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Energy Smart Pacific
OPTIMIZE YOUR HOME
Blower Door Test Form
2015 WSEC Residential Energy Compliance Certificate - Building Air Leakage
Site Address: Yo / );,` Test Info Results
.. !„ Date 1 U
Total Living (s
Builder: Cr,— S4 Volume c
Development: Flow Ring Installed
Lot Number: Flow Rate(c ) 35
House Pressure (Pa) -50
Contractor: Energy Smart Pacific Air Changes per Hour ACH
4318 S 9th St
Tacoma,WA98405
Phone: (253)448-0456
Comments:
Affidavit I certify that this ACH is accurate and determined using Blower Door Test Standard 502.4.5 Building Air leakage Testing
James Roddy a,
Technician ignat
Page 1 of 1
Ronald Buckholt - BLD2017-01103
From: Ronald Buckholt
To: LOGBUYERTOM@AOL.com
Date: 11/17/2017 4:19 PM
Subject: BLD2017-01103
Attachments: Buckholt, Ronald.vcf
Mr. Shearer
I am Ron Buckholt, with the Mason County Planning Department, reviewing permit application (BLD2017-01103)
for a proposed residence. Unfortunately, the permit has been put on HOLD for incompleteness due to the
following reason(s):
1. Since the proposed residence is located within 300 ft. of slopes consisting of greater than 15%, a geo-
technical assessment is required. Make sure the geo-engineer provides a Mason County submittal checklist in
conjunction with the written assessment, in order to avoid delays in the review process.
2. The Stream and Wetland report associated with the 2013 MEP (Mason Environmental Permit) needs to be
updated to conform with the most recent Resource Ordinance, which was updated in October of this year.
Please have the wetland biologist prepare an addendum stating that the project is in conformance with the
updated Resource Ordinance in terms of the river, stream and wetland classifications, delineations and
associated buffer/setbacks. Please be aware that this section of Union River has a wide channel migration, so be
sure that the location of the river channel is still accurate. In addition to the stream/wetland addendum, please
provide an updated scaled site plan depicting any changes to both the river, stream and wetland boundaries and
associated buffers in order for staff to verify that the septic system and residence do not encroach into said
regulated buffers.
3. When 5,000 sq.ft. of impervious surface is created, an engineered stormwater plan is required to be
submitted to our Public Works Department for review. The submitted plans indicate approximately 11,000 sq.ft.
of impervious surface will be created. Please contact Loretta Swanson, in Public Works, at 360.427.9670 x769 for
more information.
Please address all of these items at your earliest convenience to our Permit Assistance Center to allow the review
process to proceed. Thank you in advance.
Ron Buckholt
Senior Planner
Mason County
Community Services Department
615 W. Alder St., Bldg 8
Shelton, WA 98584
360.427.9670 x287
rbuckholtC-aco.mason.wa.us
I
file:///C:/Users/rbuckholt/AppData/Local/Temp/XPgrpwise/5AOFOC2AMasomnai110017... 11/17/2017
EX/STING 40'
T EASEMENT FOR 518" REBAR W/ RE CAP "TRAY 15653"
1411& 8 74 8 06-F INGRESS, EGRESS AND ELEVATION = 46.831
��4 5,58� UTILITIES I SHEARER, TOM
CLUSTER
UTILITY 4 - D !I BLD2017-01103 — NEW SFR.
�'�_ II //
/v� FOUND 112"
63 EIT REBAR W/ CAP I 232-0 -- 34 - 0()03iD
'AES 20795" ' a��P , ' r2+2 1 o
y RECEIVED
PLANNING: �__ `� �� -� ,_ I So ! .
NOV 6 ��17
ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
PROJECTION OF THE BUILDING
- _ 616 W.Alder Street
C/
w <1N PLANNING
�11
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l'�� �' 1 � \, APPROVED
Y < ON COUNTY DCD PLANNING
J__�" � ,/ i < \ 1 �--- TE PLAN REQUIRED TO BE ON SITE
SS r�s 55 / i r , NGES SUBJECT TO AP/PR JA
' ^ I + I `\\�� \\` B Date l7 Zo
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Name TOM SHEARER Parcel# 12320-34-00030 BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development, or redevelopment ,with more than 2,000 square feet of impervious surface .
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
Common impervious surfaces include,but are not limited to, rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater. Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area * All dimensions in feet
Buildings X = 5328 S.F.
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X =
X = Length of drive begins at the right of way
X =
Parking Areas X = 2960 S.F.
X = Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X = 1495 S.F.
X = Any paved, gravel or packed area per definition
above table
X =
Others X =
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area(sum of all areas) 10966
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that 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,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
desc r perty for revie inspection as may be required.
X Owner/Agent/Contractor(circle one)Date: �rla
If the Total Impervious Surface Area is GREATER THAN 2000 Sauare Feet,please f� V eE pad sign
the information provided on page 2 of 2. 1 ` E� �/ U
Page 1 of 2
RECEIVED Nov - 6 2017
,v. Alder Street
FILE
WSEC/ Ventilation Code Compliance Application
Submit with heating/cooling system size worksheet (see instruction PY
Owner: TOM SHEARER Parcel#: Type of project:
12320-34-00030 NEW CONSTRUCTION
Total Sq. Ft. 1st Floor : 2"d floor: Heated Basement:
of heated area:: 5328 AN NA
Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace
M Heat Pump with electric furnace O Heat pump with gas furnace O Ductless Heat Pump
O Boiler, specify fuel type: O Other: Specify:
X Prescriptive Option Table R402.1.1 (see table on previous page)
Compliance Method ❑ Component Performance, R402.1.3 — Calculation worksheets required
Mast Check one::
❑ Other (Specify):
Check one IN Whole House Ventilation system ❑ Whole House Ventilation
Ventilation using exhaust fans&window or wall Integrated with a Forced Air ❑ Other, describe
fresh air vents (M1507.3.4). If using System(M1507.3.5)
System window vents be sure to order
windows with vents.
Referencing Table R406.2, "Additional Residential Energy Efficiency Requirements," all residential units
must develop credits as specified in Table 406.2. Identify and describe which option(s) will be used to
comply. If the table is not attached to this form you can access the table on our website at:
http://www.co.mason.wa.ustforms/Community Devlecc wsec.pdf
a) Description: Small dwelling units: less than 1,500 sq. feet of heated or cooled floor
Additional area and less than 300 sq. ft fenestration area (skylights, doors, windows, etc).
