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Home My WebLink AboutBLD2017-00840 Final MFG Home - BLD Permit / Conditions - 8/31/2017 Inspection Line(360)427-7262 �P6oN �oUh�F MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 y ` Mason County 615 W Alder St Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2017-00840 OWNER: O ERNEST HULTGREN RECEIVED: 8/31/2017 CONTRACTOR: LICENSE: EXP: ISSUED: 8/31/2017 SITE ADDRESS: 560 NE BELFAIR MANOR DR BELFAIR EXPIRES: 2/28/2018 PARCEL NUMBER: 123307500180 LEGAL DESCRIPTION: TR 18 OF SURVEY VOL 2 PG 149 PROJECT DESCRIPTION: DIRECTIONS TO SITE: BLDG PERMIT CREATED JUST FOR FINAL SIGN-OFF. MFG HOME ORGINIALLY PLACED IN 1978. ENGINEER'S CERTIFICATON OF PERMANENT FOUNDATION COMPLIANCE FOR MFG HOME General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: Type of Use: MH Insp.Area: No. of Bathrooms: Occ. Group: Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body: Rear: Ft. Slope: Ft. SEPA?: Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Year: Serial No.: Side 2: Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Total BLD2017-00840 Please refer to the following pages for conditions of this permit. Page 1 of 2 CASE NOTES FOR BLD2017-00840 CONDITIONS FOR BLD2017-00840 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s) for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. Signature Date OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2017-00840 Please refer to the following pages for conditions of this permit. Page 2 of 2 Harrison Engineering LLC Harrison 4505 Pacific Highway E, Ste C-2 F'tfe,Wa 98424 Tel:877-736-7327 (40Engineering COA Firm#: 2851 R• HAR June 29,2017 Digitally signed by Edsefft_Hamson,PE on AdObt 06-a2017 @ 11:1Q53 —, Paul Hulpgren �p 560 Belfair Manor o� o�s Belfair,WA 98528 Ss, rstL ti 0 N L 360-509-6466 A skippy 1938@icloud.com RE: Engineer's Certification of Permanent Foundation Compliance for Manufactured Home Owner: Paul;Hulpgren,360-509-6466 Site: 560 Belfair Manor,Belfair,WA 98528(HUD Label(s): ORE 048790,ORE 048791) To Whom It May Concern: Purse&Scope of Report The scope of our work was to assess the foundation of this factory-built home for permanent foundation compliance for Paul Hulpgren.The above referenced site and manufactured home's foundation was physically examined,this engineering report reflects my assessment. Observations The foundation has a standard type crawlspace.There is a wood skirting that encloses the foundation to keep out vermin and water.The foundation has concrete masonry block piers that rest on concrete footings to support vertical loads.A pony wall with sheathing was also observed.This foundation is typical of those found in conventional construction methods with a sill plate and shear fastening around the perimeter. No indication was observed that this manufactured home has been placed in any other location or previously installed at another site.The wheels&axles,and tongue have been fully removed from the manufactured home.No indication was observed that the site-built addition(s)and/or modification(s)were impairing the structural performance requirements of this factory-built home as established in Part 3280,Subpart D of HUD's Manufactured Home Construction &Safety Standards (MHCSS). Opinions To the best of my knowledge,I conclude and certify that this manufactured home foundation is COMPLIANT with and meets the intent of the definition for a permanent foundation as stated in: HUD's Permanent Foundation Guide for Manufactured Homes dated September 1996(HUD Publication 7584)along with the retroactive amendments contained in HUD's Mortgagee Letter 2009-l 6. Respectfully, Ed Harrison,PE report is Ile property oHarrison Engineering,,L an cannot be reproduced without our prior consent. t hasbeen issue to the referenced property owner at the site indcated for the purpose of a specific loan requirement or insurance policy and it is not intended to be used for acquiring,or take the place of,a hermit or entitlement process,with the local planning.or building jurisdiction. It is site specific and may