HomeMy WebLinkAboutBLD97-00118 Cancelled Mobile Home - BLD Permit / Conditions - 10/22/1999 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
t. ON W
C1L.r 8rani 421
BLD97-01 18 PAPCEL t.s 2 1 /5229001 3 PLAT : D I V :? Pt K
JOB ADDRESS t E iOSfi MiKKrLSEN RD SHF1 TON PFEWIff
OWNER : MICHAEL ROWLEY 426-9478
CONTRACTOR t NULL & VOID BY EXPIRATION
L.EGAI. : TO I-C OF If NW NW TA 3 Of SP 12112 f 1056 1111FISEN RO L1 qq BY l�
DATE.
CLASS OF WORK . . /NEW BFDR1 BAIHt 2 TYPE AIIOUOT BY DAIS ALCEIPT ITY►E AVOt101 E DIE RECEIPT
1 YPE: OF USE . . . . :MH STORIES . . . . . . . .. 1
OCCUP . GROUP . , . :? BI DG . HEIGHT . . : O .Nf t IN, � 1 44.00 11:11` 13113191 446$9 1
TYPE OF CONS>T . . - ? FIREPLACES . . . . : 0 ISTFF
NNOF S 155.04 NJP 03f13�9T 44080
OCCtIP . LOAD . . . : 0 WOODSTOVES . . . . t 0 1 4.56 NJP 03113197 441910 E
DWELL .UNITS . . . . r 0 PARKING SPACES : 0 �EHCP 1 26.19 NJP 13113t97 44181
INSPECTION AREA : 2 SHORELINE? , . . . tN TOTAL. 229.5/ VAiUTATION� j6211
SETBACKS- - - -- -- 701 LETS . . . : 0 FUEL TYPES- - - B0 I I-FRS/COME' •_ MOBILE HOME:--
FRONT . . .F 5 .oft PATH BASINS , . . . . . : 0 t 0--3 HP . : 0
REAP . . . .W 5 .Oft BATH TUBS . . . - . . . . . 0 3-15 HP . 2 0 MODEL :
S I DF ( 1 ) .N SO .t0ft SHOWERS . . . . . . . . . . . 0 FURN < 100K BTO t 0 1 3-30 Hp . : 0 --MAKE- - -
SiGE (2 ) ,S 5 .Oft WATER HFATERS . . . . t 0 FUAN }-100K STU : 0 30-50 HP . : 0 CHAMPION
SHAL I NE . O .Oft CLOTHES WP SHERS . . t 0 FURN FLOOR . . . . 0 50•+ lip r 0 YEAR---.
AREA -__. .-_ ___.__._.__.. - _-. KI-TCHEN SINKS . . . . : 0 HEA1 PUMP . . . . . . . 0 61
I OT SIZE - - FLOOR DRAINS . . . .., t 0 VF N1 SYSTEMS . . _ 0 E:VAP COOLERS t 0 L E:NGTFI t 56
BUILDING — : Osf PkINVING FOUNT . . . : 0 VENT FANS . . . ... . . 0 HOODS . .. . . . . . : 0 WIDTH . t24
BASEMENT . . . : Osf LAUNDRY TRAYS , . . . . 0 DOMES . INCIN :O -SERIAL#--- -
DECKS . . . . . . : 09f D I >i4Wk3HERS . . . . . . . 0 AIR HANDLING UNITS--- COMML . I NC I N tO
GARICARPt? Osf GARB SPOSAI.S . . . : 0 r:= 10000 ofm . : 0 RELOC/REPAIR : 0
AT/DT . :? URINAL . . . . . . . . . 0 1000O c•f"I . . 0 OTHER UNITS . , 0
1'.1I Sc P1.) f7 I XTURE t 0 GAS OUTI_F TS 0
�zx,aaxmssnr_sc.ease+v.-.aa:sr, :u .:z�ana+rs..:,mc.,n,,,rsaes•••••. -y:.^•-7.sa•:szrs^r�aQ�-cx:aoc•.rc .rn:cw.--aaimra�:::a.vrae�sexr= sa:-rc�cG.::: :,xes<�a.�mss�arc::.. :s:—.a.::.-•rc+s.�,.. .co- -:.rs�.,:K e::•,a-a.r:x
PROJECT DESCRIPTIO1140AILF HOVE
PAO,iECT LOCAIION;kEA6 OUT OF $NELTON ON HWY 3 TURN LEFT ON VASON IAKE RO, TURN PIGHT H IIII(KELSEN NO CAOSS THE B&IDGI, TARE THE NID@Lf 1A.NE AT THE IHRFF WAY
SPLIT IN THE ROAD STAI TO THE 11CNi FOLLOW TO THE ROAD END,
TN1S PtIVII ALCOVES NULL AND Y019 If WORK OR C011STIUCTION AUTOO117ED IS NOT COVVENCED WITHIN 180 DAYS. OR If CONSTRUCTION 09 WORK IS 93 PENDED FOA A PERIOD
OF IA/ 11 $"AT ANY TIMF AFTER #ORt IS C1li"CEO. EYIDFICE� OF COWTINUAJION Of WOIK IS A PROGRESS TNSPECTIO4 WITHIN THE 161 DAY PfA100. FINAL e4SPfC1100 1831 B�
APPROVED UFORf BUII.OING CA B�OCCU►IE1F:` / :, �+
QWNfR AGf.MTt � •� •{.�` � � ;% DATEt- -_ _
rev: 111311A1 < my
IANCE TO ATTACHED CONDI VIONS IS RE OUIRFD
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons _
date by Gas Piping date J �V 7 b 4 fg
Foundation Walls date by Set Up
date by INSULATION date(o-1 rT b
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER -s e-e;VE1) >12
Groundwork date by
date b
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
I
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Case No . : BLD97-0118
