: 123305000007 LEGAL DESCRIPTION: BEARDS COVE DIV 3 TR 7 PROJECT DESCRIPTION: DIRECTIONS TO SITE: PLACE MANUFACTURED HOME NORTH ON HWY 3 TO BEARDS COVE General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: VB Type of Use: MH Insp.Area: OT No.of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No.of Stories: 1 Occ. Load: Building: Valuation: Building Height: 13 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:LIBERTY Length: 40 Ft. Front: N 35.0 Ft. Shoreline: Ft. Water Body: NONE Rear: S 38.0 Ft. Slope: Ft. SEPA?: Unkn Model:QG284445 Width: 27 Ft. Side 1: E 32.0 Ft. Shoreline Desig.: UmNnown Year:2005 Serial No.: FACTORY Side 2: W 8.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee NJP 10/5/2004 $214.50 S22004 Planning Review Fee NJP 10/5/2004 $155.00 S22004 Building State Fee ARC 10/5/2004 $4.50 S12004 Mobile Home Issuance Fee ARC 10/5/2004 $214.50 S12004 Address Fee GMM 10/6/2004 $140.00 S12004 EH Plan Review ADR 10/11/200 $75.00 S12004 Total $803.50 BLD2004-01585 Please refer to the following pages for conditions of this permit. 1 of 4 CASE NOTES FOR BLD2004-01585 CONDITIONS FOR BLD2004-01585 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 2 F 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) The internatioanl code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved ,7 access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. (/ X 3) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Department prior to any further inspections being performed or approvals granted. X 4) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads," all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting inspections. X 5) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or VW removal of approved documents will result in failure of required building inspections. X 6) The "approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the "approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the vo Building Department prior to any further inspections being performed or approvals granted. X BLD2004-01585 Please referto the following pages for conditions of this permit. 2 of 4 7) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Irrstallation cod,,,chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 V An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or installed. certification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X 8) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. 9) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the 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 current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been l� 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. OWN ER/CONTRACTOR(indicate which) Signature X This permit is for the placement and installation of the manufactured home only and does not imply approval or review for any other items indicicated on the plot plan. X All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance ` with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building UI� Inspector shall be made prior to requesting additional inspections. X The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. VK', All property lines shall be clearly identified at the time of foundation inspection. X 5) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. X BLD2004-01585 Please referto the following pages for conditions of this permit. 3 of 4 16, All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a per;W not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have prevented action from being taken. No more than one extension may be granted. INK? X vv� Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 18)(I Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. VVJ ; X This permit becomes null and void if &kK oriconst ction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of tinu on of,�brk i a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a pro ss i ectio .Th owneror the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described pro ch re fd review and inspection. OWNER OR AGENT: �.r DATE: BLD2004-01585 Please refer to the following pages for conditions of this permit. 4 of 4 o CONCRETE MECHANICAL MANUFACTURED HO o Footings/ Setbacks Date B y Ribbons v, Date �Z 13 oy By Gas Piping Date 12 I3 Qy By cn Foundation Walls Date B y Set-up C-�c Date By INSULATION Date l 3 " By 1-6k- , 13 G / Slab Insulation Floors Final Date By Date By Date FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date B y Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date B y ate By _ ,. Da10, te By � Iz �o t L3 ou �S 0 CD 621�. Sep, a ►�►� U� liP,� h ��1 t� 11 ca in S✓l fie- �� S �'_f,%i 4z J' /^-9 ,c qiL L 77—% N g D N a O S' N O En o j r t�J 0 MASON COUNTY PERMIT NO. C_T BUILDING PERMIT APPLICATION 426 W. Cedar • F0. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION-,-,"- CONTRACTOR INFORMATION Owner 14244- macjM ?= Ia_ U11C r IP-yzousk.i 1 Company Name iT'_�fL-r-_ 1-��►-+�:- Mailing Address Mailing Address rZU yIT-_'Vk(J 1, City ="k�zai A 1 State WfA Zip Code "IR5 20. City T!:j State, WA Zip Code Phone Other Ph. 15►r# Phone 41ci. 44t,.'7-, Other Ph. Lien/Title Holder Contractor Reg.