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X w Extenor Date BY Exterior-Date Bv 4 INSULATION Set-up Point Load I Isolated Footings Date By 0 Date B Y BG I SLAB INSULATION ___ z Data By FIRE DEPARTMENT Foundation Walls Floors Date By Date B Date y By DECKS FRAMING Walls Date By Date 8 Y Data By PROPANE TANKS PLUMBING Vautt Data 13y Date BY OTHER Groundwork Attic Date Date B Y Type: DRYWALL Date By Mw�)/ TypW Date Int Brace Wall Date By Py— Data By. FINAL INSPECTION 0 CD w Water Line Fire Seperatloo Cn CD CD Date BY Hate By Dato By C) Pass or Request Inspect. C1 0 Type of Insp. Fail Date Date Done By Comments 5 W CD -4 6 Z3 (D C/ Tt;, 6am% L1 0 U) _0 CD I_Z�07 10i�l-7 kg 0h MASON COUNTY PUBLIC WORKS WORK ORDER *ICU Permit#: No 0 7 711K Date: Requested by: IAS(INMIINIVPI1911P!�I r`c% Authorized by: 4 Type of Work: `=- 2-- a Le Public Works employee in charge: t; �(,t �•#� CHARGE TO: Name: f-t U i,t4 5 Billing Address: 1� Phone: WORK PERFORMED: Employee: Date: Hours: Hourly Rate: Total: ACCOUNTS RECEIVABLE INFO: Billed Date: Invoice#: P Amount Billed: Receipt# Date: t , Amount Paid: lid 1 Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2 ! Topic Index I Contact Info Search .r Horne Safety Claims I3 insurance Workplace Rights Trades It Licensing Find a Law or Rule Get a Form or Publication Look Up a Contractor, Electrician or Plumber Printer Friendly Version General/Specialty Contractor A business registered as a construction contractor with LEtl to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. License Information License ADAMSC`961 NU Licensee Name ADAMSKI'S CONSTRUCTION Licensee Type CONSTRUCTION CONTRACTOR UBI 602410417 Verify Workers Comp Premium Status Ind. Ins. Account Id Business Type INDIVIDUAL Address 1 1621 IRONSIDES AVENUE Address 2 City BREMERTON County KITSAP State WA Zip 98310 Phone 3604150830 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 8/31/2004 Expiration Date 8/31/2008 Suspend Date Separation Date Parent Company Previous License Next License Associated License https://fortress.wa.gov/lni/bbip/Detail.aspx?License=ADAMSC*961NU 12/28/2006 ISTERE (ASPRQVIDE� BT ,,OENERAL r �` XP. C z ADP, SC*�61NU . /3,: /26 TIVE ATE SKI 2 CT_I Z IRONS I S A BREMERTON W 98 -G u i? P Cif: OeANi?fNS' 04/14/2007 10:34 3605387157 PAGE 01 . � ry: ia9y ��• P April 14,2007 Page 1 of 1 APR Morta ,Engineering & Testing, PLLC MASo n, F ry To: roay and Jennifer Adamski 0 7(906. ► �" t -3 7 621 ironside Ave. remerton,WA 98310 (360)981-7162 cell,(360)415-0830,(206)374-1500 fax Subject-! Piool E Ls ou Report for Quarry Rock,detaining Wail at 521 fact. ��� 1�ti � Haven Lake,Tahuya,WA 985M On March 22,2007 Steven P.Morta P.E.of Morta Engineering and Testing,PLLC was out at ft building site to inspect the quarry rock retaining wall and the excavated foundation pad. All 4 rock j retaining walls were constructed per this engineer's reconanaendatians per MET's geotocl*ical engineering report dated Oct.27,2006. Also the foundation footing pads and interior pads are resting on undisturbed glacial till soils and,therefore,we raady for concrete farming. 