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MECHANICAL MANUFACTURED HOME m
CINCRETE
JR
Footingsi Setback Date By RRibbons N
Gas Piping /�•%�-(�T O
0 Interior Date 7/2�/� By Llby-- Interior-bate By bale By Z
CnExterior Date By Exterior-Date — V7 Set-up O
Point Load Isolated Footings INSULATION bade By Z
Date By Tie, at r SLAB IIJsIlLA71flN FIRE DEPARTMENT
/®-L3�6 bate By
Foundation Walls Floo Date By
Date g- - D( ByG� bate By DECKS
FRAMING bole By
Date 0 - ///- ? B l�i,87� bate o By PROPANE TANKS
PLUMBING Vauik Date By
Data 4 By OTHER
Groundwork Attic
Type:
Date By Date — By Date By
o.w.v DRYWALL Type_
int Brace Wall bate By W
Cate Z- /7"G 7 Bye Gate By
FINAL INSPECTION N
Water Line Fire Separation p
Date 2-�lj�'p2 ayl'l,�'� Date 3` �� By /�., bate BY
Pass or Request Inspect. o
Type of Insp. Fail Date Date DCne By Comments
CD Lf ~
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CUD
N
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7 0 7 z7 U. LQI�
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RIP 0:: ;/407
. .
PERMIT Nb-�`J��'`� V�h
` " MASON COUNTY ,
BUILDING PERMIT APPLICATION 2�y
" 426 W. Cedar• P.O. Box 186, Shelton,WA 98584
Shelton (360) 427- 6 the welb irw 360)275 on67 - Elma (360) 482-5269
APPLICANT INFORMATION us
CONTRACTOR INFORMATION
4a' Company Name cl ��
Owner n l �_ ' � ''r•s `' Mailing Address
Mailing Address N 3► �" "' '�"p State Zip Code
City > State W A Zip Code g Phone�_S'�� City
Other Ph.
Phone - 7s-. -�Q-Other Ph.3�-7 75 - 14y'7 Contractor Reg.# Exp.
Lien/Title Holder E Mail Address
E mail address Drivers Lic.# DOB
Drivers Lic.# e DOB - J
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic—j.==�— Existing Septic
Connect to Water System Name of Water System
Well Sewer System Name of Sewer Syste Fire District z
PARCEL INFORMATION - 12 Digit Parcel No. 2s
Legal Description
1 Al I/. o ..a �`�„
Site Address(Please include street name, street numberand city) 14oGpp r r�G 5
Directions to site w
14, �-
r
l timber be cut and sold in parcel preparation?Yes/No lea S�a 1roperty within 200' of Saltwater Lake +--- River/CreekPond
tland Seasonal RunoffStream Slopes or Muffs hers this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes
TYPE OF JOB - New• Add Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑
Use of Building dc. -a ) F ,�b tf Q/ Describe Work
No. of Bedrooms a- No. of Bathrooms 2.�1� Square Footage- 1 st Floor ► 1 2nd Floor
3rd Floor Basement. --Deck Covered Deck !&-'Q Other Detached ----
Garage_— Attached ✓ Detached Carport Attached
Model Year
i MANUFACTURED HOME INFORMATION - Make No. of Bedrooms No. of Bathrooms
Length Width Serial No. Replacement Unit? Yes/No
Type of Heat Purchase Price$
Certification No.
Installer Name
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 the contractor. I further declare
and to do the work as proposed in the application. I declare that I have obtained the permission from all
that I am entitled to receive this permit
the necessary parties. If permission is required from any easement holder or any other parry in interest regarding this applicy r the jw
ed
proposed
r agent on owners behalf,i�epr cents hat the Info mation provided is acermission from them to curateoand gr this aMsiemployees t and uof Mason Cct the work ounty aeccesis�{o
k g r review and inspection.This permit/application be null &void if workTINUAT ONO or authorized nstru described property and structure fo not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONMEANS OFAPROGRESS I ECTIQN.INACTIVITY OF THIS PERMIT APPLICATION OF 18o DAYS WILL INVALIDATE Tl g 1 IDate: r 3 - l - „ C
I X:�9����tive/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: NOTES Date
DEPARTMENTAL REVIEW AP D DENIED `
Building De artment Planning Department
Environmental Health Department
I Fire Marshal FEES
Building Permit Fee
O-2 SC— Site Inspection.