Energy *Including additions to existing building that are greater than 500 sq. ft. of heated floor
Efficiency but less than 1,500 sq ft of floor area. Requires 1.5 credits
Requirements b) Medium dwelling units that are not included in (a) above {small dwelling}, OR (c) below
Energy credits {large dwelling) Requires 3.5 credits
required: EXCEPTION: Dwelling units serving R-2 occupancies shall require. Requires 2.5
credits. See page two for description.
c))_floor
dwelling unit is a dwelling unit that exceeds 5,000 sq. ft. of heated or cooled
floor area. Requires 4.5 credits
d) Additions less than 500 sq feet. Requires .5 credits
(Fenestration is defined in the /ECC as skylights, roof windows, vertical windows, opaque
doors, lazed-doors that include products with glass and non-glass glazing materials.
Describe Energy Credit Option(s): 'a°I'"'N"" Y
Ion Oexc Ilan Cle t
WEIE
v Emelopt to 05 0
SING OPTION C.. 4.5 CREDITS BU D1p En mpe l0 ,0 ❑
IOT EnYMOpe 11 20 B 2.0
l Enrabpe,0 05 ❑
aape aW Eftc VeMl�m 05
Using Option number(s): — 0 anoE,�_ 100 °�
ti�a ConOtl EOt— 2[ ,aftlel[HVAC 3i 2A 5 A �K>e o m10
aleKrllv�cx 1s ❑akexyNV/�G JO/] 3 O Otkn[rlNAc syfltln 0 ❑
a, Za J 3C,, s lEft
an w+b 00 0 0.5
I.wYar.5A 5 x �a�sy50 MI Y/Ser 5G 0 ® O`�— , r _ ! C 5 _0. 6 �mlp Ekclnc E�rOy OS •1200 aw11 0.0
Vl/V�'1 C.�l//7\. J 1ota1 CrAib
3
Prescriptive Energy Code Compliance for All Climate Zones in Washington
Project Information Contact Information
TOM SHEARER TOM SHEARER
401 NE TIMBERLINE DR 360.340.3011
BELFAIR WA 98528
This project will use the requirements of the Prescriptive Path below and incorporate the
the minimum values listed.In addition, based on the size of the structure,the appropriate
number of additional credits are checked as chosen by the permit applicant.
Authorized Representative Date
All Climate Zones
R-Valuea U-Factora
Fenestration U-Factorb n/a 0.30
Skylight U-Factor n/a 0.50
Glazed Fenestration SHGC"" n/a n/a
Ceilingk 49. 0.026
Wood Frame Walig,m.n 21 int 0.056
Mass Wall R-Value' 21/21 h 0.056
Floor 301 0.029
Below Grade Wall""' 10/15/21 int+TB 0.042
Slab R-Value&Depth 10, 2 ft n/a
*Table R402.1.1 and Table R402.1.3 Footnotes included on Page 2.
Each dwelling unit in a residential building shall comply with sufficient options from Table R406.2 so as to achieve
the following minimum number of credits:
1.Small Dwelling Unit: 1.5 credits
❑ Dwelling units less than 1500 square feet in conditioned floor area with less than 300 square feet of fenestration
area. Additions to existing building that are greater than 500 square feet of heated floor area but less than 1500
square feet.
❑2.Medium Dwelling Unit: 3.5 credits
All dwelling units that are not included in#1 or#3. Exception: Dwelling units serving R-2 occupancies shall
require 2.5 credits.
03. Large Dwelling Unit: 4.5 credits
Dwelling units exceeding 5000 square feet of conditioned floor area.
❑4. Additions less than 500 square feet: .5 credits
Table R406.2 Summary
Option Description Credit(s)
1a Efficient Building Envelope 1a 0.5 0.5
1b Efficient Building Envelope I 1.0 ❑
I Efficient Building Envelope I 2.0 ❑
I Efficient Building Envelope 1d 0.5 ❑
2a Air Leakage Control and Efficient Ventilation 2a 0.5 ❑✓ 0.5
2b Air Leakage Control and Efficient Ventilation 2b 1.0 ❑
2c Air Leakage Control and Efficient Ventilation 2c 1.5 ❑
3a High Efficiency HVAC 3a 1.0 21 1.0
3b High Efficiency HVAC 3b 1.0 El 1.0
3c High Efficiency HVAC 3c 1.5 ❑
3d High Efficiency HVAC 3d 1.0 ❑
4 High Efficiency HVAC Distribution System 1.0 ❑
5a Efficient Water Heating 5a 0.5 ❑✓ 0.5
5b Efficient Water Heating 5b 1.0 El 1.0
5c Efficient Water Heating 5c 1.5 ❑
5d Efficient Water Heating 5d 0.5 ❑
6 Renewable Electric Energy 0.5 *1200 kwh 0.0
Total Credits 4.50
*Please refer to Table R406.2 for complete option descriptions
Table R402.1.1 Footnotes
• For SI: 1 foot .=304.8 mm,ci .=continuous insulation, int .=intermediate framing.
a R-values are minimums. U-factors and SHGC are maximums.When insulation is installed in a cavity which is
less than the label or design thickness of the insulation,the compressed R-value of the insulation from
Appendix Table A101.4 shall not be less than the R-value specified in the table.
b The fenestration U-factor column excludes skylights.The SHGC column applies to all glazed fenestration.
"10/15/21.+TB" means R-10 continuous insulation on the exterior of the wall,or R-15 on the continuous
insulation on the interior of the wall, or R-21 cavity insulation plus a thermal break between the slab and the
basement wall at the interior of the basement wall. "10/15/21.+TB"shall be permitted to be met with R-13
cavity insulation on the interior of the basement wall plus R-5 continuous insulation on the interior or exterior
of the wall. "10/13" means R-10 continuous insulation on the interior or exterior of the home or R-13 cavity
insulation at the interior of the basement wall. "TB" means thermal break between floor slab and basement
wall.
d R-10 continuous insulation is required under heated slab on grade floors.See R402.2.9.1.
e There are no SHGC requirements in the Marine Zone.
f Reserved.
g Reserved.
h Reserved.
The second R-value applies when more than half the insulation is on the interior of the mass wall.
Reserved.
k For single rafter-or joist-vaulted ceilings,the insulation may be reduced to R-38.
Reserved.
m Int. (intermediate framing) denotes standard framing 16 inches on center with headers insulated with a
minimum of R-10 insulation.
Table R402.1.3 Footnote
a Nonfenestration U-factors shall be obtained from measurement, calculation or an approved source or as
specified in Section R402.1.3.
Simple Heating System Size: Washington State
This heating s stem sizing calculator is based on the Prescriptive Requirements of the 2015 Washington State Ener-gy Code WSEC and ACCA Manuals
J and S.This calculator will calculate heating loads only.ACCA procedures for sizing cooling systems should be used to determine cooling loads.
The glazing(window)and door portion of this calculator assumes the installed glazing and door products have an area weighted average 1-1-factor of 0.30.
The incorporated insulation requirements are the minimum prescriptive amounts specified by the 2015 WSEC.
