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HomeMy WebLinkAboutBLD2008-01200 Final Replace SFR - BLD Permit / Conditions - 2/6/2009 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2008-01200 OWNER: DAN GOGERTY RECEIVED: 9/19/2008 CONTRACTOR: SOUTH SHORE CONSTRUCTION LICENSE: SOUTHSCO16NL EXP: 3/13/2010 ISSUED: 10/31/2008 SITE ADDRESS: 16790 E STATE ROUTE 3 ALLYN EXPIRES: 4/30/2009 PARCEL NUMBER: 122293390040 LEGAL DESCRIPTION: TR 4 OF SW SW LOT: C OF SP#48(R)#332124 PROJECT DESCRIPTION: DIRECTIONS TO SITE: REPLACE OLD SFR WITH NEW MFG HOME ST RT 3 TO SITE ADDRESS ON THE RIGHT SIDE. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 3 No. of Stories: 1 Occ. Load: Building: Valuation: Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make:LIBERTY Length: 71 Ft. Front: W 10.0 Ft. Shoreline: Ft. Water Body: Rear: E 569.0 Ft. Slope: Ft. SEPA?: Model:327501 Width: 30 Ft. Side 1: N 15.0 Ft. Shoreline Desig.: Not Applicable Year:2008 Serial No.: Side 2: S 277.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee GMM 9/19/2008 $247.00 S22008000 Planning Review Fee GMM 9/19/2008 $190.00 S22008000 EH Plan Review GMM 9/19/2008 $40.00 S22008000 Mobile Home Issuance Fee ARC 9/22/2008 $247.00 S12008000 EH Plan Review ADR 9/30/2008 $60.00 S12008000 Water Adequacy Plan Review ADR 9/30/2008 $40.00 S12008000 Wetland Delineation Review RDH 10/29/200 $130.00 S12008000 Total $954.00 BLD2008-01200 Please referto the following pages for conditions of this permit. 1 of 6 • ' CASE NOTES FOR BLD2008-01200 CONDITIONS FOR BLD20 0 8-01 2 00 1) Temporary erosion control measures must be implemented to prevent water qua de radation of adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X 2) Lake Cushman area is designated with a 551b snow load rating. The owner/agent of this permit acknowledges that if the unit permitted under this permit does not threco mmended snow load rating, there is a potential for failure due to weight accumulation beyond that of the design criteria. X b 3) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved"site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building DMen�to any further inspections being performed or approvals granted. �T 4) Approv er � ensions an X d setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. 5) Retaining walls needed to support a sur uch rs str ctures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall.X i - 6) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647- . The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 7) All property lines shall be clearly identified at the time of foundation inspection. X 8) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Department pri o ny,fuilher inspections being performed or approvals granted. X 9) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removal of ed 0ocuments will result in failure of required building inspections. X BLD2008-01200 Please referto the following pages for conditions of this permit. 2 of 6 1,0) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holde�hreyetjted action from being taken. No more than one extension may be granted. X 11) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy(Final Inspection)will be granted for the residence. OWNER/CONTRACTOR(indicate which) Signature X 12) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exp sed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X &6x---1 13) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X BLD2008-01200 Please referto the following pages for conditions of this permit. 3 of 6 14) Permanent Address must be posted and visible from the road Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails must be in good condition and meet code for year built or current code if replaced. Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit Gutters and downspouts must be installed with splash blocks provided All exterior penetrations must be sealed HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24" above grade. The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4 panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection. All conditions on the original or issued permit must be met If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available It shall be the responsibility of the person requesting the inspection to provide the manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection. Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an inspection is requested and required items are not completed prior to the inspection being performed ENFORCEMENT PROVISION: Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action and subsequent violation and penalties pursuant to the Mason County Code. 15) This permit is for the pl n n installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X 16) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or" Iled. c fication number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X BLD2008-01200 Please referto the following pages for conditions of this permit. 4 of 6 17) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI).To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can cont t O c of Manufacturing Housing (360) 725-2800. X 18) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason Count ` anc a f building regulations. X 19) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector s )b m�prio to requesting additional inspections. X 20) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occ pancy is imited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revoc ' X 21) Owner/ t' esp ' le to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X L 22) Water quali not to e degraded to the detriment of the aquatic environment as a result of this project. X z9ta L7r��-� 23) Temporary erosion control measures must be implemented to prevent water quality 'Zoan adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X 24) The Washington State Qlean Air Act prohibits the burning of any construction or demolition debris in an outdoor fire. X aw 25) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv it ensure these structures are shown and meet the setback conditions listed. X la BLD2008-01200 Please referto the following pages for conditions of this permit. 5 of 6 This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at anytime after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the a ent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described prop a structure review and' ecti OWNERORAGENT� DATE: BLD2008-01200 Please refer to the following pages for conditions of this permit. 6 of 6 0 0 o CONCRE MECHANICAL MANUFACTURED HOME 0 Footinga acks at PiP ►9 By Ribbons m interior Date y Interior-Date ByDate � - Q F By � oExterior Date By Exterior-Date B Set-up Point Load I isolated Footing. INSULATION Date . �1. By � D BG 1 SLAB INSULATION zr"i Date By Data By FIRE DEPARTMENT Foundation Waits Floors Date By Date By Date By DECKS FRAMING Wars Date By Date By Data By PROPANE TANKS PLUMBING �- Vault Leta By Date By OTHER Groundwork Attic Type, Date By Date By Data By O w.v DRYWALL Type- Date B Mt.Brace Wall Date By W y T aye By FINAL INSPECTION v Water Line Firs S spa ration N Date By Date By Date Z ' (� '" �� B y L tom./ p cu `° Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments c 0 5 c a _ 0 N O CD 0 Building Permit # i9r, D12pQ MASON COUNTY BUILDING Ili 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location ,�12 -;'Ve /2 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance si You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ This is not a complete inspection Department Date Inspector il moos NuT rimimMssV T Immak TA , Permit Number: a co? - O Parcel Number: g/a�,�%a� FILEtp /Z z 2 q - ,33_ 9ao !40 COPY