not be transferred,to any other property,propel owner,or entity.This report offers an expression of professional opinion by this engineer,,which is based on his best knowledge information provided by others,anU belief.This consultation inspection was of readily accessible areas of the.property and is limited to visual observations of appareni conditions existing at the time of the inspection only. Latent and concealed areas,defects and/or deficiencies were excluded from the inspection;further,equipment,items and systems are not necessarily dismantled therefore,we do not assume responsibility for conditions of such areas or items.A geotec nical soils report was not performed and it is assumed,that the existing soils at the site are adequate to suppport all structures.Termite,wood destroying organisms,and dry-rot assessments are excluded. This report consists of neither a guarantee,warranty,or insurance policv,expressed or implied,regardinq the adequacy,performance,or condition of anv inspected structure,item or system.Harrison Engineering.LLC reserves the riqht RETURN RECORDED DOCUMENTTO: n CILWASHINGTON STATE DEPARTMENT OF Manufactured HomePlease LICENSING Application Title Elimination For full instructions on completing this form, see Manufactured Home El Transfer in Location Application Instructions,form TD-420-730. ❑Removal from Real Property Manufactured Home Al;it purpose only(TPO)/Plate no. YearI tr-:� Length/Width(feet) Vehicle identification no.(VIN) �l I X v1O CU ' Land Ma factured home will be Real property Affixed ❑Removed Tax parcel no. Ia 3 3 "75 02/k.egal description on page Lot Block Plat name or Section/Township/Range _ Quarter/Quarter section Grantor(s) Registered/Legal Owners)—Additional names on page County no. No.registered owners No.legal owners Grantee name(if applicable) Name of registered owner p Washington driver license or UBI no. �r k ID �/�Ql 3 g Name o additional registered owner WashingtQA briver license or UBI no. Address(Address,City,State,ZIP code) 5(00 N E &-t4."/' Name of leg�al ecaner Washington driver license or UBI no. Name of additional legal owner VWashington driver license or UBI no. Address(Address,City State,ZIP code) I certify under penalty o perjury under the lawsRR2eg,—stered ashington th m we ar the registered owner(s)of this manufactured home and the toinfot' rue a orrec 05A U' .I7 �L.L L911N M V Date and place(city or county)signed Title,if signing for a business X Date and place(city or county)signed Registere owner signature Title,if signing for a business Notarization/Certification State of r County of — I igned or attested before me on JOSEPH J.OARCIA da .( o st%M Public,State Ot Flori Q� �. by 'IrF� 47b pri giste d o nee nt regist r e Gommiss�o n18.?4 r7 Notary p ted or stamp name a I n ure� / Yam_ and Title - Q Baler/couni office number or no'a ex iration TD-420-729(R/6/16)WA Page 1 of 3 Continued on next page Manufactured home TPO/Plate number (from Section 1) Title Company Certification Pt INT or TYPE Nam�pf person si Wing itle company name--., Position (Area co Telephone no. ��(^d 1 certify ttylItthe legal description of the land a d owners r an ect a real property records. Si ature Date • Building Permit Office Certification I certify that Xthe 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. PRINT or TYPE Name of person signing Building permit office Building permit no. �R }NFL gt s cfr L"Az A/ WZOI7r— 8`f0 Position (Area code)Telephone no. x P A4,W11 Signatur Date • Signature of Legal Owner(s) Signature of legal owner indicates consent for limination of Tit oval f real Leg wner signa re e,if signing for a business x Legal owner signature Title,if signing for a business Notarization/Certification State of �Gcti, County of or attested before me on ( GAFICIA rRM. by 1 . amp)tarYPsiy c,Stale of Floddab Pr' gal o ner Print legal ow fssio�# 70 �� ,G4m�mmexnlrAs Seft�'2017 otar� ted or sta pe name �^/ an natu mp, f Tit a Baler cou office number or notary expiration Land Description Legal description of land TD-420-729(13/6/16)WA Page 2 of 3 Continued on next page