1f yod have any further questions or if we can be of fiuther assistance do not hesitate to call me at(800),590-0958 or email me at Smorta cr,.AOL.C2.M, Best kegards, 06*0 Stevenn P.Morta,P.E. P.O.Box 250,Ocean Shares,Washington 98569-0250 (360)289-0958.Bus,(360)289-9682 Fax,(800)590-0958 Toll Free SmortagAOL.com Charell Holcomb -ADAMSKI - RETAINING WALLS Page 1 From: Charell Holcomb To: Barbara Robinson Date: 12/20/2006 4:16:36 PM Subject: ADAMSKI - RETAINING WALLS Barb: I went through the file and saw a note that you sent the geo to Berryman & Hennigar for review on 12-14- 2006. Have you heard back from them yet? I've created a new case since the retaining wall is not connected to the building it requires a new permit. The case number is BLD2006-02137. Charell Holcomb Permit Technician II - Lead Phone: (360)427-9670, Extension 616 Email: cmh@co.mason.wa.us Mailing address: Mason County Permit Assistance Center P.O. Box 186 Shelton, WA 98584 Inspection Line: (360)427-7262 Inspection email: pib@co.mason.wa.us Charell Holcomb- Re: ADAMSKI - RETAINING WALLS Page 1 From: Barbara Robinson To: Charell Holcomb Date: 12/20/2006 4:18:24 PM Subject: Re: ADAMSKI - RETAINING WALLS I sent all reviews to Kelly Mayo instead...you can change that comment to forwarded to K Mayo for review. Berryman & Henigar did not review it. Barbara Robinson Deputy Director Mason County Community Development P.O. Box 279 Shelton, WA 98584 360-427-9670 Ext. 603 barbarr@co.mason.wa.us Charell Holcomb- Re:ADAMSKI - RETAINING WALLS Page 1 From: Charell Holcomb To: Barbara Robinson Date: 12/21/2006 8:01:41 AM Subject: Re: ADAMSKI - RETAINING WALLS Okay, so since Public Works would not review an engineered retaining wall Tami Griffey wouldn't review it for building so you sent it to Kelly Mayo...is that correct? Charell Holcomb Permit Technician II Phone: (360)427-9670, Extension 616 Email: cmh@co.mason.wa.us Mailing address: Mason County Permit Assistance Center P.O. Box 186 Shelton, WA 98584 Inspection Line: (360) 427-7262 Inspection email: pib@co.mason.wa.us >>> Barbara Robinson 12/20/06 4:18 PM >>> I sent all reviews to Kelly Mayo instead...you can change that comment to forwarded to K Mayo for review. Berryman & Henigar did not review it. Barbara Robinson Deputy Director Mason County Community Development P.O. Box 279 Shelton, WA 98584 360-427-9670 Ext. 603 barbarr(a)-co.mason.wa.us Charell Holcomb - Re: ADAMSKI - RETAINING WALLS Page 1 From: Charell Holcomb To: Barbara Robinson Date: 12/21/2006 8:11:45 AM Subject: Re: ADAMSKI - RETAINING WALLS I actually calculated it out and Deb emailed the costs to Kelly yesterday afternoon, I asked Chuck to come over and take a look at the site plan again since the retaining walls were not on the original site plan that he saw with the house. I also sent it down to EH since one of the walls is fairly close to the septic tank. So I think we are almost there-Chuck will come over and look at the info on my desk today and hopefully EH can look at their portion fairly quickly. Charell Holcomb Permit Technician II Phone: (360)427-9670, Extension 616 Email: cmh@co.mason.wa.us Mailing address: Mason County Permit Assistance Center P.O. Box 186 Shelton, WA 98584 Inspection Line: (360)427-7262 Inspection email: pib@co.mason.wa.us >>> Barbara Robinson 12/21/06 8:03 AM >>> That is correct....The only thing I did not see was a cost from Kelly for the review that we need to charge the applicant....That was not included with the stuff he left me. I will see if I can hunt that down. Barbara Robinson Deputy Director Mason County Community Development P.O. Box 279 Shelton, WA 98584 360-427-9670 Ext. 603 barbarr(o.co.mason.wa.us Charell Holcomb- Re: ADAMSKI - RETAINING WALLS Page 1 j From: Barbara Robinson To: Charell Holcomb Date: 12/21/2006 8:12:21 AM Subject: Re: ADAMSKI - RETAINING WALLS Great...thanks for the follow up. Barbara Robinson