HomeMy WebLinkAboutBLD2000-01485 Final MFG Home - BLD Permit / Conditions - 7/5/2001 Inspection Line(360)427-7262
MASON COUNTY PERMIT ASSISTANCE CENTER Phone: (360)427-9670, ext. 352
Mason County Bldg. 3 426 W. Cedar P.O. Box 186
I4 Shelton, WA 98584
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RESIDENTIAL BUILDING PERMIT BLD2000-01485
OWNER: SHIRLEY ROHRBAUGH
RECEIVED: 11/22/2000
CONTRACTOR: ISSUED: 12/11/2000
SITE ADDRESS: 272 E DEER CREEK RD SHELTON EXPIRES: 06/11/2001
PARCEL NUMBER: 321361290060
LEGAL DESCRIPTION: N1/2 S1/2 NW NE W OF CR EX TR 1 OF SP#1787
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
MANUFACTURED HOME FOLLOW HWY 3 NORTH OF SHELTON TO LEFT ON DEER CREEK RD
FOLLOW TO 270 ON RIGHT
General Information Construction & Occupancy Information Square Footage Information
No. of Bedrooms: 3 Type of Constr.:
Type of Use: MH Insp. Area: No. of Bathrooms: 2 Occ. Group: Lot Size: Deck:
Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building.
Valuation: $99,000 Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline & Planning Information
Make MARLETTE Length: 64 Ft. Front: Ft, Shoreline: Ft. Water Body:
Rear: Ft. Slope: Fte SEPA?:
Model:PACIFICA Width: 40 Ft. Side 1: Ft. Shoreline Desig.:
Year:2001 Serial No.: 18574 Side 2: Ft. Comp. Plan Desi .:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Mobile Home Submittal KLW 11/22/200 $175.00 55123
Aftess Fee GMM 11/28/200 $15.00 55241
Mobile Home Issuance MEC 11/30/200 $175.00 55241
Stooling State Fee MEC 11/30/200 $4.50 55241
Planning Review Fee SLO 12/05/200 $38.00 55241
EH Plan Review PSD 12/08/200 $50.00 55241
Total $457.60
BLD2000-01485 Please refer to the following pages for conditions of this permit. 1 of 3
CASE NOTES FOR
BLD2000-01486
CONDITIONS FOR
BLD2000-01486
1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X
2) in accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located in such a position as to be plainly visible and
legible from the street or road fronting the property. Mason County Building Department requires that this be completed prior to calling for any site
inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or
contractor fail to post the address on site prior to requesting inspections.
X ,�
3) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
4) The "approved" plot plan is required to be on-site for inspection purposes. If an inspection is requested and the "approved" plot plan is not on site, then
approval will not be granted. In addition, a re-inspection fee in the amount of$47.00 per hour(minimum 1 hour) will be charged and shall be collected
by the Buil De artment prior to any further inspections being performed or approvals granted.
X
5) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume
all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the
inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the 1997 UBC, and will be assessed in
addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this
investigation will be scheduled as time allows. Until resolution of any�aJ probl ms no occupancy (Final Inspection) will be granted for the residence.
OWNERlCONTRACTOR(indicate which) Signature X
6) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including
installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be
clearly marked in the installation instructions. (�
7) All property lines shall be clearly identified at the time of foundation inspection. X "`-'
8) This permit is for the placement and installation of the manufactured home only and does not imply approval or review for any other items indicated on
the plot plan.
9) Approved per dimensions and setbacks on submitted site plan. Second home on site must meet 240 feet from Ordinary High Water Mark of Deer
Cree empt from shoreline regulations.
X W
BLD2000-01485 Please refer to the following pages for conditions of this permit. 2 of 3
10) All upland areas disturbed ofteua ed by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt
fencing or straw matting). X
11) This application ' bject Buffer and Landscaping requirements as established under Mason County Ordinance
1.03.036.X
12) OWNER MUST S PROO� OF SATISFACTORY WATER SAMPLE PRIOR TO TEMPORARY/PERMANENT OCCUPANCY OF THE
RESIDENCE. X
This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period
of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection
must be approved before buildi can be o cupied.
