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BLD2006-01535 Final SFR - BLD Permit / Conditions - 6/1/2007
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PLEASE RES DING PERMIT APPLICATION 00 �l Svc swo476 W. Cedar• P.O. Box 186, Shelton, WA 98584 i�fie3Tion (360) 427-9670 - Belfair(360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORM TION CONTRACTOR INFORMATION Owner w A S Company Name 44 I L I IUE b ►y_S Mailing Address G Mailin2 Address 1973$ /O"C.!' nve. A)& S30 City State��Zip Code City a State WA _ Zip o ?37O Phone •-91 Other Ph. -'78G -547Z Phone 60 9 - y Other P 80`1-I-aZ Lien/Title Holder u S Contractor Reg. I�-/AJ Exp. E mail address 5E6 C'ok--4cc E Mail Addressts5kXJ.h 1'1 i Ne Vlaw+e S . CO" Drivers Lic.# KA#jTAAQ31SDWDOB -S- 1 4o Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 2 1:�-S 109 001 1 Fire District L' 4-v Legal Description I-OT Or 540v♦ P Is*+ At Z 24 Site Address(Please include street name, street number and city))()( MAso (Aide RGA :SW:SW4w, WA 59q Dire tions to site Ma wAa► air; i& eu* r; tv o v\ Lake.R , to m_ I 1 IK Pfa;,r �s vse Will timber be cut and sold in parcel preparation?Yes No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Slopes or Bluffs /o Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add R Alt Repair Other PRIMARY SIDENCE SEASONAL ❑ Use of Building MI escribe Work - No. of Bedrooms No. of Bathrooms_& Square Footage- 1st Floo 5 Z 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage_ Attached -_)(-Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width S io. No. of Bedrooms of Bathrooms i ? Type of Heat Purchase Price$ Replaceme Yes/ No Installer Name Certification No. 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 that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.This permit/application becomes null &void if work or authorized construction is not commenced within 180 days r if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS GRESS P TION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X OU3t4AA/ Date: Owner/dwnefs Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department la Fire Marshal FEES Buildinq Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee PI n Review Fee Mechanical & Base fee Other / DO Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES 'MASON COUNTY PERMIT NO. G . DING PERMIT APPLICATION {� 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 helton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFOR TION CONTRACTOR INFORM ION Owner ••,� Z�A S Company Name M I L T I'J f-&IA4C Mailin Address ' C. Mailing Address / 3 /© ve 30 City A _State Zip Code C City Pool'5b State WM Zip Code Phone 360 86G-9109 Other Ph. -7W4 - 5l17r Phone ��` -/Aj O h r P Lien/Title Holder ��^'` "A `4ci Contractor Reg. 91 Exp. E mail address K c%%A e;, e' cc,S E Mail AddressW •�' I ¢ `18w�t Co" Drivers Lic.# AN•TA A G 315 O DOB S- I S Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well. '' _ Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parc I o. Fire District Legal Description /_0 r 1 rr 51.0t/� 1$ *1 Z 74 Site Address(Please include street name, street number and cit )X M nS,t s ¢ ov4 . , J , WiA Dire tions to siteTravA Mc.kw�►w ntr,p Rd, o,r�n L:u # C t M• p*n Lwrlt� eau r ti 1&,(k OV% Ma 6%A LAke Rd. A roK tj t ,%e vow Jtwasc,in L.K E6 - AcEtu)vA rtm,a.e Will timber be cut and sold in parcel preparation?Yes Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff i Stream Slopes or Bluff— s /o Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No j TYPE OF JOB -_lbw Add Alt Repair Other PRJMARY SIDENC SONALUseofBuilding rest yakia1 DescribeWork7571 �'�'"� No. of Bedrooms No. of Bathrooms c Square Footage- 1st Floor + / 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage.— Attached .bC Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make odel _�nit? Yes - --' Year Length Width l•No. No. of Bedroomsof Bathrooms Type of Heat ' Purchase Price $ Replacem o Installer Name Certification No. , 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 that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all �... the necessary parties. If permission is required from any easement holder or any,other party in interest regarding this application or the work proposed in the application, I have obtained permission Vom them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEAN GRESS P TION.INACTIVITYOFTHISPERMITAPPLICATIONOF11880 DAYS 1(VIL VALIDATE THE APPLICATION. a X 4G��+•W Date: +j I t[C} Owner/Owne s Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: ? Date .� !� DEPA RTMENTAL REVI EW APPRO VED DE NIED NOTES Building Department Planning Department Environmental Health Department _ Fire Marshal �`= ~ FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES -MASON COUNTY PERMIT NO. ?:�-0G)-O Ma DING PERMIT APPLICATION {3((-'-�� ' P.O. W. Cedar- Box 186, Shelton, WA 98584 6 �� QheTton (360)427-9670 - Belfair(360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us - APPLICANT INFORMATION CONTRACTOR INFORMATION Owne Company Name I L Mailing Address Mailing Address /1"1'3 S /O th oq ve. AXc S 3 0 City_011,4. State ',uA ip Coe !NMO Z City State Jam_ Zip o lt F37 Phone Other Ph. ']St,( _ 5 y Phone Other Ph� o7- I-Mt Lien/Title Holder Contractor Reg.#tj I L/1-jf Exp. E mail address K .1 a &,)� 0,6�ccaS4 &4. t E Mail Addresst.s e Inoiwe s . C.O�'1 Drivers Lic.# Legg AITA3/ D DOB - 1- Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire DistrictLa&A44.A,;cX Legal Description v ,a Site Address(Please include street name, street number and city)0 M ast u LA iee Road, Shet W 5'8 584 Directions to site o44 rb 'r c Will timber be cut and sold in parcel preparation?Yes 'No Is property within 200'of Saltwater Lake River/Creek Pond Wetland 4" Seasonal Runoff Stream Slopes or Bluffs Is this permit "bmittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - NewAdd Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building 12ss,m4-i mI Describe Work No. of Bedrooms —No. of Bathrooms r Square Footage- 1 st Floor a, t 5 Z 2nd Ploor 3rd Floor Basement Deck Covered Deck Other Sq.ft: i Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make odel �� Year Length Width Se No. No. of Bedrooms of bathrooms Type of Heat_ Purchase Price$ Replacer'ne . Yes/No Installer Name Certificbtion No. 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 that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission'from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information rovided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.This permit/application becomes null &void if work or authorized construction is not commenced within 180 days if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS QBAjW0GRESS1P ION.INACTIVITY OF THIS PERMITAPPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X 0 W tAA.A✓ Date: 'g IT 10!