# Me%Y- 14-7 ZDc;Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic — Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. - kjo Fire District Legal Description Site Address (Please lude street name, street n r and ci Directionto site AI �- Will tuber be 6-uf and sod in p r el preparation? s/ Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model - = Year Length—Width Serial No. No.of Bedrooms No. of Bathrooms Type of Heat - Purchase Price$ =r= Replacement Unit? Yes/No Installer Name ` �.- 7, R:a Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other parry in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information (Iprovided is accurate and grants employees of Mason County access to the above described property a structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. i RECEIVED X Date• i . �i Owner/Owners e resentative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: D t DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department ;( - Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee 2-t(-/, -0 Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood /Gas /Pellet Stove Fee State Fee �d Violation Fee -vo E-iVF. Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. L C PLEASE PRESS HARD 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 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner 1Z_j1" L r�r --rl �v�1C 2-c�vSK Company Name l�vi•�(L E -� �+�-""� Mailing Address - Mail in Address'Zv 1L1-rSf,f' l� City ' ra�0—State�Zip Code `�L� City 7- � State / Zip Code `I -x.o Phone � � 11G- 1�O Other Ph. � (�I+ Phone �� `��`� �� Other Ph. Lien/Title Holder Contractor Reg.# MrA:X_-_1'2L1V-7 Z-D Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic_ Existing Septic Connect to Water System Name of Water System E�fL-3`, Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. / > -_ Fire District Legal Description -- N l Site Address (Ple s cl dp stree name, str t n . ran ci l io-ta its 'F 4 - - - O A/ L t imber be cut and so d in p rcel preparation?res/ Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESI DENCEX SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make -1RztZ i� , Model Year2CC�-� Length :� Width •2-1 Serial No. No. of Bedrooms _�2- No. of_Bathrooms L Type of Heat PLC- Purchase rice $ q-"Ic� Replacement Unit? Ye / o0 Installer Name - �� ►2 Certification No. �� ^` 1� 1 OV1/NER/BUILD Acknowle es submissi of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signal e below.I d lare that I a e owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to d the work as r pose in th application.I declare that I have obtained the permission from all the necessary parties.If permission is required from,,Agny as e Ider or y ther party in interest regarding this application or the ork pr posed in the application, I have obtained permission f m e a for t r it and conduct the work proposed. The owner or age t on o Hers behalf,represents that the information provided is cc rate d r nts e s of Mason County access to the above described pr erty a d struct e for review and inspection. PROOF TI IN OFiK IS BY MEANS OF A PROGRESS INSPECTION. RECEIVED X Date FiOwner/Owners Representative/Contractor indicate which one OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department! Public Works Department /Z C S ¢ W Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview Fee Mechanical & Base fee Other a I`I(. Wood /Gas /Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES Mason County Permit Assistance Center RECEIVED PL Planning Intake Checklist OCT 0 5�1004 / 426 W. CEDAR ST. Owners Name: ri,-`C r 6 Nn b,z.q Rate: /�0- C y Project: y') f Reviewed By: Commercial DevelgpmQnt: YES O_� Comments: Planner: GBM 1 TSC--JLW Site Plan: q North Arrow ;e4 Property Dimensions: X /cc ,t Streets and Driveways Shown.Road name: L a,-so� /3/c d , All Existing Structures shown with setbacks Weir Location, Septic and Drain-field Shown with setbacks a Identify all surface water(streams,ponds, shoreline,wetlands, etc.) i t. QY Topography(slopes) Jd Proposed Structure Setbacks(Direction/Setback): F: k/ / _3�_'R: S / ( S1: L S2: t / ,7 Utility and Drainage Easements: Yes o (if yes enter condition#5022) -t Other Easements f�U ra Accessory Appurtenances P ❑ County Access Permit Needed(add condition#0010) ❑ State Access Permit Needed(add condition#0020) Standard Conditions to be added to all Building permits that planning reviews: #5019 and#0700 Shoreline and Planning Info Setbacks: Shoreline: Slope: Shoreline Designation: Comprehensive Plan: Rural Zoning: ❑ Not Applicable ❑ Agricultural ,Pf RR 2.5 K 10 20 q Urban ❑ In-holding ❑ RMF ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy R_ Rural ❑ RI - ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet ❑ RT ❑ Urban Growth Area ❑ MPR ❑ Unknown ❑ Unknown Water Body(type of water if unnamed): SEPA: Yes No Unknown Flood Plain: YES NO Unknown Map# Aquifer Recharge: YES NO Unknown Map# Tags/Cases: RLC/SPI Case: 6-Year Dev.Moratorium: YES NO Eagle Nest Tag: YES NO Other YES NO Addressing: Check box if needed 0 Reviewed by: Revisa 07.12-04