Please fill out all of the green drop-downs and boxes that are applicable to your project.As you make selections in the drop-downs for each section,some
values will be calculated for you.If you do not see the selection you need in the drop-down options,please call the WSU Energy Extension Program at
(360)956-2042 for assistance.
Project Information Contact Information
TOM SHEARER TOM SHEARER
401 NE TIMBERLINE DR 1360.340.3011
BELFAIR,WA 98528 1 --_—
Heating System Tvpe: p All Other systems Q Heat Pump
To see detailed instructions for each section,place your cursor on the word'Instructions".
Design Temperature
Instructions - -c Design Temperature Difference(AT) 47
Shelton AT=Indoor(70 degrees)-Outdoor Design Temp
�titi��[i�l�
Area of Building
Conditioned Floor Area
Instructions Conditioned Floor Area(sq ft) 5,859
Average Ceiling Height Conditioned Volume
Instructions Average Ceiling Height(ft) 10.0 58,590
Glazing and Doors U-Factor X Area = UA
Instructions
0.30 207 62.10
Skylights U-Factor X Area = UA
Instructions 0.50 4� 2.00
Insulation
Attic U-Factor X Area = UA
Instructions """ 0.026 4 idi75.; ; 105.95
Single Rafter or Joist Vaulted Ceilings U-Factor X Area UA
Instructions f "38 Vel 0.027 11t?13' 31.94
a... tte0 }
Above Grade Walls(see Figure 1) U-Factor X Area UA
Instructions 0.056 4 WOr 274.40
`i R-21 lntemMlnO! �
Floors U-Factor X Area UA
Instructions R-38 Za 0.025 4075; 101.88
� �
Below Grade Walls(see Figure a U-Factor X Area UA
Instructiur' 0.064
R-10 Continuous Exterior �
Slab Below Grade(see Figure n F-Factor X Length UA
Instructions 0.570
R-5 Thermal Break at slab edge
Slab on Grade(see Figure 1) F-Factor X Length UA
Instructions 1
R-10 Fully Insulated �. 0.360 1143 425.88
Location of Ducts
Instructions Duct Leakage Coefficient
Unconditioned Space -�....-.
-. 1.10
Sum of UA 1004.15
Envelope Heat Load 47,195 Btu/Hour
Figure 1. SumofuAXAT
Air Leakage Heat Load 29,740 Btu/Hour
volumeX 0.6XATX.018
Above Grade Building Design Heat Load 76,935 Btu/Hour
Air Leakage+Envelope Heat Loss
Building and Duct Heat Load 84,629 Btu/Hour
Ducts in unconditioned space.Sum of Building Heat Loss X 1.10
Ducts in conditioned space:Sum of Building Heat Loss X 1
Maximum Heat Equipment Output 118,480 Btu/Hour
Building and Duct Heat Loss X 1.40 for Forced Air Furnace
Building and Duct Heat Loss X 1.25 for Heat Pump
(07101113)
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0 0 0 0 0 0 0 0 0 0 0 �l w CO O �l W W O N O W (� W W Cn O w D O O D
0 0 0 0 0 0161616 0 0 0 00 0 0 co in in 0 0 0 _ 0 00 o M (o oo r, oo 0 0
O O O O O O O O O O O O O A W N N N O O M W A M O 0 A CO CO N M W O -A O O
0.22 0.0 0.00
0.22 0.0 0.00
0.22 0.0 0.00
0.22 0.0 0.00
0.22 0.01 0.00
0.22 0.0 0.00
0.22 0.01 0.00
Sum of Vertical Fenestration Area and UA 11421.51 398.02
Vertical Fenestration Area Weighted U= UA/Area 1 0.28
Overhead Glazing (Skylights)
Component Width Height
Description Ref. U-factor Qt. Feet Inch Feet Inch Area UA
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.01 0.00
0.0 0.00
Sum of Overhead Glazing Area and UA 1 0.01 0.00
Overhead Glazing Area Weighted U= UA/Area 1 0.00
Total Sum of Fenestration Area and UA (for heating system sizing calculations) 11613.51 398.02
r
TOM SHEARER
401 NE TIMBERLINE DR
BELFAIR WA 98528
Conditioned Floor Area 5 859
Component Performance,R occupancies Code Target Values Proposed Design
Area UA Area UA
Doors U=0.300 240 72 240 110
Overhead Glazing U=0.500 0 0 0 0
Vertical Glazing U= 0.300 879 264 1,422 412
Flat/Vaulted Ceilings U= 0.026 4,075 106 4,075 82
Wall(above grade) U=0.056 5,371 301 4,828 154
Floors U=0.029 4,6661 1351 4,6661 112
Slab on Grade F=0.540 1,253 677 1,253 451
Below Grade Wall U=0.042 0 0 0 0
Below Grade Slab F=0.570 0 0 0 0
Target UA Total 1,554 Proposed UA Total 1,322
Target Credits from Table 406.2 4.5 Proposed Credits from 3.5
Table 406.2
If the Proposed UA s the Target UA,and the Proposed Credits from Table 406.2 are>_those required in Section R406.2,then
the home meets the 2015 WSEC.