For : MICIIAFL ROWLt=Y
Page ; 1
1 ) The under s igne?d property owner Is aware of the tincerta i myy regard i rig Mason County 's
development regulations created by the Growth Managment Hearings Board 's Order of
October 2 . 1996 , and in #.onsideration elf Mason Cotrnty 's willingness to proveed with
processing of a�pllcations which might be affected by the Order , the undersigned
property owner ereby agrees to waive any lawsuit , action, or claim for- damages egainst
Mason County which may arise out of Mason County 's ae;tions In acceptance prooessing
and/or I ssuanne of sunh permits or approvals ( hereinafter "perm i tt. i ng ac{ i cans" ) , which
damages are ottributabie to the County 's decision to take permitting actions despite
the risk that changes to the County 's development rec.luiatIons might Later make the
Countyr.".-L,15erpiltt I ng aot i ons Invalid ,
2 ) The use, hand I i ne1 and storage of hazaruous niater i a l s or flammable and combust I b l e
liquids In excess of 10 gallons is not allowed without the approval of the Mason County
Fire Marshal .
3 ) Proposed structure or anv portion thereof greater than 30" in heri %lht from grade line,
must maintain a min #m,rpt of 5 ' setback from all property l ► nee , easements and 10 ' from
aX 1 l Co4.ntl4 and StateRoad right of ways .
Q ) Applicant sok now I edarts that this development i y sub i ee..t to policies and reuu i at i ons of
Mason. Cgunty Comprehensive Plan and Development Re4u I at i ons .
X
S 'l Placemmttnt of structures must comp# )/ with standards setf r-th per USC sec . 2907
regarding desc�eand i ng and/or amending slopes . X _
6 ) This app I i r.at i on Is subject to Suffer and L andsuap i nq r-ebqu i r ement.s as established under
Mason County Ordinance 1 .03 .036 .
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
7 ) PURSUANT TO 19., ; ;N I f : i NG 30. .; ) AND `LI
HAVE APPROVED NOMSERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO f E. PLAINLY VISIBLE
AND LEGIBLE t ROt;i rHF STREET Oft ROAD FRONTING THE PROPERTY , MA CON COUNTY BUILDING
DEPARTMENT REOUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
RE ! NSPECT I ON F'F.E . BASED ON RATES IN TABLE 3A OF It-IF 1994 UNIFORM BUILDING CODE WILL BE-
ASSESSED IF OVVNFR,'CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
INSPECTIONS .
X__.�L _
8 ) ALL POND DUCT I ON MUST MEF "F OR E XCFFD ALL LOCAL CODES AND UPC RFOOI REMENTS .
9) REQUIRED INSPECTIONS ( Footing Inspection-prior to pour , Set -up Inrpeotton-prior to
skirting, Flnal Inspection--prior to occupancy ) . I have received a copy of the General
lnforma� ion and Guide ! InQs-��toL�i ItelManufacturead Housing lnr:ta ! ! at leans andoert for
detailed deasoriptions of till required Inspections on ray mobile/manufactured home
Installation . I hereby assume all responsibility for the scherdu i 1 recl of these required
Inspections . It these required i nspeot i ons are not requested, Inspected and signed
off ( approved) by the inspector In the prescribed order , I understand that repInspection
fees and an hourly Investigation fee pursuarit to the 1991 UB0, Table 3A will be assessed
in addition to my original permit foes to roso i vev any quest i onab t o pract i oEes or
problems that hav,a been discovered . I further +.rnderstand that this Investigation wi I i
be scheduled as time allows . lint 1 l re!E o 1 ut l on of any/all problems no occupancy (Final
Inspection ) will be granted for the residenoe .
