HomeMy WebLinkAboutBLD97-00868 Cancelled SFR - BLD Permit / Conditions - 1/6/2000 MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
E3 U I L U) I N C-1 P Lz- F1 10 1 '1" FOR INSPECTIONS CALL 427-96"10
BETWEEN 5pm AND Sam 427-7262
BLD97-0068 PARCEL. :223097700300 PLAT - DIV - BLK : LO',,
JOB ADDRESS 1110 NE M11INSON BLVD RFLUA I R
OWNER : ROBERT COHEN 372---2822 P F-79-PA I T
CONTRACTOR : tiUNT 'S MANUFACTURED HOMES 4f9-7474 373--5001 NULL & VC,,: *- ,? EXPMATION
LEGAL - TO 34 OF SURV 131234 DATE
CLASS OF WORK . . .NEW BE DP 2 BA7itr I TYPE ANOORT BY DATE RECEIPT TYPE ANOUNT BY DATE IftFl-PTI
'TYPE OF USE: . . . . MH S TOR TES
OCCUP . GROUP — t? BLDG . HE I GHT O .Oft 100f 11 1'5.06 KS 1910fi98 49469
'TYPE OF CONST . FIREPLACES — , : 0 JSIFT t 4.swxS Iffitigs 48469
OCCUP . LOAD 0 WOODSTOVES . . . . 0 FHCP 11 50.0# KS 1841198 48469
DWE t I .UN I I'S 0 PARKING SPAOFSt 0
INSPECTION AREA : I S�14014 E L I NE 7 . N JIOTAI , 209,58 VAlUtATIONt 90001
TO I LF TS . 0 FUEL BOIL-FRS/COMP--- -- MOBILE HOME —
FRONT —N 110 oft BA 1714 fJAS I NS . t 0 0-3 HP . t 0
REAR . . . .S 113 .0ft BATH 'TUBS . . . 0 3-15 HP . : 0 MODEL. :
SIDE ( l ) .E 170 .0,1`-t 'SHOWE AS , . . . . . . . . 0 FURN < 100K BTU : 0 15-30 fill . : 0 MAKE-- -
SIDE ( 2 ) .W 74 .0fl. WATER HEATERS —— : 0 FORN -,-*-100K BTU : 01 30-50 HP - 1 0 BROOKWOOD
SHRLINE . 0 .oft CLOTHES WASHEIIIS, 0 f UPIN FLOOR — -, 0 504 tip . : 0 YIF AR
AREA KITCHFN SINKS — 0 HEAT POMP . — . . . : 0 66
LOT SIZE , FLOOR DRAINS . — 0 VENT SYSTFMS . — t 0 EVAP COOLERS : 0 I. ENGTH -44
BUILDING — % 900sf DRINKING FOUNT . . . -. 0 VENT FANS — — i 0 HOODS . . . . . . . . 0 WIDTH . :20
BASEMENT . . 0 ,,f LAUNDPY TRAYS . 0 DOMES . INCIN ;0 SFR I At.#--
DECKS . . . . . 0-Sf DISHWASHERS . . . . . . 0 Alfi HANDLING I.JNITS----- COMML. . INCIN ;0
GAR/CARPz? Osf GARB DISPOSALS . .. . : 0 -- 10000 ofift — 0 RELOC/RFPAIRt 0
A-TIDT . t? URINALS . . . . . . . . . . . 0 > 10000 crill , 0 OTHER UNITS . : 0
MISC PI'M FIX"TURFS1 0 GAS OUTI.FTS . c 0
PROJECT DESCRIPtIO04081IF HOME
PROJECT 100A'14#010 BEHAIR Off NORTH TURN Iffl 00 01AR CREEK DEVATIO RD, PAST HHODARI PASS 90, IffT OFF h1JC9S1I1H !AHOYA RD, TO N11>iSON 8140 1118 Ot NtVf
9ASKET $Alt ;OOF 00 STREET
THIS PfAmi! bffavES "tilt AND VOID if WoRk OR 0011SIROCTION ADIHOR17[0 P; NOT CONVENCID WITHIN 180 DAYS 01,11' C0XS1Rt1CTI0# OR ffj#K IS SOSPCODID FOR A PERIOD
OF t8f DAYS AT ANY TINE AFTER'NOIK IS P,01111FACffl, FVIOE#Cf OF CONTINUATION Of 000k 13 A F93Gq9FSS IRS FINAL INSPECTION mvsl BE
APPROVED PFFORE R91 �iS�C��Arft 0
x". W-�j�,dl
OWNER OR AGE01i
FRO PONT, 3111191 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED
Ef
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 by
FRAMING Walls - FIRE DEPT.
