HomeMy WebLinkAboutBLD2001-01124 Final MFG Home - BLD Application - 1/16/2002 proposed we I I �
691 '
��j Gp� n � � I I •;, �.
ornocr+ment Sept 001
h u r <l i n Jrer,c :.. . :7u t I
`r +r ins c.
�� p ,�-t I I ;A � �_� h.
s
ov.; sp ' fitter '� lop _ i th a"rJ � le id
50' at te'rluot ion zone
\ xn-
l
0—
1 L8
north —
1 _ 100 .
MASON COUNTY PROJECT SITE INFORMATION
Case No.
Name PARCEL NUMBER Date
SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the
site plan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Well Location (including adjacent) Drainage Plan
Names of Streets Easements
Names of Fronting Streets Septic System
DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line.
adjacent property line4 , APPR��dtbacent property line
MASON BUILDINQ 1f1 SPECTOR
' CHA�SSUEBJECT TOIAPPROV
I
DATE
I S
I �Q*
1 I
I 1
I I
1 I
I i
THESE PLANS MUST BE
W4 THE J08 SITE
CHANGES
1FCJ;R INSPECTION. SUBMIT CHANGES FOR APPROVAL:
PRIOR TO PERT-ORrAING WORK 1
I I
I I
I I
MUST MEET ALL CURRENT
�q ASHINGTON STATE CODES
I
1 I
I I
adjacent property line-> ' I Fad'acent ro ert line
SAMPLE SITE PLAN
adja�nt property line-> 3>o, _ Fadjacent property line
I D 30• �1SGRvE_ gel
sue+ n%JAL. I a L _ Pc�__,� a
CtzK '' �` HOM t
\ 1 to G n stru
]I I HOusQ
I � � Prlo PosLD sa pt!c. � �I
I 1 —
VAGrvT 7 EC,'RAaEPosCD /
\ �\ 7 A&R=L<u.AAL SO
90
I I
I
• I � � I
i
ta.e-LL
I \ I
I Ia�GLL I
I 0 \ I \
A 1
adjacent property line-� Fadjacent ro ert'line
TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the
degree of slopes. See sarbple topography profile.)
SAMPLE TOPOGRAPHY PROFILE
` dt.star.ca. to
I ructtiY'�
�t,i� dista r LG *o
`11r-----1f
- t._... 1 dii+anal
_. to
Igna ure Date
PERMIT NO.: BLDv+�`�
MASON COUNTY
BUILDING PERMIT APPLICATION
! 426 W.Cedar/P.O.Box 186,Shelton,WA 98584
Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner&&4/3,IA"Ag "f A;�a, j2 Contractor Name 4`-�A /ly,c
Mailing Address 2-1/, � / 4 r s— Mailing Addresses a. 8nY /4;,-!. 'ix
City,5,egr-� StateI&A Zip Code :&16(� Cit State Zip Code 9s'S/l/
i Phone(:;:;u ) . y),yyu30therPh.f2t ) y33-a.r°t/ Ph.QK&-, )4/S"6J4�s'G OtherPh.(Z 1.t 73/
Lien/Title Holder Contractor Reg. # P/4/#^fI3Stxo1.Tt
;
Address Expiration 0-4 / IL ,fit
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic_ ;Existing Septic Connect to Sewer
! System Name of Sewer System Well Water System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. Z �/_ _ — ire District
Legal Description
Site Address(Please include street name, street number and city) ';1 (c Af
�� w.+�
Dire c 'onstosite To Mlf�u.t�Hxy A��� �t/rr✓ aGL � � r.a dc.� i)cSN� b
Will timber be cut and sold in parcel preparation? (Yes/ ..
Is your property within 200' of the following: Body of Water (Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
PERMANENT RESIDENCW, SEASONAL RESIDENCE❑
TYPE OF JOB New_5L Add Alt Repair Other Use of Building
Describe Work :!-, ' A4itZL aG its c
No. of Bedrooms No. of Bathrooms Z. SQUARE FOOTAGE-1st Floor f2,fG 2nd Floor
3rd Floor Loft Basement Deck Other sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Dllodel 9 3 vS l� g Model Year -0 d I
Length�_Width a' Serial No. _No. of Bedrooms.3No. of Bathrooms_
Type of Heatov /r1_:. r- Purchase Price $ 64 161 le 39 Replacement Unit ?(Yes/No)
Installer Namez22 8eJEL7 ?,->^ Cerflfication No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
I Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. first obtaining approval. q
X Date X Aa —Date v
FOR OFFICIAL USE BEY , ND THIS POINT
Accepted by = fi+� Date Submittal Amount Due Receipt N
DEPARTMENTAL REVIEW PROVED.: DENIED CONDITION CODES
Building Department
Occ Group Type Constr. 0/6 /,oj
! Planning Department
MEnvironmental Health Department
I Public Works Department
� I
f Fire Marshal
F
Valuation $
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbi�&Base Fee Planning Review Fee
Mecharfical&Base Fee IS icz, Vla !ZO P Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal ( )
TOTAL FEES
51
El
Just
�sOWN
In Time For .. The 1ItTlida � Y�
y K Tax Refr�nd spring Yotil
60*
>va.a.. FRZR
SPACE
e
0 1 60- TUB/SHNQ•
KITCHEN BEDROOM #3
Ale
S k R OPTIONI
DINING uNEN
T
I N
N
S k R
® MASTER BEDR00
tz'-to' tv
LIVING ROOM
O Z' BEDROOMS ® S8
�g
i-------
40"_
MODEL 4P348D8 .
Gourmet Kitchen Utility/Bath Access
APPROXIMATELY 1,296 SO. FT. Spacious Living Area Spacious Master Bedroom tv
MILLERSBURG, OR -REV. 12/15/99 Walk-in Pantry Awnin Closet
Large Second Bedrooms
;may Pall' Harbor Homes
Haim
A,D, arbor
COPYRIGHT 1999 BY PALM HARBOR HOMES.INC � Horses
Because Pam Harbor Homes has a continuous product u Ali Fir-,TS niSFRVEP '
to change without
actual home. Square footage calculations are based on nominal widths and Improvement
room dimensions are approximate are subject
otmdu try s andards notice or
maytv2ry nion l compressed the erearsanS me I"r is
,ms pall" n component~may from
recycled after close Inspection for sate) and a �lplMlon co only end may vac,from the
... Y appearance. `