HomeMy WebLinkAboutBLD97-00805 Final Mobile Home - BLD Permit / Conditions - 6/4/1998 _ MASON COUNTY
r '
-� Mason County Bldg. III 426 W. Cedar
P.O, Box 186 Shelton, Washington 98584
III I..) I I- IC:) I N Chi P f= Wt M I T" FOR INSPECTIONS CALL 427--867O
BETWEEN 5pm AND Bata 427-7262
RLD97--080 5 PARGF I_ :3213675000 0 PLAT : D I V : BLh: : LOT .
JOB ADDRESS ! E AO t AVFNI)ER III S"FIL TON
OWNER : PATR ICK MARTIN 482-2372
CONTRACTOR , 11
LEGAL I TA 5 Of RURVrY YOI 2 PG 4 f 41 I AV[IIQ1 R IANt
�Csvl-wycr�. :_ez•.avc�:as.�..-c:-::c,:.z�;xurxzasas....�:.r..•ee�.-a r^�s.'-r^.:.ru:-�:crn.� -.:..ses;`7�
CLASS OF WOVK - , :NEW F3EDR : 3 PATH : 2 TYPE AMOUNT BY DAZE RECEIPT 11TYPE AMOUNT Ff OATE 0tF IPi
TYPE OF USE . . . . aMH STOR 1ES . . . . . . . 1 �.s .t: �x� �• ��� x.�•s _._q,�z����.; ...y. .�, _ . _.: -r.
GGCUP . GROUP — . ? Rt DG . HE I GHT . . : O .Oft FHCP I 26.66 KS 67126107 45610
'TYPE OF CONST . , :? FIREPLACES . . . , : 0 MHOf 1 156.66 KS 07128191 45016
OCGUP . LOAD . . . , : 0 WOODSTOVES . . . . : 0 $1FE I 4.50 KS 67120197 45019 i
DWELL .UNITS . . . . : 0 PARKING SPACES : 0
INSPECTION AREA : 2 SHORELINE? . . . . .N TOTAL: 165.5A VAlULA1ION: A
'a_YRT'-'�x:^,:�t.'..+4'.a3z+�niTx'.-'�R.•.TG-ZSA^.Cf'�:sm.C^.�Srk'-+T.4'"a""9eR;x:'�'<caECC.-e'Y'�tV.e.f 2>^Xng:1�T:. i
ToI LETS . . . . . . . 0 FUEL TYPES- _._.____._.__.-_ F;OII FPS/COMP- -- -- MOB ILF 1-101.4E --
FRONT . . .S 1 •15 .01tt PATH BASINS . . . . . . : 0 0--3 HP . : 0
REAR . . . .N 5 .Oft BATI-I TUBS . . . . . . . . 0 3 -15 Hp — 0 MODEL :EIF=DMAN
SIDE ( 1 ) .F. 50 .Oft SHOWERS . . . . . . . . . . : 0 FURN -- 1 OOK, BTU : 0 15- 30 Hp . - 0 MAKE --- -----
,`, I t)E (2 ) .W 5 .Lift WATER HEATERS . . . . a 0 FURN >-100K BTU I 0 30-50 HP . : 0 FOX RIVER
StlftL iNE . 0 .Uft CLOTHES WASHERS . . I 0 FURN FI. OOR . . . : 0 50+ Hp . : 0 --YEAR- ---- -- -
AREA --_ ___..__._ __. _.__ __ KITCHEN SINKS : . . . : O HEAT PUMP . . . . . . . 0 9F3
I OT S I ZE . .. : F I OOR DRAINS — . . . 0 VENT SYSTEMS — ; 0 EVAP COOLERS : 0 1-FNGTI•I :6F
PUELDING . . . : 25268f DRINKING FOUNT . . . : O VENT FANS . — . . : 0 HOODIS . . . . . . . . 0 WiD7H . :42
BASEMENT . . . I ofif LAUNDRY TRAYS . . . . : A POMUS , I NC I N :0 .- SFR I AL #--- -
DECKS . . . . . Oaf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS-- COMML . 1NCINIp
GAR/CARPI? Osf GARB, DISPOSAt.S . . . , 0 10000 ctm . : 0 RELOC/REPAIFT : P
AT/DT . :? OR INALS . . . . . . . . . . : 0 10000 (,f11) . 1 0 OTHER UNITS . i 0
M I SC PI M F I X*r1)IIFq : 0 6AS OUTLETS 0
PROJECT DESClIIF IO1,10011f. RON!