Deputy Director Mason County Community Development P.O. Box 279 Shelton, WA 98584 360-427-9670 Ext. 603 barbarr@co.mason.wa.us MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST Owner's Name: � S✓� Date: 41101ab Reviewed By: —Lv:��— Documents: ✓ Building Permit Application Completed Planning Intake Checklist Completed, ✓Site plan includes:Allowable building area,roof o VAangs,decks,etc. ✓Fire Apparatus Access Road info required? Yes/ o s�✓- Energy Code Application Form-O Electric wall eater O Electric central furnace LPG Furnace O Heat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type ) O Other.Specify: ✓ Mechanical/Plumbing Application-WATER HEATER FUEL TYPE Engineering? Yes ✓(Need 2 sets of calculations)No Z- Geotec 1 report or assessment? Yes No 01 Snow load:;4_ Seismic Zone(circle one): D1 o (D2 ConstructioryPlans: ✓3 COMPLETE SETS i,Plans Legible --✓ Ognized Scale _E evation Views ✓Gross Section F ✓ dation Plan ✓ Roof Framing Plan Floor Plan-Use of rooms noted(all floor levels) Framing Plan-all floor levels represented? Loft,crawlspaceetc. Framing Plan,including covered.porch framing Plan Detai*0: Roof framing details,thus lay-oat may be needed,truss or stick framed.--Q *a S. v'Wall Framing-Does bearing-v exceed 10'?(Engineering Wray be ed) 1a Floor flaming: Floor joists: Lf ,Floor beams: ry1 Window headers marked on plans: Typical header: Ll X 1 o r Foundation:footing size,reinforcement _ Walls-Does Concrete Wall Height Exceed 9'?(Engineering may be required) Landings at all exits? Less than 30"above grade /� �� _1oatad�By Furnace-Location of Furnace Fireplace/Stove Information Shown-Fuel Type? Location(s): Window Sizes Marked on Plans Braced wall panels(shear walls)marked on plans or lateral engineering? (Plans may not be approved ifnot provided.) _ 2z8Wry-Garage? (Engineering may be required) R602.10.1,10 story of a two-story D145%,D2-55% ENGINEERING REQUIRED: Braced wall panels/braced wall lines are not marked on plans(R602.10) Amount and location of bracing does not meet minimum required in Table R602.10.1 IRREGULAR BUILDINGS(Irregular Shape)R301.2.2.2.2 Irregular portions of structures shall be designed in accordance with accepted engineering practice. A portion of a building shall be considered to be irregular when one or more of the following conditions occur: 1)Exterior braced wall line or BWP cantilevered or offset by more than 4' 2)Roof or floor is not laterally supported on all edges 2A)Portion of roof or floor extend more than 6 ft.beyond the braced wall line. 3)End of BWP extends more than 1 ft.over an opening more than 8 R in width below. 4)Opening in a floor or roof exceed the lesser of 12 ft.or 5001a of the least floor or roof dimension. 5)Portions of floor level are offset vertically 6)Shear wall lines do not occur in two perpendicular directions. 7)When a story above grade is includes masonry or concrete construction(exe:fireplaces,chimneys,and veneer). When this applies the entire story shall be designed.In accordance with accepted engineering practice- DESIGN CRITERIA:Wind 85 mph exp B(unless proven otherwise), Seismic Zone: Snow: psf 2003 lRc Plans submittal checklist simplific(MO Mason County Permit Assistance Center Planning Intake Checklist Owners Name: Ma Date: lq-(c Project: Reviewed By: Commercial Development• YES N Comments: Planner: GBM TSC CM SNG BJR Site Plan: 0- North Arrow i (21, Property Dimensions: _X ,.')