date by date by date by
PLUMBING - OTHER
Groundwork Attic
date by
date b
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
X_.__.____._.._...___.__....___....._._.._______ _______
RF001 RFD INSPECTIONS (Foot I nq l respect Ion- prr, I or to pour , Set..up i nsp+ect Ion--pr I or, Io
,skirting, Final Inspection-prior to occupancy) . I have received a copy of the General
Information and f►.rlderl ines-�Mobt le/Manufactured anufactured Hour, Ing instal lations andout for
detailed descriptions of all required inspections on my mobile/manufactured home
Installation . f hereby assume all respons i bi i i ty f or the schedu l f net of these required
Inspections . If these required Inspections are not requested, inspected and signed
off (approved) by the Ins ector in the prescribed order , I under stand that re I nspect i ()n
fees and an hourly investlgatlon fee pursuant to the 1991 IJBC , Table 3A will be assessed
in acid i t i ore to my original permit feed to resolve agy` c;cam:� I ona l e ttraot l cep: nr
robs ems that have been discovered . l further ►and r t�i fi h `` investigation w i l l
e %4chedu i ed as 'time a I i ows . tint I i reset I tat I orr o tr Occupancy ( r i na I
inspection ) will he granted for the residence .
OWNER/CONIPAC`OR ( Indicrate which ) Sicinaturet X_______..__.___..__._....__._..._.._._�..___
9 A I l +nob i i e/manuf act ured home landings or decks crust be freestanding ( self supporting ) .
'rhe largest landing or deck permitted w i i bout drawings or a building permit is 36" x
36" . Any landing or deck that is 38" or more In height from walking surface to finish
grade requires a guardrail . Any landing or deck that has Q or more risers requires a
handrail . Anv banding, oy deck iarger than 36" x 36" must be permitted which requires
structura l,,,dr n c bu i I d I ng p"rm i t app I i coat I can . This I nsta I I Kt I on Ream 1 t does
NOT 1 nc L-+,t�-- U+d eck larger- than the 36" x 36" size .
X.__....__.__ ___.__.. .__._......_._._..__._____.__.___._..._...... ._,_..,_
,
GARY YAM)O,1311ZEMR
DEPAR'TMEN'I' OF COMMUNITY DEVEL,OPMEM
PLANNING -SOM WASTE-UntrtlM
�o`►° BLDG. I • 411 N. 5TH ST. + P.O. BOX 578
rge4 SHELTON,WA 98584 o (360) 427-9670
DISCLAI1VI1 AIWAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS,SHOREME PERMIT'S, VARIANCES,AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created
by the Orowth 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 fdr damages against Mason County which may arise out of
Macon County's actions in acceptance, processing and/or issuance of such permits or approvals Omen altet`permitting
ecdohl"),which darnages are attrh table 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)
z r7k tJ� 4 ( -n
Property owner's signature otarized)
(or the County may accept the signature of the owner's authorized agent upon proper proof of authorization)
RECEIVED
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 Comity use My y-
Revk%ed by appUmmt on
Notary's signature ( )
My Commission Expires: Staff Initial:
fuc},I;•J
Page No. 1 CASE HISTORY FOR CASE NO.: BLD97-0868
ROBERT COHEN
NE1110 MUNSON BLVD BELFAIR
09/17/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
------ ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- ---
BLDA010 Application received 07/22/97 / / 07/24/97 DONE KW 07/24/97 KW
BLDA015 Waiver in File / / / / 07/24/97 DONE KW 07/24/97 KW
BLDA900 Telephone call / / / / 09/09/97 Barry from Hunt Mfg Homes is faxing L & DC 09/12/97 TLG
I sign off today
BLDB110 Structural Plan Review 08/14/97 / / 09/12/97 NEED SIGNED OFF L & I INSPECTION REPORT DONE TLG 09/12/97 TLG
Received signed off report
BLDB130 Planning Review 08/04/97 / / 08/13/97 for Allan DONE PBC O8/14/97 PBC
BLDB134 RLC Review / / / / / / 07/24/97 KW
BLDB135 Addressing 07/31/97 / / 08/01/97 DONE GMM 08/01/97 GMM
BLDB138 Planning Pre-Review 08/01/97 / / 08/04/97 DONE MMS 08/04/97 MMS
BLDB200 Environmental Health Review 07/24/97 / / 07/31/97 This is a non-shoreline placement. Per HOLD PSD 08/12/97 PSD
the application the septic system is
existing. There are no septic records.