PROJECT LOCATIONISIX MILES 10010 OF SHELTON ROY 1, FIRS1 0 TO LffI vIt R PASSING 1HF UAIF .RD. , AT TOP Of Hitt f 40 IS THE FIRST PRIVATE EASEMENT OM IHE
RIGHT HAND �IQE OF LAVEROER LANE,
THIS Pf.RNIT 91411ES Noll AND VOID If WORK UR `01STRUM1011 AUTHORIZED IS RD] WWII LACED WITHIN 180 (LAYS, OR IF CONSTRUCTION OR WORK IS SUSP!ND1D FOR A PFRI OA
Of III DAYS At ANY TINE AFTER 1019 I!, CO11ENCEI.' 1:VTOENCf Of C0 TINUATION Of WORN. 13 A PROGRESS iNSPECE101- 1110I0 THE 166 OAY PERIOD. FINAL INSPEC101 MUST BE
APPROVED PEFORE 901tDING CAM-.BE OCCUPIED
DIRER OR AGENT c .�, �e;.,� �'....__ ' _...___.._ ._ __ -. --- DATE:
BL6_PRMT, rev: 030091 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date _ by
BG/SLAB Insulation Floors Final /
date by date by date _Z1 ` by
FRAMING Walls FIRE DEPT.
date by date by
PLUMBING date by Attic OTHER
Groundwork date b
date b y
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
�Jr' Fs TO �� .!�t� �-lreioS i v ,� ►�/���'
I(
II
N
II
ICI
MASON COUNTY
Mason County Bldg, III 426 W. Cedar
RO, Box 186 Shelton, Washington 98584
Fa F= F-1 M I T r C3 N 17) 1 T 1 C7 N
Casey No . : BLD97-0805
For : PATRICK MAPTiN
Page : 1
1 ) OWNFR MUST SHOW PROOF nF SATISFACTORY WATER SAMPLE PRIOR TO TFMPORARY/PERMANEN7
OCCi,SPANCY OF j.HE RFS I DENCF .
l
2 ) This app l i cation i :y subject to Buffer and L.andseap i nq re(lu i remetnt s as established under
e Mason county Ord,' ance 1 .03 .036 .
3 ) the use. hand 1 1 nq and storage of hazardous mater I a 1 !3 nr f I ammah 1 E. and combustible
liquids In exoess of 10 gallons is not al lowed without the approval of they Mason Cwinty
F Ire liarsha 1 .
4 ) Proposed structure or any portion thereof greater than 30" In height from nrsarle Iine,
must maintain a minimum of 5 ' setback from all property tines , easements and 10 ' from
all County. . _State Road right of ways .
x. _..� . _
5 ) Appi Icant acknowledegs that this development is Kubject to poi IoIe s arid reclu1atiOtis of
MVasan Count Com]]pregensive Plan and Development Regulations .
6 ) PURSUANT' TO 1994 UN I FORM fill 1 LD I NG CODE , ` E:CT I ON 30�)(C: ) AND SECT I ON F) 13. Al-1 S I TF-F M(18 i
HAVE APPROVED NUMBERS OR ADDRESSES PROVID1D IN SUCH A POSITION AS TO BE PLAINLY VISIBLE
AND LEGIBLE FROM THE' STREET OR ROAD FRONTING '[HE PROPERTY MASON COUNTY B,U I I_.l!I NG
DEPARTMENT RI GIG I RFS THAT THIS BE COMPL.FTED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
RE 1 NSPECT 1 ON FF'F , RASED ON RATES IN TAI5LE 3A OF TIIF 1994 ON I FORM RU 11_D 1 NG COOF W 1 l 1. Sr.
ASSESSED IF OWNER/CONTRACTOR PAILS TO POST ADDRESS ON SITE PRIOR TO REOUESTINC
INSPECTIONS .