gag cha�'/� a1010, , Owner Name: L A 00, 0/0 Pra/ Aa Type of Permit: THESE PLANS MUST BE ON THE JOB SITE FOR INSPECTION. CHANGES SLjBMIT PRIOR TO PERFORMING WORKS MUST MEET ALL CURRENT WASHINGTON STATE CODES W ENT 'J�\giI oL7 AT 1 Sq Ft Per 150 Sq F CHANGES SUBMIT CHANGES FOR APPROVAL PRIOR TO PERFORMING WORK APPROVE® MASON BUILDING INSPECTOR CHAN ES SUBJECT TO APPROVAL Aee DATE vnXs&� 0-0t& J , mom- vvn(t, V CAA,_e_r VEND AT 1 Sq Ft Per 150 Sq Ft E P `sT B I^ M, $SITE �p �SPECTlO� CHANGES I t� D(-Q SUBMIT CHANGES FOR APPROVAL PRIOR TO PERFORMING WORK MUST MEET ALL CURIZENT a t Fr rr .._ �c•7---- �� '� gel � rrr rr 10 ' r�: �• Vim/' M - '' ' �' � � i rr CS L : • • • _�� • �� �� ■✓.b.M►Ti 7 ,/ SON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST Owner's Name: Date: Reviewed By: nu Documents: Building permit application complete STORM WATER WORKSHE, Oa-i� NWLETE9. (] Planning intake checklist complete lQ'Site plan includes allowable building area,roof overhands, decks, etc. Fire apparatus access road info required: Yes 0 ❑ Energy code application O Electric wall heater O Electric central furnace O LPG Furnace O HP w/elec.Fum. O HP w/LPG furn. O Boiler(heat type) n O Other: Specify Mechanical/plumbing application—WATER HEATER fuel type/location: ❑ Engineering? Yes/No - Snow Load: Seismic: ck plan: APPROVED Snow Load: Seismic: Manufactured Homes— FLOOR PLANS oun a on e: �ANSI/Manf.Method ❑ Engineered footing/found. ❑ Basement Decks: ❑ Covered? Uncovered over 4a6 and 30"? - construction plans required Construction Plans:❑3 COMPLETE SETS ❑ Plans legible ❑ Recognized scale 0 Elevation views ❑ Cross section ❑ Foundation plan ❑ Roof framing plan ❑ Floor plan—use of rooms noted(all floors) ❑ Floor framing—all floor levels ❑ Deck framing including covered porch framing Plan Details: ❑ Roof framing details,truss layout may be needed(hip and girder location shown) ❑ Wall framing—does bearing wall height exceed 10'(engineering may be required). ❑ Floor framing: floor joists , spacing? floor beams' ❑ Window headers: typical header Garage door header: 0 Foundation: footing size,reinforcement 0 Concrete walls—does concrete wall height exceed 8'? (engineering ma required) 0 Landings at all exits? Less than 30"above grade? Y/N 0 Heated by furnace—location: ❑ Fireplace/stove information shown—fuel type: Location(s): ❑ Window sizes marked on plans ❑ Braced wall panels(shear walls)marked ans? ❑ 2-story garage: (engineering may equired) I"story of two story D 1—451/o, D2—55% COMMENTS: ENGINEE REQUIRED ❑ Braced wall panels/brace wall lines are not marked on plans (R602.10) ❑ Amount and location of bracing does not meet minimum required in Table R602.10.0 DESIGN CRITERIA: All notes and details required as a result of the engineered analysis shall be transferred onto proposed building plans. Wind 85 MPH, Exposure B(unless proven otherwise). Seismic Zone: Snow psf. IRREGULAR BUILDINGS 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) a.Roof/floor is not laterally supported on all edges b.Portion of roof/floor extend>than 6 ft.beyond the braced wall line. ❑ 3)End of BWP extends more than 1 ft. over an opening more than 8 ft in width below. ❑ 4)Opening in a floor or roof exceed the lesser of 12 ft. or 50%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 includes masonry or concrete construction(fireplaces/chimneys/veneer)entire_story shall be designed in accordance with accepted engineering practice. H:\pemiit tech checkhk'st-02-05-2008 .M MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. L oo EASE PRESS HARD BUILDING PERMIT APPLICATION A 426 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 NFORMATION CONTRACTOR INFORMATI N Owner 4 C' &—�Ty Company Name `r Mailing Address Mailin dd ss � City State� Zip Code City State Zip Code Phone Other Ph. Phone Oth r h. O Lien/Title Hol er Contractor Reg. �� xP E mail address E Mail Address Drivers Lic.