Exterior Doors
Plan Component Door Width Height
ID Description Ref. U Qt. Feet Inch Feet "`h Area UA
Wood stab in wood frame(WoodSWF) 'w 10-6C 0.46 3 6 8 144 66
Woad slab in wood frame(WoodSWF) 10-6C 0.46 4 3 8 96 44
0 0.00 0 0
0 0.00 0 0
0 0.00 0 0
0 0.00 4- 0 0
0 1 0.00 1 01 0
Sum of Area and UA 1 2401 110
Overhead Glazing:
Plan Component Glazing Width Height
ID Description Ref. U Qt. Feet Inc' Feet Inch Area UA
0 0.00 0 0
0 0.00 0 0
0 0.00 0 0
0 0.00 0 0
0 0.00 0 0
Sum of Area and UA 1 0 0
Copyright 2013,WSUEEPIO-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions)
Vertical Glazing
Plan Component Glazing Width Height
ID Description Ref U Qt. Feet 1"`h Feet In& Area UA
3gl W000vino,Low-el V="+argon 10-61B 0.29 2 6 16 16 781 23
-V Wood/ATA Low-el%-+argon _• 10-61B 0.29 2 6 6 78 23
3g1 WoodMnyl,Low-el V:•+argon • 10-6B 0.29 1 5 6 30 9
3gl WoodtA",Low-e1 V:•+argon • 10-6B 0.29 1 3 s 6 21 6
3g1 WooW*r 1,Low-el V:"+argon - • 10-613 0.29 2 3 7 42 12
3g1 Wood(vkrA Low-el%'+argon • 10-6B 0.2911 8 8 64 19
3gill WoodMnyl,Low-el%"+argon • 10-613 0.29 4 16 6 156 45
3gI Wood/virryl,Lowe1%"+argon • 10-613 0.29 1 6 6 36 10
3gl WoWvkM,Low-el%I+argon • 10-613 0.29 1 16 8 128 37
3g1 Wood/vinyl,Low-el%*+argon 10-68 0.29 3 8 5 120 35
3gi Wood/virryl,Low-el%"+argon _ 10-6B 029 1 6 5 30 9
3g1 WooWvfny%Low-el%I+argon _ � 10-613 0.29 1 4 6 24 7
3g1 W000Mnyl,Low-el V2"+argon • 10-6B 0.29 1 18 6 48 14
3g1 WoodMnyl,Low-e1%"+argon • 10-613 0.29 1 6 6 36 10
391 WooWvhtyl,Low-el W'+argon • 10-613 0.29 1 3 s 2 7 2
3gf Wood/vtrtyl,Law-el Vx"+argon • 10-613 029 2 3 7 16 45 13
3g1 W000Mmyl,Lm-el Va•+argon • 10-6B 0.29 1 5 6 6 331 9
3g1 WoodMnyl,Low-ei Vi"+argon - • 10-6B 0.29 2 7 6 84 24
3gi womvvkr 1,Lower ti4•+argon • 10-613 0,2912 7 6 84 24
3g1 WooWvhryl,Low-el V:•+argon • 10-6B 0.29 1 8 8 64 19
3g1 Wood/vi",low-ei V:•+argon • 10-61B 0.29 1 6 6 36 10
-V Wood/vinyl,Lower W+argon • 10-6B 0.29 1 8 8 U 68 20
3g1 woowvk-A Low-el%-+argon • 10-6B 0.29 2 5 8 1685 25
3gl Wood/vinyl,Lower V:•+argon - • 10-6B 0.29 1 5 5 25 7
w 0 0.00 0 0
• 0 0,001 0 0
• 0 0.00 0 0
• 0 0.00 0 0
0 0.00 0 0
_• 0 000 0 0
• 0 0.00 0 0
0 0.001 0 0
0 0.00 01 0
0 0.00 0 0
• 0 0.00 0 0
• 0 0.00 0 0
_ • 0 0.00 0 0
___ • 0 0.00 0 0
• 0 0.00 01 0
• 0 0.00 0 0
• 0 0.00 0 0
• 0 0,001 0 0
-. - • 0 0.00 0 0
• 0 0.00 0 0
• 0 000 0 0
• 0 0.00 0 0
0 0-00 0 0
0 0.00 0 0
_ 0 000 0 0
• 0 0.001 01 0
• 0 0.00 0 0
• 0 0.00 0 0
• 0 0.00 0 0
• 0 0.00 0 0
0 0.00 0 0
Sum of Area and UAI 1,4221 412
Glazing Area Weighted U 1 0.290
Copyright 2013,WSUEEP10-009_(version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions)
• Plan Component Attic
ID Description Ref. U Area UA
R49 blown Attic ADV baffled • 10-7 0.0201 4,0751 82
• 0 0.000 0
• 0 0.000 0
• 0 0.000 0
Sum of Area and UA 1 4,0751
82
Walls(Above Grade)
Plan Component Wal I
ID Description Ref. U Net Area UA
R21 cavity+R12 foam STD 2x6W tap • 10-5 0.032 4,8281 154
• 0 0.000 0
• 0 0.000 0
• 0 0.000 0
Sum of Area and UA 1 4,8281
154
Floor(over crawl or exterior)
Plan Component Floor
ID Description Ref. U Area UA
R38+RI perm vented Post/Beam 48oc • 10-3 0.024 4,6661 112
• 0 0.000 0
• 0 0.000 0
• 0 0.000 0
Sum of Area and UA 1 4,6661
112
Slab on Grade(less than 2 feet below grade)
Plan Component Slab Slab
ID Description Ref. F Length UA
R10 Fusty insulated • 10-2 0.360 1,2531 451
• 0 0.000 0
• 0 0.000 0
• 0 0.000 0
Sum of Area and UA 1 1,2531 451
Below Grade Walls and Slabs
Plan Component Wall Wall Wall Slab Slab Slab
ID Description Ref. U Area UA F Length UA
• 0 0.0001 0.0 0.000 1 0
• 0 0.000 0.0 0.000 0
• 0 0.000 0.0 0.000 0
0 0.000 0.0 0.000 0
Sum of Area,Length and UAI 01 0.0 1 0 0
Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) - -
r
Table R406.2 Summary
Opt. Description
Credit(s)
1a Efficient Building Envelope 1a 0.5 ❑
1b Efficient Building Envelope 1b 1.0 ❑
1c Efficient Building Envelope 1c 2.0 U1 2.0
1d Efficient Building Envelope 1d 0.5 ❑
2a Air Leakage Control and Efficient Ventilation 2a 0.5 ❑ 0.5
2b Air Leakage Control and Efficient Ventilation 2b 1.0 ❑
2c Air Leakage Control and Efficient Ventilation 2c 1.5 ❑
3a High Efficiency HVAC 3a 1.0 1.0
3b High Efficiency HVAC 3b 1.0 ❑
3c IHigh Efficiency HVAC 3c 1.5 ❑
3d High Efficiency HVAC 3d 1.0 ❑
4 High Efficiency HVAC Distribution System 1.0 ❑
5a Efficient Water Heating 5a 0.5 ❑
5b Efficient Water Heating 5b 1.0 ❑
5c Efficient Water Heating 5c 1.5 ❑
5d I Efficient Water heating 5d 0.5 ❑
6 IRenewable Electric Energy 0.5 kWh ❑
Total Credits 3.5
'Please refer to Table R406.2 for complete option descriptions
Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions)
Page 1 of 3
Trish Woolett- RE: clarification for the Shearer Project
From: "Luke Moerke" <luke@exodusengineer.com>
To: "'Trish Woolett"' <tw@co.mason.wa.us>
Date: 2/23/2018 4:06 PM
Subject: RE: clarification for the Shearer Project
Trish, see comments below. Do you need revised calcs for this? I apologize for the order on some of those
calculations, I'm not exactly sure whey they didn't print in the right order. It appeared to jump around quite a
bit looking back on that.
ENGINEERING
Luke Moerke, P.E.
Exodus Engineering, Inc.
1286 NW Maryland Ave
Chehalis, WA 98532
360.345.1566
From:Trish Woolett [tw@co.mason.wa.us]
Sent:Thursday, February 22, 2018 3:48 PM
To: Luke Moerke duke@exodusengineer.com>
Subject: clarification for the Shearer Project
Luke,
Thanks. I have a couple items I need you to address or clarify.