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
7 ) FiHAJ I FIFE) 11SIRPE CT IONS ( Foot I nA I rif:pec t ion- prior t poirr ,, et up I rispeo t I on-• -,r i or, t.(>
sk I r t In F I na I I nsper.t ! on-prior t oe>cupanny ) I have received a oc�p�?'V of the Genera f
Inforn+atior► and Gu idol Ities--Mob► le/Manufactttre�d Nou - inn Instfallations Plandout For
Jejta I I end desor I pt ions of all required inspections ►3n my motel I oimzanufacture+i h►7nte
ingtal fat ion . I heret-y assume al I rv,;ponslbi I lty For ttie sc hedliI fng of these regsrIred
inspections . If these required Inspections are not requested, inspected and signed
oft ( approved) by the Inspector in the prescribed order , 1 understand that roinspeotlon
fees and an hourly investigation fee pu► scant to the 1991 UBC, Table 3A will he assessed
irr addition to my ►arI9ina1 permit fees to resolve any questionable practices or
probloms that have; been discovered . 1 farther understand that this investigation will
e scheduled as time a I 11ws tint i I reso I tit I on of any/a i I prr►b I emE4 no orc..upanc:y f F l na I
Inspection ) will be granted for the residence .
OWN[' R/CONTRACTOR ( I nd I cat a wh I rh ) 3 I gnat tyre X_...._.�
R i All mobile/manufactured home landings or deck must be freaestand i ng ( self supporting) .
The largest landing c�r desk pet•m i t l ed without dr Eaw i ngs of- a bu i I cI I rig perm I t I s .36" x
303" Any ! end ► ng or, deck that: Is 30" or more in height from walking surfac=f to finish
grFade requires a gu4rdra i I . Any land i nca or deck that liar, 4 or ►cores risers roolu i re s a
andrn i I . Any landing or deck larger than 36" x 36" must be permitted which requires
structural drawings, and a building permlt appl is>.at iron . Thl .a Installation f �r,mft does
NOT Inclu44-1cany landing or deck larger than the 36" x 36" size .
X
0
P vs
�PeopoSED
Ho usc- SITE-
. �
0�
e
0
G P� a
0
0
%4,json County Dept. Health Services �RP � 0,;�
APPROVED
Initials 411, PR
Date 3'
DASHED Lwe-z
INDICATE (3) L1' LONG
RLSI;RV F D,- ie-LD t�3�
: 1
PL.dt PL"
10/k-r M"TiN joycelyn JohnsoM Scfig-E ,"= so'
p
pPrRcEL 3Q, 3(o '75Vod.5p Certified Designer o, so' too,
Septic Systems
1
GARY YANDO, DIRECTOR
PSoN.srgrFo
O A =
U DEPARTMENT OF COMMUNITY DEVELOPMENT
H Y �? PLANNING - SOLID WASTE - UTILITIES
BLDG. I • 411 N. 51 ST. • P.O. BOX 578
1864 SHELTON, WA 98584 • (360) 427-9670
DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SHORELINE PERNQTS, VARIANCES, AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainly regarding Mason County's development regulations created
by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's
willingness to proceed with processing of applications which might be affected by that Order, the undersigned property
owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of
Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter "pernhiuing
actions', which damages are attnbutable to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations night later make the County's permitting actions invalid.
C-.29 - `�� .2 0006
Date (Parcel No. or Legal Descri ion)
roperty ow er's signature(Notarized)
(or the County may accept the signature of the owner's authorized agent upon proper proof of authorization)
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL)
STATE OF Nk1
COUNTY OF�S o
On this day of IV9 , in the year tYf-�?before me y C�/4} � Notary Public,
personally appeared �G � � �} personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it.
NOTARY PUBLIC
WITNESS my hand and fficial seal. State of Wastlington
ARCHAEL LESTER - For County use only
IJuft29'20M Reviewed by applicant on
N s ignature \
(Date)
My Comrnission Expires: Q Vl Staff Initial:
C_f—jo
7
AuDil'U' ;
ALL fir;"
G48858 11q1 JUN 30 A 11: 45
REQUEST OF:
C"(
C 0'Cr_ C
i , � L
(tk ok
R etWn To
--
R EE t1a.-K F U,1-1 E
C' Lc mpr'�� AUDITOR MA,3014 COUNTY
vojL-io -6 ALLAN 1. BRIOW'HE
5' Rz L 7e lqql JUL -q P 3: 1
CERTIFICATE OF RESIDENTIAL USE REQUEST OF:
LIMITATION ON NUMBER OF BEDROOMS
I(We)the undersigned,hereby place this notice on record that the following described real estate situated in
Mason County, State of Washington;to wit: (abbreviated legal description)
IR t) OF -SOkU Uo P(2
and having the Tax Parcel Number of. �5 C)C� OCD CD
is subject to the following understandings and conditions:
1. The use of the residence on this parcel will be restricted to no more than 3 bedrooms.
2. The on-site sewage system was designed for and the building permit for the residence was issued on
the basis of no more than bedrooms,and a maximum residential occupancy of not more than
407 persons.
