HomeMy WebLinkAboutBLD2015-00541 Final MFG Home DDR2015-00090 - BLD Permit / Conditions - 12/16/2018 II IbPt:!L'uV1I LII IC tJVV/HG f-f LVL
�6ox COO MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III
426 W. Cedar
Shelton, WA 98584
`"'` RESIDENTIAL BUILDING PERMIT
BLD2015-00541
OWNER: EDWARD HANNAH
CONTRACTOR: SOUTH SHORE CONSTRUCTION LICENSE: SOUTHSCO16NL EXP: 2/10/2016 RECEIVED: 7/2/2015
SITE ADDRESS: 131 NE PINE TREE PL TAHUYA ISSUED: 8/19/2015EXPIRES: 2/19/2016
PARCEL NUMBER: 223315100034
LEGAL DESCRIPTION: COLLINS LAKE#2 TRS 34 &35-A
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW MFH -2015 FLEETWOOD 26X48, 2 BEDROOMS, 2 BATH WA ST RT 3 N TO BELFAIR, LT ONTO WA-300W, CONTINUE ONTO NE
NORTH SHORE RD, RT ONTO NE BELFAIR TAHUYA RD, RT NE COLLINS
LAKE DR, RT ONTO NE PINE TREE PL, SITE ON LEFT
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: 2 Type of Constr.: VB
Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck:
Type of Work: NEW Fire Dist.: 8 No. of Stories: 1 Occ. Load: Building:
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make:fleetwood Length: 48 Ft. Front: N 103.0 Ft. Shoreline: Ft. Water Body:
Rear: S 283.0 Ft. Slope: Ft. SEPA?: Unkn
Model:waverly cr Width: 26 Ft. Side 1: E 41.0 Ft. Shoreline Desig.: bWttApplicable
Year:2015 Serial No.: Side 2: W 20.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Manufact.Home Submittal JBN 7/2/2015 $264.25 S2201500000001
Planning Review Fee JBN 7/2/2015 $205.00 S2201500000001
EH Minor Plan Review JBN 7/2/2015 $ 100.00 S2201500000001
Manufact. Home Issuance RTB 8/17/2015 $264.25 S2201500000001
Total $833.50
BLD2015-00541 Please refer to the following pages for conditions of this permit. Page 1 of 7
CASE NOTES FOR
BLD2015-00541
CONDITIONS FOR
BLD2015-00541
1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/ Reserve requires a 1 Oft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. N�dati n drains within 30ft, down gradient of drainfield/reserve area.
X
2) Approved a ,�iXpensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X �� �
3) All construction and demolition debris must be removed from the site after project completion. Proper disposal Visposal of construction debris must be on land in
such a manner that debris cannot enter or cause water quality degradation of State waters. X LE
4) Temporary erosion control measures must be implemented to prevent water quality degradation of adja ent �k rs or properties. Silt fencing, straw, or
surface matting must be installed and maintained until upland vegetation has become established. X — /�
5) All property lines shall be clearly identified at the time of foundation inspection. X
6) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/age nt/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system
of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contractor is a knowJedging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X V
7) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Appro ed P)jn"to ensure these structures are shown and meet the setback conditions listed.
X �- .T e
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BLD2015-00541 Please refer to the following pages for conditions of this permit. Page 2 of 7
1
u) by aeTlmtlon, propane tanKs ano neatpumps are suu(Awes, wniai niusi nieCt sewaUK uU11UniUiia. rieaaC WneuK yvui r%NNiUvcu 31LU nail w UlIJUIC
these structures meet the setback conditions listed.
X 1/�
9) All other ecessary permits from Mason County, Washington State and/or Federal Agencies that are req it fo{this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X / I
10) 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 and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-64 -09 i AhT person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
_� /"�f I11) 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 granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Departm t pri r�to any further inspections being performed or approvals granted.
12) Owner Ag nt i r sponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X
13) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal f prpve,documents will result in failure of required building inspections.
