HomeMy WebLinkAboutBLD93-00501 Final Mobile - BLD Permit / Conditions - 9/5/2001 MASON COUNTY PERMIT
Mason County Bldg, 111 426 W. Cedar NULL & VOID 13Y EXPIRATICJ
P.O. Box 186 Shelton, Washington 98584 DATE B I y A:A4)
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date
Foundation Walls date by Set Up
date by INSULATION d by
BG/SLAB Insulation Floors
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date
PLUMBING
Groundwork Attic
date by
date b
D.W.V. WALLBOARD NAILING
date by
date by
Water Line FINAL INSPECTION
date by ate date by
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Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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BY FLEETWOOD®
BK/48/SEP92
BETTER HOMES SYSTEMS, INC.
Every Person who buys a home
from you needs to have these documents to obtain a building
permit from usll
1 . ) Copy of ernest money agreement
2 . ) Transit of America
3 . ) Business license of set up contractor
4 . ) Every home requires :
In` Park
a. Tie downs
b. � Skirting twin rib
Private Land
a. ) Pitset back fill skirting and tie downs
1 . ) option cement runners
a. ) -Standard
b. ) FHA
b. ) Thurston, Kitsap and Mason Counties
1 . ) twin rib skirting and tie downs
a . ) pitset optional as cement runners
FHA and Other Mortgage Companies Require
a . ) Pitset
b. ) FHA Runners and tie downs
For Building Permit, the customer will need this information:
1 . ) Transit Homes of America
2 . ) Dot # 321677
3 . ) W. UTC # 15019
4 . ) FTC # MC170105
5. ) Need name of driver
Loulse : ( 800) 669-6503 ( fot quotes )
Fax # (206 ) 37-0150
0
NEED TO OBTAIN BUILDING PERMIT
GAVE COPY TO CUSTOMER
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Short Plat for'
' Rut 424 Fe 08ri SNORT PLAT No. v/FlG�
+ Robert Mikkelsen
,.z E 992 Nikkeleen Road AP EV
E
Shelton, WA 98584
494�$� �Ert�IL'E9--
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35 N. CUUIUY
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70
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No. 57134 ,
Robe-, I' Mi kkalscti !
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WARNING; Fuson County has no responsibility to build, improve, '
' maintain, or otherwise service the private roads contained
within or providing service to the
the Short Subdivision. Property described in
.SNORT PLAT OF the Went half W'
( �) of the North half N
� h o half (w.V) of the Northwest quarter N{ ) of the E the West
qyuarter (tRlk) of Section 35. Township 21 North. Range
9•tilcat,'W,M. ttaic:2 Fto. 52153 22 00U30.
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VAULT- ti
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 Owner A F_z1 Phone# o
Site Address loco M i RK f L Jfr AJ Rol Fire District#
City 54,zf= St w. Zip 485u
Directions to Job Site E
l� r<
Owner Mailing AddressS�-
City or
S,4,Zt, , St was _Zip 9_ 8
Lien/Title Holder M tzr s t-
Address Poi `f
Clty 04 4.4 1•s _St wa —Zip�<.3 :2 _
#2 Contractor Name bus Contractor Reg #
Address Y'$> Expiration Date
City Ik' St _Zip ci Phone # ci2_7 y s.go
#3 If septic is located on project site, include records.
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.3 a! 3 5 - c2.Z _- 5 o o 5o
Legal Description 72 � of N W N W 7k t of 5/04t 1865
#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/ / Describe work
#7 Type of Job: New_) Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year 7 Make 1 ti�TwModel
Length 5-Z. ' Width yo / Serial No.
# Bedrooms 3 # Bathrooms_Type of Heat ELF_ct
Purchase Price $ 5'2 &o o
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
I V I River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences w
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements 5
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
b-)C,I j C� 's (�e_" 4�
Se /t4(e_ �3 ux,
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 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 15.00 _ Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $ Other
Ga utlets
Wood, Gas, t 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 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 _�i� X BY
DATE = 3 DATE
I
FOR OFFICIAL USE ONLY: Accepted by Date: 3
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
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