OWNER!CONTRACTOR ; I net i cate. wh i oh ) Signature X
10) All mobi 1 e/manufr;ctured home 1 and I ngs or decks mast be free!3tand i nq ( self supporting ) .
The largest landing or, deck permitted without drawings or a building permit Is 36" r.
36" . Any landing or deck that is 30" or more In height from walking surfaces to finish
Rradp requires a gitardr a i l . Any land i ng or deck that hats 4 or more risers requires a
handrail . Any I and l rig or deck larger than 36" x 36" must be permitted which requires
struotural drawings and a b llding permit application . This Installation Permit does
NOT inolude any landing or %ck larger than the 36" x :36" slae .
11 CONSTRUCT I ON PROCESS TO BE is I EL D CORRECTED A`' StOl!i RED PER MASON COUNTY Bit I L.I)I NG
DEPARTMENT AND UNIFORM B111 LD I NC CODE .x 'j
GARY YANDO,DIRECTOR
yON.STATFo
M
A p DEPARTMENT OF COMMUNITY DEVELOPMENT
x
o
T i PLANNING -SOLID WASTE-UTILITIES
N Y Y BLDG. I • 411 N. 5 ni ST. • P.O. BOX 578
of 1864 aO SHELTON,WA 98584 • (360) 427-9670
DISCLAIIIIER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS,SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created
by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's
willingness to proceed with processing of applications which might be affected by that Order, the undersigned property
owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of
Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting
actions'),which damages are attAx table to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations might later make the County's permitting actions invalid.
c4 (5 0 �c --�tbOl�a
Da (Parcel No. or Legal Description)
Property owner's signature(No
(or the County may accept the signature o the owner's authorized agent upon proper proof of authoriza ��•®�\
•
�• 5
a x•�'tAOTM y�
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL)
PUBLIC ;
�.<
STATE OF �% 9�•�•06���e•,� f•
COUNTY OF
On this ja day o _, in tth^^ e`
e year�,before m4( 1l�I t! 0 9�Ia T_Notary Public,
personally appeared 1 I4� personally known to me to be the person whose name is
subscribed to this instrument, and acknowle d that he/she executed it.
WITNESS my hand and official seal.
-For County use only-
Reviewed by applicant on
(Date)
Notary's signature
My Commission Expires: Staff Initial:
1i�Cy.:le:1
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
0.
PLEASE PRINT
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
j f
W
r V1 l Phone# � — 9���ddress Q S (� Fire District#St Zip
Directions to Job Site Allam. vZon
-�
Owner l4ailing Address a` ' ,,P
City St Zip
Lien/Title Holder
Address
Clty
#2 Contractor Name Contraci5 eg#�
Address Expiratioate - / /
City St Zip Phones O i/
#3 If septic is located on project site, include records. �L
Connect to Septic? Public Water Supply Well G .
Connect to Sewer System? Name of System .
(If residential, proof of potable water is required)
# a I No.3 al35- - 0J3
egal Description r 1 i �, 6V A-la-) 7—k-34P
pRC�IC Vyu(�..�lJ1 rrw- &;" "�Q' j cz
#5 Building Square Footage: (existing/proposed) �C Np P L{�}� oT NLLupc(�
Ll
1st FI / 2nd FI / 3rd FI / 1 Loft N / rptP P
Basement / Deck / bedr a roomsgk
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building 30 )Q. J�'f t,J,dQ' a!�,� ��YYIl . ZC �2S escribe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model !2!f �
Length Width 2q / Serial No.
# Bedrooms 3 #Bathrooms .-e Type of Heat E/o C
Purchase Price$ 414a 0. �a
#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
Indicate Directional by (N, S, E, W)
Name of Flanking Street , in relation to plot plan
Name of Fronting Street K� c q
APPLICANT TO DRAW SITE PLAN BELOW
�7
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
�� od`�
Plumbing 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 BTU
Hot Water Htr Heatpumps
_Laundry Washer Vent Systems
Sinks _ Spot Vent Fans
Floor Drains No. Boilers/Compressors
_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 NULL AND VOID IF
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 16.75
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
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 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 OBT IN APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEP TM DEPARTMENT.
c
X OWNER X BY
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by: Dateti
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Health: )
Building Plan Review (�J�
3�u
Occupancy Group: j2- 3 Type of Const: Sly
Fire Marshal:
Other:
Special Conditions: ______ FEES
No P(,Pr,/ S Icbg- Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee 44. SC)
Other
Other E4
Building Valuation: TOTAL FEE