HomeMy WebLinkAboutBLD97-0930 SFR, Deck, Propane, Wood Stoves - BLD Permit / Conditions - 8/12/1997 Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. EMM 27-9670/1-800-562-5628
(Calling From, SITE Wnrgs 67, Elma 482.5269) 'ry
PLEASE PRINT SCHEDULED FOR THE
FIELD ON
91 Owner �0>4 CG U SS`GN�A_ o Phone#�Q U-Lt 1-7 10 to
Site Address P Fire District# to
City _ St Zip
Directions to Job Site 9r i Ve �oWa��� s Uh Io�l r�/;t me
Owner Mailing Address P 0 , 5D--f- 5-4-9
City S 'q LTo JJ StL'2�Zip
Lien/Title Holder j e
Address 9XftT'4- rB n103.e
City St Zip
_ S"IRS
#2 Contractor Name:,, l_ , Contractor Reg
Address 7 � �ti! �,� r Expiration Date��
City �Lyy . St /, 4 Tip �? �( -2 —Phone# 366- 1-3 c 1 Z
#3 If septic is located on pr ect site, include records.
Connect to Septic? ° Public Water Supply Well
—/
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
3_--I 1 o5-0 &'16 0'11
#4 Parcel No.--!3� - go -
Legal Description - - �LJ r u QV 62- - s'P 13 GO
SE 5V�rvey ('0 1Sot -� (0 - 0� F
#5 Building Square Footage: / '_I _
1st FI `� c r r" 2nd FI 7 3rd FI WSJ Loft �^� Basement
# Bedrooms # bathrooms Deck Other
Garage Carport (Circle: Attached or Detached?)
#6 Use of building /�� c"� . Describe work
#7 Type of Job: New Add Alt Repair Other
t
#8 %OBILE/MANUFACTURED HOME INFOR ATIONI ear Make ode Q u C�
Length -�ll�th Serial No. Cj�v
#Bedrooms a S. Type of Heat
�v
Purchase P ' $
#9 Indicate by circling the applicable source if any water is on or adjacent to subject proper�fi
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other 1J�7��J7Z
Show following on the site plan
y,
Lot Dimensions Fen�e�
Existing Structures F �� Driveways
Structure Setbacks 5 � 5 Shorelines
Water Lines Topography
Drainage Plan Wells
Septic Systems, Easements
Proposed Improvements Indicate Directional
Name of Side Stree y N, , E,b SW)
Name of Fronting Street-- in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
v �/ Gov 6,,
Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 eachl
No. Toilets CIRCLE FUEL TYP : Gas, lectric,
Bath Basins Heat Other
Bath Tubs No. Units Fees
Showers _ Furn BTU
e— Hot Water Htr Heatpumps
L Laundry Washer Vent Systems
ASinks Spot Vent Fans y'7.2 S'
door Drains No. Boilers/Compressors
Laundry Basins _ HP
Dishwasher No. Air Handling Units
0 Disposal _ ctm#
Uc-
Urinals No. Fire Protection Systems
Other _ Auto. Fire Alarm Sys 50.00
Ig*.3. 35 (DO.3a Fixed Fire Supp. Sys 50.00
Permit Basic Fee 16.75 _ Auto Fire Sprink Sys 35•00
TOTAL PLUMBING $7 . ` No. Other
Gas Outlets -
' Woo , Gas, Pellet Stove L°b -
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 16.75
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $J1
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 OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WI-y1CH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE TLL BE IN CONFORMANCE
CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO PfIANgES SHALL BE MADI4 WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINIK OVA FRO T BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNE G X BY
DATE l f DATE r
FOR OFFICIAL USEONLY: Accepted by: Date::
i
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: Alm
Environmental Health:
Building Plan Review W��-
to'I
Occupancy Group:K 3 u'{ Type of Const: i"J
Fire Marshal:
Other:
Special Conditions: FEES
89 6 7" 15= so Building Permit S(7• o
70,f X t 3's ��'� Plan Check o.-
16 = 7 "f 118 531 .
(4 ` - -Z 9 ,.0 2_8 Plumbing Fee 7 7• pS-
`f 7 K qb = f 9 I 1 S22 Mechanical Fee 00
009 7x 6• Z Jr- ' 6 $ f I Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee
Other �e
OtherQl;y, rttr?4, Q--V
Other
Building Valuation: �h2� t/ TOTAL FEE
h
Enemy Code Information
Project. Corley
Date: 08/01/97
Insulation and Vapor Barrier:
A. Minimum R- in ceiling (attic)
B. Minimum R- 30 in vaulted ceiling (cathedral)
C. Minimum R- 21 in wall
D. Minimum R- 30 in floor
E. Minimum R- 10 at slab-on-grade edge
F. Minimum R-
Code Conformance:
A. Climate Zone: 1
B. Conforms to the Washington State Energy Code.
C. Conforms to the Prescriptive method of Code Conformance
Option no. V
1. Group R Occupancy Heating by Electric Resistance: No
2. Group R Occupancy Heating by Other Fuels: Yes
D. See Compliance Report for further information.
Framing Methods:
A. Wall framing method shall be: Intermediate
B. Roof framing method shall be: Standard
Floor Area: 4275
Glazing Area: 743.44
Percent of Glazing: 17.39%
Analyst: Neil A. Meyer
(F& w) Foster and Williams Associates, P.S.
