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HomeMy WebLinkAboutBLD94-1311 Cancelled Mobile Home Replacement - BLD Permit / Conditions - 3/9/1999 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 H 1.094-- 131 1 !'m i,i t I I l, .i4)0o14) I'I i� I tit,1 0 HE 40 PI*Mt, IREIL IN I AHUYA PER 'PIVIXTION III INf I� CHRfSTINA KOENIG MIT Cot I INS list 14 1114(1 It I'S #5419 of #44 tAXL SL �11�c� rI 411; W UlljrK I:t- I, tit 1110 I I R A I I I TYtI A11011111 Ni IjAlf R1111*111 111:1-4 py 0AIE Rf(flptl I y F,I- ,it 0-,1 I 01� If 14 1 1)Cl , III 11,141 0 0 t I t lot 00 ts 0-111t�144 I Y 1'1- lit i 110,: 1 F 1 ta F PI A i'l 0 ISM 1 4 1-# V'ti 01:;iQ14 lit 1 1 44 00 IE" *q i5/44 0 ttt,lI I I II IV IV 11 0 Nli ,P P,IF 1 0 IIIFF I S 00 1,, sqjjs/44 0 J)N iWiit I 10-40ki I I NC N 110M. 149 511 VAIIIIA4140, ""I I f Hfli I o I I I I 4y Fill I I -i- I I I W. 0 M I' - MOH I I, I it CI M I I O,M 1 I0 0 fl 1`1 A I H H ilt S I N', 0 tit It N 10 0 I'l 14 A 1 14 1 1)H 0 111 1110 1)1: 1 t "01,4 p 0 f IIVN 1 001, H I if I t, ty9 lit, 0 14(11, f I lit Ij t 11 A I f- I, H f- A I I W-, 0 F I I p N 1 04)1, H 1 11 0 its 0 111' 0 H I�I f Nt 0 0 f r 11 it I HI:`, t4A IS H V k 0 F I I I?N t- Ie 0 ',O lip 0 .-Yt Ill, itkt A - K I I C Its-N I, I N 1, IV) H 1, A 1 1,t I M 11 0 t 1 1- 1 MW DRAf lll� 0 V F N t y•-; I I M (1111 1 k 1 1 N I; I It H It to I j"I I I D Iv I N� I N C I OIIN 1 0 Vt N I V It Wi 0 1.11111011 0 1.)f W I it F NI N I I I WINUWY I-PAYI; 0 Imm( I; I Ni I N 0 1 I. 4 f It i V 0 1 1) 1 `--I-II4WiH1 k", , • 114 A I k M%Nli I I N 6 IIN I I ',-- I "Mml 1 t41 1 N 0 /1 0r. 1 G A k 1, 1 i I ',I A 1 0 t 0000 fill 0 f,-I I ill r P 1- P 1I I 0 II I 10 1 ilia I N A 1 0 1 0000 tltr 0 to I Ill f4 IIr4 I 1 0 m I Ill ill m f I X I til-o 0 i,Al. tilt I I l- I 1)(1101PTIOUNARM Hoof REPI'Moto, PRIIIHI W111TIP11, 10f. 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Q Owofp OR AGENT' DAII : 61.0-PRIlT, rpy- Viji'. ?14J COMP I I ANCt 10 A I ]'Ait:HE 1) C OND I I IONS 1% RFQkJIRFD 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 by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by —! �1 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 MASON COUNTY Mason County Bldg. III 426 W, Cedar P.O. Box 186 Shelton, Washington 98584 II II I I Department of Labor&Industries r ALTERATION PERMIT Factory Assembled Structures Section Do not complete shaded areas INSTRUCTIONS: ` ,. ermit# A 6 4 A 1. Complete all spaces to and including the box with the signature X In it. �-a 2. Draw map on revere side of WHITE copy only. invoice M 3. Submit completed permit and fee to the nearest office listed on the back. 4. Contact and schedule the inspection with the office in which you submitted the permit insignia N within 15 days '::57��� t ` Owner last name first name Day time phone Date ............................................................................................................... ............................................................................................................................ Address City State ZIP 10310 nrchard avo 011a'.a. Wa. 98359 !ns aller/Contractor/Dealer Phone t registration number J.Contracos ............................................................. Address Ci State ZIP+4 Check the appropriate boxes in section A and section B. FEES A B Alteration Inspection(check appropriate boxes below) $75.00 Commercial Coach Air Conditioning/Heat Pump Serial No. Electrical Electrical Appliances i Mobile Home Fire Safety Serial No. Gas Furnace Gas Piping = . .-17 :4: 3 312:3247 HUD No. Plumbing Structural Recreational Vehicle or ❑ Park Trailer Wood/Pellet Stove - - serial No. Serial No. Plan Review - - - - - - - - - - - - - - - -- -. $70.00 RV Inspection - - - - - - - - - - - - - -- - $70.00 Model No.or Plan Approval No. Re-Inspection- - - - - gtna etmu $50.00 technical Inspection - - - - — -— _ $50.00/hr Signature of applicant or at thorized representative Make check payable to: Dept.of Labor&Industries X FEES DUE $ 76, ADe aztment use only , Request approved or ❑ Request denied because of specific violations of Washington rules and regulations. Violations mus 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. - - - - - - - - - - - - - - 401� s E�V�. . .. �44.(� ''�� Gct!"a(vec . . ... . . . .. . . . .�.. . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . ... . . . .. . . . . . . I . . . . . . _ . . . . . . . . . . . . . . ... .. . . . . . .. . . . . .. . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . a - - - - - - - - - - - - - -- - - -- - . - - - - - - - - - - - - . _ . . -. . . . -- - - - - - - - -- - - -- -- - - -- - - . . -- - - - - - - - - - - - -- - . .-. . . . ---- - - . . . . . . . . . . . . . . . : .