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Fall Gate date Done By Comments �I _0 �. CD Cn PA55F0 C)t9/02-A5 N031t j,,P L65 47-fA4 0 K,Tf> �3:340 pvl 8 8 a N 0 Cm / )DID 53 told �C o t,C tiC' " 07 oo�5 �� C 14.E MASON COUNTY PERMIT NO. i�� � ' BUILDING PERMIT APPLICATION ,-w` , 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 j Shelton (360) 427-9670• Belfair(360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATIQfj r�� Company Name ��'%� iY16 Y'IPS T�, ti Y" i'7r� , l iv P v Mailer Address���Ox il0 Mail' g Address QC� fa-- States uU Yk Zi Codect855 9 City�A lyelitaie State XAJA Zip Code Q T313- Cit r State P PhoneL300 X11 -4i4 Other Ph. Phone; �- Other Ph. Lien/Title Holder Contractor Reg.# Exp. C E mail address i>r,t�?� 1%�i�4 - -\jWNW•C061 E Mail Address Drivers Lic.# P DOB C)s"~l- m$ Drivers Lic.# DOB— SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septi Existinl�g `S`e tic Connect to Water System _;' _Name of Water System ��kh � l�OL Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No Fire District Legal Description V- 0 VW,5 11FIT N 0 4,1,0 f XS Site Address(Please e nu include street name s rember and city) 511 E�1 (`OJT 'Qll� r (ylJ et�'S�y Direc e ions to site view Y1 r, Will timber be cut and sold in parcel preparation?Yes/® Is property . hi 00' of Saltwater Lake River/Creek Pond Wetland) 1=c.z�-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 TYPE OF JO - New ) Add Alt Repair Other PRIMARY RESIDENCE JK SEASONAL ❑ Use of Building i t Describe Work , C No. of Bedrooms No. of Bathrooms _Square Footage- 1st Floor 2nd Floor 3rd Floor asement N Deck Covered Deck Other Sq.ft. Z 90 Garage_ kitached—,)(- -Detached Carport Attached Detached 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. 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)-4m 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 necessaryipartip .If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,.l,.f�ave pbtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,rep,�,��:,��n�ts that-the(reformation provided is accurate and grants employees of Mason County access to the above described property and structure for re�i�Lno,inspection.; .i PRO, OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. E r x Date OS•D t�tp /ow rs 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 Building Permit Fee 3 Site Inspection Plan Review Fee A EH Review Fee Plumbing& Base Fee d-L 3 00/ Planning Review Fee Mechanical & Base fee Tj d D Other Wood/Gas/ Pellet Stove Fee I State Fee " s Violation Fee 1 ^/o eeF Pre-Paid at Submittal Valuation$ �1� -2-Co TOTAL FEES PERMIT NO. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 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 INFORMATION CONTRACTOR IN'FORMATI Owner LIAe- tat f'1Fft1 T)1216611S Company Name UJ I-1 It Wa Mail. Address b 601 610-1 Mail. g Address Citykt1VM�� State�-Zip Code Ci.8383 city41:RAj.X& StateW Zip Cod4a9&3 PhoneZtob';1_12-Y5A Other Ph. Phone-_ eb Rn 19�� Other Ph. Lien/Title Holder Contractor Reg. #J�jk I1jE4*ghI RT Exp.1 E mail address VUF3t 1;D 103 `ViPrHtfD.Cb1M E Mail Address IrM Drivers Lic.# DOB OS•n-141'I% Drivers Lic.# DOB SEPTIC INFORMATION - Conne t�_to New Se tic xist.ng Se tic Connect to Sewer System _ Name of Sewer System U�l� PARCEL INFORMATION- 12 Digit Parcel No Fire District Legal Description LlY'r 4iA SS W0 "11 ) Q'1-W Cat>V LT.