HomeMy WebLinkAboutBLD97-00592 Mobile Home - BLD Permit / Conditions - 7/1/1997 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
U I L- 0 1 N Ci 11", F-1 F-i r\111 i 1 I-OR I N-r 1.( I I i;N ,, L L_ 4".'. ;
BETWEEN 5pm AND Sam 427-7262
Bt,D97-0592 PARCFL12230111300010 PIAT - r) I V . BL K LOT :
AOR ADDRESS : NE 552, Q4EFK DFWAT10 Rf) BEL FAIR
OWNER - JODY n. S 377-9457
CONTRAcrom , Alklflfrlf!ON OF INC . 2014 f 4070
VFGAL N112 81 $1 IF
C[ AS� OF WORK , tNFW BEDR : 3 F,AT H 2 1#PE ANOVAT BY DA I I RECEIPT IT`iPE' ANOUNT BY DAIF Amm!
TYPE OF OISE . , ,t*4 'STOR I E S . . . _ 11
occup . GROUP _ 7 BLDG , HE I GHT a to Jit I INHOF t 155.00 TV 01101191 44824
TYPE OF C,(.)N'.',T . 7 F I RE PL ACE S . 0 STFE 1 4.50 TV 111101/97 440?4
OCCUP . LOAD , 0 W0OI)STOvf_S . . .. . f 0 !INC? f 26,60 TV 07101191 44624
DWF L I_ AIN I TS PARKING SPACES : 0 f
INSPU031` 10N AtIFA -, I SlIORE I INF? . . . . ..N TOTAL. 135,50 VAHIIA1104i 348251
SETBACKS--- -- -- - -- - TOILETS , . . . . . . . . . : 0 ILIEL TYPES---- BOILERS/COMP- ---- 1,4013 1 LE HOME-
FRONT _ . N 45 Oft BATH ETAS INq . . . . . . t 0 0 lip 0
A FA R . . . .E 600 .Of t, BATH TUBS . . . . . . . 0 3-- 15 111? . 0 MODEL tGOLDEN WS1
I OF ( I N 200 ,Oft 9I1I0wFRS . . . _ _ 0 F 1114 N « 100K BTU 0 15-30 UIP . r 0 "AI(F,
-'3InE (2 ) ,8 40 .Oft WATER HEATERS ., a 0 FURN >-100K BTUt 0 30-50 lip . -. 0 4808B
SSli R I IN F 0 .(A r CLOTHES WASHERS i t (A FORN FLOOR . . . : 0 S 0+ ip � - 0 YEAR---- , -
ARFA -- KITCHEN SINKS . . 0 HEAT PUMP _ . . . , 0 97
107 s I 7F F I n0f, TRAIN'S . : 0 VtNl SYSTEMS - -, 0 EVAP COOLURSt 0 tUNGFH -.44
14 U I L D I NG 1300sf D11INKING FOUNT . . . s 0 VENT FANS . . . . . . 0 HOODS . 0 WIDTH . :28
BASUMFNT , 0 Fif I AIINDPY TRAYS 0 VOMFS . INC INrO -GE P I At-
DECKS . . . . . 08f D18HWASHERS , 0 AIR HANDLING tJNIT-'5- rOMML, . INC IN 10 970671
GAP/CARP :? 0 f GARB DISPOSALS . 0 .f 10000 (, m , : 0 RELOCIPEPAIR - 0
A11DT . -7 UPINALS . . . . . . . . . . s 0 10000 ctm - I 0 OTHER UNITS . . 0
M I �',C P t.M r I X T IJ R f"S 0 GAS OUILFTf' . : 0
�RO.IECT OE SCRIa' IOR;N06itE NONE
ROJECI IOCA11040',D 8fifAIR 111''' 10 BFAR ClIfEW, OfKA110 P01 PARTNER [Al(f 1:090 Pl)� XO 0010 PR[VA11F PAIIVfVAY APPROX 3tO MILE 911`011f fIFANDARI PASS ROAD,
PPRO) 410' PASS f#A#Sf4A1f1 ON IEFT
HIS PIRVIT SECONfs WILL AND VOID If VORK 611 '�1011 A04114111.7 A FDS 111T.1tolvilitfl) 111RIN 184 DAYS, 4P if CONSIRmlow OP lopt I(,, som mll 191 A PtRIOD
I t8f DAYS AT ANY TIME AffEll 1019 IS CONNEINCED. EV.IOFICF OF COJITINUATIOV Or 11101K 13 A P#QfRFSS INSPECTt011 VIIIIN flif 1110 DAY PERIOD, fl#At INSPECH01 1931 8f
PPROVto Offorf 00JOIN9 fAN BE 0fcvPIfk
pf R OP AGEN11 lip,If t
�t0 Poll, re'#1 v fill COMPLIANCE 10 AT'IACHE0 COND I Y'I ONS 18 ffFQU I RED
_Ij
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 t/✓
BG/SLAB Insulation Floors Final
date by date by date 7— by 4--
FRAMING FIRE DEPT.
