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HomeMy WebLinkAboutBLD2013-00217 INSPECTIONS FINALED. - BLD Inspections - 9/4/2013 r c MASON COUNTY PERMIT No&DZDF .(00 Zi-7 BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 - Ileffair (360) 275-4467• Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION ,t Owner I A I, ; a .- ©t ea,0` �►CG e Company Name ►V Mailing Address 48:0 �4 s't 5+f?A 0 2, MailingAddress o 5-7 City State Tip Code �� �-- C State Zip Code Phone Other Ph. PhongQ53-3 7 7- 3 o?z 7r _ Other Ph. Contractor Reg.#D Y A xx i 71 1 f�/ E Mail Address Drivers Lic.r DOB SEPTIC I WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System A PARCEL INFORMATION - 12 Digit Parcel No I Z 2SS - Z 00o 0- Fire District Lagal Description o Site Address (Please include street name,street number and crty) Directions to site Will timber be cut and sold in parcel preparation?Yes No Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Corr on Noti or other enforcement action?Y o TYPE OF JOB - New Add Aft )( Repair Othe RIMARY RESIDENCE X,SEASONAL ❑ Use of Building Re Describe Work No. of Bedrooms No.of Bathrooms Square Footage- 1st Floor L/�` e� 2nd Floor _ 3rd Floor Basement Deck Covered Deck Other Sq. ft- Garaoe c e Detached Carport Attached Detached MANUF HOME INFORMATION -Make Model Year - Len Width Serial No. of Bedrooms No. o throomS T of Heat rchase Price S Replacement Unit? Yes/No nstaller Name Certification No. + CVVNER/3UdDEi:3 A;imovviedges s>mission o,inaD:�Lraie thfomma ion may resift in a stop work order or permit ravaavo2 A3mowledpamant of sum is by sianaJ d below.I dez�are that I am the owne. owners le�representative,or the contractor.I further dectare that I am e,7tled to rac—eive tis oermri and to do the work as proposed in the appfica iat.I dear that I have obtained the permssion from all th necessary parti s If pemission is re7jired from any easement holdar.or any other party in merest ragarzirng this appfi;ation or the work proposed m the appfrcanon,I have obtained peirrrssian from tha._m to apply for this prmu3 and conduct th work pmpasazL The owner or ageTt on owners behalf,represents tat the i i 'on provided is ao-rate and grants errployees of Mason CDur ty a2----.-s to the above desabed property and stru-ture for review and inspection. PROF ``CC$$C�QNIUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X : �,G-,� Date- owner/Owners Revresentabve/Contractor 5nyoate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by. Date DEPARTMENTAL REVIEW I APPROVED DENIED NOTES Building Department u i 3 ,a Planning Department Environmental Health Deoartment Public Works 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 S I TOTAd FEES MASON COUNTY PERMIT NOBld ZOO -M2-1 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 INkORMA I Owner /fit_ k-6-Dla %.If 4G Company Name- ya Mailing Address 48 40 !f -± !kj 124 3o a, Mailing o City State Zip Code 4$ 5� City Addr WA State Zip Code 5 Phone Other Ph Phone er Ph. Lien/Title Holder Contractor Reg. f " th ?L Ex I t 1 E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic. Connect to Sewer System Name of Sewer System \/ t, Cr:I-o w " PARCEL INFORMATION- 12 Digit Parcel No Fire District Legal Description Site Address(Please include street name,stree numb r and city) Directions to site � 3 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 Fixture Fees Fuel Type:Electdc-*,*&,LPG_Natural Gas_Heat PumpX Toilets _ _ Type of Unit No. of Units Fees Bathroom Sink -t „1•f Furnace Bath Tubs I HeaSpot Vent Ft Showers � Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher ! $ Kitchen Exhaust Hood Hosebibs �y'�.� Dryer Vent Other ` 1 Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWI,slER/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 holler 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 pert 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. PROQ;Z CON'DN y OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X 4!'� I_ Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid 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 DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/ Ventilation Code Compliance Application Owner: Parcel#: Type of project Total Sq. Ft. /� 1 Floor: 2" floor. Bated Basement: of heated area:: &h Heating System Electric wall heater Electric Central Furnace O LPG Furnace ® Heat Pump with electric furnace O Heat pump with gas furnace O Ductless Heat Pump O Boiler, specify fuel type: O Other. Specify: Glazing Compliance O Prescriptive Option (see reverse side) circle one: I 11 III Percentage: Method O Component Performance , Chapter 5— Calculation worksheets required Check one:: O Other (Specify): Check one O Whole House Ventilation system Whole House Ventilation o Other, Ventilation using exhaust fans&window or Integrated with a Forced Air descnbe: System Fall fresh air vents (M1508.4) System (M1508.5) Referencing WSEC Section 901, "Additional Residential Energy Efficiency Requirements,"all NEW residential units must develop 1credit from Table 9-1. Identify and describe which option(s)will be used ENERGY to comply. If the table is not attached to this form you can access the table on our website at: CREDITS hftp://www.co.masc)n.wa.us/forms/CommuniLf DeV/jndex. h . Option: Description: Table 9-1 Window & Door Schedule (If needed, attach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Win do ws: 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