HomeMy WebLinkAboutBLD2005-01156 Final MFG Home - BLD Permit / Conditions - 12/19/2005 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Irflo Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2005-01156
OWNER: PAVEL VINICKY RECEIVED: 7/11/2005
CONTRACTOR: PARAMOUNT BUILDERS LICENSE: PARAMB1001JE EXP:3/25/2006 ISSUED: 8/17/2005
SITE ADDRESS: 1020 NE TAHUYA RIVER RD TAHUYA EXPIRES: 2/17/2006
PARCEL NUMBER: 322127600070
LEGAL DESCRIPTION: TR 7 OF SURVEY 2/134 NW1/4
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Manufatured Home North Shore Rd to right on Belfair Tahuya Rd. to left on NE Tahuya River Rd.
General Information Construction&Occupancy Information Square Footage Information
No.of Bedrooms: 4 Type of Constr.: 23200
Type of Use: MH Insp.Area: No.of Bathrooms: 25 Occ. Group: Lot Size: Deck:
Type of Work: NEW Fire Dist.: 8 No.of Stories: 1 Occ. Load: Building:2,420
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make-.Palm Harbo Length: 70 Ft. Front: E 746.0 Ft. Shoreline: Ft. Water Body:
Rear: W 20.0 Ft. Slope: Ft. SEPA?:
ModeI:N5V471A2 Width: 40 Ft. Side 1: N 40.0 Ft. Shoreline Desig.:
Year:2005 Serial No.: Side 2: S 159.0 Ft. Comp. Plan Desig.:
Plumbing Fixtures FEES
Mechanical Fixtures
Type Qty. Type e By Date Amount Receipt
Mobile Home Submittal Fee KKK 7/11/2005 $214.50 S22005
Planning Review Fee KKK 7/11/2005 $155.00 S22005
Mobile Home Issuance Fee MEC 7/27/2005 $214.50 S12005
Building State Fee MEC 7/27/2005 $4.50 S12005
EH Plan Review ADR 8/5/2005 $75.00 S12005
Total $663.50
BLD2005-01156 Please referto the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
BLD2005-01156
CONDITIONS FOR
BLD2005-01156
1) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be r nted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
De or any further inspections being performed or approvals granted.
X pa
2) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that
require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the
access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background.
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 jurisdi tion and t international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting
inspectio
X
3) The"approved"site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved"site plan is not on site, then
approval will not be ranted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Build in t prior to any further inspections being performed or approvals granted.
X
4) The internatioanl code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such r co a with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
X
5) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of VIshington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
per v ti
X
6) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the irltWnational codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspec r II made prior to requesting additional inspections.
X
BLD2005-01156 Please referto the following pages for oonditionsofthis permit. 2 of 5
1) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at
(360)427-9670, e 45 . The building permit will not be "finaled" until the permit holder can show proof that the access permit from Public Works has
' been "finaled"a ed.
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8) The new portion of septic stem must be installed and inspected before final can be completed on Manufactured Home.
X
9) Prior to final approval, all upland areas disturbed or newly' construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
11) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State
Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present
to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified
installer responsible for each major part of the installation. RCW43-63B.090
An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily
located in plain site within thr of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each
installer performed or instal ti ion number and signature of the certified installer responsible for each major part of the installation.
WAC365-210 X
12) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American
National Standards Institute (ANSI).To order the ANSI instructions you may either get an order form from the Mason County Building Department or you
can contact the Offfice of Manufacturing Housing (360) 725-2800.
13) 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 current fees adopted by the Mason
County Building Dept., 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/all problems no occupancy(Final
Inspection)will be granted for the residence.
OWN ER/CONTRACTOR(indicate which)Signature X
14) This permit is for the placem�tallation of the manufactured home only and does not imply approval or review for any other items indidcated on
the plot plan. X
BLD2005-01156 Please refer to the following pages for conditions of this permit. 3 of 5
15) • Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact
adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the
stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further
information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access
connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which
is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may
affect your project.
X
16) Placement of str�omply with standards setforth per the 2003 international codes regarding descending and/or ascending slopes.