1. On the back wall of the hot tub area is shows a 8 ft opening with a calculation reference of R10.The R10
calculation is for a 6 ft opening. Please address.
\ a. The R10 Calc is for a separate window on an adjacent opening, and was just a typo. R09 is for an
V 8ft loading, and works as a 4x8 in that location, however we kept the gable end header a 6x12
incase we needed to do a portal frame there.
2. The calculation package include R28 & R29.I can not locate on plans.
a. These are for the timber framing shown on the elevation drawing of detail 13/S-6.The rake and
horizontal beams are labeled R28 & R29. However, beam R28 was sized as a 8x12, but later
changed to 12x12 (oversize) so we didn't bother changing that one.
3. Calculation page 74, (Interior F1 bearing) I can not location on the foundation plan details.
\ a. The footing on 74 corresponds to the typical floor beam reaction for (F1) shown on page 67 of the
V
calculations.
file:///C:/Users/Trishw/AppData/Local/Temp/XPgrpwise/5A903BFOMasonmail1001626B... 2/26/2018
Page 2 of 3
5. Calculation on page 49 for"Front Girder" failed? Please provide clarity.
a. This was a preliminary load check for us that should not have been included in the calculation.We
sometimes create a mock beam to anticipate truss girder loads prior to receiving truss layouts.
6. Calculation page 52 for Porch column,I can not locate a detail. Please provide clarity.
a. This was atypical column support with a worse case loading for the timber frame porch. (beam
R28/29 reaction) it's not specifically labeled on the plan that way.Also, these were left as 8x8 in
the calculation, but are now detailed as 12x12 on the plan.It was oversizing the requirement, so
we left it as 8x8 in the calculation.
Thank you, I am looking forward working with you to finish up this project.
Tricia Woolett
Building Inspector II
Mason County Community Dev.
615 W Alder Street
Shelton WA 98584
360.427.9670 ext. 281
fax 360.427.7798
tw(a,co.mason.wa.us
County Web-Site: www.co.mason.wa.us
>>> "Luke Moerke" <luke@exodusengineer.com> 1/31/2018 4:13 PM >>>
See attached.
Luke Moerke, P.E.
Exodus Engineering, Inc.
1286 NW Maryland Ave
Chehalis, WA 98532
360.345.1566
From:Yuchun Santory [mailto:yuchunsantory92@gmail.com]
Sent:Tuesday,January 30, 2018 6:56 PM
To: Luke Moerke<Luke@exodusengineer.com>;Tom Shearer<logbuyertom@aol.com>
Subject: Fwd: link to energy credits: http://www.co.mason.wa.us/forms/Community Dev/iecc wsec.pdf
Luke,
file:///C:/Users/Trishw/AppData/Local/Temp/XPgrpwise/5A903BFOMasonmai11001626B... 2/26/2018
Page 3 of 3
I Can you address this? This is one of the last items we need to get a building permit.
III call you in the morning to discuss.
I
---------- Forwarded message----------
From:Tom Shearer<logbuyertom@aol.com>
Date:Tue,Jan 30, 2018 at 2:56 PM
Subject: Fwd: link to energy credits: http://www.co.mason.wa.us/forms/Community Dev/iecc wsec.pdf
To: yuchunsantory92@gmail.com
-----Original Message-----
From: Trish Woolett<tw(a_co.mason.wa.us>
To: logbuyertom <logbuyertom(aD_aol.com>
Sent: Tue, Jan 30, 2018 2:13 pm
Subject: link to energy credits: http://www.co.mason.wa.us/forms/Community Dev/iecc wsecpdf
link to energy credits: http://www.co.mason.wa.us/forms/Community_Dev/iecc_wsecpdf
Special Inspection Agreement for Shear walls. See attached
Tricia Woolett
Building Inspector II
Mason County, Community Dev.
615 W Alder Street
Shelton WA 98584
360.427.9670 ext. 281
fax 360.427.7798
tw(&co.mason.wa.us
County Web-Site: www.co.mason.wa.us
Virus-free. www.avast.com
file:///C:/Jsers/Trishw/AppData/Local/Temp/XPgrpwise/5A903BFOMasonmai11001626B... 2/26/2018
TO BE KEPT IN THE
PARCELFILE Mason County Y Communit Services
Building Division
% SPECIAL INSPECTION & 615 W Alder Street
Shelton, WA 98584
TESTING AGREEMENT 360.427.9670 ext. 352
www.co.mason.wo.us
(All references are per the 2015 International Building Code)
Project Name: _Shearer SFR
A Timberline f Project Address: _401 NE Timbe ne Bel air,WA
Building Permit Number: Date Issued:
BEFORE A PERMIT CAN BE ISSUED: The registered Design Professional in responsible charge shall fill out the Agreement
and include the name and address of the company or inspector. Two (2) copies of this form are to be submitted to the
County prior to the issuance of a building permit. If changes are made as to who will perform the special inspections a new
form shall be submitted and turned into the Building Permits&Inspections Division for approval.
STATEMENT OF SPECIAL INSPECTIONS: In addition to this Agreement, a "Statement of Special Inspections" shall be
provided per IBC 1704.3. This Statement shall be made as part of the approved plans, and be placed in a conspicuous
location,such as the first page of the construction plans or the first page of the structural sheets.
SPECIAL INSPECTORS: All special inspectors shall be approved by the Building Division prior to performing any duties. The
special inspector shall provide proof of certification as a special inspector for each inspection item and be licensed by the
State of Washington.
SPECIAL INSPECTION REPORTS: Special inspection reports are to meet the requirements of IBC 1704.2.4. Copies of each
report are to be sent to the address listed in the letterhead noting the Project Address and Permit Number. A final report
shall be submitted stating that all special inspection and structural testing items were completed and are in conformance
with the approved design drawings and specifications. Items not in conformance, unresolved items, or any discrepancies in
inspection coverage (i.e. missing inspections, periodic inspections when continuous was required, etc.) shall be specifically
itemized in the final report.
Areas requiring special inspection: Name of Agency: =ess&Contact Information
❑ Unapproved Fabricators(IBC 1704.2.5) Not applicable.
Other than Structural Steel(IBC Table 1705.2.2)
❑ Steel floor&roof decks
❑ Welding of reinforcement
❑ Cold-formed steel
Structural Steel
❑ Welding(Per N5.4 of AISC 360-10)
❑ Details(Per N5.7 of AISC 360-10)
❑ Nigh-strength bolts(Per N5.6 of AISC 360-10)
Concrete Construction (per IBC Table 1705.3)
❑ Reinforcement,embeds,anchors
❑ Formwork
❑ Materials
❑ Shotcrete
❑ Post-tensioned/Pre-stressed Concrete
❑ Erection of precast concrete
Page 1 of 3
Mason County Community Services
Building Division
SPECIAL INSPECTION & 615 W Alder Street
Shelton, WA 98584
TESTING AGREEMENT 360.427.9670 ext. 352
www.co.moson.wo.us
Areas requiring special inspection: Name of Agency: Address&Contact Information
Masonry Construction(IBC 1705.4)
❑ Prior to Construction(Article 1.15,TMS-602) Not applicable.