Plan Review Fee -4- 43, I' . EH Review Fee
Plumbing & Base Fee t 3 7 . i�I PlanningReview Fee `
Mechanical & Base fee l(A Other
i State Fee �•5
Wood/Gas/ Pellet Stove Fee Pre-Paid at Submittal
Violation Fee
TOTAL FEES
Valuation $ M?- ��• �� �.. a. .
PERMIT NO.
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.Cedar•P.O.Box 186, Shelton,WA 98584
Shelton (360) 427-On the welb irww3w.0co 75-44mason67-Elma(360) 482-5269
us
A
PPLICANTFORMATION CONTRACTOR INFO�iMATION
a l d S to I •., Company Name a '"`
„ , _ Mailing Address
`j / D g
city
---State Gt) Zip Code S `/ City State Zip Code
-SG:3 Other Ph ZZE , '7S-t4 47"7 Phone-, Other Ph.
Lien/Title Holder Contractor Reg.4 Exp.
aa'1 '
E mail address r "' r>1 `� E Mail Address DOB
Drivers Lic.# r '+T✓`� � DOB G 2 `f& Drivers Lic.#
SEPTIC INFORMATION - Connect to New Septic ''" Existing Septic Connect to Sewer System _._.—
Name of Sewer System
PARCEL INFORMATION- 12 Digit Par el No. f' �'c• r" Fire District
Legal Description ) 1,e "_ J_a 1, 1
/ �7 / A E C i1 t> 7'a , t LIP
Site Address (Please include street name, street number and city Yam(t 'r L^ r, e la'o
Directions to site I t
�, p t' : fee.^ Zif . Lie E. ,f fr cF
River/Creek 2600°04 ' and
Is property within 260'of Saltwater Lake
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New f!' Add Alt Repair Other Use of Building
__ __ 2nd Floor Basement 4 Garage—Closet—
ow
Location of Fixtures/Units- 1st Floor
PLUMBING FIXTURES (Sh Number of each) MECHANICAL UNITS
Pump—
Type of Fixture No. of Fixtures Fees Fuel Type:Electric v' LPCs Natural Gas __ Heat Fees p
Toilets Tvpe of Unit No.of Units
Furnace --T--
Bathroom Sink Heatpumps
Bath Tubs Spot Vent Fan
Showers z
Propane Tank
Water Heater l Gas-OutietS
Clothes Washer elletStove t
Kithen Sinks tumen Exhaust Hood I
Dishwasher Dryer Vent f
Hosebibs Other
Other Base Fee
i Base Fee TOTAL MECHANICAL
TOTAL PLUMBING
ment of
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation•Admowled9e
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled toreceive
o is
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all thenecessan,I haveeobtained
the app!
required from any easement holder or any other party in interest regarding this application
owner or agent on pprope behalf,represents that the information
` ed
permission from them to apply for this pees and conduct th of Mason e work proposed. propertyand structure for review and inspection.
{ PROO is accurate andF OF CONTINUATION OF rants employees
O K IS BY MEANS OF A ROGRE to the above described
Date:
X Owner/Owners Representative(Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
d Pd Receipt No.
Accepted by: Planning Pd Ck# Date B
DEPARTMENTAL REVIEW APPROVED DENIED
NOTES
f Building Department
1 Occ Grou T e Constr.
! Planning Department
II Environmental Health Department
FEES
Site Inspection
Plumbing&Base Fee
UFC Plan Review Fee
Mechanical& Base fee
Wood/Gas/Pellet Stove Fee Other
TOTAL FEES
Violation Fee
TH'IS 'PAR' C-EL.
INCLUDES
PlA- NSf ' BL-UEPR* YNTS
OR OVERSIZE
IMAGE$ - .
LARGE 'FORMAT
IMAGES HAVE BEEN STORED ' I-N
FILE CABINETS) UNDER
PARCEL NUMBER
PARCEL # ,d, So - C�oo4U
CASE # ro LL Z60(�
5 i T'�
MASON COUNTY
DEPARTMENT OF HEALTH SERVICES
March 17, 2006 PO BOX 1666 Shelton WA 98584
Shelton (360)427-9670
Fax (360)427-8442
RON JENSON Elma (360)482-5269
431 E RAINIER DRIVE
ALLYN WA 98524 Belfair (360) 275-4467
Case No.: BLD2006-00357 Parcel No.:223195000094
Dear Applicant:
Your building p PP Y permit cannot be approved b Mason County Environmental Health until the
following are completed and turned in:
Application for Water Adequacy
Complete and accurate scaled plot plan which shows all building (actual and proposed),
I
driveways, location of septic system, location of reserve drainfield and wells.
