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HomeMy WebLinkAboutBLD93-0610 Final Log Home - BLD Permit / Conditions - 6/28/1996 t• M' COW it �l/LZ�..0 L•� - - i. • � ,l• f_ .a ) � _ � .+ �•• !�_ Vic'• 1 1 � i �� / /��► ��. ��/• �• ►nt_ ) t_ � :•�. 'its Flit- IN IWS Imo► i � I Z:z X z Z: c mi z z z z z mt < z rr, z 3> oc 00 77 c 0 x ---Jo OD C: z ol I; =) rr, cn (D 00- :3 (P 0% -0 T, _ ,' i OD cyl 7� f -� �ac-•` ._:. _�'� �` � '' -� - .ate:. .G :.c '� �' sa s �C . x 3 �. - _ "- '?� ,, ice• ter, R_ -» v .z S 40 ..: tt. { fti T go ML jb - : 48 1- T MV Im rr R+•n r '�i, F y S z 7,- 7 4 J' w 'at Am ye x : im, 2 OL W ^i � Ar .�Y :Y .ems• :zr w - $ � $ #�' � '..0 l ' _ �. m -tie � - :%; f z >••+ '� 1 7 E -V 00 CA o 0D x o Cl) _ - o 0 OD of cn oOL 0 - CD 10 Q _- Oo - . 01 Q OD Permit No. MASON COUNTY (9vo 426V1IBUILD Box PERMIT ton, WA 9APPLICATI8584 ON 562s a�� PLEASE PRINT �O CA)- ro `a�E3 #1 Owner �01>~/�2Q �Ti _�il/TOil1o/l/ Phone# lea Irn Pr: Site Addr ss LO L a y,% Fire District# City g S St zip Directions to Job ite _ CLvg v.- CIO io O— r aC Owner Mailina Address zd, City GG !-6 St UU (2. Zip Lien/Title Holder Address f- AeZ) 31 City a 6� tlL5,c0o St zip O #2 Contractor Name �G<'/1/ /��/�� Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply la Well Connect to Sewer ystem? Name of System (If residential, proof of potable water is required) #4 Parcel No.-22 83 0 - 73" - 000 70 , Legal Description S� #5 Building Square Foliage: (existing/proposed) 1st FI 114D8 2nd FI ^mil n 3rd FI YN / Loft Basement Y\0 Deck /-n-3 2#bedroomE._ t l d 9'2 #bathrooms- Garage Jti,01), Carport to to (Circle:Attached or Detached?) Other sq.ft. l lohZ Z611-9f Use of building NY\e- Describe work #7 Type of Job: New Add Alt Repair Other #8 MGWLQMANUFACTURED HOME INFORM Model Year odel i Length Wid e #Bedroom #Bathrooms Type W8t P se Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other V ID 1^e, Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways fit/ Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Directional N, S, E, Name of Flanking Street in relation to of y W Ian ) Name of Fronting Street p p APPLICANT TO DRAW SITE PLAN BELOW o 7— i p � Sid i ds --54 7- #� APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW GJ o� I Plumbing Fixtures ($3 each) EPg Mechanical Fixtures ($6 each) No. Toilets 3 CIRCLE FUEL TYPE: Ga Electric, Bath Basins Heatpump, Other L5jeC+,r%c. WSA, �ea, er Bath Tubs 3 No. Units Fees Showers Furn BTU Hot Water Htr �J /kpr Heatpumps Laundry Washer 3 Vent Systems Sinks /Spot Vent Fans Floor Drains No. Boilers/Compressors ` v Laundry Basins / HP Dishwasher Ng,, Air Handling Units isposal cfm# 7VUrinals Ng, ire Protection Systems _Other V_ Auto. Fire Alarm Sys 50.00 ;��Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 Av Auto Fire Sprink Sys 25•00 TOTAL PLUMBING $4L Ns, Qjhe Gas Outlets Wood as, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM.AWARE OF THE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH.NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER (( X BY DATE LI — �� DATE v:.. ............. ..... .;:::;../.' ....:.:.::::.:...E. :: :. Ni;....... ......:.;>:r: i::ii'•.;?iiiii::iiii�:;:i;;::;.;;r.�.r.:, tq�U:p, :.:...... ::.:.:..::•.::::.:::., ;.f;.✓:..^.c:::::nn;:c:>S ,':,.lnh;";'ll::E;i�.yi::. .,.»:.::t.t;i'::isa.ii^><:>::}:?x:;?s::% ::i:::i>::::�:::<:i>ii;:::i;�i;�ii:;i' ff : ..:.....:....:................ G.. `f DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: (.j �T Building Plan Review m) gtite 6Z5� Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee a Mechanical Fee Wood/Gas/Pellet Stove ) Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE Aloo "'D, o. 14 DO LL, w � Y I w Per r R-ch t Vyl- - tVJ 40 �1 MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg.III 426 W.Cedar . P.O.Box 186 Shelton,Washington 98584 (360)427-9670 BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION )00 Re: Permit No. : Dear V7v'71, �� As per your recent reCEUest, this office has noted the above permit for extension to a 1996. In order to keep your permit valid, mu call for inspection prior to this date. In the event that u do not call for inspection, the Uniform Building Code allows for jurisdictions to require the renewal of building permits. Depending on the length of time of expiration, there are two methods used. If the permit is expired by less than one year, renewal may be obtained by paying half of the original building permit fee at the discretion of the building official and if the permit is expired by more than one year, the jurisdiction can require that the permit actually be processed as a new permit with routing to all required departments. If you should have any further questions regarding the validity of permits, please contact the Building Department at (360) 427-9670, Monday-Friday between the hours of 8 : 00am and 5 : 00pm. Sincerely, Zonoun y B ilding Department CC: Property File 6qO'�,6-3Q -76�/O Date Checklist Prepared S n 9 MASON COUNTY BUILDING DEPARTMENT PLAN REVIEWER AND INSPECTOR CHECKLIST 1991 WSEC AND V&IAQ CODE COMPLIANCE 28x36 loop ,2)Y 2r j-04 S88 Permit Number q 3- O G 10 Address N-F /// a c l ems;ev �, e_ Sq. Ft. /sqG Name on Permit A N 70 N SO N Contractor/Phone# Compliance Method: >< Prescriptive (Option) ( ) Component ( ) Systems Analysis �v✓f�c.c't �trJon : Cameo. {�c.ln.e� J-P t }�or►+eb - .�leci�lL Neaf Date 4J7to-2(v83 V c?7 cf7oo FOUNDATION Insp. Rev. ( ) ( ) Slab: R- (Ext.foundation down to frostline/slab bo om;or interior 24"top of slab&horizontal. Radiant under entire.) ( ) ( ) Below grade exterior wall insulation: R- r� Crawlspace ventilation: �_ (- /-2Pf(1 sq.ft.NFA/150 sq.ft.floor area-cross vented) /SO FRAMING -Y-5andard ( ) Intermediate ( ) Advanced ( ) ( �.),'�Woodstoves and/or fireplaces: (6 sq.inches combustion air supply duct with damper direct to firebox.) ( ) ( �tandard air seal: (Bottom plate/subfloor,rim joist/mudsill,window/door frames,penetrations condition to non-condition.) ( ) ( 'Attic ventilation (1 sq.ft. `i&1150 sq.ft.ceiling area) vQ u l+- 7d1�0usla CJt Ve4+ &4ch .bay /Con'1. lk hl3 e. ( ) ( � pot exhaust fans: (4"exhaust-bath/laundry 50 cfm @.25 WG;kitchen 100 din @.25 WG. Vented out with dampers.) ( ) ( J r sh air ventilation: Available to all habitable rooms. Installed and operational. (Integrated forced air,windows,wall ports.) ( ) ( Whole house exhaust fan:10 cfm Inte r"miittenr eset-em�Pnu�&au©tto`controls/sone less than or=to 1.5 at.1 WG) INSULATION ( ) ( Attic baffles installed to deflect incoming air(Rigid material resistant to wind-driven moisture,extend 12"above loose fill or 6" _Above batt insulation) ( ) ( echanical ventilation ducts R-4(Exhaust in unconditioned space&supply in conditioned space.) ( ) ) Wall insulation(above grade) R- (Batts face stapled) /A�' 4C/( ( 14k�f9,5 14-k sC ( ) ( ) Wall insulation(below grade-interior) R- (Batts face Stapled) / X ( ) (7) Vapor retarders on walls (Faced batt,or 4 mil poly or perm paint.