❑ As Construction Begins(Article 1.19.2,TMS-402)
❑ Prior to Grouting(Table 1.19.2,TMS-402)
❑ During Construction(Per TMS-402&TMS-602)
Wood Construction
❑ High-Load Diaphragms(IBC 1705.5.1)
❑ Wood Trusses>60ft(IBC 1705.5.2)
❑ Soils(IBC Table 1705.6)
❑ Driven Deep Foundations(IBC Table 1705.7)
❑ Cast-in-place Deep Foundations(IBC Table 1705.8)
❑ Helical Pile Foundations(IBC 1705.9)
❑ Sprayed Fire-Resistant Materials(IBC 1705.13)
❑ Mastic&Intumescent Coatings(IBC 1705.14)
❑ EIFS(IBC 1705.15)
❑ Fire-Resistant Penetrations(IBC 1705.16)
❑ Smoke Control(IBC 1705.17)
❑ Structural Steel(IBC 1705.12.1&AISC 341-10)
❑ Structural Wood(IBC 1705.12.2)
Page 2 of 3
Mason County Community Services
Building Division
SPECIAL INSPECTION & 615 W Alder Street
Shelton, WA 98584
-� TESTING AGREEMENT 360.427.9670 ext. 352
www.co.mason.wo.us
❑ Cold-formed Steel(IBC 1705.12.3) Not applicable.
❑ Mechanical&Electrical Components(1705.12.4)
❑ Architectural Components(IBC 1705.12.5)
❑ Storage Racks(IBC 1705.12.7)
❑ other (IBC 1705.1.1) Prior to foundation pour and at substantial
framing completion, prior to cover.
Structural Observations E,d_R, izg6 Nw ^&ry" ua-
Ue,W's. wA q$S3L
Per p�nS
Declaration by Architect/Engineer
I, the design professional in responsible charge for this project, declare that the above listed special
inspection and structural testing items are required for this project in accordance with IBC Chapter 17.
Signature(Engineer) Date
�J , � )/�, -2 y ,
Signatur r itect) Date
Signature (Geologist) Date
Declaration by Owner
I,the Owner of the project,declare that the above listed firm(s)or individual(s)are hired by me to perform special
inspections and structural testing for the project pursuant to IBC 1704.2.
Signature Date
CONTRACTOR RESPONSIBILITY: Each contractor involved with the construction of wind or seismic force-resisting systems
shall comply with the requirements of IBC 1704.4. The contractor is responsible for providing the special inspector access
to approved plans and contract documents at the job site. All special inspection records shall be retained at the job site by
the contractor and shall be made available to the Building Department upon request.
Declaration by General Contractor
I,the General Contractor of the project,agree to comply with the"Contractor Responsibility"items noted above.
Signature Date
Page 3 of 3
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MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST
Owner's Name: (\�r? I 7(y) Date: I I � Project description: jJ
Documents:Building Permit Application Completed. RECEIVED
ED
echanical/Plumbing Application Completed. NOV ' 6 2017
Planning Intake Checklist Completed.
ite plan includes: Allowable building area, roof over4aws, decks, etc. 615 W. /Jder Str ire Apparatus &Access Road info required? Yes No eet
,C Stormwater Checklist Completed.
Energy Code Application Form - O Electric wall heater O Electric central furnace O LPG Furnace
0 Heat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type )
O Ductless Heat Pump O Other: Specify:
Construction Plans:
✓ 3 Sets (2 full size sets w/engineered calculations4 1 reduced sized set 11X17 min.(no calculation needed )
✓ Pins Legible ✓ ecognized Scale Elevation Views Cross Section
_✓Foundation Plan -
✓ Roof Framing Plan /Floor Plan Use of rooms labeled (all floors)
door Framing Plan -all floor levels including loft, crawlspace, etc.
Deck Framing Plan including covered porch, carports
Plan Details: '
oof framing details, truss lay-out may be neede (Hip and girder location showw 1 YOS .
Wall Framing - Does bearing-wall height exceed 1 '? (Engineering may be require E
✓ loor framing: Floor joists (size & s�ppacing - x Floor beams: *C 1 D K 1 ' 6C1
Window headers. Typical header:gY In _ Garage header:LPX 12 - e
_ Foundation: footing size, reinforcement
j1k Concrete Walls - Does Concrete Wall Height Exce 1 8'? (Engineering may be required, see details)
V Landings at all exits? Less than 30" abo a grade.. Y/ N (must be shown on site plan)
./ Water Heater: Location: GIO,_.'_� Typ i
F✓ eated By Furnace- Location of Furnace G 105 Fuel type: C.J
ireplace/Stove Information Shown - Fuel Type? Location(s): M
endow Sizes Marked on Plans. C�
Braced wall panels (shear walls) MUST be marked/indicated on plans.
Engineered es! No Snow load: Seismic: D2 Design Code: We plans stamkd
Manufactured Homes:
4 Floor Plans (rooms r s must be labeled)
Foundation Type:
ANSI/Manufacture rhethod Engineered footing/fou ation Basement
Decks':` 4x4 in. landings requir at each entranc must be show on site/plot plan)
�er ed ecks and/or an decks re th 4'x4' that exceed 30"from rade requires a permit and
cons on la
COMME TS:
_ _
Intake review(initials . Date:
H:\permit tech building checklist2015.doc Revised 8.5.2016
If any of the items listed below are either indicated or missing within the construction
documents; the plans must be engineered or returned to the applicant for resolution.
ENGINEERING 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 R602.10.1
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: D2, Snow psf.
IRREGULAR BUILDINGS R301.2.2.2.5 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 shear wall or braced wall line are not in one plane vertically from the foundation to the uppermost
story in which they are required. See exceptions.
2) Roof or floor is not laterally supported by shear walls or brace walls lines on all edges.
3) Portion of roof or floor extend more than 6 ft. beyond the braced wall line.
4) End of BWP extends more than 1 ft. over an opening more than 8 ft in width below.
5) Opening in a floor or roof exceed the lesser of 12 ft. or 50% of the least floor or roof dimension.
6) Portions of floor level are offset vertically
7) Shear wall lines do not occur in two perpendicular directions.
8) If a story above grade includes masonry or concrete construction*When this applies the entire story shall be
designed. In accordance with accepted engineering practice. *(exception: fireplaces, chimneys, and veneer as
permitted by the code).