X �V/
14) 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 granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building QepraJtren t prior to any further inspections being performed or approvals granted.
15) 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 three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each
installer performed o ins Iced. certification number and signature of the certified installer responsible for each major part of the installation.
WAC365-210 X /`
16) 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 th f Ii of Manufacturing Housing (360) 725-2800.
X
BLD2015-00541 Please refer to the following pages for conditions of this permit. Page 3 of 7
17) A concrete encased grounding electrode must be installed and used at each new building or structure that is built upon a permanent concrete foundation.
In Mason County the electrical code is regulated by Washington State Department of Labor& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-4000.
X
/1
18) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed
exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X
19) 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 Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit evo ' ti
X
20) REQ'tiTRED 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 b the Mason
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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 sc eduled as time,allo Until resolution of any/all problems no occupancy (Final
Inspection)will be graht&H—oF the residence. �� R /i
OWN Ek/CONTRACTOR(indiCate which) Signature V,
21) This permit is for the placg t,4id installation of the manufac[l ed home only and does not imply approval or review for any other items indidcated on
the plot plan. X1� '
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BLD2015-00541 Please refer to the following pages for conditions of this permit. Page 4 of 7
Lt) rerrnanerumaaiess rnusl. oe pusieu aim visiuie nuns uie luau
Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails
must be in good condition and meet code for year built or current code if replaced.
Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit
Gutters and downspouts must be installed with splash blocks provided
All exterior penetrations must be sealed
HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24" above grade.
The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4
panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection.
All conditions on the original or issued permit must be met
If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available
It shall be the responsibility of the person requesting the inspection to provide the
manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection.
Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an
inspection is requested and required items are not completed prior to the inspection being performed
ENFORCEMENT PROVISION:
Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action
and bsequennt/violation and penalties pursuant to the Mason County Code.
X - !�
23) 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 '1
24) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinanc or re
gul tion, must be reviewed and approved by Mason County prior to construction.
X
Please refer to the foll win BLD2015 00541 owing pages for conditions of this permit. Page 5 of 7
2b) UUNS I KUU I IUN F'KUUtJS I U tit F'ItLU UUhCKtkl I tU/-1J I1L:UUIKCU t'L:M IVIHJUIV UUUN I T bUILUINU UCF'HYC I IVItIV I HIVU I t1t HUUt'I tU
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 international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector. hall ace prior to requesting additional inspections.
X --
26) The instalo 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 mare in�ie installation instructions.
X ���
27) All pro y lines shall be clearly identified at the time of foundation inspection. X
28) 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 inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason oun r�iytTnces and building regulations.
X �� V
29) All perm'ifs 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 ave irevent d action from being taken. No more than one extension may be granted.
X
30) Pressu (eated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
conneetor.; nd flashing. Install metal connectors approved for contact with the new types of pressure treated material.
X ,-F ,/ L
31) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
O=i\Y
X
BLD2015-00541 Please refer to the following pages for conditions of this permit. Page 6 of 7
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 contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s) for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
i�ture Date
OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2015-00541 Please refer to the following pages for conditions of this permit. Page 7 of 7
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CONCRETE MECHANICAL MANUFACTURED HOME MCI
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� Date By z
Un Footings 111�� Gas Piping Ribbons z
C) Interior Date By Interior-Date By >
C) Date ay 6,0C
Cn Exterior Date By Exterior-Date By m
It Set-up m
Point Load I Isolated Footings INSULATION Date By
Date By BG I SLAB INSULATION
Data By FIRE DEPARTMENT >
Foundation Walls X
Floors Date By
Date BY Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING Vault Date By
Date By OTHER
Groundvwork Attic
Date By Date By Type
DRYWALL Date By
D.W.V Type-
Int Brace Wall Date By Im
_V Date BY
yoat
By r-
FINAL INSPECTION 0
Water Line Fire Separation
Date By Date By Date
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Pass or Request Inspect. 6
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Permit# OpS%, a MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location = pt
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This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items listed below must be corrected to gain compliance
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You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
❑ Call for re-inspection when corrections are made before continuing ❑ Please contact our office
❑ Make corrections, items will be checked on next inspection regarding possible structural
❑ OK to damage incurred by recent
"natural/man made"
❑This is not a complete inspection disasters.This is NOT a
Date 1011 to I Department �d CORRECTION NOTICE.
