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MIS95-00794 Cancelled Mobile Home Storage Only - MIS Permit / Conditions - 10/9/1995
MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 M I S C: >= L L._ A N FF C3 tJ lc�; P!= R M I T FOR INSPECTIONS CALL 427-9670 MIS95-0794 PARCEI_ :321341490010 PLATa DI1/ : BLK : LOT : JOB ADDRESS : E 672 MiKKEL.SEN AD SHELTON APPLICANT : SANDRA GARDNER 426--4298 OWNER : SANDRA GARDNE R 426-4298 LEGAL t 1112 SE SE IF I!1 OF CAI( TA A OF Sf i01A PROJECT DESCRIPTION : MOB I L_E HOME: STORAGE PERMIT PROJECT LOCATION : MIKKELSEN RD TO BRIDGE 1ST RIGHT TO END OF DRIVE PROJECT NOTES : Cranberry Crook - Conservancy designation TYPE AMOUNT BY DATE: RECEIPT zm�m STi`E $ 4 .50 NJP 10/09/95 4048- PRMT $ 15 .00 NJP 10/09/95 4048 TOTALt 19 .50 OWNER Ct ACENT AT ,118till, rev: 041#1 i 92 COMPLIANCE TO ATTACHED CONDITIONS IS 116U I RED CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by PLUMBING date by OTHER Groundwork Attic date b date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Case No . t MIS95-0794 For : SANDRA GARDNER Page , 1 1 ) The proposed projeci mtist be consistent with all applicable poll (,,,- ies and other, provisions of the Shoreline Management Act , Its rules , and the Mason County Shoreline Master Program . Proposal Is located within a shoreline designation requafteed as a Conservancy Environment by the Shoreline Master Program . X_ Proposed structure or any portion thereof greater than 30" In tteiqht from grade I I ne, must maintain a mi n Imum of 25 ' setback from a I 1property I I nes , easements and r igh� of-,ways and a mI n imum 50 ' setback from Cranberry Creek X 3 ) Proposed structure or portions thereof with art projection over 30" in height f roin grade line, must maintain a 5 ' separation distance between adjacent structures and that 'furthest project Ion . X 49 This permit is being Issued to the applicant to allow the moving of this mobile home. onto his/tier private property to perform the necessary oorreotions to this unit to bring it Into compliance with HUD Standards , and get the unit reeertifled by the State of Washington Department of Labor and Industries . This unit is not to be ocoupled , No utilities are to be connected to the unit . No permanent set up Is to begin . This permit ——————————— MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Is valid for sixty (60) days only . No extensions will he granted . Any violation of 'the conditions of this permit or the denial of a permanent installation permit will result In the determination that the unit must be removed from the property At the expense of the owner . 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I., I I ""' i: :::- 1-,,Z,-',,�','1'1'1.i,-.-,.-...-...-,.,.",,- �.,... .. i..... .......... � ."". ........S :. .. -,...::.;:::::.:.%.......411 I, "I'll", ..', I ::::::.. : ..i. .. . ... . ,, ., ..., :x. .*.*.,.*.,I.. ..... - . 4�--.............-.....0........-....:..:..:-:-:-:-:........ 1! ............. ................ ......-,,-, Copyright 0 1997-1999 Tidemark Computer Systems Inc. 3/21/01 All Rights Reserved. � r r 3/21i01 Information Summary for Case #: MIS95-00794 1:04:53 PM Activity Hold Updated Activity Description Date 1 Date 2 Date 3 Disp. Level By Updated MISA010 Application received 10/4/95 KW 10/4/95 MISB135 RLC Checklist Review 10/9/95 SHR GBM 10/9/95 conservancy designation-Cranberry Creek.Mobil is approx.200'from creek MISB110 Structural Plan Review 10/9/95 10/9/95 DONE TLG 10/9/95 MISB130 Planning Review 10/4/95 10/9/95 DONE GBM 10/9/95 MISA050 Approved For Issuance 10/9/95 DONE NJP 10/9/95 MISA500 (F)Issue permit 10/9/95 DONE NJP 10/9/95 MISA920 Miscellaneous action 10/9/95 DONE NJP 10/9/95 CUSTOMER BROUGHT IN L&I FORM. I MADE A COPY AND PUT IN FILE. ISSUED THE PERMIT. PLACED THE FILE FOLDER IN PAM'S HOLD SHELVES WAITING FOR PUMPER'S REPORT. Condition Cond. Stat. Changed Updated Code Title Hold Status Changed By Tag Updated By 0070 Shoreline Management Act Not Met 10/9/95 GBM 10/9/95 GBM The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules,and the Mason County Shoreline Master Program. Proposal is located within a shoreline designation regualted as a Conservancy Environment by the Shoreline Master Program.X 5025 Sideyard Setback Not Met 10/9/95 GBM 10/9/95 GBM Proposed structure or any portion thereof greater than 30"in height from grade line,must maintain a minimum of 25' setback from all property lines,easements and right-of-ways and a minimum 50'setback from Cranberry Creek. X 5026 Structure Setback Not Met 10/9/95 TLG Proposed structure or portions thereof with an projection over 30"in height from grade line,must maintain a 5'separation distance between adjacent structures and that furthest projection.X 5000 Conditional Installation Permit Not Met 10/9/95 TLG This permit is being issued to the applicant to allow the moving of this mobile home onto his/her private property to perform the necessary corrections