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Home My WebLink AboutBLD16392 Mobile Home - BLD Permit / Conditions - 12/13/1984 BRIGHT, Jeanne #16392 12-13-84 W-1/2, W-1/2, SE-1/4, NW-1/4 35-21-3 E 360-741 Mikkelsen Rd. Shelton 98584 426-1425 Mason Lake Rd to Mikkelsen, right to several mobils on left. Right 1/3 mile, right into driveway. CALL FIRST Contractor None Mobile Home 14x66 1979 2 bdrm 1 den $18,278.00 Shorelines: Setback: Special Conditions: Footing: Setback: Foundation Walls: Framing: j Fireplace: Wood Stove: Plumbing: Mechanical: Roof: Exterior: Interior: Final: Stop Work: Mobile Home: Smoke Detector: Remarks: F7 4 Ti,# o BUILDING PERMIT APPLICATION 1 MASON COUNTY P.O. Box 186 Shelton, Washington 98584 n 426-5593 PERMIT NO. J OWNER NAME MAIL ADDRESS CITY&STATE ZIP PP E-- _ / `` DIRECTIONS In 4 Sd A L4 j'h �`C�'�5�/ ,)-1 247 7— io, �z v t A-.a MGCi j� U .4 L c f T TO JOB SITE w LEGAL r , , C (ClSEE ATTACHE _ SC Uj CONTRACTOR - NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE ----- USE OF BUILDING rn'D b/ I Y"5 J Class of wor ❑ NEW ❑ ADDIT ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: l dhP o h7 a pr T/ O!t 7— 4;0/ A >o?� Valuation of work: $ �,� (I� PLAN CHECK FEE PERMIT FEE SPECIAL CONDITIONS: j G' BEDROOMS {DECKS CARPORT [J NOTICE BATHROOMS I TOTAL SO. FT._ GARAGE [] SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT [i ATTACHED I_] OR AIR CONDITIONING. TOTAL SQ. FT. FIREPLACE DETACHED L] THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER I cert' that I am a currently registered contractor In WORK IS COMMENCED. the tate of Washington and I am aware of the FO F F I C E USE ONLY or nance requirements regulating the work for which t4 permit is issued and all work done will be in nformance therewith. PERMANENT SHORELINES SEASONAL I 1 FLOODPLAIN Firm E.D. NO. S.E.P.A. B Special Approvals IN OUT YES APPROVED NO Li Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware BUILDING DEPT. of the Mason County ordinance requirements for which this permit is issued and that all work done will ROAD ACCESS b 'n conformance therewith. MOTOR VEHICLE PERMIT PLI T N ACCEPTED BY PLANS CHECK BY "M.O. CASH Owner Date)2_'a — sl PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. PLOT PLAN ADDRESS / /"'/ram y, ' /(� PERMIT NO. f o0 fit_ � '�.� Lv'`/� ��• '�� /v'G�-' '/5� _3 -� , -�/- '� n a LEGAL / • ) DESCRIPTION LOT BILK ADDITION U SITE AREA —Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION Al"D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' e I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without first obtaining approval. �rh r NAME(S) OF OWNERS) OF SITE 5T UCTURE(51 (PRINT) SI A URE OF OWNE l5I OR AU ORIZE R P ESENTATIVE DO NOT WRITE BELO ,T IS LINE APPROVED DISTRICT AS NOTED DATE GHELTON PR:NTINS MASON COUNTY HEALTH DEPARTMENT i:r,§Eft-Qf SYSTEM DESIGN ENVIRONMENTAL HEALTH SECTION 303 NORTH 4th STREET r SHfLTON, WA 98584 iAy 19 1983 F DEPTH OF BACKFILL PHONE (206) 426-5561 t< 2"STRAW OR PAPER PROPERTY OWNER DATE SUBMITTED f STONE ADDRESS DESIGNE Y l� OVER TILE PIPE SIZE SOIL LOG — DATA �—f� LEGAL DESCRIPTION �� STONE y GcJfia Shy, ,�wy� UNDER TILE Depth to ��_�I _ ✓� ��' — 1�Cl�� CROSS SECTION OF TRENCH E� � Layerictive CALCULATIONS: ` 1 GPD if other SHOW THE FOLLOWING ITEMS IN GRID BELOW: No. Bedrooms than residence A. Horizontal system plan and, if mound system is proposed or Application Rate: gal./sq.ft./day 11 ,20 slopes exceeding 15% provide cross section. B. Scale Drainfield Sizing: Absorption Area !:240 Ft.2 Total Length _Ft. C. Benchmark L , stubout elevation, tank outlet elevation, (bot- tom of pipe), elevation at finish grade at center of drainfield. Pump Specifications: High level alarm Elevation Difference Ft. D. Property lines,building,trees,slopes in excess of 5%,driveway. GPM. Discharge Volume E. All wells or drinking water supplies within 100 ft.,water lines. Volume of sump F. Drainage system detail (i.e.curtain drain). Septic Tank Size and Manufacturer G. Replacement area. : } _._.}....}......_}.._,....}....€................ .._i......, a... ....i... j._._..........._ } _ _ .. ... .i a Y Y a Y } }-: }• � f,.,.}........G....L...4.,, ,.., : f ! Y .............�,...{....1..,E... _ 1 Y„ 4. a..a...,. ., i....Y........K....;..,.i...•a,...{....}....i,...€....¢. .tea. :.,.. 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L .... } i f i Y1 }.. .....}.,..i....d...,`....>...,},,,.},,,, _.,....d....x.........,!.._'.... ...................a.._a.._d.._i...i,,...:..._?.....i.._i....,, a•.-}.._}....... 1 a_...._ ..,.}... .. .._F-..........., a..F,.,.w...},...a'.,..6....i....i....i..,.....5........1....L.,..}.....A....}..._i.......... a i } NOTARY BLIC I, agree not to hold the Health Department responsible in the event/at the special system as pr posed by Cat fails to operate as required by Articles VI and VII, f the Mason County Health Department Code. a Signature Subscribed and sworn before me this / day Notary Public for the State of Washington of /1/✓JL 19 2 residing at � //G AIM & ASSOCIATES — Olympia, WA