HomeMy WebLinkAboutBLD2006-00177 Windows - BLD Permit / Conditions - 2/8/2006 03
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MASON COON PERMIT NO.��D C t!Zl� �
BUILDING PERMIT A /
426 W. Cedar-P.O. Box 186, Shelton,
Shelton (360) 427-9670-Beffair(360)275-+ff qE t(SfiU} 2-5269
On the web www.co.m n.wT.0
APP IN.r-'s — I N CO Ii A[I
Owner Company Name
Mailigg Address 3 TW I 1ANr S Mailing Address
City StateW4 Zip Code City_ State Z' Code
Phone dZ<��7 269'7 Other Ph.ZOL'C-7Z QB4 Phone Other .
Lien/Title Holder Contractor Reg.# Expl
Emailaddresqaore rvs/t E Mail Address
Drivers Lic.# B I Z Z 5-6 o I Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic
yll-
Connect Water System Name of Water System
Well Water System Name of Water System
PARCEL INFORMATION-12 D' It Parcel No_ 1 ZZ "90c5-r Fire District s
Legal Description ! — L C>f: 1'
Site Address(Please include street name,street number and city)
Directions to site
Will timber be cut and sold in parcel pr ration?Yes I(N)
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
lethWPmwift submMW the result of a Stop Work NothxiCoffedlon Notice or other entacalnwit
TYPE OF JOB-New Add Alt Repair Other PRIMARY FJESIDENCE []'SEASONAL
Use of Building Describe Work149?WqLgjd
►
No.of Bed s No.of t rooms oars Footage- 1st Floor nd Floor ^�
3rd Floor Basement Deck Covered Deck Other Sq.ft.
Garage Attached Detached Carport Attached Detached N
MANUFACTURED HOME INFORMATION -Make Model Year
Length Width Serial No. No.of Bedrooms No.of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/No
Installer Name Certification No.
OV063/BULDER Admowledges submission of inacwroe inbrambon may result in a slop work order or pemrt revocation.Adamwledgemerrt of
such is by sigi alure below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
perm and ID do the work as proposed in the application.I declare that I have obtained the pemiesion from all the necessary parties.9 permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the appicalon,I have obtained
wrosion from them to apply for this pemrt and condtxx the work proposed. The owner or agent on behalf,represents that the inlornm lion
provided is aocu a and grants employees of Mason County comes to fhe above described rty structure for review and inspection.
Al
LXOMO
OF UATION OF WORK B BY MEANS OF A PROGRESS INSPECTION.
Date•
er/Owners 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
Public Works Department
Fire Marshal
FEES
Buildina Permit Fee C1 U Site Inspection
Plan Review Fee EH Review Fee
Plumbina&Base Fee Plannina Review Fee
Mechanical&Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Vio
lation Fee Pre-Paid at Submittal lValuation$ 1 am torn JACM tab TOTAL FEES
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MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner: Telephone: 377- Parcel#: D
Type of project ( ) New Residence ( )Addition ( ) Remodel VP M
Total Sq. Ft. 1 Floor: 2 floor: Heated Bas ent:
of heated area::
Heating System Type: lectric wall heater O Electric Central Furnace O LPG Furnace
O Heat Pump with electric fumace O Heat pump with gas furnace O Boiler, specify fuel type:
O Other: Specify
Glazing O Prescriptive Option see reverse side circle one: I I I 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
System
vents (VIAQ 303.4.1) Recovery Ventilation System (VIAQ 303.4.4)
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 303.4.3)
6O
Window & Door Schedule (If needed, attach an additional sheet) c
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windows: l �3 f
olC70r\ 18 2 3
►� a �� 36 z
A13 .� Doi L G
L hJ (J 10 5 a�_l
vri G L o
Windows: Total Sq. ft. ASMT
Doors:
i
I
I
i
Doors: Total Sq. Ft
Total window and door area
i Total window&door area 4_1(divided by)total sq.ft of heated area V = %of glazing
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