� 5 Gf 2-2- I Site Address(Please include treet name,street number and city) t S LOVE Da VN-k t IN WA Directions to site H�htJ Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 1506 TYPE OF JOB -New Add Alt Repair Other Use of Building Location of Fixtures/Units- 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric LPG_Natural Gas_Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink ."9 Furnace Bath Tubs f Heatpumps Showers a' Spot Vent Fan Water Heater I Propane Tank Clothes Washer l Gas Outlets Kithen Sinks f Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs 1 Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 parry in interest regarding this application or the work proposed in the application,Irh�ve obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents tHat this;information provided is accurate and grants employees of Mason County access to the above described property and structure for rev.i4w.and inspection. P 00 OF CONTINUITION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. , x X Date: er ners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPF(OVED DENIED NOTES Building Department Occ Group—Type Constr. Planning Department 21 5`3' o Environmental Health Department FEES Plumbing& Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee I TOTAL FEES .lif ��"W I MASON COUNTY PERMIT NO PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar•P.O. Box 186, Shelton,WA 98584 Shelton (360)427-9670•Belf air(360)275-4467•Elma(360)482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR IN,FORMATIQt4 Owner- +71IPIFIAI'1 'Do 6ens - Company Name J 1AJ3&- YYtC_S Maili q Address Pb P,,OX Rllk-1 Maili g Address City State WW Zip Code CI8383 City Statew I& Zip CodERA513 I - PhoneVcnO,"1a12-LW2-4 Other Ph. Phone 2i�b SO L9,4S Other Ph. Lien/Title Holder Contractor Reg.# i Exp.OA J 3fl 1 0-' E mail address DI�UF,itZI)103 `VIA'N15D.CD1M E Mail Address WWW'H�I�t1G1f1C1�M2S.[-dYv� Drivers Lic.#nAQ)t'fkZ2,!>YS DOB OS-n•Iq'?% I Drivers Lic.# DOB SEPTIC INFORMATION -Connect to New Se tic xisting Se tic Connect to Sewer System X _ Name of Sewer System I.� PARCEL INFORMATION- 12 Digit Parcel No Fire District Legal Description t-t rr 4A SS No d_l I 1 - iP TW C21W 1.>T5 r , ci -a Z' 1 Site Address(Please include treet name,street number and city) 5 11 - 0 1 L.L s. toyG pQ_ykt tV N WAi Directions to site UIC.t�I> Jz Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB- New-)( Add Alt Repair Other Use of Building Location of Fixtures/Units- 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG—Natural Gas_Heat Pump_ Toilets jype of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater I Propane Tank Clothes Washer 1 Gas Outlets Kithen Sinks f Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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,l 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. PROO OF CONTINU TI OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Qom' V'4' a-UOCA er ners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group-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 MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST Owner's Name: _1 Date: ( Reviewed By: CAI -- Docuinents: _Building Permit Application Completed /Planning Intake Checklist Completed, mite plan includes:Allowable building area,roof overhangs,decks,etc. _�_� ire Apparatus Access Road info required? Yes( �n : ergy Code Application Form-0 Electric wall heater 0 Electric central furnace 0 LPG Furnace 0 Heat pump with electric furnace 0 Heat pump with LPG furnace 0 Boiler(heat type 0 Other: Specify: ✓Mechanical/Plumbing 'cation-WATER HEATER FUEL TYPE gineering? Vse� No Snow load used: Seismic Zone(circle one): D 1 rDJ2 —Geotechnical report osment? Construction Plans:_3 COMPLETE SETS Plans Legible —Recognized Scale —Elevation Views _Cross Section T Foundation Plan —Roof Framing Plan —Floor Plan-Use of Rooms Noted —Floor Framing Plan-all floor levels represented? Loft, crawlspace,etc. ��� Deck Framing Plan,including covered.porch framing J,t � 0la / � a Plan Details: T Roof framing details,truss lay-out may be needed _Wall Framing-Does bearing-wall height exceed 10'?