HomeMy WebLinkAboutBLD5481 Mobile Home - BLD Permit / Conditions - 6/30/1977 McBride, Virgil L. #5481
6-30-77
E 1/2 N 1/2 SE 1/4 NW 1/4 36-21-3
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Allied Home Service
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BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
DATE ISSUED — 540 17
PERMIT NO. '5�44?
OWNER NAME AIL ADDRESS CITY&STATE ZIP PHONE
L L !� �iY G7rJL' �r9 C 2 (J�/
DIRECTIONS AlO JOB SITE ;may/ g A10 .r> j �,Q�E,IC 400 1 .4�F47 '// /Y7/
LEGAL / / (❑SEE ATTACHED SHEET)
DESCR. �� �/� CS / A/10 /' S6C 36 �T EG .�
NAME MAIL ADDRESS CITY&STATE LICENSE Ng.V 3-(y
CONTRACTOR /AGL/t. �O e-�vIC� 2, 017
7� ,
USE OF /T /� a
BUILDING OW166 A/om t 1110 4
Class of work: 3MEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
Describe work:
Valuation of work: $ PLAN CHECK FEE PERMIT FEE OG
SPECIAL CONDITIONS:
APPN ACCEPTED BY PLANS CHECK BY APPROV D FO ISSUANCE Type of Occupancy Division
BY Const. Group
Size of Bldg. No. of Max.
(Total) Sq. Ft. Stories Occ. Load
CONTRACTOR AFFIDAVIT
PERMANENT SEASONAL E.D.NUMBER
I certify that I am a currently registered contractor In RESIDENCE
the State of Washington and I am aware of the MOBILE HOME
ordinance requirements regulating the work for which
the permit is issued and all work done will be in Special Approvals Required Received Not Required
conformance therewith. ZONING
HEALTH DEPT.
Firm PUBLIC WORKS
ROAD DEPT.
By
Lic. No.'!::Z C- -0/C Date �Z�� 7
OWNERS AFFIDAVIT
I certify that I am exempt from the requirements of the N O T I C E
contract or registration law RCW 18.27, and am aware SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
of the Mason County ordinance requirements for VENTILATING OR AIR CONDITIONING.
which this permit is issued and that all work done will
be In conformance therewith. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
Owner Date. WORK IS COMMENCED.
LAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PARCEL NO.
IPT
CEIPT
Pr"TASON HEALTH DISTRICT DATE BASIS FOR FEE AMOUNT N MBER
DIVISION OF ENVIRONMENTAL HEALTH ,
i 71� Y
529 WEST FOURTH 110 W.K ST P.O.BOX 746
PHONE 753-8073 PHONE 426-4407
OLYMPIA, WA 98501 SHELTON, WA 98584
APPLICANT
ADDRESS PHONE DATE APPLICANT MUST CALL FOR INSPECTIONS LISTED BELOW
SITE: APPROVED ❑ NOTAPPROVED
SEWAGE
CONTRACTOR
NAME OF PLAI- -. /. LOT
NO SEWAGE: ❑ APPROVED ❑ NOT
APPROVED
SEC. TOWNSHIP RANGE
BY:
DESIGNER:
TYPE OF NO.OF LOT SOIL TYPE
BUILDING BEDROOMS SIZE - 'x
WATER GARBAGE DEPTH TO WATER TABLE FT.
SYSTEM DISPOSAL
LIQUID WASTE G.P.D. PERC TESTS INCHES PER HOUR
BY DATE
PRIMARY
NORTH - SITE PLAN AND SPECIAL STIPULATIONS: SEPTIC TANK(S) 1 ; GAL. PUMP REQ.
tINDICATE DIRECTION OF DRAINAGE)
DISTRIBUTION TILE TOTAL �� `_ FEET
FILTRATION AREA SQ. FEET
QUANTITY OF
APPROVED STONE_ CU. YD. SAND CU. YD.
FILL REQUIRED CU. YDS.
SPECIAL SYSTEM REQUIRED
THE ELEVATION OF THE BUILDING SEWER SHALL BE SUCH THAT
- THE MAXIMUM DEPTH OF THE DISTRIBUTION TILE SHALL BE BE-
D n 12 INCHES AND 36 INCHES FROM FINISHED GRADE TO
fUj !JF �).
TILE UNLESS OTHERWISE STIPULATED BY THE HEALTH
IF THE ELEVATION OF THE BUILDING SEWER IS TOO
j�� MEET THESE ELEVATIONS, A SEWAGE EJECTOR MAY BE
JUN 15 'ISOLATION STANDARDS FOR PRIVATE WATER SUPPLIES:
BETWEEN WELL AND TANK OR ANY PART OF THE TILE FIELD,
100 FEET FOR SINGLE RESIDENCE, MOBILE HONES, DUPLEXES
REGIONiAu t L -- !'AMtWULTIPLE DWELLINGS. NO DRAINFIELD WITHIN 100 FEET
OF ANY WELL, FRESH WATER LAKE OR STREAM; 100 FEET FROM
ANY SALT WATER BODY.
NOTE: "FOOTING DRAINAGE, DOWNSPOUTS, WATER-SOFTENER AND ANY
OTHER WASTE WATER NOT DEFINED AS SEWAGE SHALL NOT BE"CONNECTED
TO OR DISCHARGED INTO THE SEPTIC TANK SYSTEM OR THE SEWAGE DISPOSAL
AREA". ALL SEWAGE, INCLUDING SINK AND LAUNDRY WASTE, MUST BE
DIRECTIONS TO SITE: CONNECTED TO THE SEPTIC TANK.
FINAL INSPECTION REQUIRED BEFORE BACKFILLING
TO BE BACKFILLED
AFTER INSPECTION
ki 2" STRAW
STONE
OOVER TILE
F I II STONE
UNDER TILE
THIS SITE PERMIT EXPIRES
E
CROSS SECTION OF TRENCH
O M