Window Schedule 08/01/97 Project Name: Corley
BASEMENT
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Kolbe& Kolbe KCN33 0.36 1 5030 15
H°K, Argon
Total Window Area: 15
Skylights
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Total Skylight Area: 0
Doors
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Peachtree Solid 0.09 3 3068 60
Total Door Area: 60
�F�� Foster and Williams Associates, P.S. Analyst. Neil A. Meyer
Window Schedule 08101197 Project Name: Corley
MAIN FLOOR
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Kolbe S Kolbe X16 0.36 8 2660 114.64
H°K, Argon
X14 0.36 4 2640 37.32
W 14 0.36 9 2040 68.14
W 16 0.36 3 2060 34.71
S 14 0.36 2 1440 10.29
S 15 0.36 1 1450 6.48
KC30181 0.36 1 3018 5
Peachtree Full-GIs. - Rnd.-top 0.29 1 3076 21.53
Total Window Area: 298.11
Skylights
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Total Skylight Area: 0
Doors
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Peachtree Solid- Rnd.-top 0.09 1 4068 24.95
1/2-GIs. 0.114 1 3068 20
Total Door Area: 44.95
F& W Foster and Williams Associates, P.S. Analyst: Neil A. Meyer
Window Schedule 08/01/97 Project Name: Corlev
SECOND FLOOR
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Kolbe & Kolbe KCX35 0.36 2 7650 75
H°K, Argon
KCW34 0.36 1 6040 24
KC26262 0.36 1 5026 12.5
N 14 0.36 3 1840 19.11
S 14 0.36 2 1440 10.29
S 146 0.36 2 1456 14.29
KW3 0.36 1 6016 7.06
KX2 0.36 1 5016 5.89
Rnd. 0.36 8 20 25.13
Total Window Area: 193.27
Skylights
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Velux FS 0.4 2 2020 8
2 2030 12
1 2040 8
VS 0.47 1 2020 4
6 1 203 36
1 1 204 8
Total Skylight Area: 76
Doors
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Total Door Area: 0
F & W Foster and Williams Associates, P.S. Analyst: Neil A. Meyer
Window Schedule 08101197 Project Name: Corley
THIRD FLOOR
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Kolbe & Kolbe KCW35 0.36 2 6050 60
H°K, Argon
W16 0.36 2 2060 23.14
KW3 0.36 2 6016 14.13
KX2 0.36 1 5016 5.89
Rnd. 0.36 4 20 12.57
Peachtree French 0.36 1 5068 33.33
Total Window Area: 149.06
Skylights
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Velux VS 0.47 2 2030 12
Total Skylight Area: 12
Doors
Brand Model Number U-Value Quant. Size Area (Sq. Ft.)
Total Door Area: 0
F& W Foster and Williams Associates, P.S. Analyst: Neil A. Meyer
APPLICANT NAME:--U Q DATE: ``• I
BUILDING PERMIT CHECKLIST
SITE ADDRESS
If site address has not been issued refer the customer to Community Dev. ext 291.
FIRE DISTRICTS
Please make sure the fire district is included in the application information. Refer to map located at counter.
DIRECTIONS TO JOB SITE
Needs to be as complete as possible (i.e. major roads, is house on left or right side of road, etc.). Be sure to read for
clarity (Landmarks, signage, owners name on mailbox, etc.?).
LIENITITLE HOLDER
Who holds the mortgage (Bank or name of private owner holding contract)?
CONTRACTOR REGISTRATION # AND EXPIRATION DATE
This information needs to be provided. The Building Department may be able to research expiration information if
customer does not know it. We must have a signature in 1 of the 2 boxes, either the applicant or the contractor.
SEPTIC RECORDS
New systems must have test holes dug prior to submission and Septic Application must be filed and paid in full.
A B �--
WATER COMMUNITY PRIVATE
G
SEPTIC EXISTING % DESIGN 11 APP 11. �� V i
DEV REMODEL ANEW
STATUS
IS THIS A REPLACEMENT UNIT? YES NO
IF SO: MASON COUNTY BUILDING PERMIT APPLICATION SECTION #5, BUILDING SQUARE FOOTAGE, MUST BE
FILLED OUT COMPLETELY.
AND: SECTION #6 MUST CLEARLY STATE, "REPLACEMENT UNIT"
PARCEL #/LEGAL DESCRIPTION
Parcel # must be included. If number is not available contact Addressing at Ext. 291
BUILDING SQUARE FOOTAGE
Clearly show existing square footage and that of which is proposed. If there is a garage, verify whether it is attached
or detached. Include square footage information for mobile homes.(ie. 10X20=200 square feet.)
USE OF BUILDING
Residence, garage, greenhouse, designate if it is commercial.
DESCRIBE WORK
(i.e. mobile home addition, addition to a house, etc. . .)