1) Need to create records and
2)pump/inspect tank and 3) show a
reserve area. psd
CUSTOMER MAILED THE INFORMATION. PUT IN
PAM'S BOX 8/8/97 NJP
8/12/97 The applicant submitted a
drawing of the septic system. I called
him and told him we need either the
designer to create the records, or he
could expose the critical areas of the
system and apply for a $62.00 EH review.
The tank needs to be pumped and
inspected.psd
BLDB200 Environmental Health Review 09/12/97 / / 09/17/97 per Pam's comments HOLD CAJ 09/17/97 CAJ
BLDB210 Water Adequacy 07/24/97 / / 07/31/97 There is a well log in the file. Need DONE PSD 07/31/97 PSD
water sample...see condition.psd
Sep. 9 '97 16:03 HUNT MOBILE HOME TEL 20647jD-'R E0 P.
sent of Labor&Industries ALTE RATION gPE MIT
haded
Feriory Assembled Structures Section �. F
INSTRUCTIONS:
1. completi'aU spaces to and Including the box With the slsanature X In It. ItN�
L Draw map on reverw side or WHITp ropy only-
e back.
3, Submit completed permit and fee to the nearest arflce hated on Waubtnitled the 1permit �....:.,. x:' r::;;::^;a';x.? i ;•:: " Cr,;;;
a. Contact and schedule the inspection With the ofTtre In Whkh you .
Within 1S da L _ c ,,
Owner art n e firn� N r
> , ......................•..............-..-.--.-.
. ---.....
- a�.... ........ .... .
r�t GU
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VAMACIWI tn6ituaUon number
lnxtalle trot/Ditakr (� _ ��q 7 q
/�fr" ! �.. r ' ! �.......................... _._..f.._..... I-.....................-...........
. ....... "
stem
Cti'�/ !� •__._
G• r gFFPS
Check the appropriate boxes In section A and a 41M B. r riate boxcS below)
g ❑ Alteration Int:pC.ction(cheek app 1)75:69
A m
Comercial Cow* Air Conditioning/Heat Pump
Svri�l2+la:: Electrical
Electrical Appliances
Mobile Home Fire Safely
Set+al n, Gas Furnace
t3as Piping
715Nm Plumbinr t r• gtira
SLTucptrul :... �
W ood/Pe llet S rove H
Recreational Vehicle or Park Tfailer — — _ —_ — ——— ———— — 70
Plan RevicW� — S ►,.
;Sorlal No
RV Inspection00
r
tylodel NA.prPlanApprair'd.Na Re-Inspectiat> — — — iVb
Technical Inspection — — — — — — — S 00/ht
Make check payable o1'L.a & dustria p�
Signa of applicant or auth reptesen taut j `
X $ 7 J 111
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#nle4ar Total pages
ri - -Contrac tor Can ns pce 'nk-Puirch er` Goldcrmc d-Purchaser
FG22-012- altcraticm permit I2-92 Whitt Olympia Carenn
Department of Labor&Industries •Y ALTERATION PERMIT
Factory Assembled Structures Section �,y
.�' Do not complete shaded areas
INSTRUCTIONS: 3 0) ���—�� 0 fruit 72711
1. Complete all spaces,inc(ding the signature box(marked with an X). Invoice a
2. Draw a map on reverse side of WHITE copy only.
3. Forward completed permit and fee to the nearest L&I office. See list on reverse.
4. Contact and schedule the inspection with the same L&I office within 15 days. Insignia k
Owner last name first name Day time phone Date
�.-
Addrerssh) ) l ) / City t State ZIP
installer/Contractor/Dealer Phone ;c PJ q ) Contractors registration number
Address CI State ZIP+4
k
Check the appropriate boxes in section A and section B. FEES
AIj Commercial Coach B ❑ Alteration Inspection(check appropriate boxes below) $75.00
Air Conditioning/Heat Pump
Serial�10. Electrical
Electrical Appliances r
Mobile Home
Fire Safety U 07/10/97 11:05 97149 5
F
Serial No. Gas Furnace' 78.00
1IUo: Gas Piping
D v
-- -` Plumbing
Structural
oriel No.