-circle one) Rim joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.) ( ) (•-"'aulted ceiling insulation R- (Vapor retarder&1"air space) ?? FINAL ( ) ( Floor insulation R- y0 (Substantial contact w/surface,supports less than or=to 24"OC,not blocking vents.) ( ) Ventilation system is operational(spot,whole house,fresh air to all habitable rooms. If integrated system,certification by installer is required.) ( ) ( ) HVAC ducts in unconditioned areas R-8 (Joints sealed;mechanically fastened with a minimum of 3 fasteners.) ( ) ( �pe insulation R-3 (Hot and cold lines in unconditioned areas-service or recirc.see Table 5-12). ( ) ( -)----SHW heaters: (NAECA label,separate power or gas shut-off,on R-10 pad if electric in unconditioned or on concrete.) ( ) ( -)�-�Heating system type: 'gL./eCq(%L ( ) (Radon monitor on site with instructions.No. - Supplied by MCBD ( ) ( ) Thermostat: (Heat range 55-75;AC 70-85;both 55-85. Backup heat controls(lockout)prevent simultaneous operation of primary system.) O ( �—id fuel appls.: (Glass/metal tight-fitting doors;dir.comb.air source,or 4"dia.dampered,indir.source for existing cons[.) ( ) ( Ground cover: (6 mil black polyethylene or approved equal lapped 12"at joints,extending to foundation wall.) ( ) ( Penetrations(All exterior wall and ceiling penetrations sealed to drywall-plumbing,exposed beams,wall receptacles,fans,recessed lights.) ( ) ( ) Ceiling Insulation R- (Insulate&weatherstrip access,baffle to prevent spillover-no cardboard) Vapor retarder paint if a vapor retarder was not installed when insulation was installed. - nr9rrnriir��rr,rr, GLAZING Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. Impector- Verify window information during field inspections. Include skylights,glass doors and all other glazing on this form. Use rough opening area for calculations. ` Date Size Quantity Area S . Ft. U-Value Manufacturer Rev. Insp. ?° q0 a r 0 o i / / lwee- 0 0 / 64 D i Gr,5 Total glazing area: Total conditioned area: 9cj�z Percentage glazing: �� `� % Verified: DOORS Plan Reviewer_-List opaque doors by type(solid core,insulated,etc.)quantity,U-value,and manufacturer. Impector- Verify door information during field inspection. Date Type/Quantity U-Value Manufacturer Rev. Insp. Signature of Building Inspector: Date of Final Inspection: Page No. 1 CASE HISTORY FOR CASE NO.: BLD93-0610 RONALD A ANTONSON NE111 EAGLEVIEW LN TAHUYA 12/27/94 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- BLDA010 Application received / / / / 05/10/93 05/10/93 KW BLDA500 (F) Issue building permit / / / / 05/27/93 COMP NJP 05/27/93 NJP BLDS110 Structural Plan Review 05/11/93 / / 05/25/93 plans lack detail of connections DONE OH 05/26/93 DWH connections to be approved and stamped by engineer BLDB120 WSEC Compliance Review 05/13/93 / / 05/18/93 DONE DC 05/18/93 WFK BLDB129 Sent to Planning / / / / 05/10/93 05/10/93 CPH BLDB130 Planning Review 05/11/93 / / 05/11/93 DONE MMS 05/11/93 MMS BLDB200 Environmental Health Review 05/18/93 / / 05/19/93 Per septic records. DONE MMT 05/19/93 MMT BLDB210 Water Adequacy 05/19/93 / / 05/19/93 DONE MMT 05/19/93 MMT BLDC100 Inspection 05/12/94 05/12/94 05/12/94 OWNER/CONTRACTOR HAD FLASHING QUESTIONS. DONE LW 05/13/94 LAW BLDC111 Footing/Foundation Wall Inspct 06/08/93 06/10/93 06/10/93 THE EXTERIOR FOOTING AND WALL ARE COND LW 06/10/93 LAW APPROVED. THE INTERIOR FOOTINGS DO NOT MATCH WHAT IS ON THE APPROVED PLANS I ASKED THE OWNER TO HAVE HIS CONTRACTOR TO CALL ME BEFORE POURING CONCRETE. LW BLDC125 Framing inspection 10/26/93 10/26/93 10/26/93 see notes on card PASS DH 05/13/94 LAW BLDC130 