***Applicant must take plans to a design professional to address items indicated above***
Notes/Comments for design professional:
H:\permit tech building checklist2015.doc Revised 8.5.2016
MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
January 26, 2018
Tom Shearer
70 NE Daybreak Drive
Belfair, WA 98528
Re: BLD2017-01103
Mr. Shearer,
The following items must be addressed prior to permit approval.
1. In accordance with the International Residential Code Chapter 4 Section R403.1.7.2 the site plan
must be clarified to provide compliance to slope setback. The current site plan does not have clarity
to compliance. Please provide a topography for the site showing slope, footings and setback
compliance. You may wish to speak with you geologist or design professional.
2. On sheet A13 the detail provided must be clarified as to not conflict with the engineered plans.
Please remove details for footings from detail shows as 1,2,3.You may wish to indicate see
engineering page for specifications.
3. On sheet A13,the details for insulation contradict the energy code options chosen.The options
chosen are; 1C, 2A, 313, 5A and 5D. Please update the plans to show the credits and details on the
plan sheet(s). Such as:
a. Windows to be rated as.22
b. Ceiling to be R-49 and vault to be R-49 Advanced.This detail should
show trusses and rafter detail.
c. Exterior walls to be R-21 plus R-12 ci- provide detail for compliance.
d. Floors to be insulated to R-39
4. Floor plan to be updated to show location and compliance to the energy credit of for drain water
heat recovery unit(s). Must show where they will be installed (from all the showers) and has a
minimum efficiency of 40%if installed for equal flow or a minimum efficiency of 52% if installed for
unequal flow. Such units shall be rated in accordance CSA 1355.1 and be so labeled. Please provide
this detail on the plans.
5. Windows in pool and hot tub area.The plans lack clarity regarding tempered window requirement in
this area. Please provide information regarding the windows in this area and installation height
regarding International Residential Code Section R308.
Public Health Community Development
(Community Health/Environmental Health) (Permit Assistance Center/Building/Planning)
415 N.61 Street—Shelton,WA 98584 615 W.Alder Street—Shelton,WA 98584
Shelton:360-427-9670,Ext.400 Shelton:360-427-9670,Ext.352
Belfair:360-275-4467,Ext.400 Belfair:360-275-4467,Ext.352
Elma:360-482-5269,Ext.400 Elma:360-482-5269,Ext.352
6. The project will require Structural Observation and Special Inspection.The Architect has identified
structural observation and Chapter 17 of International Building Code require Special Inspection for
Shearwall nailing 4" or less. Please see attached agreement,this must be completed, signed by the
Architect, Engineer and yourself. Please be certain to include the name or organization that will
perform the inspections.You may email the scanned completed document.
7. If the pool is going to be a deferred submittal, please provide me with an email confirming your
intentions.
I do not need an entire new set of plans. Feel free to email the updated plan pages for efficiency.
Best regards,
Tricia Woolett
Building Inspector II
tw@co.mason.wa.us
360.427.9670 ext. 281
i
Public Health Community Development
(Community Health/Environmental Health) (Permit Assistance Center/Building/Planning)
415 N.6t"Street—Shelton,WA 98584 615 W.Alder Street—Shelton,WA 98584
Shelton:360-427-9670,Ext.400 Shelton:360-427-9670,Ext.352
Belfair:360-275-4467,Ext.400 Belfair:360-275-4467,Ext.352
Elma:360-482-5269,Ext.400 Elma:360-482-5269,Ext.352
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PROJECT/ OWNER/ LOCATION,
SINGLE FAMILY PROPERTY
CLYDQ GE❑LOGICAL ASSESSMENT
Vl'h �l TOM SHEARER
TIMBERLINE DRIVE
PARCEL 12320-34-00030
MASON COUNTY WASHINGTON
LEGEND ENGINEER,
ENVIROTECH ENGINEERING
PO BOX 984
p 4i43045 SLOPE INDICATOR BELFAIR, WASHINGTON 98528
1'SI�,yALbt�� 2 7S/i8 PQ PROBE 360-275-9374
TPle TEST PIT SITE PLAN
4° N MASON COUNTY COMMUNITY SERVICES / n
PERMIT ASSISTANCE CENTER: Permit No: (��
240
•BUILDING•PLANNING.PUBLIC HEALTH-FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
BeBeir.(360)275-4467•Phone Elmo:(360)482-5269
B U I L®I N BUILDING PERMIT APPLICATION E I V E D
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: TOM SHEARER NAME: NO — 6 Ltd i-
MAILING ADDRESS: NE 70 DAYBREAK DRIVE MAILING ADDRESS:
CITY: BELFAIR STATE: WA ZIP: CITY: STATE: ZIP: Alder Street
PHONE#1: 360.340.3011 PHONE: CELL:
PHONE#2: EMAIL:
EMAIL: LOGBUYERTOM@AOL.COM L&I REG# EXP.
PRIMARY CQNTA�T: OWNER[� CONTRACTOR❑ OTHER❑
NAME I 31"ILEARER EMAIL LOGB Y RTOM AOL OM
MAILINGADDRESS NE 70 DAYBREAK DRIVE CITY BELFAIR s[ATE WA zIP 0528
PHONE CELL 360,340.3011
PARCEL INFORMATION: 6 .
PARCEL NUMBER(12 Digit Number) 12320-34-00030 ZONING
LEGAL DESCRIPTION(Abbreviated) PCL 3 OF BLA f12-13 PTN OF SE SW,SW SE S 38M9,S 43i80 FIRE DISTRICT
SITE ADDRESS 401 NETIMRFRI INF DR CLTY BELFAIR
DIRECTIONS TO SITE ADDRESS
r
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 141/.: YES® NO❑ J
e
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check an that apply):
SALTWATER❑ LAKE❑ RIVEWCREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW IN ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage co m cwB/dg Etc) RESIDENCE WITH ATTACHED GARAGE
IS USE: PRIMARY IN SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 3 1/?
HEATED STRUCTURE? YES(Whole Blr*)N 3 YES mart$1 of Or 6SW,sy1($E S 382�,S 43R30
DESCRIBE WORK NEW CONSTRUCTION LL1J 1VO L�JJ n
SOUARE FOOTAGE:(prw-a+atstinW q D + I ,-Z`I'52Y 1 = r--
IST FLOO&Fdg' .sq.ft 2ND FLOOR NA sq.ft. 3RD FLOOR NA sq.ft. BASEMENT NA
sq.R.
DECK sq.ft COVERED DECK 1495 sq.ft. STORAGE NA sq.ft. OTHER NA sq.ft.