OWNER OR AGENT:6� DATE: t2— 07D
BLD2000-01485 Please refer to the following pages for conditions of this permit. 3 of 3
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CONCRETE MECHANICAL MOBILE HOME
Footi•inf-Setback date by Ribbons
date_ by Gas Pipng date 7Z o , by
Foundaic,n Walls date by Set Up C C ' " .
dude by INSULATION date y/ by -
FG/SLA'l Insulation ors Final cIvc
date by date by date 7--- by ✓
FRAMING Walls FIRE DEPT.
data, by date by date by
PLUMBING Attic OTHER
Groundwork
date b date by
f te V WALLBOARD NAILING
D.date by date by
Water Line FINAL INSPECTION
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MODEL 8225 APPROX 2400 SQ. FT. - 40'-0" X 64'-0"/6C)%0"/56'^0"
OPT. PORCH ADDS APPROX. 320 SQ. FT,
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_ PERMIT NO.: BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Vakow34-vy h Contractor Name
Mailing Address Z"lO e. W99-U4 k- IR.cI Mailing Address ixfo I.J. 41:t kj" 6d
City State Wa Zip Code 9f SF Y City S rti. State_IAJ.4_ Zip Code %U k K
Phone( Other Ph.( ) Ph.( Jt6O yZv V7&Wther Ph.( &fG 1
Lien/Title Holder Contractor Reg. #
Address Expiration , / /
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic_X_Existing Septic Connect to Sewer
System Name of Sewer System Well r System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. 3112.15 if!e / - / 0 0 - Fire District �3
Legal Description paxyi - vf- I eF A)W Ua-c S6r-, 3& 7UJal-*;IiIV AL'SW [.uM
Site Address(Please include street name, street number and city) 170 C, Dj% D GAG. X_L/
Directions to site S
Will timber be cut and sold in parcel preps ation? (Yes/No) pJ13
Is your property within 200' of the following: Body of Water (Name) T)a1r . CAZ6-sV__ Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
PERMANENT RESIDENCE[3'' SEASONAL RESIDENCE❑
TYPE OF JOB New Add Alt Repair Other Use of Building
Describe Work nNO_kJT.�u€ ^-c-4. / s , A A>0J gwl;z;f�v�
No. of Bedrooms %� No. of Bathrooms_ SQUARE FOOTAGE-1st Floor 2nd Floor
3rd Floor Loft Basement Deck Other sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make�MAR-Ic-r;ii Model fZZS Model Year
Length Width Serial No. AC47V No. of Bedrooms'_No. of Batl ooms Z..
Type of Heat F_J3&6,,. ra Purchase Price —gg, � Replacement Unit ?(Yes/No) Mo
P Installer Name Certification No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. first obtaining approval. i;J
X Date X Date
FOR OFFICIAL USE BEYOND THIS POINT 1
-750P
Accepted b I Dat bmittal Amount Due Receipt t�-�
DEPARTMENTAL. REV1 1N ; APPROVED DENIED CONDITION CODES
Building Departmt�pt',L*v /,?ep SQO.09 S-F9.ON pARcet 43 �2 It 's Fop
Occ Group �`��T""y e Cons ,
Planning Department p or
Environmental Health Department
Public Works Department
I
Fire Marshal
Valuation $ /
FEES
Building Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing & Base Fee Public Works Review Fee
Mechanical & Base Fee Other
Wood/Gas/Pellet Stove Fee Other
Violation Fee Pre-Paid at Submittal ( )
TOTAL
FEES
FORM MUST BE COMPLETED IN INK
PLEASE PRESS HARD
. MASON COUNTY PROJECT SITE INFORMATION
Case No.
Name PARCEL NUMBER ��13�-/l -yDb(f1•r j Date ��`ZC �C
SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the
site plan
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Lot Dimensions Fences ,v
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Well Location (including adjacent) Drainage Plan
Names of Streets Easements
Names of Fronting Streets Septic System
DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line.
adjacent property lined , I Fadjacent property line
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adjacent property line- adjacent prop rty line
SAMPLE SITE PLAN
adja�nt property lined 3io� _ <-adjacent property line
I v 30• ra�scnv& gel
.gEI�SO w!Al_ 1 r1 L
CREEK fi HOM t j
Gndtiu
I Houses
I j PRoPasLa
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VAGnjT 1 c.�Artnae 1 %
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adjacent property lined ; A'. \; <-adjacent properfy line
TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the
degree of slopes. See sample topography profile.)
SAMPLE TOPOGRAPHY PROFILE
distar.cm tv
ructu_Y�
loci
to d1L
a 601 Mau 7
d�at�►,c� rc
S�opd t-o¢
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�ner� Date