Plumbing inspection 08/20/93 08/23/93 08/23/93 PASS LW 08/23/93 LAW BLDC145 Insulation inspection 11/29/93 11/30/93 11/30/93 GABLE END OF SECOND FLOOR ONLY PART LW 01/25/94 DLC WAS THIS THE ONLY FRAMED AREA? BLDC155 Final inspection 10/20/94 10/21/94 10/21/94 WAITED FOR 20. MIN. 11:45-12:05 FAIL DH 12/27/94 LAW BLDC155 Final inspection 12/23/94 12/27/94 12/27/ 4 CORRECTIONS: FAIL LW 12/27/94 LAW OVE THE INSULATION FROM THE BUST ION AIR OPENING AND ADD A DUCT EXTENDING THE OPENING BELOW THE INSULATION ON THE WOOD STOVE. SMOOTH WALL METAL PIPE IS REQUIRED FOR THE RANGE DUCT, SEE SECTION UNDER ST REMOVE PLASTIC FLEX. ANCHOR WATER TANK. 4. PROVIDE AN EGRESS WINDOW IN SLEEPING r AREA. _ ---------------- i E A- - -MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg.III 426 W.Cedar P.O.Box 186 Shelton,Washington 98SU (206)427-9670 BUILDING PARKS&RECREATION FAIR/CONVENTION CENTER ADMINISTRATION December 28, 1994 Ronald Antonson P.O. Box 1788 Belfair, WA 98528 Re: BLD93-0610 Dear Mr. Antonson: Prior to the Final Inspetion to the above referenced permit I will need verification of the following information: 1) The window from the loft must meet egress, the net clear opening is 5.7 sq.ft. 2) The minimum net clear operable width is 20 inches, net clear operable height is 24" inches. 3) The finished sill height shall not exceed 44". IfI can be of any further assistance you can reach me Mon-Friday 8.00-9:00Mon-Fri (206)427- 9670 Ext. 357. Sincerely, Dana Herron Building Inspector III cc: property file ADDIMS N M It (nild posaibbly taM 5 ftys FO[� issue t��us'� to il Mnsgwet Middleton - x291 MASON COUNTY [PLANNING DEPT. P.o. sox as. 42e W. CEDAR ST.. SHELTON. WA osss4427-967 (first) --- o-n Q��; . (middle initial) cacJ 1V'r MULIM AnDMS: P soxc PANEL NE24M (assessor's account ) LEGAL DESCRIPTION: Please draw a diagram of your property, including nearest existing named road and the nearest existing address. Draw your Clouse and driveway. Indicate northerly direction. PLEASE have your DRIVE W S12M or MUUM for easy identification: Ob OF nV a d I' O 3� 11W AD '�'Ss Aesidents shall place, within sixty (60) days, the address on the mailbox and place the address number in a conspicuous location on the, Structure if visible from the named road; or at the principal place of access (driveway entrance) if the house is not visible from the named road. When an address is assigned with a building pe=it, the new address shall be posted at the Pru=Pal Pie of access to the construction site at the time coasstruction begs and shall be placed on the mailbox upon occupancy. All information is required in order to process your address request. received 4�A.ss�_ entered answererA bld4 ciept PIM PIM F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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'v T� . . • • • • . •, pate•�(� . ------------- DESIGNER PLOT PLAN CHECKLIST Gr' FFdrain plot plan if lot is under } acres 9 yo ation and dimensions of reserve area ng and proposed wells, includinithin no ft of groadways, easements, parking Property linesphical features, cuts, banks, IR"I�roperty lines, building stub-out and direction of slope Mound horizontal gradients, endelope n and orientation of curtain and upslope/downslope widths, overallC. absorption area components fill length and width, depth of mound ponents cap at center and edges of bed MASON COUNTY DEPARTMENT OF HEALTH SERVICES POST OFFICE BOX 1666 SHELTON, WA 98584 (206) 427-9670 FAX 427-8425 APPLICATION FOR DETERMINATION OF ADEQUACY Revised 09/01/92 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 i3£ _ - ££t i I.: ::::?: :___:_ .