to this unit to bring it into compliance with HUD Standards,and get the unit recertified by the State of Washington Department of Labor and Industries.This unit is not to be occupied.No utilities are to be connected to the unit. No permanent set up is to begin. This permit is valid for sixty(60)days only. No extensions will be granted. Any violation of the conditions of this permit or the denial of a permanent installation permit will result in the determination that the unit must be removed from the property at the expense of the owner.X Fees Fee Trans. Create Created Type Description Code Revenue Account No. Date By Amt.Due STFE Building State Fee 386.00.05 NJP $4.50 PRMT PERMIT FEE.......... 322.10 NJP $15.00 Case People Listing Role Type Name/Address Company Name Hold Primary APL SANDRA GARDNER Y E 672 MIKKELSEN RD SHELTON WA 98584 - - ,,. I : 1 , PERM lT*PLAN ................. --------------------------� -,�.---'-'---------�.-�.:---------------.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.- ::::: .,.:::::::::::::::::::.",.,...'.'- ........ . . ....... . ...... ....... ............................ ....._... : :.... . .... ............................ . Lx�j _......... . ... - ................,... P.����."...".'..*'.��"""............... , - ... . . :::: ..... .. ..- _.............4," Uw ................ .. .......... ....... 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SM.$ .. - - : ........ . 110: .... :+, a . .....................'....... , � .9 .. , - , I I . .. ..::. ......�.-,, . . .1. . .......... . ....... . .......:;:. .................... ......... *,*,""*,,*,,-,,,,,,,,****"**,,,,,,,,--- ,,,, ,,,,-----------I,I-----,,,--,,,,,,*-------- I I - -`�- I; I .:1 Idw ,*,*,,,,",",","",, - ..-.._- - -...`-..- -...`- -.....- -`...-` I " - 10 Copyright 0 1997-1999 Tidemark Computer Systems Inc. 3/21/01 . All Rights Reserved. 3/21/01 Information Summary for Case #: BLD95-01494 1:04:24 PM Activity Hold Updated Activity Description Date 1 Date 2 Date 3 Disp. Level By Updated BLDA010 Application received 10/4/95 KW 10/4/95 BLDB134 RLC Checklist Review 10/9/95 SHR GBM 10/9/95 BLDB135 Addressing 10/5/95 DONE GMM 10/5/95 BLDB110 Structural Plan Review 10/9/95 HOLD TLG 10/9/95 do not issue until L&I papers are submitted BLDB130 Planning Review 10/4/95 10/9/95 DONE GBM 10/9/95 BLDB200 Environmental Health Review KW 10/4/95 BLDA900 Telephone call 10/9/95 TLG 10/9/95 1 called her today and she has L&I permit which she will bring in for us to photo copy. This unit will replace the one on site which is to be demolished when the new one is made liveable. BLDA920 Miscellaneous action 10/6/95 DONE NJP 10/9/95 CUSTOMER BROUGHT IN L&I FORM. I MAKE COPY OF FORM AND PUT IN FILE. ISSUED THE STORAGE PERMIT AND PUT FILE FOLDER BACK ON PAM'S HOLD SHELVES WAITING FOR THE PUMPER'S REPORT. Condition Cond. Stat. Changed Updated Code Title Hold Status Changed By Tag Updated By 0070 Shoreline Management Act Not Met 10/9/95 GBM 10/9/95 GBM The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules,and the Mason County Shoreline Master Program. Proposal is located on Cranberry Creek which is designated as a Conservancy Environment and regulated by the Shoreline Master Program.X 5025 Sideyard Setback Not Met 10/9/95 GBM 10/9/95 GBM Proposed structure or any portion thereof greater than 30"in height from grade line,must maintain a minimum of 25' setback from all property lines,easements and right of ways.X Case People Listing Role Type Name/Address Company Name Hold Primary APL SANDRA GARDNER Y E 672 MIKKELSEN RD SHELTON WA 98584 PERM lT*PLAN -------------------- ............................... ...... ... .. .................... %........... .. .....................4' ....... ....... ............... .................... ..................... .. ........................... ....... ... ... 3. ..................... .......... . ............ .... ........ ................ ........ .. ............................. ............ . ..................... ..................... ..... . . ... .. ....... .... ............ ................ ........... ......... ..................... ..................... ...................... ......... Building Permit B LD95-0 1494 Status P ------------- ------------------------- .... ---------------------- Uw ................. .............. ................ ...... ............... ............. .... ......... ................... . .................... ........ .................. ................ .......... .... ....... .............. . .......... ........ MOBILE HOME REPLACEMENT ........... ...................... .......... .............................................................................................................................. ........................................................... .......... ............... ........ .. ....... ......... ..... ... ........ ........ .......... ................ ................. ....... ................. ............. ......... .......... .......... ......................... ....... ................ ... ........ ... ........ .......... .............. ........ ....... .... ...................... ............. .... ...... ....... ........... ........... FLAMINGO . ......... ............... ................................... .. ....... . ...... ............ ......... .................. ............... . ....... ...... ............. . .............. ...............:x. ................ ....... ..... .. ....... ....... ................................. .......... .................... .........-... .......... ................. ................... ................ .......... ............................ .......................... ........... . .......... . ............. ................. .......... .......... ................... .......... .............. ...................... . ........... ........... .......... ........... ..... ........ ................ . .... 'a ............................ ......... ...................... ....................... ....................�kkk ........................... ............ .......... ............. ....... ............... ........ ... ........... ... ..... .................. ........................... ......... ... ............ .......... ........ ............ .......... ............. ............ ............ X. ......... .... ......................... .......... :X ------- - - ---------- ......................................................................................................................... ................................................................... . . ........ . ....... . . . . ............ ................................. . ... ........ ................... ... ........... ............... ............. ::::: . ........ ....... ... .... . . ... . ..... ....... . ..... .......... 0 JA -::.i, %4:A... .M.4 . ............ ............ ................. ......... ............................ ................................................................................ .......................... ............. . .... ... ... ...... PER M I .... ----- .... ....... ............ ..........-.... ....... ....... D9 Copyright 0 1997 1999 Tidemark Computer Systems Inc. 3/21/01 All Rights Reserved. 4 PERMI-T*-PLAN ................ ................ ........... .... ....i*--i*--*--*----�-------- .............ili* ............................... ......................... ............ .......... ................ ............... ............................. ...... . ... . ..... "..X .. ..... ....... .... ...... ................................ ........... i., . ................... : ................. ................................... ...........".........I..."....-..-. ..."....,..- .,.-..,Ill"."..—........"."..".."..-..". ...... . . . . m--,%-..-."""... ..a. M I.Mm.... E ...... Ji1 ...I.................................J.............. ....... ... -------------- ............ ........ 'Wi Enforcement ENF96-00127 Status PEN 10 ----------------------------- ...................- ............. ---- - T,----— -T.-p- ... ............ ..............:..1.... .-....................... ......... ............. ........... ........... ............ . ....... ...... .......... ................... . .......... ................. ...... ............ .......................... ...... . ........ ... . ..... ......... ................ ........ .......... .......... ...... .... ...................... -........ ........... ... ....... .......... ....... X .... ......... L D95-01494 ............ ............ ... ....... .x. . ........living in Mobile Home that hasn't been permitted .... ............ ................ .... ............... ... ................ . .... ............... ... ................ . .... ............... ............ ........................... ........ ............ .................................................. ................................................................................................................................................ ..... .............................. .............%...... ............ .... ............... ...... ...................... N ........................... ........................ ................. ......... ........................... .................. ................ .... ...................... . ...... ... .. .. .. ......... ......... ........... xxxxxxx:". . ..... .... ...... ..... ................................ ....... . .......... . ........................................................................ . ............. ........................................................................ .............. ........... ..... .... ....................... ............ . ..............................%........... ............... ..... ................................................................................. ..................... .. ............ .................................................................. ..... . ............................... ................................................... .............. :.*. . .......i...... ...................... ........ - ........ ........... .......................... ......... .... .. ...........:::..: .......... .... ........................................................................................................................................... ..... ........ ...... ...... .............................. .................................................................................... .................................. ................... m"..�i�i�i���::::*::***:,*:"::"::"::"::";:"::........... ....... ........................... . ...................... ....................................................................... ..................... .............. ......................... . ................................... ........................... ...... ................ .................................................. ............................. .............. M."... J 0"0' 04 1: 4: MIKKELSEN PD TO BRIDGE 1 ST RIGHT TO END OF" .......... ................ ............. ............................................. .............................................. ....... ............. ... .............................. . ................... .... DRIVE Qther .................................................................... . . .. ... . ........... ........ .. ........ ... .............. ....................... ........ 4 ......... ......... -........................................ .... ................... .............- .... ................. ............... ......... . .......... ........... .......... R. ................... 011�.................................................................................................................................................. ......................................... ...................................... ............. .............................. vx�vvxvxxxxxxxx.......... ............... ......... ........................... ...................... .................................................. .................... :%,.,.".",.,.,.,.,.,.'.'.'.'..'..'..'..'..'..'..'*............................ ........... ............ ................. .. ........................ ..... ................... .... ........ ..................................... . ...... .. .... ... ... .. ................................ .. ... .... ................................. .. ... .. ... .. .. ..................... ....................... .. ....... ................................... .............. .............................. .... ..... �X.011 .... ..... ..... .............. .. ... ...... .......... ......-�i ... ......................................... ............... . ....................... ..... .. ...... ....................... ..... .......... .......... ......... ............ ..... ... ...........:................................. ............ ..... ......................................... ........... ...................... ........................ ------.......................... ................................................................................................................................................................... ................................ ................... ............................... ............. ...... .......... .1.1.1.1.1.1.1.1.1.1.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I.I......................... ........ ............... ......................................... .... ......... ............................................................. .... ........................... "— : ..................................... .......... ... ....... ....... .................................. .................. ........... ................ ...................................................... ..................... . ..... ..... P15 A K :,-S.:t ... ........ . ......................-............... .......................................... Copyright 0 1997-1999 Tidemark Computer Systems Inc. 3121t01 All Rights Reserved. 3/21/01 Information Summary for Case #: ENF96-00127 1:04:41,PM Activity Hold Updated Activity Description Date 1 Date 2 Date 3 Disp. Level By Updated ENFA010 Complaint received 7/10/96 TLG 7/10/96 ENFB002 Site investigation 7/10/96 7/16/96 PEND TLG 7/10/96 Case People Listing Role Type Name/Address Company Name Hold Primary APL SANDRA GARDNER Y E 672 MIKKELSEN RD SHELTON WA 98584 - Department oi•Labor&Industries '" ALTERATION PERMIT Factory Assembled Structures Section Do not complete shaded areas S<: INSTRUCTIONS: ermtt 1. Complete all spaces,including the signature box(marked with an X.). Invoice# 2. Draw a map on reverse side of WHITE copy only. 3. Forward completed permit and fee to the nearest L&I office. See list on reverse. 