Recreational Vehicle or ❑ Park Trailer Wood/Pellet Stove— —
Serial No Plan Review — —— — — — — — — — — — — — — — — — $70.00
RV Inspection — — — —— — — — — — — — — —— — $70.00
Model No.or Plan Approval No. ReinSpectl0n— — — — — jOnginal Permit $50.00
Technical Inspection — — — — — — — — — — — — — — $50.00/hr
Signature of applicant or authorized representative Make check payable to: Dept.of Labor&Industri
X FEES DUE $ l
Department use only;
Request approved or Request denied because of specific violations of Washington rules and regulations. Violations
must be corrected and reinspection requested within 10 days for recreational vehicles and 20 days'for mobile homes and
commercial coaches of the notice of violation date. (This does not apply to technical inspections). It is unlawful to offer for sale,
rent,or lease any non-complying mobile home,commercial coach or recreational vehicle:'
Included are forms required which must be completed and fees submitted before reinspection.
Date Area office Inspector —� Total pages
F622-012-000 alteration permit 4-96 White-Olympia Green-Contractor Canary-Inspector Pink-Purchaser Goldenrod-Purchaser
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �� 1
(Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269) f1,U 006
PLEASE PRINT V
#1 ner POSe/P7r y C_40 Phone# 360-3Z2-Z82 Z
Ate Address &Z0 /1�. C M a/S/So PO �LLI,� Fire District# Z
City Ile GtJ A ) /e # (j_1 St Zip
Directions to Job Site �_/ ,�¢�,� ,ti yBF C.� .0 A&2E a44-7ze-0 />�dMD
C fN D -T _ R
Za MV/Vs0•t) F,LVD /iio N E Rqs�-E7-'r3��.t
Owner Mailing Address SAA,e!5:—
City St Zip
Lien/Title Holder _ �/,'9 zf���//1�C i4ec#D3o-5,0 7.Sr
Address Bc' ack
CItYW00EK73AO,1,2A St Zip? 12-
#2 /Contractor Name h�0117-" /y1i4 qV,;i4G7'V"e- 1y1bvW&-S *ontractor Reg#
Address P.O. aox '7 79 9 2-C:,xpiration Date &
City 66,r(;7- w A St Zip 9833 ? Phone# Vjp1-
#3 If septic is located on project site, include records. D
Connect to Septic? � Public Water Supply Well
Connect to Sewer S tem? Name of System Lo
(If residential, proof of potable water is required) JUL
3
Q, Uy
# Par el Noxo' 309 - 7Z -DD36d
1
Legal Description '�f' d of S'& Ll /3 .a 3
#5 Building Square Footage:
1 st FI 9leo 2nd FI 3rd FI Loft Basement
# Bedrooms 1, # bathrooms r Deck Other
Garage & Carport (circle: Attached or Detached?)
#6 Use of building Describe work
G
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make --r Model��aD � 2 G9l
Length Y�( Width aO Serial No.
# Bedrooms # Bathrooms Type of Heat s�-?ZEf,
Purchase Price$
#9 Indicate by circling the applicable source if a ter is on or adjacent to subject property:
River Pond Creek Stream Wetland L arsh Saltwater Seasonal Runoff Other
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
Name of Side Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
m U ASO st) 3 LV _
N
Ep17G�"
4 fl r u
y
APPLICANT TO DRAW TOPOGRAPHY PROFILE B L
Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
th Basins tpump, Other
Bath Tubs No. Units F s
Showe rn BTU
Hot Wate Htr _ He pumps
_Laundry Wa her _ Vent stems
Sinks Spot Ve t Fans
Floor Drain No. Boilers C ressors
Laundry asins _ HP
Dishw sher No. Air Handlin nit
Dis sal _ cfm#
U nals No. Fire Protectio stems
ther _ Auto. Fire arm s 50.00
Fixed Fir 5upp. S s 50.00
/ ermit Basic Fee 16. 5 _ Auto Fir Sprink Sys 35.00
TOTAL PLUMBING $ No. Other
I
Ga Outlets
od, Gas, Pellet Stov
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Per it 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 r X BY
DATE / DATE
FOR OFFICIAL USE ONLY: Accepted by:
Date: l -21_ r-7
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
pproval
Planning:
Environmental Health: 1
L
Building Plan Review 1211a k��4� 41 %
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 a 9 '