-::: -.: :s£ :_: ? £ 33: 3 3 ?=33? 2 £ 333=333 ? :III-: j73£33=:•i s 3,3:x:s:,:iii iiiI[:3 x...:?# 131ie€!!{€ =' =s?!= .. .........£---_•.•-::x::3:z::,3:3::x33x3#:#`=.#i„3x::at1IIlI,1:1:3:xxl iiI!I:iII:,:3:,x1xli3, , ...- i .....: :i NAME OF APPLICANT n E 14r o "Y1 DATE J-)- - 2 MAILING ADDRESS TELEPHONE ct- city n Q at-t• Z&]P� 1J ASSESSOR'S PARCEL NUMBER 2 3 J©— SUBDIVISION (If Applicable) LOT TYPE OF WATER SYSTEM (Check One) REASON FOR AP CATION (Check One) Public/Community Water System Building Permit, Single Family Res Individual System, Drilled Well El Building Permit, Commercial El Individual System, Dug Well 11 Building Permit, Replace/Remodel Individual System, Spring El Land Use Application aName Individual System, Surface Water Type El Individual System, Other El Other PART 2-A: PUBLIC WATER SYSTEM t33!{t{iiiliiilill{1l1lilltli#tiliil{1{i{#tltllilill{ilitlti!#lili!llllitllilttl{II11Itllttitltllilllt!#tfll!lill#i##ttililltlt#I!li31ti1ltitUtlililltititlitilllitt111##till NAME WATER SYSTEM WFI ID The water p for this system has previously filed a certificate of adequacy with the health district. I an manager of the above referenced Sys The water system has DOH approval for service connections, with Conn ans presently in use. • applicant has approval to connect to this water system. Service of w to the applicant for domestic purpos a consistent with both the water system plan and the w right permit presently in effect. water lines are ava a to the applicant-* property line, a applicant has made satisfactory arrangements to extend the lines. SIGMTM OF SYSTEM MANAGM DATE t,- PART 2-B: INDIVIDUAL WELL llllllillll#I#lIIIliilllllliil!#!1!llllltlllIlil3IIIIII1Ilfil!!!!#t#Iitliltl111lllli!lltlitllltl!!IlIIIIIlI#illliitllltlilllitilllltltlititlltllllttllllilllrtillitlilllili!!ii WELL DEPTH � Ft WELL CAPACITY 4..dl G llons/Minute Gallons/Day Well log is attached to this application El Well capacity test results are attached to this application NOTES: Well capacity tests are often performed by the well driller at the time the well is con- structed. Test results from these tests are noted on the well log. Results from these tests will be accepted by the health department. If a well log cannot be located by the applicant, a well capacity test moat be performed by a licensed contractor. Haler or pump tests are acceptable, provided stabilization of draw-down has been measured and recorded. Satisfactory total coliform test is attached to this application. PART 2-C: INDIVIDUAL SPRING OR SURFACE WATER illlltll�lilllllitlt°lillllttlllllllllllilllllllllllltlllttlllll9liiilllllllll ilttilllilll illt llll'slilltttlllllllulllllllllllllllllllilltltttlll tllllltll:lllllllllliilltltll WDOE permit is attached to this application ave reason to believe the spring proposed as the water a will supply ade to water its intended purpose. This belief is d on the following observat' no: AUTHOR OF STATE DATE RELATIONS TO APPLICANT In addition to providing the above statement, the applicant will need t range an on-sits inspection by the health district prior to determination of adequacy. PART 3: HEALTH DISTRICT EVALUATION (Health District Use Only) f iiti lllliliil i iiii#lii#11!#IlIII#II!#tliltlIllllilU#iillillltl!#i#1!t!!ll#i#tltif#1#t#II!#tli#il!!I!i!i#titlltlN#i#!!t!3#liliiltlIll#i!I!i#Iillililt#tlttttt#t#ti!