Please see comments at the end of this letter.
Please call me at (360)427-9670, ext. 554 if you have any questions.
Sincerely,
i
l
Trish Woolett
Environmental Health
Mason County Health Services
Comments: 03/17/06 need revised site plan, existing site plan has the home
enchroaching the drainfield area. We need a new site plan to scale with
1 Oft setback to foundation from drainfield and 5 ft to septic tanks and
30ft setback from a downgradiant foundation drain.
3/17/2006 1 of 1 BLD2006-00357
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/Y plication
Owner. a ephone: r S- Parcel#: .
Type of project ( .)New Residence ( ddition ( ) Remodel
Total Sq. Ft. 1• Fl floor: Heated Basement:
of heated area:: 1 •7 8 �1
Heating System Type: O Electric wall heater X Flectric Central Fumace O LPG Furnace
V Heat Pump with electric furnace O Heat pump with gas furnace O Boner,specify fuel We:
O Other.SDecffy
Glazing p Prescriptive Option see reverse side circle one: 1 II III
Percentage: Compliance
Method' O Component P ;,G r 5— catoutavon worksheets tequw
Cheat one::
% O S stems.ana , er
O Whole House-Ventilation system p Whole House Ventilation using a Heat
Ventilation using e*aust fans&window or wall fresh air Recovery Ventilation System (NIAQ 303.4.4)
System vents (F7AQ 303.4.1)
deck one
O 'Whole House Ventilation Integrated O Whole House Ventilation using an inline
with a Forced Air System (FIAQ 303.4.2) su I fan. VIA 303.4.3
Window & Door Schedule (if needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
LMndows. e �c 3 0
srcr,
-4 1 iZ R
E�7N c t �. z R
loses x .
_ :3` K5°
cj e wt e� -3
Windows: Total Sq.ft.
Doors:
�Q9W e -I j
C7 q0 �O
3 `
AAu• d,,
Doors:Total Sq. Ft
Total window and-door area
Total window &door area /(divided by)total sq.ft of heated area = %of glazing
The CIA Group of Washington
Service Contract
Date: t4Lq 10
Customer Name: �RflN .JE�Jsetl
Site Location: r f NLI mfN. bX
City: wVA State: bVit _ ZIP:
Home Phone#: 360-'7T 1- 79z3 Mobile Phone#: FAX#:
This document constitutes a Service Contract between At TE n/S ed and The CIA
Group of Washington, LLC. This contract lists the services to be supplied by The CIA Group, LLC,
and may not be changed without the written consent of both parties. The customer requests a to year
Warranty.
Services Required(check and initial all that apply)
❑ Mold Prevention: applies the AEGIS Microbe Shield to all areas selected(Initial)
Main Floor Attic _Crawl Space _Garage add-on
✓_Complete Interior Wood Frame Structure including Attic, Crawl Space,and Garage
Other Areas(description):
❑ Mold Abatement: eliminates areas of known mold(describe on a separate sheet which
becomes part of this contract)
❑ Repairs As Required: may be needed during the mold abatement process—will definitely
need to be completed before issuance of The CIA Group, Inc. Warranty.All
required repairs and estimates will be furnished on a separate list and,when completed,will
become part of this contract.
I accept the terms of this contract.
Z.
us mer Name and ate The CIA Group,Inc. Representative
•P.O.Box 12615 Olympia,WA 98508 (360)480-9188 Fax(360)754-6087•
The CIA Group of Washington Estimate
P.O. Box 12615
Olympia, WA 98508 Date Estimate#
2/2/2007 23
Name/Address
Ron Jensen
P.O.Box 2358
Belfair,WA 98528
Project
Description Qty Rate Total
Anti-microbial treatment of all interior wood surfaces including stud 2,300 0.60 1,380.00T
walls,sheathing,truss system and crawl space.
Anti-microbial treatment of garage. 1 450.00 450.00T
Site Location: 151 NE Mountain Drive
Tahuya,WA
n
We look forward to working with you!