�p Owner/O ne epresentative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: ; ZLC-) Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee 49 PlanningReview Fee Mechanical& Base fee rig, Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee /mod �/U� Pre-Paid at Submittal Valuation $ 0; 1(p S$0, b TOTAL FEES ,MASON COUNTY PERMIT NO. s.•_ - ` ,. DING PERMIT APPLICATIONf�=�'" W. Cedar• P.O. Box 186, Shelton, WA 98584 -� 'Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner""" lk W.,� y Company Name I a r e •� g Mailing Address �� - t Mailing Address City States ;►l Zip Coe ,.. —. City .s State r Zip Code Phone Other Ph. r_. Phone'..;, Other Ph _ s. K ! we Lien/Title Holder _ Contractor Reg. # ; i ! ! * f: '�i Exp. E mail address E Mail Address;c wt ), x = 4 + l Drivers Lic.# 4 "a -7 P4 !r, �,r1 DOB `' Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic_-_.i Existing Septic Connect to Water System Name of Water System Weller Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. _.Z I �y :; 9 1 fj -�+ I + Fire District 4 - � a-K Legal Description L-� T "' i ,� ' L ,. i_t #'I'I I .ad Z 76,9 Site Address(Please include street name, street number and city) '�; Lt�yu A6 ,,ad = £_{ 142A, L of y °' Directions to site tat rye 1—zA . ,i,.v.y, k.t ;.,,.:,� � ,.� ,;� ,.��� � �-�. � V'w Will timber be cut and sold in parcel preparation?Yes,moo") Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - NewAdd Alt Repair Other PRIMARY RESIDENCE Q SEASONAL ❑ Use of Building ig-a L - �l, ,} j Describe Work • � ` jd.A Lai* No. of Bedrooms �, No. of Bathrooms 6--� Square Footage- 1 st Floor - `-= 2nd loot 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make __Model Year Length Width Serial No. - fr —____No. of Bedrooms—_No.of Bathrooms Type of Heat Purchase Price$ ,-- m Replacement.U-nit. Yes/ No Installer Name Certification No. 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 that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.This permit/application becomes null &void if work or authorized construction is not commenced within 180 days if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS QFARROGRESS I ION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X t.�_: Date: I! Iv Lo Lra Owner/O ne epresentative!Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: 'r l Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department 1t , Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST BE COMPLETED IN INK PERMIT NO.—& ' 1535 PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar•P.O.Box 186, Shelton,WA 98584 Shelton (360) 427-9670• elf (360)275-4467• Elma(360) 482-5269 Un the web www.co.mason.wa.us APPLICANT INFOR ATION CONTRACTOR INFORIII�ATION Owner To rJ u aLA4.S Company Name-�{I�-�N� i4O� S Mailin Address 3 7 2-7 Wes c.�• �U C,�• Mailin Address 197 S,& WOTJ AUt.A 6 S 361 City ftate L A Zip Code 6 Z City 6 tate t,3 Zip od Qg370 Phon 4- Other Ph. 7SG_ 7Z Phone S9 9-1 Tq9 Other Ph I $01- "ILL Lien/Title Holder Contractor Reg.# H t L I W 9S I &'�Ex . E mail address Ida ti dn'Z � �'� - t� E Mail Address tAtOt' h (;rn 2L�aw S_CO�M Drivers Lic.