(Engineering may be required) Floor framing: Floor joists: ,Floor beams: Window headers: Typical header: _Foundation: footing size,reinforcement Concrete Walls-Does Concrete Wall Height Exceed 9'?(Engineering may be required) Landings at all exits? Less than 30"above grade? Y / N Heated By Furnace-Location of Furnace Fireplace/Stove Information Shown-Fuel Type? Window Sizes Marked on Plans 2-Story Garage? (Engineering maybe required) R602.10.1, I"story of a two-story D 1-45%,D2—55% — Braced wall panels(shear walls)marked on plans or lateral engineering? (Plans may not be approved if not provided.) COMMENTS: 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 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 is includes masonry or concrete construction(exc:fireplaces,chimneys, and veneer). When this applies the entire story shall be designed. In accordance with accepted engineering practice. 2003 IRC Plans submittal checklist simplified/WORD MASON COUNTY DEPARTMENT OF HEALTH SERVICES 114 May 11, 2006 PO BOX 1666 Shelton WA 98584 Shelton (360)427-9670 Fax (360)427-8442 DUANE DOBBINS Elma (360)482-5269 P.O. BOX 967 SILVERDALE WA 98383 Belfair (360) 275-4467 Case No.: BLD2006-00741 Parcel No.: 122297890041 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Please see comments at the end of this letter. Please call me at (360)427-9670, ext. 279 if you have any questions. Sincerely, Amanda Reynolds Environmental Health Mason County Health Services Comments: Your water adequacy application needs to be signed. 5/11/2006 1 of 1 BLD2006-00741 Mason County Permit Assistance Center Planning Intake Checklists r, Owners Name: Gh 11 S Date: ( 0 f Project: Reviewed By: Commercial Development: YES NO mments: Planner: GBM TSC CMM KJ PBC RDH Site Plan: North Arrow Vroperty Dimensions: 0 2- X�(� /1 streets and Driveways Shown. Road name: C�21 ❑ A41 Existing Structures shown with setbacks ❑ "'e'�ation, Septic and Drain-field Shown with setbacks W'Identify all surface water (streams, ponds, shoreline, wetlands, etc.) 1"Topography(slopes) ai- proposed Structur, Setbacks (Direction/Setback): R / 3S R: S / I�6 S 1: /)S2: �/ �CI Utility and Drainage Easements: Yes No (if yes enter condition#5022) ❑ Other Easements Accessory Appurtenances no --- �.� ta�County Access Permit Needed (add condition#0010) &A M� Od =andar=nPditions ermit Needed(add condition#0020) 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: lc6 Slope: Shoreline Designation: Comprehensive Plan: Rural Zoning: Not Applicable ❑ Agricultural Q�_RR 2.5 0 10 20 ❑ Urban ❑ In-holding ❑ RMF ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ Conservancy Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR nknow ❑ RCC-Hamlet ❑ RT ❑ Urban Growth Area ❑ MPR ❑ Unknown ❑ Unknown Water Body(type of water if unnamed): � � SEPA: Yes N Unknown Flood Plain. ES N U Aquifer Recharge: YES O U o A� wn Map# Tags/Cases: RLC/SPI Case: — 6-Year Dev. Moratorium: S NO Eagle Nest Tag: YES NO 5 Other ES Addressing: Check box if needed ❑ Reviewed by: Revised:03-22-2006 C\PLANNING\PAC\PLANNING INTAKE Look Up a Contractor, Electrician or Plumber License Detail Pagel of 3 Topic index Contact Info I H Safety Claims&Insurance Workplace Ruts Trams 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 LEdi 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 