Subtotal $1,830.00
Sales Tax (8.3%) $151.89
Total $1,981.89
Prudential
Northwest Real Estate
Next Unread. Rely Re�ly_To.._Ail Forward
Back to_1_nBox Delete. Set Flag ]rCj-oseasUn�readl_
From: "Dan Waggoner" <Dan@kingstonI umber.com>
Subject: Fwd: RE: TRUSS HELP
Date: Tue, 30 Jan 2007 12:04:14 -0800
To: <rjensen@pnwre.com>
What that means is that GE trusses are not structural because their
loads are transferred directly down through the wall. I will work with
Phil, he is the TCT representative that youy met, to get a layout for
you.
Thanks Dan
Daniel Waggoner
Contractor Sales
Kingston Lumber Supply
360-385-1310
dan@kingstonlumber. com
From: "Launa Fry" <Launa.Fry@tricountytruss.com>
Subject: RE: TRUSS HELP
Date: Tue, 30 Jan 2007 11:55:49 -0800
To: "Dan Waggoner" <Dan@kingstonlumber.com>
Did you get my message? The two trusses in question (TO5 & TO5A) are
gable ends, which we are not required to provide engeering for unless
of course they are structural. Unfortunatly we were not supplied with
a plan so there was is not a layout created for this project.
Let me know if there is something more you need.
Thanks
Launa
-----Original Message-----
From: Dan Waggoner [mailto: Dan@kingstonlumber. com]
Sent: Tuesday, January 30, 2007 9: 55 AM
To: Launa Fry
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THIS PARCEL INCLUDES
RECORDS FROM THE
AUDITORS OFFICE
PARCEL # 50 003 cl�
AF# I%y 'i -i tt DOCUMENT nc�4-ic Q r�
AF# I%USg,� DOCUMENT—,u4 Q noi-ic o cl- Ljab Ji
AF# DOCUMENT
AF# DOCUMENT
AF# DOCUMENT
AF# DOCUMENT
THIS MAY NOT INCLUDE ALL DOCUMENTS
RECORDED ON THIS PARCEL
___ II lYIM1YY111IY'Wiir
PLANNIN4n County Permit Assistance Center
Planning Intake Checklist
Owners Name: c-1'f o" Date:
Project: �S' 2 Reviewed By:
Commercial Develop ent: ES Comments:
Planner: GBM TS CMM KJM SNG PBC
Site Plan: RECEIVED
,ot< North Arrow MAR 13 2006
Property Dimensions: � % X 'VC/S- r
Streets and Driveways Shown.Road name: ,4
All Existing Structures shown with setbacks
-W Well Location, Septic and Drain-field Shown with setbacks
,Identify all surface water(streams,ponds,shoreline,wetlands, etc.)
Me," Topography(slopes)
Proposed Structure Setbacks(Direction/Setback):
F:S / 7,7 R: Al / S�1: Q /�S2: _/ )
- _ a Utility and Drainage Easements: Yes� if yes enter condition#5022)
.1(- Other Easements
Accessory Appurtenances Am/
• County Access Permit Needed(add condition#0010)
❑ State Access Permit Needed(add condition#0020)
Standard Conditions to be added to all Building permits that planning reviews:#5019 and#0700
E
Are there any impediments that may restrict access to your site? (dogs/gates)
Shoreline and Planning Info
Setbacks: Shoreline: Slope:
Shoreline Designation: Comprehensive Plan: Rural Zoning:
❑ Not Applicable ❑ Agricultural RR 2.5 5 1 20
❑ Urban ❑ In-holding "❑IMF
❑ Rural ❑ LTCFL ❑ RC 1 2 3
❑ Conservancy Rural ❑ RI
❑ Natural ❑ RAC ❑ RNR
❑ Unknown ❑ RCC-Hamlet ❑ RT
❑ Urban Growth Area ❑ WR
❑ Unknown ❑ Unknown
Water Body(type of water if unnamed):
SEPA: Yes` Nonknown --
Flood Plain: YES N U wn M #
Aquifer Recharge: YE Unknown Map#
Tags/Cases:
RLC/SPI Case: - ear Dev.Moratorium: YE O
Eagle Nest Tag: YES Other S NO
Addressing: Check box if need ❑ Reviewed by:
Revised:11-01-2005 I:\PLANNING\PAGIPLANNING INTAKE