# DOB Drivers Lic. DOB -? SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septicx Existing Septic Conne t to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address(Pleas include stre t name, street number and ity Directions to siteatk1' Will timber be cut and sold in parcel pre ara La Ye A/e PondJ�— Is property within 200'of Saltwater _Lake m River/Creek-,=�— Wetland�® Seasonal Runoff Stream,�_Slopes or Bluffs 15%.)0 Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL �] Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model � I Yea Length y—Wi th -10 Serial No. o. of Bedrooms-- o. of Bathrooms Type of Heat Purc ase rice$ � �O Replacement Unit? e�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 informaticn 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 withW 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS PRO SS INSP ION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 PAYS WI INVALIDATE THEAPPLICATION. X Date: owner/Owners Represen99�r�dicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by-6fanLi Date DEPARTMENTAL REVIEW APPROVED DENIED C1 NOTES IN I Building--Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection 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. BUILDING PERMIT APPLICATION Q A 426 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 FORMATION CONTRACTOR INFORMATI N Owner Company Name Mailing Add ess Mailin `dd s City State Zip Code City State L//�'� Zip Code Phone Other Ph. Phone Othe h. Lien/Title HoI er Contractor Reg. �d m) E E Mail Address mail address Drivers Lid.# DOB Drivers Lic.0,sor IC3 DOB e► if/ .� .� SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Conne t to Water System Name of Water System Well Sewer System Name of Sewer System PAR EL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address(Pleas_a include street name, street number and ity Directions to site 4t k Cold. , V__&_ 5 Y Will timber be cut and sold in parcel prep ration?Ye / Q Pond Is property within 200'of Saltwater Lak me River/Creek Wetland�_Seasonal Runoff StreamQ_Slopes or Bluffs 15% 11) 2 Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model 7101 Yea Length— i th3.Q_Serial No. o. of Bedrooms o. of Bathrooms Type of Heat Purc ase Price $ Sra cy Replacement Unit? es o ` Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or peer�mit 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 with' 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK .BY MEANS PRO S INSP ON.INACTIVITY OF THIS PERMIT APPLICATION OF 180 AYSWI INVALID TETHEAPPLiCATION X Date: Owner/Owne Repre entative G %ontractor (indicate which one) FOR OFFICIAL U BE f OND T#IfS P OINT Accepted by: Date DEPARTMENTAL EVIE APPROV ED DENIED NOTES w Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee z ov- Site Inspection EH Review Fee Plan Review Fee ,;I Plumbin & Base Fee Plannin Review Fee Other � Mechanical& Base fee p Wood/Gas/ Pellet Stove Fee State Fee Violation Fee, A% &�A Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. I A- c�i_i .' 'f ;�l't ) BUILDING PERMIT APPLICATION tv r ' - 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 t_,3 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT_LN FORMATION CONTRACTOR INFORMATI N� 1 Owner c`? ~'� Company Name Sr t e f c. t Mailin ddre s " ' �� Mailing Add less I . City ~State Zi Code City f State . Zip Code Phone "' �.r Other Ph. Phone -s'� ? r" Other h. .. Lien/Title Holder Contractor Reg.