__ :,.. . .. . . . . . . . - - - - - - - - - -- • . . .. . . . . ... . . . . .. . . . . .. . . . .. . . . . . . . . . . . . . . . . . .. . . . ... . . . .. . . . . . . . . .. . . . .. . . .�_ .. . . . ... . . . . . . . . . ... . . .... . . . . . . . . ... . . . . .. . . Included are forms required which must be completed and fees submitted before reinspection. D a office al pages F622-012-000 alteration permit 12-92 White-Olympia reen-Contractor Canary-Inspector Pink-Purchaser Goldenrod-Purchaser MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg. III 426 W.Cedar P.O.Box 186 Shelton,Washington 98584 (360)427-9670 BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION Re: Permit No. Dear �rsQ , h�41 _ /' As per your recent r quest, this office has noted the above permit for extension to ([/w�9 , 1996 . In order to keep your permit valid, u must call for inspection prior to this date. In the event that ou do not call for inspection, the Uniform Building Code allows for jurisdictions to require the renewal of building permits. Depending on the length of time of expiration, there are two methods used. If the permit is expired by less than one year, renewal may be obtained by paying half of the original building permit fee at the discretion of the building official and if the permit is expired by more than one year, the jurisdiction can require that the permit actually be processed as a new permit with routing to all required departments . If you should have any further questions regarding the validity of permits, please contact the Building Department at (360) 427-9670, Monday-Friday between the hours of 8 : 00am and 5 : 00pm. Sinc rely, �Sa - unty Building Department cc: Property File [flR@R0TRM Permit No. MASON COUNTY AUG 2 2 N4 BUILDING PERMIT APPLICATION 11gA- 42 edar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 #1 r Chr1'5+1tla L , l LCrl (G Phone# aCL - 41'7S -6 COIN. to Address AhF, !%Q An e- tre-e /,4 Ire Fire District#�� City 7^A N C-y A St U)A Zip 9�5 9.9 Directions to Job Site TaKe -tie Sec end ri d h•t pa-si kit-En-ir S+aie PQ=r K TA Ke- e `tom rtG h�- Tog Huv i4 l7eLi:ct _rc rcl) - E l lore 1,-n-4-1 I \JDU-C©n'Le 4-o ID.n K +n l re- S40A*,On 4r r.'-n (? 5 h± , Ill l'n e I S 3 r e-d 4o 44iQ ►—r a h-f- P►n e i rc-e- bg n i Am 4KQ - ,-A c f eoh 4 h e ri d hl zaA,-- - nice-. Owner Mailing Address ALE 96) P:ne Tree /A/ie City 'TH 61i tyA aM St '-L)? Zip �!96 9s' Lien/Title Holder Rim/o Cr 7- Ma 4-{hFrn Address !2!5& C e-Cnr _(�-f Clty RUCK 1eV1.):4 St��zp 9,33a/ #2 Contractor Name Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic?__V/' Public Water Supply Well CQmmun t Connect to Sewer System? Name of System c S i s c e. CD m m cam.zi i q i A Q 11 (If residential, proof of potable water is required) #46 lNo. J:3� / -!S3 - GDO/U �eg? Description Lc2t l0 o>F=C61h/ S /�►ke Nd. 5 .c5 rere,rd-Ed 1n volt/vie Q r-sf "e• t9, f;ec6,1zl S o*' ftVL5an Cet-,^+y 1 WASh.n j fof), #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FI f% / 3rd FICA/ Loft_/ Basement Deck / #bedrooms_/ #bathrooms 0 / Garage / Carport / (Circle:Attached or Detached?) Other M p e l f l6 m e. sq. ft. / #6 Use of building Flonki e (40. Il y t. zo Describe work re jQ lac-c merit C �x1�.-�inC. J #7 Type of Job: New Add Alt Repair Other Cc -f It #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year / i MakeNeu;,IWtA Model Length 5 C_Width Serial No. FS /3 Q-� S5 #Bedrooms LR #Bathrooms Type of Heat,:�lec 1-r�c, c.�rnaL� Purchase Price$ 5,0C7b, on #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pon Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other prl&S in Sarnln e r Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways w 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 APPLICANT TO DRAW SITE PLAN BELOW APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No.=J_Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other Bath Tubs No. Units Fees �- Showers Furn BTU rHot Water Htr Heatpumps Laundry Washer _ Vent Systems Sinks Spot Vent Fans _Floor Drains No. Boilers/Compressors __Laundry Basins HP D Dishwasher No.. Air Handling Units 1-Disposal _ cfm# _Urinals N� Fite Prote"chti n 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 0 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- TOTAL MECHANICAL $ 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 X BY DATE DATE FOR OFFICIAL USE ONLY:Accepted by: Date: ��)ZZ DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Shy-cl%ya- YYIu:54- bz Se}1asK 0,4 )eared- 9- ' &un_Q 11 I' ilT$ Q1Vtii Aq-Q- �e b44IS . Q 10 k( O f �J i Kvcim - Ovile-s-S Environmental Health: OWNER/BUILDER TO ASSUME ALL 1 RESPONSIBILITY IF DRAINFIELD AREA IS ENCUMBERED. Building PI n ReviewZt.Z:: 6f GG(dAJL" 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 q6-cxj Other CJ Building Valuation: TOTAL FEE � TOT C-