#1KA&3Y AAG3t'SDA DOB 3-1-69 Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No. Fire District L• ocK Legal Description LOt �- Sho,r+ fl(x,+ 4LZ69 Site Address (Please include street name, street number and city) S . Skcl WA Q S$ Directions to site-F cum► M tv we Rd. ,r -I- o - MAzo" twee W. A-ap Oh f 1 + -54e eN Hwsatn LA K ')y P.4 -FveL A misw-) a Rd--Ill ir. �-► Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff C Stream Slopes or Bluffs > 15% TYPE OF JOB - New-)(_Add Alt Repair Other Use of Building Location of Fixtures/Units- 1 st Floors 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNJTS Type of Fixture No. of Fixtures Fees Fuel Type:Electri LPG Natural Gas_ Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace f Bath Tubs / Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/PelletStove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUL.DER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Aclviowledgement of 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 to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. P TIN7F ORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: A I t g' j o Cn Owner/Owners IWresentative/Contractor (indicate which one) FOR OFFICIAL USE BEYONDTHIS POINT Accepted b lanning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Grouo—Type Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical&Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES JUN-29-06 09:58AM FROM-Hiline Financial 2537702226 T-770 P-002/002 F-011 DEPARTMENT 6F.LA80R AIYD INDUSTRIES REGISTERED AS' PROVIDED BYLAW AS 1' CONST CONT QENERALz' 1" '* i ` tf� HILINE• HOMES 113.06 62ND AVE E PUYALLUP WA 98373 r-6�-oss•oo0 rev;� *- - non A„d Misplay CcMJ CWB— REGISTERED AS PROVIDED BY LAW AS) CONST• CONT GENERAL Please Remove REGIST. # -EXP. DATE CCO And Sign 1' " HILINH*g81BT '02/10/200B EFFECTIVE DATE 01/.3 0/2 0 0 2 Identification Card Before HILINE HOMES,**, Placing In 62ND AVE E Billfold PUYALLUP •WA ::983 73 S�Q1Sru!'e Jhpcd h- DfP'�RTMENY'OF L-A80K AND 1NDUSTRIO 1.621-03-101(AN7j APR-12-2006(WED) 13: 06 Mason County Title Insurance (FAX)3604260716 P. 006/006 +sa.xr_,z SHORT PLA r .��1►I .N ffim DA M 0 •.• ✓AAth'S A. & SHIRLEY SR/X JOHN A. & rr DE'V t`a' MI JEAN BISHOP, PA E. E.& &Me RE 0 6 12 2 2 PW C f/x Ar;W br 714 Or 28 2 SECTION .33, TOWUR:IP ,21 AfORN, RANGE 3' MT. W.A.I. 33 34 3JM KITSAP YIAY RXMe M+aM 8/V-4ERWAI. WA. 98X2 woRUMENT Put I PAR=AK1 =fJ.1+7p.0W0 VOME 14 PACE 170 G OF 3URVE1y N I. b » 1.43 ACRES.. �. e 9 Re4o'41' wYAU t5r'. /� II 21t0y P05318LC � !` � { 100' R yry^'i J� U a .A 1.RI..Z'•••'... • �� MGBAAL o ' 11.43 AC RCS � 7071'30' 7 ;f WELL 1'oS98CC ' I 101.10- • 1 o•11?Y'Ss' •IWOER Co. MONUMLO PER S L.14.7.Y I I •• VQUW 14 PAGE 170 or SURVE" Or� 99.7T ao' '.1ZW ,...... s O AIC27" w 1� R�7Z1.Oa'.•' �� �r. 1 21 0 $ •�..rr�.T ......... QZ 1 POSSIBLE •••• I eb•li'•1O' pr71]•9�' 31 8 P05518Lt: z ` 10.R k WELL in low R I3 a r• R.73�.04 xIE z1b L•-Zor 1.N�ACE,• 1 x . 1.43 ACRES N 0071110' w •+ ULU. —LEGEND Q Mum CO mm Ay me= p r sR 51a,KwMERIDIAN 1,64"a tw BASED ON MASON LAKE ROAD mmul/r PPEERR m Vm�° NUMB Y ROAD PROJECT %CLUUL 14 NUMBER 1005 '? 'ice PACE R ; ' ' ' ' y FOREST LAND SURVEYS or RICHARD B.NORRIS P.LS. P.0. Doc 307 34 •• RNFLIM ruswwetnu n.... (S00) 427—OD7D - Building Permit Information Form - 2152 Plari This form contains the information you'll need to complete your building permit packet. We've included information for all counties, some of it may rot apply to yours.If you have any questions,please give us a call at 360-807-1849 Applicant/Owner I Contact information: Your name.address,phone number Contractor Information: Name: HILIne Homes Address: 12 3 Long mad Centralia. _ Phone: 236-8 7- License# 1 Expiration: 0 1 