3. The use of the other rooms in the residence as bedrooms,in excess of the number identified herein,
could result in hydraulic overload and premature failure of the on-site sewage system,and could
result in Mason County taking steps to cause vacation of the premises.
4. In the event of any future residential remodeling,expansion,or replacement that results in additional
bedrooms to the number specified herein,the property owner will obtain the appropriate permits for
expansion of the on-site sewage system.
WITNESS hand this '9 -2 71- day of C-) 199�.
Signature
Signature
NOTARY PUBLIC
State of Washington State Of Washington
County of Mason MICHAEL LESTER
L the L�ridrTsigned,a 14otary Public m' and for the abo certify
fore me I Q, ,6 EU that on this
- , �_k .. )h,.4 Ail A,er—,IV t
day 199-/,personally appeared before me -A
know�, o�bethe individuabdescribed in and who executed the within instrument and acknowledge that he(sheo'they))
signed and sealed the same as free and voluntary act and deed,for the uses d purposes herein mentioned.
GIVEN under my hand and official seal the day and 7 ..en.
Notary Public in and for the S ash1i'71n,residing at �'L ��C:4.:k
My Commission Expires:
i
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION LL
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 qq/ %
(Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269) OID
PLEASE PRINT V
#1k-ow6r 'f''�q►r t V 3, r('� -�C �. ��4�l 1 P'� Phone# Q8�2- 23
Site Address � - yV A2 1/9 o✓droe LN Fire District#
City j -kL St uJ74 Zip O �b
Directions to Job Site s ism r t1, o 1= S Vw Ctoff I-kn��► , F)'i's`_JZag4 ro 1--a FT
cLF�r;.sS,�R, 'fk-c gnamL 1Zo. ar `P� OF j-r',LL — 15 -Vk-k E r5 i Psc%'Jc,.T—,
F'AS-o o rJ `0,-z Z,'a 1nT RU.y S�'�Q c F L4(-/,o i Car 1.JJ
Owner Mailing Address w I '1 C
City S A,6k L 7UJ St W 19- Zip 8'5'
Lien/Title Holder C.c,.,T:0-rJ AJ a L "Raw IBC
Address yr,5- •+fir /'JA/ke' ,8,4d0 )?A- o60A 79/
City 01ha/is St G')A Zip *',3 2
#2 Contractor Name Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well X
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
J�
Parcel No. �,2/3 C - �- OVo
Legal DescriptionYno•J orF Sac .3C 7'V e?/ A.), I-e 3 UJI W, r �ib�c h Q11. Q
#5 Building Square Footage:
1 st FI 2nd FI 3rd FI Loft Basement
# Bedrooms #bathrooms Deck Other
Garage Carport (Circle:Attached or Detached?)
#6 Use of building P 1 u D eSbff OW rM
InIlbw
#7 Type of Job: New ,S Add Alt Repair OthdpL �JJ(
#8 MOBILE/MANUFACTURED HOME INFORMATION HEALTH SERVICES
Model Year 199F Make 1(ra,IModel�r
Lengthy Width 2 Serial No.
#Bedrooms _# Bathrooms- 2 Type of Heat %-L.ecrret ?V'0" a,,v
Purchase Price$ -r� !O.ZO
#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 A43N2
Show following on the site plan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Drainage Plan Wells
Septic Systems Easements
Proposed Improvements Indicate Directional by (N, S, E, W)
Name of Side Street
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 eachl
No. l-oilets 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 o. Air Handling Units
_Disposal _ cfm# _
Urinals No. Fire rotection Systems
Other _ Auto. Fire larm Sys 50.00
Fixed Fire Sup Sys 50.00
Permit Basic Fee 16.75 Auto Fire Sprink Sys 35.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet 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 16.75
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 OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
DATE C'-- 2 - c7 ? DATE
FOR OFFICIAL USE ONLY: Accepted by: ct4 Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
1-l1ZF
Planning: Wo C e,n C 4t- l9R,:;:A5 ON 5i rE - No Fi&c,D WiK CWq4o 07116
.47-IWS 7-1/06 1W F 4M4 zoV fK-tn ryyy ,yccx mA s f I°4i✓r %W1s 9�
E ✓�K �NDt.�c.F-D6E of T H�stiC
Environmental Health:
17
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
Violation Fee
Site Inspection
Building State Fee
Other
Other
Other
Building Valuation: TOTAL FEE f
_ I