HomeMy WebLinkAboutBLD93-01890 Final Modular Home - BLD Permit / Conditions - 6/15/1994 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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DID Pool. rov! 13131141 COMPI 1ANC1- 141 At UACHIFA) CONDL (EOIAIS T-S fwQt1liltut)
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date � � J — 'bey- l ;Z=L Gas Piping date b
Foundation Walls date by Set Up
date �- / 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 Attic OTHER
Groundwork
date by
date b
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by da date by
I
i
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MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Vp 11F� ll.� M 11. 1 lq 1 ,
Ose No . : 111.17141- 11490
For : FRILDRII-11 "If
1 ) the "se . hAndlt "q and Gtorage of hayardoun maIQr1nIu or ti "ITIMRI) I9 And V"MIA"41ibi
liquids in excess of 10 riallonn im "ol- allow"d without 1-he mppr--ml. of VICR MA* n"
fi ' 9 M h to 1
Pro osed structure or any portion Lhkroof qroater tha" 10" in 1piqhl From qrade Ii "Q
MUN maintAin a minimum if S , -! hack tiom all prop"rly Woo . �avemm"in, and tirlht o
w a y s
A. .......
It PURSUANT ro 1991 IINIVORM 10" I' L" IN6 COOP . 4111toN (040 ) AND 41 1 1 1 "N b I I
HAVE APPROVED NUMBFRN OR ADORL5404 PROVIM111 IN SLIL" A P"nl ! IOM nn IA HV PIAIWIY VI - MI
RND LLGI.HLI; FROM THE STIAT'Ll ON ROAD VHONIINQ I "t PROPI- 101V MA40H iouNlY b" Il It Imul
DLPARIMENT PEUUIRES THAI I " th "t COMPIETI' D I'lljok 10 LA! JIM" P"k ANY Will I.N%PKIIIW
RLINSPUCIION FEE , SAqI` IC ON phlis IN IAHIF; ;A 01 IHF I "ql KINIIIARM h" 110 = IOU! Will
AssEssru jr OWNFR11COMINACI "In VA1Iq 10 Pnql nO0kIqq ON sill Vitt "N 10 krq"r4IIN(1
X
41 All CONSIR"fCION 41 NFFl 111? [ XFFFD All IUCAI C ODE % AND "M
kFQ" lRFNFNK'
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vlolkailpd denvilVtio"n of all requirwrl j "sporl, io"s on my home
installation . I hPlvhV A-011MV all rewpn"wibilily for kh- suh-d"Ji "q " I thww" Ioqlf
• itiqpPrilo"n If Woks roquirod iri-p"cl- iony Are not rPqnv4VPd i ""p- t -4 and niqn-1
otf ( apyrovvd ) by thR innp-rt-or in thr prpsciihorl "rdpr . I u0i " I ; —
Wey and Mn hourly ; "vPqtiq"li "n Ivo pivlo"Mnl I " IhR I "ql "HI . lawl , n "ili
K addition to my "Iioioal pprmiV lv-v lo tovoloo any quenli ""mbly prafil ,
ptohlpmv Lhah ha-P boon dictovored . I furkh-r "ndPrqEA"l Choi this., i "v"4liqAtI (
he nched"Ipd aw Lime al lolls _ until rpoolbri "not ony /011- plobt"m- no om "Pawy
In4ppcti "n ) will he quamb-d loi Tho ravide"xe
"WMl R /I "MrNArlOP ( indicaI 'P uhith) SirInaturp
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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/Y1 Permit No. C1 3- i L
OMASON COUNTY
BUILDING PERMIT APPLICATION
�O y�j►� 4 Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEAS v O
#1 nv FTC Phone# S 0 Q-q ci - 'S
e Ad C. 13.0 K 1LrV%A KNQ'c.1< PLO . Fire District# S
city It St w,g zip
Dire ions to Job Site L K (10 iV oLQ cYmr- RD 1P6 f#T urn Cx,o LY.,V /24
0 CQ C-A r ON K l c n^R lLNo c,►G POOL .) l..or i g ,- A MKCn
TL-1- DXAN4a IZ( s3bur+ S [per T(lC S .4rwO HnS A YELL. Q r(^.L
�GPT Sr-AryoprrC- )A F(Lu'r.� Ul' iT'
Owner Mailing Address & i 1� 41 i ryiAAr)oc-K R..n
City S)-Ff-L-rori St [",'p Zip R6 sUg
Lien/Title Holder rK1/p(L%c H 14. z lrS[�ISS
Address Pao' i3o.,x /5c'
Clty St L✓P Zip QSSS(.
#2 Contractor Name -;1E—= A U/A LI.F_!f I' x--C�i Erx,. Contractor Reg# it rN-LL-E'Q -14(3(c
Address I-)3o ti, W( i'utkF t; Expiration Date 0 / /_�'J
City �J(...) 4LL St w/'_ Zip qti u/ Phone# Sar-Ck;-:�3Q9
#3 If septic is located on project site, include recor
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. 3aia1 -54-oc.c>ca9
Legal Description ( ,>fi t�9 D w, S' Wg Kc Lim0nucr-
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
C
#6 Use of building c. Describe work 71(, �r
#7 Type of Job: New ✓ Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 9 y Make VAL,.f,Y Model c.oQ.,r&Y c
Length5a' o Width a(o, Y," Serial No.
# Bedrooms_ I # Bathrooms Type of Heat 14&],T POMP
Purchase Price$ 55. ?a(e. ky
#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
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
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
ly
r o
�S
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_ o %
� i t
�-� -> > 3 J
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t �
c-� G— cr Linn
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbingr h Fee Mechanical Fixtures ($6 each)
No. -'� Toilets CIRCLE FUEL TYPE: Gas, ectri
Bath Basins Heatpu�, Other
Bath Tubs No. Units Fees
Showers Furn BTU
I Hot Water Htr Heatpu ps
i Laundry Washer t Systems
Sinks Spot Vent Fans
Floor Drains No. Boilers/Compressors
Laundry Basins HP
Dishwasher No. Air Handling Units
Disposal cfm#
Urinals Fire Protection Systems
_Other _ Auto. Fire Alarm Sys 50.00
ed Fire Supp. Sys 50.00
ermit Basic Fee 15.00 Auto 're Sprink Sys 25.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pelle tove
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.
X OWNER ;.A;,.A,__ 'h-. g,.;, - X BY
DATE iul a-1 C13 DATE
FOR OFFICIAL USE ONLY: Accepted by: Date: j
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
'(fin ���-� 1 i a S �c�wi
eC1S9- n 6 ; i Yei�)e,�
Environmental Health:
,
Building Plan Review N SOH LA- QG2 mP7 6, .S c=S ri1 r/ c.4ro,cAlQ--i'
Occupancy Group: 3 M ype of Const: SN
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
Building Valuation: TOTAL FEE