TYPE OF JOB I F'
Verify appropriate boxes are marked.
MOBILE HOME INFORMATION
Verify appropriate boxes are marked. If factory order, please put factory order#in mobile home serial #. If unit was
assembled prior to June 15, 1976, refer to procedures handout for "Obtaining Installation Permits for Mobiles
Assembled Prior to June 15, 1976."
SHORELINES/CREEKIWETLAN D
If property is within 200 feet(includina adiacent properties) of Shorelines/Creek/Wetlands, #9 must be complete. If
none of the conditions are present please enter "na" or "none".
SITE PLAN DRAWING MUST SHOW THE FOLLOWING:
* LOT DIMENSIONS * DRIVEWAYS
` EXISTING STRUCTURES * SHORELINES
* STRUCTURE SETBACKS * WELLS
* WATER LINES * SEPTIC SYSTEMS
` PROPOSED IMPROVEMENTS * EASEMENTS
* NAME OF FLANKING STREET * NAME OF FRONTING STREET
ALSO PLEASE MAKE SURE DIRECTIONAL IS FILLED IN ON APPLICATION
TOPOGRAPHY DRAWING
If property is flat write "flat" on the topography section. If house or structure is near a slope or hill, drawing must
reflect this. This should show an accurate side view of the property.
PLUMBING/MECHANICAL
This form must be completed for any structure with plumbing and mechanical excluding mobiles/modulars.
OWNER OR CONTRACTOR AFFIDAVIT
Owner or contractor must sign affidavit statement and date it.
ACCEPTED BY
Whoever is accepting permit information must sign your initials and date form on the bottom of page 3 or use date
stamp and initial on back of permit.
PRINTS
Need two sets of prints unless it is a stock plan. For stock plans, we only require one copy.
Commercial protects require four sets of plans.
WATER ADEQUACY
For new residences and mobiles. PRIVATE WELLS MUST HAVE WELL LOGS OR CAPACITY TEST AND BACTERIAL
TEST. If they are on a public water system, check for signature to verify that the system is not on the State's "out
of compliance list"
WSEC &V & IAQ CODE
Required for all residential, additions and commercial buildings. Energy Code compliance form needs to be
COMPLETED. Verify heat source(no wood or pellet stoves are permitted as primary system). Window schedule must
be filled out and reflect what appears on submitted building plans. If applicant has decided to go with the PUD in a
Long Term Super Good Cents program, we require a copy of the signed agreement with the utility.
•� ROAD ACCESS PERMIT
If you will be accessing your driveway from a County road, contact the Public Works Department in Mason County
Building I, 427-9670 extension 450. Access from State Highways requires Department of Transportation approval.
Contact office (206)895-4753 (Port Orchard).
❑ "Notarized statement for GMA"
Checklist.2
2-5-97
Trish 2
6V
BIIILDING PERMIT #
DATE
Planner Area
- IIC)S - an �
CHECKLIST F
OR PROPOSED CONSTRUCTION
Ye
[ ] Within 200 FT of designated shoreline, wetland, or-
associated wetland
Where?
I ] [ I Proposed construction on/over/in wetland
I__]___. l__ _Proposed construction within floodplain
i[ Eagle nes'
State road access needed
17 [ ] Commercial Development (parking standards, sign
ordinance, public works review, other applicable
agencies)
[ 7 [ ] Mobile Home or RV Park
[ 7 [ 7 Exempt from building permit application
[ 7 [ ] Exempt from SEPA process (WAC 197-11-305, WAC 197-11-800)
17 [ ] Meets all requirements (which section(s) of SMP does
proposed construction pertain to?)
7 [ l Variance or Conditional Use Permit required
[ ) l ] Exempt from Shoreline Substantial Development Permit
process (Wac 1.73 -14 -040)
I 3 [ ) Exempt from Substantial Development, but within Ar_zny
Corp_ ji;r3 >dicti_on (WAC 173 -14-115)
MASON COUNTY
PRE-SUBMISSION CONFERENCE APPLICATION
Mason County uses the pre-submission conference to assist applicants in
preparing proposals which are consistent with all Mason County, City of Shelton
(when applicable) and PUD concerns and regulations. At the pre-submission
conference representatives of all relevant departments will be in attendance and
will be able to inform you of the regulations and standards with which your
proposal must comply. Pre-submission conferences are only held on Wednesdays
and are approximately 60 minutes in length. Seven copies of a detailed site plan
shall be submitted one week prior to the conference. The site plan must contain all
setbacks between proposed and existing structures and the property lines. If
applicable, please show all critical areas (shorelines, wetlands, landslide hazard
areas). All existing and proposed structures must be shown and labeled with their
use and the type of construction materials to be used (i.e. stick.built, modular,
etc). PLEASE PRINT when completing this application.
Applicants Name:
Contractor:
Contact: Telephone #
New Project: Expansion or remodel of existing use:
Describe Project:
Site Address:
Tax Parcel Number:
******************* For Official Use *******************
Meeting Date & Time:
1 .0
t .C:s
Location:
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