X
17) Proposed structure(s) must main ain a minimum of a 5'setback from all property lines, easements and 25'from all County and State Road right of ways.
Setbacks are meas t furthest projection of the structure.
X
18) 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.
19) All property lines shall be clearly identified at the time of foundation inspection. X
20) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspecti n or to obta' approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason County ordinanc bu g regulations.
X
21) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prevented a r being taken. No more than one extension may be granted.
X
22) Pressure treated w d man fact red after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and fl st metal connectors approved for contact with the new types of pressure treated material.
X
23) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks an oneta liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0982. The pe this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
24) Water quality is not to be deg etriment of the aquatic environment as a result of this project.
X
25) Prior to final approval, all upland areas disturbed or newly creat tr tion activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
BLD2005-01156 Please refer to the following pages for conditions of this permit. 4 of 5
• '26) Approved per si and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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 fora 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 building can be occupied.Proof of continuation of
work is by means of a progress inspection.The owner or the went on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to
the above described prope ructure revi and i pe ion.
OWN ER OR AGENT: DATE:
BLD2005-01156 Please refer to the following pages for conditions of this permit. 5 of 5
W '
o CONCRETE MECHANICAL MANUFACTURED HOME
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C) Footings/Setbacks Date By Ribbons
Date - q pg- By L,o K , Gas Piping Date By
rn Foundation Walls sate 8y Set-up
Date By INSULATION Date By
BG I Slab Insulation Floors FINAL INSPECTION
Date By Date By Date By
FRAMING wells FIDE DEPARTMENT
Date By Date By Date By
PLUMBING Attic OTHER
G roundwor k Ogle By
Date By WALLBOARD NAILING
Date By
D.WN
Date By
Water Line FINAL INSPECTION
Date By Date By Date By
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s Type of Insp. Pass/Fail Request Date Inspect. Date Done By Comments
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RETURN ADDRESS
CILtt eLnIH;TarerATEaErAATIUAt9F Manur,-rtured E'` '
LICENSING Application I ITRANSFrVTITLE I TION
LOCATION
Anyone Who knowingly makes a false statement of a materfaf L_1REMOVA rM REAL PROPERTY
of a felony, and upon conviction may be punished by n fine, 'anment,or both.(RCW 10)
MANUFACTURED HOME
TMIPLATENUMBER I YEAR MAKH LEN",--,��tFEET) yE}eCLE IDENi1F1CA710N- �yy,
+380715 2005 Palm 6n I0 PH2O-7800ABC
LAND 'GAL DFSCR^IIPTpIIORN ON P- _
MANUFACTURED HOME WILL BE ZAFFIxED 0 REMOVED i 1,07600070 PA BEA
LOT BIa" PLATNAME OR 8ECn OWrOWN8KFYRA�11t pU. ARIEH SEOTION
TRACT 7 134NW 1 TOWNSHIP 22 NORTH,RAN% WEST,' I' :Y
91 GRANTORS REOISTEREDILEGAL OWNER(8) ADDrrIOr.,, ,'.1E5 ON PA(
COUNTY NUMean NLAABER OF P,EGI9TEREO OWNER9 NUYBEROFI YNERS
NNAI!OF na0I9TERED OWNER Pavel
Pavel Vinicky OOL I' 'MER AC COUNT NUMBER
NAM E OF AD DMONAL FLEGISTERe0 OWNER DOL CUB iFA ACCOUNTNU,IaER
Zdcnka Vinicky
ATIMESS CrrY ni-r 21P CODE
1020 Tahuya River RD Tabuya JA 98588-9509
NAME OF LEGAL OwNEn 'OLCU37CMER ACtYJUNT NUMBER
Pavel Vinicky
NA ME OF A0a1T10NAL LEGAL dNYER ODL GUSTOWR ACCOUNT NuwSER
Zdonka Vinicky
AGGRESS CITY STATE ZIP CODE
1020 Tahuya River M Tahuya WA 98588-9509
GRANTEE
NMIE
I DO SOLEMNLY ATTEST UND R PE ALTY OF PERJURY THAT I/ JAINR '; ERED OWNER(S)OF THIS
VEHICLE AND THIS INFORMATION IS ACCURATE.