6 Tax Parcel#/Assessor's AccL#: This will be with your property information. Job Site Address: Your new home address(example:xxx Filmore St.) Legal Description: This will be with your property information. (example:Lot xx t aW W Sub Division xxx In Thurston County act.) This will be a New Singh Family Residence Describe work I Type of Job:New Home construction Home Information: Floor Area:(sq.footage) Main/1st: 2152 #of stories: 1 Carports: 0 Second: --iT— m Bedroos: —3 Decks: 0 Basement: 0 Bathrooms: 2 Porches: 0 Total: Garage: 576 (Attached) Construction Method: Wood frame Heating System: Be sure to choose the information below that correlates with the heat system you have ordered. HVAC I Mechanical Contractor is the company Installing your heat system. Cadet I Wall Mount I Zone Heaters: Standard heat s n i a tc m 11-icense#: a Phone: 2 Expiration: 7 Location: Olympia E0,mmits. uf: Cadet_ Brand: Register Plus dule#: �11�ib2— KW: 7F: AMPS: 20 for the#of wall heaters 1 or u'II be charged extra for every one. Heat Pump wl furnace wIHWH.. n s Dave e [onnage se#: 2 Phone: �— ation: 09/2 Location: hehalis uf: Trane Module 2TWR103OA1000A KW: 10 2'A HSPF: 8% Seer: 10 Effidancy: 1 r. Is -W Metal tact: ave es ceasI #: M25 Imo— Phone: 0-748-992 pits ion: O/04 Location: Chehalis anuf: Trans Module: TDE06OA936 Watts: 977 TU: 60,000 Efflcancy: 80% r=n rs av es #: H 252 Phone: 7 8 9921 Location: lis Trans Module: TDE06OA936Watts: 977 60.000 Efficancy: 80 Spot Vent Fan:1 Kitchen Exhaust Fan: 1 Drver Vent• 1 Wood/Gas/Pellet Stoves: 0 Gas Outlets: 0 Plumbing System: Installer. DeeDubS Plumbic Contact: DARREN License#: UPLI9900KK l Phone: 360 56.7� Expiration: 03/07/05 Location: Olympia Toilets:2 Bathroom Sinks: 3 Bath Tubs: 1 Showers: 2 Kitchen Sinks: 1 Water Heater. 1 Clothes Washerl Dishwasher. 1 Hose Bibbs: 1 (first 4 enter quantity of 1,every home has 2) Energy Compliance Information: Compliance Method/Path:Always#3 (Per Washington State Energy Code) Total sq.it of glazing(glass): Standard home: 247.3 . wl sliding glass door option: 264.3 divided by total sq.ft.of heated area: 2152 equals a glazing percentage of 11% standard or 12% wl sliding glass door option. Swinging doors and skylights are not included in configuration because they meet all minimum requirements Window Schedule: See attatched form. Ventelatlon System: Intermittently operatinowhole House Ventilation System using exhaust fans&window fresh air vents.(VIAQ 303.4.1) House Fan Specifications: Whole house fan:Qty:1 Manut NuTone QuieTTest Module#:QT130 CFM:130 Bathroom One-Bulb Heater/Fans:Qty2 Manuf:Solitaire Ultra Silent Model#:162 CFM:70 r.—A.►.+Onna Wit i—►.r— MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/VIAQ Compliance Application Owner: t, Ko"Ak-S Telephone: 364, q`o8` Parcel#:-3Z t 3-3 i O-j,, Type of project (' 4 New Residence ( )Addition ( ) Remodel Total Sq. Ft. i Floor: nd floor: --FHeated Basement: of heated area:: I Z, k 5 Z Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type: O Other:Specify Glazing O Prescri tive Option see reverse side circle one: 1 II IV Percentage: Compliance Method O Component Performance , Chapter 5— Calculation worksheets required Check one:: % O Systems analysis, Chapter 4 O Whole House Ventilation system O Whole House Ventilation using a Heat Ventilation using exhaust fans&window or wall fresh air Recovery Ventilation System (VIAQ 303.4.4) System vents (VIAQ 303.4.1 Check one O Whole House Ventilation Integrated O Whole House Ventilation using an inline with a Forced Air System (VIAQ 303.4.2) supply fan. VIAQ 303.43) Window & Door Schedule(If needed, attach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Windows: NA a.