HomeMy WebLinkAboutBLD94-01037 Final Mobile Home - BLD Permit / Conditions - 6/23/1995 CONCRETE MECHANICAL MOBILE HOME
Footin Se�aclij— date by Ribbons
date 4 by Gas Piping date by
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING 1�
date by date by
Water Line FINAL INSPECTION
date by datev f yZ� s��y date by
:ED IZ1u,S
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MASON COUNTY
Mason County Bldg. III 426 W, Cedar
P.O. Box 186 Shelton, Washington 98584
COMPLIANC7 T. 1T`.f"1F0 CONOTTION
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MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
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J Make corrections, items will be checked on next inspection
■ OK to
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DepaffM--&n—t —,--\-
Date ,/
MASON COUNTY
BUILDING III 426 W. CEDAR
SHELTOH,.WASHINGTON 98584
(206) 427-9670
CORRECTION NOTICE
Job Location S1 7/ dT
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found:
Items listed below must be corrected to gain code compliance
c 1'
e— ��r
[� 4-
You are hereby notified that the above corrections shall be made BEFORE
PROCEEDING WITH ANY FURTHER WORK
Call for re-inspection when corrections are made before continuing
❑ Make corrections, items will be checked on next inspection
❑ OK to
Department—
Date Inspector z
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STATE.OF WASHINGTON
DEPARTMENT OF HEALTH
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GREEN COPY
i If instructions are not followed,sample will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH DAY YEAR
JAM � 'PM
TYPE OF SYSTEM IF PUBLIC SYSTEM,COMPLETE:
j PUBLIC
I r I.D.N0. CIRCLE GROUP
FOINDIVIDUAL A B
(serves only 1 residence) —
NAME OF SYSTEM
/ t1 �
SPECIFIC LOCATION WHERE SAMPLE COLLECTED T LEPHONE NO. ct
II DAY ) -16�,6
EVENING(;
SAMPLE COLLECTED BY:(Name) SYSTEM OWNER/MGR.:(Name)
SOURCE TYPE [ I GROUND WATER UNDER SURFACE INFLUENCE
SURFACE V1WELLor I I SPRING I I PURCHASED or I I COMBINATION
ELL FIELD INTERTIE or OTHER
SENQ,RFPORT TO:(PrintpllN ame,Address and ip_Gode)
I � Y
j r )PJ �WASHINGTON
TYPE OF SAMPLE(check only one in this column)
ROUTINE i Chlorinated(Residual•' Total Free)
DRINKING WATER
check treatment —> Filtered
I Untreated or Other_
I I REPEAT SAMPLE
Previous coliform presence Lab#
Date
RAW SOURCE WATER Source# s m J Total Coliform
NEW CONTRUCTION or REPAIRS I _i Fecal Coliform
�'VOTHER(Specify) ) __
REMARKS:
1.
(LAB USE ONLY)DRINKING WATER RTISATISFACTORY,
S
UNSATISFACTORY,coli}orms presentREPEAT iforms absent
SAMPLES I i E.Coli present E.Coli absent
REQUIRED 1.1 Fecal present ; I Fecal absentt
OTHER LABORATORY RESULTS
iii TOTAL COLIFORM /100 ml E.COLT /100 ml
FECAL COLIFORM /100 ml PLATE COUNT ml
ANOTHER SAMPLE REQUIRED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE:
11 Sample too old I ! Confluent growth
IJ Wrong container iITNTC
Incomplete form Turbid culture
Excess debris
IE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS
Q DIGITS) DATE,TIME RECEIVED _
0015
ED LABORATORY:
Center Copy BLUE-Laboratory Copy GRFEN-Water Sur,
July 29, 1994
Michael Lamont
E5200 HWY 3
Shelton, WA 98584
Dear Mr. Lamont:
Your property is in or adjacent to Bald Eagle habitat and may
require site specific mitigation measures in the form of conditions
attached to any construction and/or a Site Management Plan
administered by the Washington State Department of Wildlife.
WAC 232-12-292 BALD EAGLE PROTECTION RULES. PURPOSE
" 1. 1 The purpose of these rules is to protect the habitat and
thereby increase and maintain the population of the Bald Eagle so
thereby increase and maintain the population of the Bald Eagle so
that the species no longer is classified as threatened or
endangered in Washington State. The "delisting" of the Bald Eagle
for Washington State is a realistic goal which can best be
accomplished by promoting cooperative efforts to manage for site-
specific landowner goals as well . "
Please contact Shell Ament, Habitat Biologist for the Washington
State Dept. of Wildlife regarding site-specific management . Ms .
Ament can be contacted at (206) 681-4276 .
Respectfully,
Grace Miller, Planner
DEPT. OF COMMUNITY DEVELOPMENT
cc: Shelly Ament
1
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-6628
PLEASE PRINT
#1 A&Wfier c—W A Phone# x;U'/o — /h�k
Mite Address Fire District#
r,ity � � St / _Zip
Directions to Job Site on l / --/ f •
Owner Mailing Address
City SkC-,/f,-., i'I St-04 _Zip
Lien/Title Holder
Address
City St Zip
#2 Contractor Na a Reg#
Address 11 pi t
Y
Cit St Zip Ph�
#3 If septic is to ed o' roject site, include records. /A J <J NN
Connect to Sep'c? Public Water Supply Well
Connect to Sew Sy tem? Name of System J
(If residential, pr of potable water is required)
#4 fagrcel No. - - (DC Leal Description
n o��CQ� Q� 1i2 � D L,bf' r
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI 3rd FI / Loft /
Basement / ck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building kC , t l )au Describe work
#7 Type of Job: New _Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INF RMATT
Model Year - Make del
Length��Width Serial NO. u l CU
# Bedrooms 3 # Bathrooms 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
1 '
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 �1A)�
C
4Vi
k
(I df h U v
{
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-,�,F7 —
QLJ
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
�C
kIL
Plumbing Fixtures ($3 eachl _FDQ Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
h Basins Heatpump, Other
_Bath s No. Units .- Fees
_Showers ,� _ Furn U
Hot Water Htr _ Heatp s
_Laundry Washer _ ent Systems
Sinks S of Vent Fans
Floor Drains N I r / m r rs
_Laundry Basins HP
Dishwasher N Air Handling Units
_Disposal _ cfm#
Urinals No. Fire Protection Systems
Other Auto. Fire Alarm Sys 50�00
ixed Fire Supp. Sys 50.00
Permit Basic F 15.00 _ Auto 're Sprink Sys 25.00
TOTAL UMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet St e
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
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 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 INI APPROVAL OM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPAR ME DEPARTMENT.
XOWNEP X BY
DATE DATE
FOR OFFICIAL USE ONLY:Accepted by: Date: f ,ci.............
..........I..........
3
- — -- -
J
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: —;(A)2 jev�' -)U G 7
Environmental Health:
Building Plan ReviewhJW c= Z 1 Co -i5y13 1V%Nf U. NDrrJ GQ , lrad, ADD �—
l�
Occupancy Group: '�'3 Type of Const: :5;N
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 ��(