Inspector UL,
Permit# S s 11( MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location 131 ]l}i- lr'j� �✓ L vt,
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
foun Items listed below must be corrected to gain compliance
-rL) S l wJ 94.
You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
❑ Call for re-inspection when corrections are made before continuing ❑ please contact our office
Make corrections, items will be checked on next inspection regarding possible structural
® OK to (,ice 1 �v �: damage incurred by recent
"natural/man made"
❑This is not a domplete inspection disasters.This is NOTa
Date f z/Q)l's- Department CORRECTION NOTICE.
Inspector
6Lb2,0) 5 -- 00541/
Plot Plan PLANN NG
Ed Hannah
131 NE Pine Tree PI. N�7Parcel # 22331 -51 -00034p,,�
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PLANNING :
ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
PROJECTION OF THE BUILDING
Ole 113.5 .00
GJ6 51. 1 "Q01 �X
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ZECEIVED
JUL 0 2 2015
426 W. CEDAR ST.
293. t0.001
APPROVED
o MASON COUNTY DCD PLANNING
E PLAN REQUIRED TO BE ON SITE
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CHANGES SUBJECT TO APPROVAL
By Date
4(r!r-
Scale 1 " = 50'
ed
�O20) 5"- ()D54/1
RECEIVED
Plot Plan SEP 16 2015
Ed Hannah 426 W. CEDAR ST.
131 NE Pine Tree PI. N
Parcel # 22331 -51 -00034 FPine Tr
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a
81 63
Propos 22'X 22'Garage
68.946
243.969
APPROVED
lb`' MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
D� C NGES SUBJECT TO APPROVAL
By Date
0
0
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Scale 1 " = 50'
9
FILE
copy
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REVIEWED FOR
CODE COMPLIANCE
MASON COUNTY
B LDING DfPAR E
Date
Documenis attached to approved plans.:
Site Plan he
Plan review chec PiSN
Pages
Engineering: YLateral Vertical
MumhQr of na.Qes—
THESE PLANS MUST BE
ON THE JOB SITE
FOR INSPECTION
11:HANGE
SUBMIT GkIANGES FOR APPROVAL_ MUST WEE! ALL Ct1R62LjVT
PRIOR TO PERFORMING WORK WASHiNGTON STATE CODES
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THESE PLANS MUST BE
MUST MEET ALL CURRENT ON THE JOE! SITE
VVASHINGTON STATE CODES FOR INSPECTION BUILDING
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JUL 0 2 2015
MODEL� 2 $ 482L 4�6W, CEDARST.
a
2 Bedroom 2 Bath 1 ,279 Square Feet
Important:Because we continually update and modify our products,it is important for you to r
know that our brochures and literature are for illustrative purposes only.Illustrations may show
optional features.All information contained herein may vary from the actual home we bulld.
Dimensions are nominal and length and width measurements are from exterior wall to exterior
wall.We reserve the right to make changes at any time,without notice or obligation,in prices,
colors,materials,specifications,features and models.Please check with your retailer for 0
specific information about the home you select.
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JUL 0 2 2015
MODEL 28482L 426 IV. CEDAR ST.
2 Bedroom 2 Bath 1 ,279 Square Feet
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Important:Because we continually update and modify our products,it is important for you to
know that our brochures and literature are for illustrative purposes only.Illustrations may show
optional features.All information contained herein may vary from the actual home we build.
Dimensions are nominal and length and width measurements are from exterior wall to exterior
wall.We reserve the right to make changes at any time,without notice or obligation,in prices,
colors,materials,specifications,features and models.Please check with your retailer for Q
specific information about the home you select.