#hilt#t# SATISFACTORY DETERMINATION: Applicant's water supply appears adequate to most needs of its intended use. Note: This determination does not address adequacy of the distribution system, guarantee an adequate supply of water indefinitely into the future, or guarantee compliance with all applicable WDOB water resource regu- lations. UNSATISFACTORY DETERMINATION: Applicant's water supply does not appear ade- quate to meet needs of its intended use for the following reason(s) : HEALTH INSPECTOR DATE Rev!-,' "9/01/92 saw BuildingRecord "� B wsEo con�ract# - For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps (please check one) lease check one) XNew Building ❑Addition over 500 sq.ft. Single Family ❑Duplex Jurisdiction: AA .4_sOoa Multifamily ❑Zero Lot Line Home r ❑Planned Unit Development + please check one: ❑ City Vcounty Permit# 3 —0& /o Fi le I D#(if different from PefmitI + A. Site Information B. Owner Information Address E � a r1e4A,1 Owner ownefat time of swcdon receives ent /9GQ� %5L2n City aAV_ zip. �.��� Company Assessor's Pro Wrty Tax# or attach legal descfi tion : Address /// e Yi,GGt) oZ.? Oa 07 5000 770 City Cc. U tat Zip Servicing Electric Utility P000_ Phone C. If Family,Single ,Zero Lot Line or D.Duplex E.If Multifamily(R-1) 9 ty Planned Unit Development First Duplex Unit sq.ft. Total#/Bld s. - - Total Conditioned Floor Area n Duplex Unit .ft. Total#/Units ft Second A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat Type (check one) (check all that apply) (check one) ❑ Electric Baseboard ❑ None Electric Electric Wall HeaterWood ❑ Gas ❑ Electric Furnace ❑ Electric Baseboard ❑ Other(specify below) ri H Pump ❑ Other below ❑ Electric eat u (specify ) P ❑ Other WSEC Compliance Method For Heat Pump Only: 3 Date of Permit Application rescriptive Path Built to the Electric `! Component Performance Requirements of WSEC? Date Buildin Permit Issued — , Date of Insulation Inspection // — — ❑ System Analysis ❑ Yes ❑ No (If yes Date of Final Inspection "-9cr utility may offer incentive.) / I hereby certify that this building or addition has been inspected for the measures required I ",byhe 1991 Washington State Energy Code(WSEC), that ft Is In substantial compliance with WSEC,and th the WSEC checklist for this building Is on file. store f BuNdng Official or Authorized Representative Date 'V9,8ubding Department:Return white copy to Gaul Burris,Washington State Energy Office,P.O.Box 43166,Olympia,WA 98504-3165. a Owner or Building Depamtent:Forward canary copy to the servicing electric utility to trigger WSEC compliance payment. ' . . 0 Building Department: Retain pink copy for jurisdiction's building file. WSEW94-015 5-95 /L �.M���'�e�•')'�s�, STATE Atmchnent B Building Record WSEO # . PROGRAM For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps :h:a ,.>. : .. <.. . (please check one) lease check one) )eNew Building ❑Addition over 500 sq.ft. Single Family ❑Duplex Jurisdiction: M 4_S061 Multifamily ❑Zero Lot Line Home IDPlanned Unit Development + please check one: ❑ City Jr County Permit# 3 —0& /o FI le I D#(if different from Permit A) + A. Site Information B. Owner Information Address AIC- —"Ie Owner owner at time of st ycUon receives utillity paymeno RIO/1Q.