HILINH"981BT Licensee Name HI-LINE HOMES Licensee Type CONSTRUCTION CONTRACTOR UBI 602167453 Verify Workers Comp Premium Status Ind. Ins. Account Id 0 Business Type CORPORATION Address 1 11306 62ND AVE E Address 2 City PUYALLUP County PIERCE State WA Zip 98373 Phone 2538401849 Status ACTIVE Specialty 1 GENERAL Specialty 2 UNUSED Effective Date 1/30/2002 Expiration Date 2/10/2008 Suspend Date Separation Date Parent Company NW CENTRAL CONSTRUCTION INC Previous License Next License HILINW*960BL Associated License https:Hfortress.wa.gov/lni/bbip/Detail.aspx?License=HILINH*981 BT 6/6/2006 ACCESS & GRADE WORKSHEET DATE: ADDRESS L L S i P ✓�. q,. INSPECTOR DRIVEWAY ACCESS Length: Width• Surface• t Size of turn-around: --. �J, � s Condition of shoulders: Ca- Vertical clearance: --- 1 ) need post at end of driveway with reflective address numbers GRADErOF DRIVEWAY % OF ROAD o /o ROAD ACCESS Length: Width• Surface Condition: Vertical clearance: ( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. 1w � ) LOT INSIDE SMZ, 4X4 FIRES ONLY. (_) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES. REMARKS continue remarks on back 1 H r - �O 2 z � £L'Iz z z (Z 3 J �a m Qd Wpoo OpW � c it � w G.. z d 0- D � N Qo zw z a oz O w co Qc N G T m C 4 0 1 co 40 05/22/2006 15:07 FAX 360 698 2597 SILVERDALE KCSO Z 002 05/22/2006 06:35 2530572900 GUTTORMSEN PAGE 01 e- . PO BOX am SNf LTON.wA Q8U4 EL*Lf MR Zr*4467 actlacy �tW h. 1. �►tN pART 1: Appiken o ce!ident#Wadon • Daten� .!�!�•�db�s_ Nam of r Tewl0m-&pD m�— oil I cu�moolfa�I" � Q SP"Y*Mf-l=�ve r •^•Af jm boa mono-Not am i9sk%a r �t��socplptrsl © Q�p tllis Wilfl.ci1� Pvb11C�X Pub& systm wsrfacHl�Wft Ago"V inventory w_Fa)Num © `a 05/22/2006 MON 15: 05 [JOB NO. 51561 U002 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/VIAQ Compliance Application Owner andr�� '010jr1STelephone: D Parcel#: $ptD 41 Type of protect (, New Residence ( )Addition ( ) Remodel Total Sq. Ft. �� I� 15 Fl0000r: 2" floor: Heated Basement: of heated area:: 116 Heating System Type: ctric 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 Prescriptive Option see reverse side circle one: 1 II IV Percentage: Compliance, Method O Component Performance , Chapter 5— Calculason worksheets require Check one:: _% O Systems analysis, Chapter 4 Whole House Ventilation system O Whole House Ventilation using a Heat Ventilation sing exhaust fans&window or wall fresh air Recovery Ventilation System (VIAQ 3o3.a.a) 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 303.4.3) Window & Door Schedule (If needed, attach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Windows: VQ Windows: Total Sq. ft. Doors: Doors: Total Sq. Ft Total window and door area Total window&door area /(divided by)total sq.ft of heated area = %of glazing Window Schedule HIL NE for 2318 plan H O M E S Hiline Homes of Centralia Manufacturer: Milgard Windows Inc. Model: Classic Series Type: Vinyl U-Value = .36 Windows Quantity Size/ Handing Glazing area Total S . Ft. Location width x height 1 5'0 x 5'0 25 25 Den 1 5'0 x 5'0 25 25 Bedroom 3 1 4'0 x 4'0 16 16 Bedroom 2 2 2'6 x 5'0 12.5 25 Great Room 1 6'0 x 5'0 30 30 Great Room 1 6'0 x 5'0 30 30 Media Room *1 6'0 x 4'0 24 24 Master Bedroom 1 3'0 x 3'0 9 9 Master Bath 1 3'0 x 3'0 9 9 Utility Room 2 2'6 x 5'0 12.5 25 Dining Room 1 2'6 x 5'0 12.5 12.5 Dining Room 2 2'6 x 5'0 12.5 25 Dining Room 1 2'0 x 5'0 10 10 Entry Total glazing area 265.5 sq. ft. 265.5 - 2318 = .114 X 100 = 11% Glazing Area + 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 282.5 r 2318 = .121 X 100 = 12% Glazing Area i 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.