Signature of Registered Owner and Tllle,IF APPLICABLE Stgnature of Additional R letered Owner and Title,IFAPPLJCABLE
PL NOWY �NOrARY 9EALan sr NOTA R IZATIONICERM FI CATION FOR REGIST OWNER(S)SIONATU13E
S♦'d10 of WCts Ington State or Waoington Sig,-+�r air red /y
TRACY l KER County at acyyl— Deiore me an � 7 Tt� Z�7
My Appointment Expit as Sep 26,2010 by Pave �l h I <y slgnalu
PRWT NAHU OF Ra018TBRa0 OWNER T OR
www by I ti ; � T_ L L I P6-(-K'w
PRMT' �EDFFREOISTE R1 OWNER PRINTED NAME NOTARY
TIIIe 0 J -t� County/Ofrto No,OR
AND: R
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DeulorNo.O
OEAIEAB}9P P08 FMRfO My NOIa fallen Oale
TITLE COMPANY CERTIFICATION
I certify that the legal dasorlplion of the land and oWnorsNp Is Lve and eormet per the mal property records.
NMAE MPEO OR PAPNTE➢1 THE OOMPANY J PHONE hTUUBER
MHATUREIPOSMON DATE
Finalize this application with a Llcsnsing Agent within 10 calendar days of the date TIIIe Company Representative slbne.
El BUILDING PERMIT OFFICE CERTIFICATION
I certify that: (�019 manufactured home has been affixed 1D the real property as described.
a building permit has been Issued for this purpose and the attachment writ be Inspected upon completlom
(TYPEOOR NTEDI SLDG PERKTT0 RCErPHONE0 aLDO PERMIYI
1
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TO-420- W P 12
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MASON COUNTY PERMIT NO. �
BUILDING PERMIT APPLICATION c)
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Pc ue.1 s Qe A,.. V, k., Company Name IS 'Ut's
Mailing Address 10.20 NE I�1.,, .� A,vim:- AS Mailing Address_ 112H5.2 PO&., 'T
City T_-�J 1(c- State LJ A Zip Code 595 8 City Tc Lom, State (�A Zip Code 9,?*1
Phone- 0-01- I?35- Other Ph. Phone 360-q5g_Iq'6 Other Ph..253 406 7313
Lien/Title Holder Contractor Reg. # 0AAAM61601JE Exp.31a310`
E mail address E Mail Address V-no�i1t6C no e, vwC=--e-.c.o.
Drivers Lic.# DOB Drivers Lic.# OB 7/l 2/
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic X
Connect t Water System Name of Water System
Well ^ Water System Name of Water System
PARCEL INFORMATION- 12 Digit Parcel No,322-11 7A<200 70 Fire District
Legal Description 1'"6 7 af NE yq S Se-c- 12 -t NE ALL/ ntr Q 113 3,1
Site Address (Please include street name street number and ity)_IOZO NF_
DirectionstQsite-Ff- SI.. I(a�: on 3 +o L o., C.- 1: foh LAl C-, 1,,�,,� �,,� A 300
C i31-1+ T.4v AA L - f t� "vim f
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE aSEASONAL ❑
Use of Buildin Describe Work 0--A- V\A,,,,,, c f (41 k
No. of Bedrooms 4—No. of Bathrooms Z 7 Square Footage- 1st Floor 2790 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq.ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make C-�� 11c,r r- Model V V1 Year'��'
Length 0 ' Width DL Serial No. No. of Bedrooms /'` No. of Bathrooms'
Type of Heat "• E r i A,, Purchase Price$ Replacement Unit? Yes/No
Installer Name L.-ka I S<< Certification No. 1,2 11
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF C I A71 F WORK IS BY MEANS OF A PROGRESS INSPECTION.
X Date: 7/ 11/Q 5'
Owner/O ers Re esentative/Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVE DENIED , OTES
Building Department ?�Z7wS )
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal /I �
FEES
Building Permit Fee I<{ Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal J
Valuation$ TOTAL FEES