# f #' _xp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# ,r 'f X"r `C- DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well--y Sewer System Name of Sewer System PARC L INFORMATION - 12 Digit Parcel No. "' Fire District Legal Description Site Address(Pleas include street name, street number and, ity _3 " Directions to site le-k Will timber be cut and sold in parcel preparation?Yes/ Is property within 200'of Saltwater L_Lake r River/Creek Pond Wetland r• ;? Seasonal Runoff ...; Stream 4-) Slopes or Bluff/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—Alt—Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make J, #A '9-.rtiy Model Zir 1 Year rf Length I Wi thy-Serial No. I o. of Bedrooms^. -No. of Bathrooms TypeofHeat ' Purchase Price $ Replacement Unit? tesAp,,., Installer Name ± } V 14p, 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 informaticn 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 withi ,180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF,$PROQ�Sy INSP ON.INACTIVITY OF THIS PERMIT APPLICATION OF180 AYSWI INVALID TETHEAPPLICATION. ,� ') X Date: �' Owner/Owne Representative/Contractor (indicate which one) FOR OFFICIAL USA BEYOND THIS POINT Accepted by }-" Date DEPARTMENTAL F EVIEW APPROVED DENIED i NOTES e per/ Building Department— Planninq Department Environmental Health Department c1 Fire Marshal FEES Buildina Permit Fee Site Ins ection _ -- Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Wood/Gas/ Pellet State Fee Stove Fee TY ^C)UN L ion Fee Pre-Paid at Submittal tion $ TOTAL FEES ; f „ MASON COUNTY PERMIT NO. "d 1XZ BUILDING PERMIT APPLICATION r !X-OK'd 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 K„ Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANTINFORMATION CONTRACTOR INFORMATION t Owne C., &,e-­ry Company Name 7 Mailing Add less Mailin dd s City 4tatell�Zip Code City Stt &Id Zip Code Phone Other Ph. Phone Othe h. : E Contractor Reg. Lien/Title Hol er E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.#/`fact•��� �dC DOB •2 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 District Legal Description Site Address (Please stree name, street number and�ity Directions to site 2��r' + 3 � l--&SS Will timber be cut and sold in parcel preparation?Yes,/ , Is property within 200' of Saltwater _L =Lake ) River/Creek .Pond — Wetland Seasonal Runoff (� el _Streamer ' _.Slopes or Bluffs ' 15 0 � Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New—Add—Alt—Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedroom No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor—Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model 3� 7�SG'/ Yea Length— i th3 Serial No. c o. of Bedrooms, -- o. of Bathrooms li Type of Heat Purc ase Price$ Replacement Unit? es ow i Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or pel\mit 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 with' 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS PRO S.S INSP ON.INACTIVITY OF THIS PERMITAPPLICATION OF 180 AYS WI INVALID TETHEAPPLICATION. X Date: Owner/Owne Representative/Contractor (indicate which one) FOR OFFICIAL U BE`l'OND THIS POINT Accepted byar. Date DEPARTMENTAL EVIE APPROVED DENIED NOTES BuildingDepartment Plannina Department Environmental Health Department Fire Marshal FEES j Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbin & Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Pre-Paid at Submittal MAS( IN COUNTY Violation Fee Valuation $ TOTAL FEES Look Up a Contractor,Electrician, Plumber or Elevator Professional License Detail Page 1 of 2 Information in Spanish I Topic Index I Contact Info I .................................................. Home Safety Claims @ Insurance Workplace Rights Trades @ Licensing ...............................: ......................................... ....... Find a Law(RCW)or Rule(WAC) Get a form or publication Return to List > Start a New Search > 18 Printer friendly GeneraVSpecialty Contractor A business registered as a construction contractor with L&I 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. Business and Licensing Information Verify Workers' Comp Premium Status Check for Dept. of Revenue Account Name SOUTH SHORE UBI No. Ax 601949089 CONSTRUCTION INC Phone No. (360) 