4. Contact and schedule the inspection with the same L&I office within 15 days. Insignia# Owner last name first name Day time phone Date C�#1-12:f......tt�.t� .... Hfi�.-1 -f Vi m.... 2. ...�. ? ... �. .L112. .9.. '...... Address City AA --�� State IP G Installer/Contractor/Dealer Phone Contractors registration number Add .................-.......................................................................................-----............--... -......................- ........................ .............................................................. ..............--...--- ress City State ZIP+4 Check the appropriate boxes in section A and section B. FEES A $Commercial Coach Alteration Inspection(check appropriate boxes below) $75.00 ; ' Air Conditioning/Heat Pump Serial No, Electrical Electrical Appliances Mobile Home Fire Safety 10.'02 95 14:46 951919,1 Serial No, Gas Furnace 75.00 Gas Piping HUD No. Plumbing Structural Recreational Vehicle or ❑ Park Trailer Wood/Pellet Stove — — Serial No Serial No. Plan Review — — —— — — — — — — — — — — — — — — $70.00 RV Inspection — — — — — — — — — — —— — $70.00 Model No.or Plan Approval No. Reinspection- —— —_ Noma ermrt $50.00 Technical Inspection —— — —— — — —— — —— —— $50.00/hr Signature of applicant or authorized representative ake check payable to: Dept.of Labor&Industries M X FEES DUE $ tjartment use only Request approved or, Request denied heeause of specific violations of Washington rules and regulations. Violations must be corrected and"reinspection requested within 10 days for recreational vehicles and 20 days for mobile homes and commercial coaches of the notice of violation date. (This does not apply to technical inspections). It is unlawful to offer for sale, rent,or lease any non-complying mobile home,commercial coach or recreational vehicle. -- - - - - - D - 01 _ R .......... ............... - - - - .- O -- - - - .. . . .. -- ---'-EAL-'H S_RVICE 1...J Included are forms required which must be completed and fees submitted before reinspection. Date Area office Inspector Total pages F622-012-OW alteration permit 6-94 White-Olympia Green-Contractor Canary-Inspector ?'ink-Purchaser Goldenrod-Purchaser MIS _ a ` . MASON COUNTY MISCELLANEOUS PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584. 427-9670 PLEASE PRINT #1 Ow S AQD h�F�1201�C Phone# u 2(0 — i4,aq� Fire District#� Site Address r(n`7c� ►Vl I }� ne�7 City-- '1'0 ' Mail Address City ��L.'t- /J St 6 ) /a Zip Applicant Sf�N(a6�lA �. f�-� f.�/l! 1 Phone # Applicant Address S19-M City St Zip Directions to Site: P r 3y `] _�il 11-S-6A) kK leb X K EL.S ItIQ 20 k_q M 1 1, E D V L� BfQ i r41-S' # Parpel No. - 4 egal Description '/�, 51EY4I S '/L►.N L Yq 1 -5L-� 34 ► 1 1 , 12 3 %y(�T OF C2rB� #3 Indicate by circling the applicable source if any water is on or adjacent to the property site: saltwater lake river Ccr!�ek:)stream pond wetland seasonal runoff marsh other #4 Project Start Date / Q��s- Project Completion Date rvl o #5 Use of Buildiing 3-M P— l6-F (i Orl 1, M PfiS Z- Describe proposed construction jA S T1 SD Ia-�L A-T- S 70� 'ekoha..35tA � 5 NHS TO be, MOWS Tb 4Ay A-T NUIS&Slur 77"f:5' 'Depending upon the type of permit,a floor plan and plot plan may be required. 'This permit is valid for 180 days from the date of issuance. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON- MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT- ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE- FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST WITHOUT FIRSTOBTAINING APPROVAL FROMTHE BUILD- OBTAINING APPROVAL FROM THE BUILDING DEPART- ING DEPARTMENT. MENT. X OWNER 4 �,��t_u y..� CY•l�lll.C. X BY DATE / /2.f Ct.S DATE Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Wells Water Lines Shorelines Drainage Plan Easements Septic Systems Name of Fronting Street Indicate directional by Proposed Improvements Name of Flanking Stree N, S, E, W etc. PLOT PLAN AREA v 0 r II FOR OFFICIAL USE ONLY:Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Planning r > > APP COND APP HOLD Building Fire Marshal Other Special Conditions Fees i Permit Fee $ Plan Check Other Other State Building Fee TOTAL DUE $ INVESTIGATION REPORT FORM 'j, a C�6Revised 10/6/94 � Part A: Nature of Complaint • Initiator's Name: • Address: • Telephone: • Owner Name: • Address: • Telephone: • Department of Concern ❑ Clerical ❑ Building ❑ Health ❑ Comm Development ❑ Fire • Area of Concern: ❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other Refer to Director • Loc ti n of Concern: r� • Mture of Concern: A cern Intake and Referral eferred To: Response Date: Date Name Date Date Part C:Findings Referral Forwarded to: ❑N/A i Name Date 4 Findings: dG O-,P /1*709/Le #0407E > 60,095 ro ,d.E STo e.E.o r.clL y. 6 & ,��5 aEE� ��otiE� , Yf��i�� T.eucrtic� Part D: Resolution Name Date Intake Copy-White File Copy-Yellow Referral Copy-Pink ,QpNo l' R y-/8.9G l - 44 - r� I �� �� �l � � a � .� ..l�af,rc,,. .wr .. 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