-rd - 3Ce 6`6 -1" 5 `U I 3© M:1 S Av-d6e, -cx" Z 5A 1�; ,C) Z5' Z q G � MI o.r mrs},w 9,%+t1A+ 3& -3`o 3 CU o X IkA t .d GkP�k ems,. , 3L� V- Naa k .3 f. Z'o x !V0 M;1 laid Q L-eA0k ac>ole .3Ce 3lo r< S`D i 15 f�►'I S� K 6�r,%"kAA 3 (a Z Z I `� 6A,% wJd ����� R .3� 6'C),K S`0 3� M 11 vrJ(� So tAQS IR VA ' 3 6 6'0 15 0 t 3© ENVY L , 3Co i `g 5r .3 Windows: Total Sq. ft. Doors: �,1�, gut✓c�i e 41gr i i i Doors: Total Sq. Ft `� Total window and door area Total window&door area VS\ /(divided by)total sq.ft of heated area 2 t IS L, = (2 %of glazing i i Window Schedule HIL I\E for 2152 plan H O M E S Manufacturer: Milgard Windows Inc. Model: Classic Series Type: Vinyl U-Value = .36 Windows Quantity Size/Handing Glazing area Total S . Ft. Location width x heighth / 1 6'0 x 5'0 30 30 Den 1 5'0 x 5'0 25 25 Bedroom 2 "1 6'0 x 4'0 24 24 Mstr. Bedrm 1 SO x SO 9 9 Mstr.Bath 1 7'0 x 5'0 35 35 Great Rm. 2 2'0 x 5'0 10 20 Break. Nook i 1 SO x 60 15 15 Break. Nook i 2 3'0 x 3'6 10.5 21 Kitchen 1 6'0 x 5'0 30 30 Dining Rm 1 6'0 x 5'0 30 30 Bonus Room 1 1'8 x 5'0 8.3 8.3 Entry Total glazing area 247.3 sq. ft. 247.3 - 2152 = .114 X 100 = 11% Glazing Area s Conditioned floor Area Glazing Percentage If a sliding glass door option was chosen, switch the appropriate window w/the sliding glass door and use the calculation below. 1 6'0 x 6'10"sgd 41 41 Appropriate Room 264.3 - 2152 = .122 X 100 = 12% Glazing Area + Conditioned floor Area Glazing Percentage All other doors,windows&skylights do not need to be calculated do to the fact they meet all minimum requirements. Mason County Permit Assistance Center Planning Intake Checklist Owners Name: AAAS Date: Project: Reviewed By: Commercial Development: YES NO nments: Planner: GBM TSC CMM KJM PB RDH Site an: North Arrow a� -a''Pro erty Dimensions: _X Q—Sbeets and Driveways Shown. Road name: hoo xj- A Existing Structures shown with setbacks a"Well Location. Septic and Drain-field Shown with setbacks q-,k fy all surface water(streams,ponds, shoreline,wetlands,etc.) Topography(slopes) u- Proposed Struc Setbacks(Direction/Setback): F: /�R:F_/� S 1:�/ p 10 S2: a"'Utility and Drainage Easements: Yes No (if yes enter condition#5022) l er Easements ef Accessory Appurtenances OC County Access Permit Needed(add condition#0010) State Access Permit Needed(add condition#0020) 0 Standard Conditions to be added to all Building permits that planning reviews:#5019 and#0700 Are there any impediments that may restrict access to your site? (dogs/gates) Shoreline and Planning Info Setbacks: Shoreline: l Slope: _ Shore ' e Designation: Comprehensive Plan: Rural Zonin of Applicable ❑ Agricultural 0- 1�R- 2.-Sg 5 gj0 20 ❑ Urban ❑ In-holding ❑ RMF ❑ Rural 0 LTCFL ❑ RC 1 2 3 ❑ Conservancy AT R_oral ❑ RI ❑ Natural 0 RAC ❑ RNR ❑ Unknown 0 RCC Hamlet 0 RT ❑ Urban.Growth Area ❑ MPR ❑ Unkno ❑ Unknown j Water Body(type of water if unnamed): SEPA: Yes No Undo M !^� Flood Plain: YES NO L6" Map# Aquifer Recharge: YES NOwn Map# Tags/Cases: 3 RLC/SPI Case: 6-Year Dev. Moratorium: YES Eagle Nest Tag: YES PO Other YES O Addressing: Check box if needed 0 Reviewed by: i S Revised: I 1-01-2005 .1:1PLANNINGPAOPLANNING INTAKE