275-0818 Status ACTIVE Address 230 E HILLSIDE DR License No. SOUTHSCO16NL 1 Suite/Apt. License Type ipio CONTRACTOR CONSTRUCTION City BELFAIR Effective Date 11/15/1999 State WA Expiration Date 3/13/2010 Zip 98528 Suspend Date County MASON Previous SOUTHSCO61 D5 License Business Type CORPORATION Next License Parent Associated Company License Specialty 1 AV GENERAL Specialty 2 &i UNUSED r Business Owner Information >>> Hide All Name Role Effective Date Expiration Date MOORE RICHARD B PRESIDENT 11/15/1999 MOORE, CARLA VICE PRESIDENT 11/15/1999 https://fortress.wa.gov/lni/bbip/Detail.aspx?License=SOUTHSCO16NL 10/30/2008 Mason County Planning Intake Checklist Owners e: n JVtA Date: Project EA ffim Reviewed By: Proposed use s)of structures Commercial Development: YES O PLANNER: GBM TSW WC(aLDZK ]MS Site Plan: North Arrow a Survey required in Allyyn UGA - o AF# o Monuments •,d Property Dimensions: '4911) X LOU � r ,rd Struts and Driveways Shown.Road name: . Pr_1 116hP, !�_a tee:.uvi o !' U t F d cks and use f- 12+ 3 ,,d ell Location, tic nd Drain-field own with setbacks ,ate I nds,shoreline, wetlands, natural or hisbDric drainage,defined drainage ditches)? -1-(7 on Of A Y-) Topography(slopes) �(p -}p !�6 Minimum Structure (Direction/ tback): ; F: (d.�J-1Z R: Si: �/5 S2: 5—/ r7� ,W Utility and Drainage Easements: Yes No (if yes enter condition #5022) X Other Easements h ,a Accessory Appurtenances: d r d Pfepane / Hea � Does site plan show la gs at all exits? ,d Variance applied for•. Y)/ No - parking spaces allotted? (G) No o County Access Permit Needed(add condition #0010) �Ex 15.+.r h ❑ State Access Permit Needed'(add condition #0020) Standard Conditions to.be added to all Building perm' that planning re ' s: #5019 and #0700 Site Access: Are there an im iments(dogs/gates) my restrict access to your si ? w Is the site dears ark How. .,Er lWress L-t L) ❑ Name A+ 1)f l U E2.� Zoning: ❑ Other: Plan: ral��Lnln UGA Zoning: ural ❑ RR0 20 ❑ RT/RTC 0 R 1 ❑ R 5 0 HC 0 BI ,4r10 RAC ❑ RMF ❑ Unknown ❑ R 1P 0 R 10 0 LTA 0 VC 0 Allyn UGA. ❑ .RC 1 2. 3 0 Agricultural ❑ R-1R 0 PD 0 .FR 0 T 0 Belfair UGA 0 RI 0 In-holding _ 0 R 2 ❑ PF O MU o MHP 0 Shelton UGA 0 RNR ❑ LTCFL ❑ R 3 0 POS ❑ GC ❑ SP ❑ Tribal 0 Gc-a Critical Areas: (streams, ponds,shoreline,wetlands,steep slopes) Shoreline Designation: X N/A 0 Urban 0 Rural' D Conservancy ❑ Natural ❑ Unkown Water Body(type of water if unnamed): no SEPA: Yes/P CpU:nk�:nown Flood Plain: YES/ Unknown ap# Aquifer Recharge. YES/NO �wna # -- Taw/Cases: RWSPI Case: — lrl C) " 6-Year Dev. Moratorium:.YES/NO Eagle Nest Tag: YES/NO other YESINO Revised: 02-07-2008 L\PLANNINWAC P1.41N G INTAIT rrrrm.., �.: OFL � NSECOOR4 r=ii�R rir rnwvjx .� 1 r�r GFIEff ROOMc _ r—r r IL LJ rM �� rrrYY�f■ru r�tiiY. •��' � ri�rrrxrrrrrYr'�r■ moo .• BEDROOMFOR� Pon In Nal apomKum000m w Sri- cm cow " rrrrrrsr�air ■rrrrirrrr, a� rr_ t ROM 008 �(�� , ..• Sep 08 08 11:50a Joy n Johnson 360-898-2255 p.2 _ N .vvi(3 f PLAN PLOT REVISION o 0 °� RECEIVED - g k � - N C. �J M t' O •� t � r 11 Audio-visual Alar ©J Gmnout Y 1200 Ganes Sept c Tank AP P OV E D 2 Com Effluent nt ith MASON COUNT DCD PLANNING SITE PLAN REQUI ED TO BE ON SITE 0 1000 Gallon Pun, p Ch CHANGES SLIBJ CTTO APPROVAL By Date 0 Valve Control OL 30 19B o 3o bo 90 tte ..rrr..rr..r.r�rn�lr i t v Q a v � o o d m m 3 v -i m o o N W 3 0) o, m -4 m 0 ao0 ctn m w v O m D v N O O C O N 00 0C) 0.. . 0 o ;a mmm r Z r N x m = a � � �_ zo � 0 c ai zXz �a Ch� nZ o y w �, -n y 3 m � Cl) 0 -' o O O � p � N) -4Pi 0) D g Z O N V It 0D � cN° o �-IZ -n ca O o 00 0 O � pDOM (° Z 9 U) o m ; m � � N -� 0 CD cn cn a) ° o O� o z m m c CD m m m o n o ° ° O C) m -i n CD _0 N �' to o a d7 O DC a . _ cn rn ,' O D cnZm � m, o c $ � -� m � '71 S N _ Cn SCD 3 3 o ZZ CO) b n 3 �1 CJ1 COO O CAD d 0000 c -' NGJ 3� ^� Z O O s _ 3 -'� mY ?' 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