— 005,11
Name_1rd Parcel# 22331-51-00034 BLD# -
�s� E D
Mason County JUL 0 2
Department of Community Development 2015
Small Parcel Stormwater Management Application/Worksheet (0 61 BAR ST_
Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development, or redevelopment', with more than 2,000 square feet of impervious surface'.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater. Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area * All dimensions in feet
Buildings 48 X 26.8 = 1287
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections (example:
eaves/gutters)
X =
Driveways X =
X = Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved, gravel or packed area per definition
above table
X =
PatiosANalks X
X = Any paved, gravel or packed area per definition
above table
X =
Others X =
PORCH 8 X 26.8 = 215 If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area (sum of all areas) 1502
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read, acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that 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,owner's legal representative,or the contractor. I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
descri ed prgp rty for review and inspection as may be required.
X Owner/A Cent/C___to ircle one)Date: 07/01/2015
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
` MASON COUNTY Mason County Permit Center Use:
DEPARTMENT OF COMMUNITY DEVELOPMENT DDR 0�90
�lJ -
411 N.Fifth Street/P.O.Box 279, Shelton WA 98584
360.427.9670 ext. 352 Date Rcvd
Request for affiTViNt-T A,14
Administrative Variance for Reduction in the Required Setbacks ($115.00)
For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including roof eaves and gutters.
utters. pp
Applicant/Owners: �C�(. I-L il-A lh�n Q�
'CEIVED
Mailing Address: Z ffit) SEP 16 2015
City: A State: Zip: Z _ 426 W. CEDAR S T.
Telephone:
Email: Q CSC
If this reduction is tied to abuilding permit, please give permit case number.
BLD - )U�f"l I 0
Parcel Number(s): L 3 _6iHON Zoning
Site Address: WC C, uLvz A
Requested setback variance:
ft. ❑ Front ❑ Rear Side
rrV ftft. ❑ Front ❑ Rear �ide t-AL w
1ibly (('A�
J
Frg ❑ Real ElSide-
ft Front ❑ Rear ❑ Side
Front Setbacks—From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks—From the rear property line. Minimum 10 feet.
Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, set backs to all
property lines and existing buildings, slopes, surface water,wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
1ACommunity Development\PAC-Permit Assistance Center\VARIANCES\Admin Variance.doc Edited on 7/16/10
FRONT AND OR REAR YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
1) One of the following exists on the lot(check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) to width at the front yard line of no more than 50 feet;
❑ of size of no more than one-fourth acre;
e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must meet one of the following:
2) One of the following exists on the lot(check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑�e)lexisting
ot size of no more than one-half acre;
improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
ti l/lil V.Q/U-Q/ln U
wv t
?�4
Owne Agent lease indicate) e c�/ /// ce
L-lysignature Date
Official Use Only
Approved by: I kv�� Date
Denied by: Date
Reason for denial:
I:\Community Development\PAC-Permit Assistance Center\VARIANCES\Admin Variance.doc Edited on 7/16/10
0
N CO°ETA MASON COUNTY ' i 'PERMIT NO. L 0054//
_ DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING• PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
r Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext. 352
lsci PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext. 352
BUILDING BUILDING PERMIT APPLICATION a , s, 2 i tr
OWNER INFORMATION: CONTRACTOR INFORMATION:
^i r"- ^
T.
