HomeMy WebLinkAboutBLD97-01429 Cancelled Mobile Home - BLD Application - 1/28/1999 S] MASON COUNTY
DEPARTMENT of HEALTH SERVICES
Shelton,Washington 98584
(360)427-9670• Beifair:275-4467
ENVIRONMENTAL HEALTH PERSONAL HEALTH WATER QUALITY
P.O. BOX 1666 303 N. FOURTH P.O. BOX 1666
January 12, 1999
Rita & Robert Thomas
791 SE Crescent Drive
Shelton, WA 98584
RE: B1d97-1429
To Whom it May Concern,
The above reference permit has been on hold in Environmental Health
for at least six months . You must respond to this letter either in
writing or by compliance within the next fifteen working days .
If you do not respond we will send out an inspector to check if the
project has been completed without a permit, a double permit fee
will be assessed. If no work has commenced the permit will be
canceled and plan check fee of 0 . 00 dollars will be due.
If you have any questions please feel free to call me.
Thanks,
Trish Wagner
(360) 427-9670 ext . 287
P.O. Box 1666
Shelton, WA 98584
attachement : copy of original letter to comply
0
31-
5"
4 _1"
10'-0"
109'-3"
12-0"
26'-0"
FUTURE GARAGE
DRIVE WAY
q-
DRAT 4 FIELD N
107-11" HOUSE 52'-0` I LINES 155' LONI EACH I m 90-O
--4 10'-0 W a
10-0"
3'-7"
27'-4` 10'-0"
90-d'
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 ner i J?' b �7- /4p Phone# `- , / "/ � Gar
w
rSite a Address ✓ Fire District#
City St _Zip
Directions to Job Site t977 -
n '�
Owner Mailing Address :Rt Ji5. 1� b ✓+ 3 -71?/ (.YL° I'1-r< 'Drl ye
City ����Q �C�'1 St q Zipqa-1534
Lien/Title Holder G-K01 rl L :72e%F,c1 --,erviejna e(?✓D
Address 1& &)( 3,,jq6 J
City Fe-eJP_✓aj wni-" St WA ZipqYW--,bgib
#2 Contractor Name Contractor Reg# HOUSE&a--nc,
Address _ C I U• /rY�� _ Il'���r� �� Expiration Date O Z / c7 2J-1112>
City Weyea, ✓Lt St IA)4 _Zip 8 '-7 Phone# 4E -qql -7
#3 If septic is located on project site, include records. RBI,4-L+
Connect to Septic? --S Public Water Supply 1 Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 rcel No.�lQ_-��
Legal Description V +
#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. /
#6 Use of building Llel7 to Describe work
#7 Type of Job: New_X Add Alt Repair W1 y E 0 W E D
#8 MOBILE/MANUF TURED� DEC 23W
FORMATIO /
Model Year Make' Model J '�
Length Width Serial No. �
PERMIT ASSISTANCE CENTER
# Bedrooms # Ba hrooms Type of Heat
Purchase Price$
#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 CJ/,IQ
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
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
v31 r
j4
e l
Plumbinq Fixtures ($3.35 each] Fee Mechanical Fixtures ($6.75 each]
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins Heatpump, Other
_Bath Tubs No. Units Fees
Showers Furn B
_Hot Water Htr _ Heatpumps
_Laundry Washer _ Vent Syste s
_Sinks _ Spot Ve Fans
Floor Drains No. Boil s Com ressors
_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 16.75 _ Auto Fire Sprink Sys 35.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT BECOMES NU AND VOID IF
WORK OR CONSTRUCTION AUTHOR ED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF NSTRUCTION OR Permit Basic Fee 16.75
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD
OF 180 DAYS AT ANY TIME AFTER WORK IS COM- TOTAL MECHANICAL $
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 OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUEO AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORM REWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE W,ROUT FIR OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE ILDING DEP TMENT. DEPARTMENT.
XO R XBY
TE f Z - Z DATE
FOR OFFICIAL USE ONLY: Accepted by: / Ili Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: 4xcl h G �Gc�►/j /fJP�%
D/
Environmental Health:
Building Plan Review 11J
Occupancy Group:tL 3 Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit SS• o�
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee (4• YC'
Other
Other
Building Valuation: TOTAL FEE