date by dates by date by
PLUMBING OTHER
Groundwork Attic
date b date by
D.W.V. WALLBOARD NAILING
date by
date by
Water Line FINAL INSPECTION
date by date by date by
I
I
I
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
P F F1 1\/i I -T' C7 0k N 0 1 1 1 C 111
�Case No , t BLD97 -0592
For .)Vr)v ;ATE VFNS
1 ) Ttie tinder v lqncd property owtior I r: aware (if the i1noeria I ril ✓ r ec �on Counl:V ' ;
Bard Mas
development roogolations oreated by the Growth Managinent Hearings BoArd 's Order of
October 2, 19�)6 , arid In considerat loin of Mason Courity ' s willingnesb to proodea with
prone"'isinq of applications' which might be affP,4-.!t:Pd h,,� the Order , the undersigned
ropertv owner heret)v afire to waive arty lawsult , °)ctican , or olaim for damaqe-.i agaitist
via!ion County which may arise out of Mason County 's an.tions In acoeptatioe processing
endear Issuance of such permits or approvals ( herpinRftor "Permittino acilons ") , Which
dam4ges are attributable to the County ' s decision to take permilting actions despite
the risk that (,hencies to the County 's development requ I at ions might later mane the
tau;ty 's permitting act ions I riva I i d
;? T h. I f% app I i cat I on is sub I elc, t to guff or and Land^=;)ep I ng requirement .: as eKit ab I i shed under
Ma�-or) County Ordinance 1 .03 .036 ..
3 ) The use. , hand I I nq and storage of hazardoos, eater i a I s or flammable and combust jble
llqujd�: in exoef,-7. of 10 gallons 1 .w not fillowed without the approval of the Mason Cotinty
F I t e Mart3ha I
�4 ) Proposed strii(Atit e or, any port ion the-reof areater than 30" i ri he I ght -from grade I I ne,
must maintain a minimum of 5 ' setback from all property linsas , easements and W from
a I I County., acid State Road right of waVs ,
5 Approved per dimenqions and setbacks on subrt; itted site plan .
� 6 ) PURSUANT TO 1994 UNIFORM BUILDING CODE , sEcrION 305(C ) AND SECTION 513 ALI' sirES MUST
HAVE APPROVED NIIMBFR.', 011, At PROVIDED IN SUCH A POSITIW4 ASTO St PI-AINlY V1 ,31SLE
AND LEGIBLE FROM THE STREET OR ROAD FRONT I.NG THE PROPERTY . MASON COUNTY BUILhING
DEPARTMENT kFOUIRFS THAT THIS BE COMPLETUD PRIOR TO CALLING FOR ANY SITE. INSPFCTIONS . A
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
l y P.O. Box 186 Shelton, Washington 98584
R& 1 111S�926QT- 14-361 Ffifi . BA$;" ON k 4. 1 1 jP 41i- ii
ASSESSEV 11" OWNERICONTRAClOR VA - ; A 1)1)R f- SS 1`0 M.
INSPECTIONS .
...........
REOU I RED I NSPFCT I ONS ( Foot i rig I nt� eot I on--pr i or to pour Set -rap lnspe(..�tion--prfor to
-Rkirtinq, Final Inspectionprior U. occupancy ) . I have received a co y of the General
Intot-mation and Gu I tie I I near;--blob I I e/fAanufsottired Housing installations Fiandout for
detailed desorl P tlon�,, of all required inspections on my mobilelmani,ifsotured home
in-,tallation . I hereby assume all res i?nsiblilty for the scheduling --I the-se recittired
Inspections . It these required inspeNlons are not requested, 3 Inpected and signed off ( approved ) b V the inspector In the prescribed order 1 understand that reinspeotlun
fee6 and an hourly inveNi7ation fee pursuant to the 911 06C , Table 3A will be asgessed 9
in addition to my or- I q 1na Permit fee s to resolve any questionable p r a ot 1 c es, or
rublems that have beers.1 disovvered . I further understand that this investigation will
e scheduled as time allowr . lint I resolution of any/al I prok0ems no ocouparicNi r i n a I
Inspection ) will be granted for the residence .
OWNERICONTRACTOR ( indiate which ) Signature
8 All m,.)bl le ,manufactured home landings or decks must be freestanding ( self -,upportlaq ) .
The largest l and inq or deck permitted without drawings or a bul Iding permit is 36"' x
36" . Any landing or deck that is 30" or more in heiglit from walking surface to finish
grade requires to guardrail . Any landing or de�:k that hns 4 or more rlserr; recittires a
handrail . Any- landing or deck larger than 36" x 36" mutsit be permitted whieh requires
4trtictural drawings and a building permit application . This Installation Permit does
NOT include any landing or deck larger than the 36" x 36" size .