— p--Streets and Driveways Shown. Road name: er-All Existing Structures shown with setbacks V Well Location, Septic and Drain-field Shown with setbacks d�(' Identify all surface water(streams,ponds, shoreline,wetlands, etc.) d Topography(slopes) ar'Proposed Struc a Setbacks (Dire tion/Setback): sy' F: / y R: / 9 S 1: / 5---S2: V_"Utility and Drainage Easements: Yes (if yes enter condition#5022) Other Easements u,"' Accessory Appurtenances Prep&(1�- ,,,,J1 � �County Access Permit Needed(add condition#0010) �W -� ❑ �tandar ccess P t Neede a ition#0020) nditions to a added to all Building permits that planning reviews: #5019 and#0700 Are there any impedime is that may restrict access to your site? (dogs/gates) - Shoreline and Planning Info Setbacks: Shoreline: 13 V Slope: Shoreline Designation: Comprehensive Plan: Rural Zoning: ❑ Not Applicable ❑ Agricultural ERR 2.5 0 10 20 ❑ Urban ❑ In-holding ❑ RMF C3 Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy R-'Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet ❑ RT ❑ Urban Growth Area ❑ MPR ❑ Unknown ❑ Unknown Water Body(type of water if unnamed): 1 A!l ll ��-Q-- SEPA: Yes Unknown Flood Plain: YES NL—C nknowwn p# Aquifer Recharge: YES NOnkn Map# Tags/Cases: - LC/SPI Case: 6-Year Dev. Moratorium: YES Eagle Nest Tag: YES N Other YES N(� Addressing: Check box if needed ❑ Reviewed by: 'Revised:07-12-2005 1:\PLANNING\CHARELL&RENEE\PLANNING INTAKE Drop (Inches) -- s o Co 0 0 0 0 0 C31, 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Vo W N CD O N � W N O w V A (A O A � O o m O CD O m i V w Co V N w V O ■ A m O tWal O 0 i i m 0 W O N Ni °'n o i M A ■ i w O mn "' Z ■ N O - O i °D m o o o O N � N W O N N 1� cn o nr o N aD A N a rn 41 N O 75, N N � m Ca o .PJ� I V N O _ N O MASON COUNTY DEPARTMENT OF HEALTH SERVICES Environmental Health _ Personal Health PO BOX 1666 SHELTON,WA 98584 LOCAL(360)427-9670 BELFAIR (360)275-4467 FAX(360)427-7798 Application for Determination of Adequacy Instructions 1. Complete Part 1. No determination can be made until Part 1 is fully completed. 2. Complete only the portion of Part 2 applying to the type of water system utilized. 3. Submit completed application,with attachments to the health department for review. PART 1: Applicant/Parcel Identification Name of Applicant ian� A dam5k Date -Ge Mailing Address 1 b 4 ;�., :c��; �� Telephone (Vic ) 415 0 L30 (3remec+01-\, wA y93)(, Assessor's Parcel Number 2 Z -3 3o,cLo 10 p Type of Water System Check One): Reason for Application Check One): ❑ Public/Community Water System (2 or more Building permit connections)~ ❑ Land use application, if so.. Individual water source(one connection), ❑ Division of land: if so.. Well #of Parcels? SPH - Spring/surface water ❑ Other(explain) ❑ Boundary line adjustment **If you have more than one residence ❑ Other(explain) tit connected to this well,check the Public box. yn n PART 2: Water System Information o D AC Complete the section appropriate for the type of water system being evaluated: Z a� Public Water S stem Name ot VVater bystem Water Facility Inventory (WFI) Number: (write "none" for two party) The water purveyor has filed a letter granting blanket hookups to this water system. I am the manager of this water system. The water system has been approved for services. There are presently connections in use. This will be the connecFion.This water system is able and wi i�ii ng�provide water to this(these)connection s wi out exceeding the limits of the water system or any limits set by state and local regulation. Signature of Water System Manager Date Update:December 2005