� City a_'hV Zi ps--I ' Company Assessor's ProWrty Tax# or attach legal description): Address- /// e yi,e, oZ a? as 07 5900 -70 city Cc. U tat Zip Servicing Electric Utility p(>Q3 Phone s3•Co �f 7(0 C. If Single Family,Zero Lot Line or D. Duplex E.If Multifamily(R-1) Planned Unit Development _ First Duplex Unit .ft. Total#/Bld s. Total Conditioned Floor Area .ft. Second Duplex Unit sq.ft. Total#/Units A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat Type (check one) (check all that apply) (check one) ❑ Electric Baseboard ❑ None K Electric AElectric Wall Heater Wood ❑ Gas ❑ Electric Furnace ❑ Electric Baseboard ❑ Other(specify befw) ❑ Electric Heat Pump ❑ Other (specify below) ❑ Other All WSEC Compliance Method For Heat Pump Only: �Ilcomponerit rescriptive Path Built to the Electric Date of Permit Application �--/Q Perform n R uirem Date Buildin Permit Issued — — ace Requirements of WSEC? _Date of Insulation Inspection // — ❑ System Analysis ❑ Yes El No (If Yes, Date of Final Inspection utility may offer incentive.) - t' I hereby certify that this building or addition has been Inspected fdr the measures required by the 1991 Washington State Energy Code(WSEC), that R is In substantial compliance with At e*WSEC,and th the WSEC checklist for this building Is on file. store f Building Official or Authorized Representative Data ■ Building Department:Return white copy to Gail Burris,Washington State Energy Office,P.O.Box 43165,Olympia,WA 98504-3165. ■ Owner or Building Deparment:Forward canary copy to the servicing electric utility to trigger WSEC compliance payment. ' ■ Building Department: Retain pink copy for jurisdiction's building file. ` WSE0194-015 5-95 HEAT LOSS CALCULATION For waft loss factor tables,please refer to Department of La (BASED ON INSULATION VALUES LISTED) Installing Electric Wires. DESIGN INDOOR TEMP:700 DESIGN OUTDOOR TEMP._ ADDED HEATED SPACE — 01. INSULATION R-VALUE TABLE WATT So.CU. WATT So.cu. WATT So.cu. So.cu. MATERIALONLY SOURCE OF HEAT LOSS NO. LOSS or LIN. or LIN. or LIN. WATT or LIN. FACTOR FEET LOSS FEET LOSS FEET I LOSS FEET GROSS WALLS (EXTERIOR) E ' LESS WINDOWS (SINGLE) LESS WINDOWS �� 40 (DOUBLE) 1 LESS DOORS NET WALLS - ;I' 2 or 12 0 NET WALLS-CONCRETE , ° ABOVE GRADE 3 or 13 CEILING -VENTED ATTIC ABOVE 4 CEILING -OPEN BEAM CONSTRUCTION 5 or 13 2 FLOOR - OVER VENTED CRAWL SPACE 6 or13 - FLOOR-OVER UNVENTED e UNHEATED AREA 7 _.��, FLOOR-SLAB INCLUDING BELOW ;. Vy GRADE WALLS INDICATE LIN.FEET 8 z 3.. � COMMON WALLS (MULTIPLE UNITS) 9 COMMON CEILING (MULTIPLE UNITS) 9 -- COMMON FLOOR # (MULTIPLE UNITS) 9 � >, INFILTRATION(CU.FT) ( AIR CHANGE/HOUR) 10 TO CONVERT WATT LOSS TO ROOM WATT LOSS y BTUH LOSS,MULTIPLY WATT d LOSS BY 3.413. ROOM BTUH LOSS '9 CFM/BTUH FACTOR= ROOM CFM REQ. DUCT SIZE 7 BRANCH DUCTS EXISTING AND REGISTERS REGISTER AT 600 F.P.M. CHANGE or ADD DUCT SIZE REGISTER MAIN SUPPLY DUCTS AT 0.1 IN./100 FT. ••x Q MAIN RETURN DUCTS AT 0.05 IN./100 FT. "x 1. St u a Heat Loss(SHL) oC "► � BTUH BRANCH RETURN DUCTS AT 600 F.P.M. "x 2• ��� Duct or piping insulation RETURN AIR GRILLES AT 400 F.P.M. "x (inches or approx. R-Value) 3. Duct Heat Loss Multiplier(Table 11)DHLM= SUPPLEMENTAL HEATERS:Indicate total kw,and kw and ball 4. 10 °Jo Fraction of ductwork in unheated space. Total Stage 1 kw 5. Estimated Duct Heat Loss—SHL(1)x DHLM(3)x Fraction(4) g = 17 SS BTUH kw Set Point OF 6. Total Heat Loss(Add Line 1 To Line 51, _ 3� BTUH 7y�'red Estimated Equipment Noise Level at Property Line Worked By 7. Total CFM Re Date -&- IQ z Approximate Distance to Nearest Property Line a�n ,DATE ALE MOUSE HEAT LOSS CUSTOMER/BUILDER CONTRACTOR ADDRESS CITY STATE ZIP HOME PHONE BUSINESS PHONE CONTACT PERSON/JOB NAME JOB SITE INSULATION: COMFORT PLUS? WALLlp ATTIC v HSPF VAULT - O HEAT PUMP FLOOR OVCS - ) DAMPER FLOOR ODUA HP READY SLAB GAS WINDOWS _ _ '1 PROPANE DOORS Owl:p So&di OIL COMMENTS CONTRACTOR REPRESENTATIVE