to
NAME: EDWARD HANNAH NAME:SOUTH SHORE CONSTRUCTION
MAILING ADDRESS: 1R2R9 Hwy:j MAILING ADDRESS: PO BOX 963
CITY: ALLYN STATEVVA ZIP: 98524 CITY: BELFAIR STATE: WA ZIP: 98528
PHONE:,-360-275-4133 CELL: PHONE: 1-360-275-0818 CELL: 1-360-616-1697
EMAIL: N/A EMAIL : SOUTHSHORECc COM
L&I REG# souTHSG016NI EXP. 02 / 10 /2016
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 22331-51-00034 FIRE DISTRICT
LEGAL DESCRIPTION(ABBREVIATED) : COLLINS LAKE#2 TRS 34&35-A
SITE ADDRESS 131 NE PINE TREE PL CITY TAHUYA
DIRECTIONS TO SITE ADDRESS Follow WA-3 N to WA-300 W in Belfair,Turn left onto WA-300 W Turn right onto NE Belfair Tahuy 3 R(
Turn right onto NE Collins Lake Dr,Turn right onto NE Pine Tree Pl, Lot on the left 0.1 mi.
IS PROPERTY WITHIN 200 FT:
SALTWATER ❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STRFOAM ❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES[] NO
TYPE OF JOB: NEW;or ADDITION ❑ ALTERATION ❑ REPAIR ❑ OTHER ❑
USE OF STRUCTURE( SIDENCE,GARAGE ETC.) RESIDENCE
V I `- ' 0,ZIMARYy SEASONAL ❑ NUMBER OF BEDROOMS 2 NUPNZ BER OF BATHROOMS 2
DESCRIBE WORK INSTALL NEW MANUFACTURED HOME
SQUARE FOOTAGE:
I ST FLOOR 1287 sq. ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq.ft.
DECK 215 sq. ft. COVERED DECK sq. ft. STORAGE sq. ft. OTHER sq.ft.
GARAGE sq.ft. ATTACHED ❑ DETACHED ❑ CARPORT sq. ft. ATTACHED ❑ DETACHED ❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN
MAKE FLEETWOOD MODELWAVERLY CREST 28482L YEAR 2015 LENGTH 48
WIDTH 26.8 BEDROOMS 2 BATHS 2 SERIAL NUMBER
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 contractor. I further
declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary
parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for
review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180
days or if constructi n work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF
INSPECT VITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X 07/01/2015
Si nature o pplicant Date
X TONI MOORE OWNER/ REPRESENTATIVEVCONTRACTOR )
Print Name (CIRCLE TO INDICATE)
DEPARTMENTAL REVIEW APPROVED DA DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT 7
PLANNING DEPARTMENT 10
FIRE MARSHAL
Request To Revise An Approved Plan
Permit Number: BLD 20b -0054 Name t-O4 4,) ,10-L
P arcel Number 2?, _3 1 Phone Number daydme (3(oM ) _a 7 S—C/
Project Address 131 l)F_ -P;n e j ree Pl. Mailing Address ?Z e
—l' n 52
t Please rovide a complet , d ed descri 'on of the proposed revisions to the approved plans:
�� C
M; hVe bGr;a nCR CO ACk rr{1vi-L
Are two sets of the revised plans or addendum indicating the changes included? e
Are the approved site plans included? Yes #e—
Are the revisions clearly and accurately identified on the plans or addendum? Yes -
Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes A� No
If Yes, Has the engineer or architect approved this revision? ❑ Yes •L�j No
Is a stamped and signed approval included with this request? ❑ Yes No
(Note:No structural chanties to a"designed"plan will be approved without the written consent of the cnginecr and/or architect of record.)
Does the proposed revision modify the footprint or location of the structure? KYes ❑ No
If Yes, Is a revised site plan, with all new setback dimensions included-�Aith this request?
Yes ❑ No
Additional Information:
Applicants signature Date: L�0
Office Use Oniy Received by.
Date Sent Assigned To Approved By Date
Original Valuation: $
Additional Valuation: $
91 �s 0-8all�l Sq.Sq.� X S $
E.H. q 9/ /S Total New Valuation $
Additional Fees:
Additional Planning Dept $
Additional Plan Review $
Additional Conditions / Comments: Additional Building Permit $
Additional Plumbing $
Additional Mechanical $
Additional E.H.Dept. $ -7 N
Other $
Total Amount Due: $
Amount To Be Paid Up-Front$