� s roa
p IS 30
cd
reserve oreo 20
1250sq.f L.
✓ I p 25 r
50' ,
10 '
' 1
new m06110 50 '
home locoLlon `
6
O
131 '
20 50 100
well
Thy r c e7t- i
P P J
GARY YANDO,DIRECTOR
STq rF 0
so �, DEPARTMENT OF COMMUNITY DEVELOPMENT
N = PLANNING -SOLID WASTE - UTILITIES
�o N Y oy BLDG. I • 411 N. 51 ST. * P.O. BOX 578
SHELTON,WA 98584 • (360) 427-9670
1864
DISCLAIM[ER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainty 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"permitting
actions'), which damages are attributable to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations might later make the County's permitting actions invalid.
Date (Parcel No. or Legal Description)
Property kyer'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
COUNTY OF
On this day of , in the year , before me Notary Public,
personally appeared personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it.
WITNESS my hand and official seal.
-For County use only -
Reviewed by applicant on
(Date)
Notary's signature
Staff Initial:
My Commission Expires:
oN.sraT GARY YANDO, DIRECTOR
P� Fo
O S
U DEPARTMENT OF COMMUNITY DEVELOPMENT
O T s
2 PLANNING -SOLID WASTE - UTILITIES
�0 N Y Doti BLDG. I • 411 N. 51 ST. • P.O. BOX 578
1864 SHELTON, WA 98584 • (360) 427-9670
DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXIS`MG LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SUORELMrE PERMITS, VARIANCES, AND SPECIAL USE PERMITS:
The undersigned property owner is awvare of the uncertainty regarding Mason County's development regulations created
by the Growth Management Hearings Board's Omer 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 Qiereinafier "permitting
actions'), which damages are ennbutable to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations might later make(lie County's permitting actions invalid.
Date (Parcel No. or Legal Description)
Property owner's ture(Notarized)
(or the County ma accept the signature of the owner's authorized agent upon proper proof of authorization)
ACKNOWLEDGEMENT CERTIFICATE(INDIVIDUAL)
STATE OF
COUNTY OF
On this_day of , in the year before me Notary Public,
personally appeared personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it.
WITNESS my hand and official seal.
- For County use only -
Revie p i n
Notary's signature
(D e
My Commission Expires: Staff Initial:
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION a
60
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 IQ
O
PLEASE PRINT
#1 n_ Phone# 77-9V s-
4 Address 73 ,r2 Fire District#
ity St G�r Zip
Directions to Job Site '!n/V A/A ro- Yam„- /�/ E d��c.�d� /�/c.s� ®�..�e� lsq�lwa "z
Owner Mailing Address `/l 9 Z V1 dirl � 4 y-t-
City ter. St zip 9L /
Lien/Title Holder
Address
City T2F �r� St Zip
#2 Contractor Name AK d e rswl 041, t;�rr Contractor Reg#4N,O�z/Q®,-101 Tf
Address 'ZS"Ol S bi>,o,/ sT- Expiration Date g
City T, St Zip JJ-Ya 2_ Phone#OV6 5-72 `-l076
#3 If septic is located on project site, include records.
Connect to Septic?-Y—" Public Water Supply Well��
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 arcel No.
Legal Description n l� _StcJ .5t.y rx�
#5 Building Square Footage: (existing/proposed)
1 st FI !36k_l 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building sir.�� ../ Describe work
#7 Type of Job: New V-- Add Alt Repair I n fiofmr
_
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year!_Make�/�L, l�/Model � e MAY 2 7
Length Width 2&� Serial No. Ly
# Bedrooms _# Bathrooms Z Type of Heat !ckTM Srr"'+��
Purchase Price $ 3�(S-7- L4 �✓✓ i
#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 n o,m e-,
Show following on the site plan
Lot Dimensions Flood Zones
xisting 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
APPLICA T TO DRAW SITE PLAN BELOW
1 I i-ice
1a
1 le
l
�{U 131'
1 �
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
fy z",l t Z
660❑
j
l
Plumbing'Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets 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 No. Air Handling Units
_Disposal _ cfm#
Urinals No. Fire Protection Systems
Other _ Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25.00
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 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 OF THE 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 6Igsr�-G �---
DATE DATE
I
FOR OFFICIAL USE ONLY: Accepted by: Date:
�i
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review -�/j
A/
Occupancy Group: Type of Const:
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 E
Other
Building Valuation: TOTAL FEE