GA�sq.ft. Attached X] Detached❑ CARPORT— —sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE NA MODEL NA YEAR NA LENGTH NA
WIDTH NA BEDROOMS NA BATHS NA SERIAL NUMBER NA
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC® SEWER❑ / NEW EI EXISTING❑
PLUMBING IN STRUCTURE? YES® NO❑ Ifyes,attach completed WaterAdequacyFornt
PERIMBTERNOUNDATION DRAINS PROPOSED? YES NO[] EXISTING SQ.Fr.
EXISTING BEDROOMS -&— PROPOSED BEDROOMS 2 TOTAL BEDROOMS_2—
OWNER acknowledges that 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 and I further declare that I am entitled to receive this penult and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null 8 void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATIPN OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
P APPLICATIO 80 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
TOM X 11
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
-Aqua Rec's Fireside Hearth N' Home Purchase Order
POACCO058971
Tom Shearer
Created 10/5/2018
Expected 10/19/2018
Account Number 170058
Vendor: Bill To: Ship To:
SCP Distributors, LLC Aqua Rec Inc Warehouse Aqua Rec's Fireside Hearth & Home
Angie Federici -A/R 1407 Puyallup Ave 1407 Puyallup Ave
PO Box 80248 Tacoma, WA 98421 Tacoma, WA 98421
City of Industry, CA 91716-8248 (253) 682-1792 (253)682-1792
(800) 213-4455 Fax (253) 682-1791 Fax (253) 682-1791
Fax (253) 939-6792
Item Bin Request Unit Price Total
MISC SUPPLY Engineering Plans 1 Each $1.00 $1.00
Customers: Shearer, Tom&Shawn
Total $1.00
Friday,October 5,2018, 11:06:06 AM, Printed By jamie III IIII IIII I I I II I IIIIIIIII IIII IIIIIIII II III POACCO058971
SCP Distributors, LLC, Phone(800)213-4455, Fax(253)939-6792 Page 1 of 1
' Aqua Rec's Fireside Hearth N' Home
1407 Puyallup Ave Sales Order
Tacoma, WA 98421
Sales Order ID: 419097
Customer ID: 81575
Employee ID: Chris
Ordered: 9/27/2018
Invoiced:
Distribution: Delivery/ Install
Ship To:
Tom & Shawn Shearer Tom & Shawn Shearer
401 NE Timberline Drive 401 NE Timberline Drive
Belfair, WA 98528 Belfair, WA 98528
Home (360) 340-3011
Qty Item List Price Unit Price Total
1 NEWCON - Liner Pool 10x24 $58,000.00 $58,000.00 $58,000.00
See contract
1 AQUAMATICOVER-Aquamatic Cover System Pool Cover $10,980.00 $10,980.00 $10,980.00
1 A8- Bullfrog Spas A8"A"Series Non-Lounger $14,599.00 $12,499.00 $12,499.00
Bullfrog A8
Deposits/Invoices Terms:Due On Receipt Sub Total $81,479.00
09/27/2018 Deposit-Check - Checks - 50141 $8,000.00 Taxes $6,925.72
Total $88,404.72
Deposits -$8,000.00
Invoices $0.00
Order Balance $80,404.72
Terms And Conditions
NO RETURN ON ELECTRICAL PARTS
NO RETURN ON CHEMICALS-COMPANY POLICY.
RECEIPT REQUIRED FOR REFUNDS WITHIN LAST 30 DAYS.
CHECK PURCHASE REFUND REQUIRES 15 DAY WAIT PERIOD.
NO RETURN ON SPECIAL ORDERD PARTS
1407 Puyallup Ave, Tacoma, WA 98421, (253) 682-1792, Fax:(253) 682-1791, info@aquarec.com
1111111111111111111
IIIIIIIIIIII Accepted Date
Friday, October 5, 2018, 11:08:17 AM Received By Date
Printed By jamie Page 1 of 1
Chris Kovacs
From: Chris Kovacs
Sent: Monday, October 1, 2018 12:09 PM
To: 'logbuyertom@aol.com'
Subject: Update on permit
Hi Tom:
Thanks for meeting with me late last week, as I just wanted you to know that the engineered drawings for the pool walls
are ordered and soon as I get them in my hands, I will be down applying for the pool permit.
I will keep you updated throughout the process.
Thanks,
Chris Kovacs
Aqua Rec's, Inc.
Aqua Rec's Fireside Hearth N'Home
1407 Puyallup Ave.
Tacoma, WA. 98421
(253) 682-1792 (Office)
(253)227-2001 (Cell)
chrisra,aquarec.com(E-mail)
1
Chris Kovacs
From: Chris Kovacs
Sent: Monday, October 1, 2018 12:04 PM
To: 'ANDERSON, RICK'
Cc: Jamie Rasmussen;Joshua Shamp
Subject: Need engineered drawings
Rick Flair:
I need the engineered drawings for another pool I just sold:
Liner pool: 10'x 24' pool in ground liner pool (TV -5'6" depth)with corner in-set steps.
Customer: Shearer,Tom
Please send as soon as possible, as I need to get on the permits ASAP.
Thanks,
Chris Kovacs
Aqua Rec's, Inc.
Aqua Rec's Fireside Hearth N'Home
1407 Puyallup Ave.
Tacoma, WA. 98421
(253) 682-1792 (Office)
(253) 227-2001 (Cell)
chris:a,aciuuarec.cou}(E-mail)
a
E
1
q u a .,Re c's
Spas Fireplaces Stoves New Pool Construction . Pool Renovations
September 27, 2018
Shearer, Tom/Shawn *** Updated September 27, 2018 ***
401 N.E. Timberline Drive
Belfair, WA. 98528
(360) 340-3011
logbuyertom@aol.com
Re: In-Ground "Vinyl Liner"Pool: 10 X 24 X(3.5'to 5.5' depth; to be determined) Rectangle
Swimming Pool
Hello Tom & Shawn,
Thanks for the time we spent together at our Gig Harbor Store discussing a possible new pool, along
with a Bullfrog hot tub. As we discussed, I think a great size would be a 10' X 24' "Rectangle"
swimming pool and still have a good size deck around the pool to be able to relax in(but more
importantly not have to re-do the plans with the city if you tried to get the pool to 12'). The following
is the bid for the installation of the in-ground Vinyl 10 X 24 X(3.5'to 5.S'depth; to be determined)
(Rectangle) style pool, along with two options on the Bullfrog Spa(as per your request) that we
discussed when we met. The proposal is as follows:
The following in ground pool bid will include all of the following:
• Rectangle 10 X 24 X(3.S'to 5.5'depth; to be determined) in-ground vinyl pool.
• Pool Excavation-Customer responsible for digging the pool(Aqua Rec's will provide dig
spec's based on final determination of pool depths). Customer also responsible for dirt
removal and grading out dirt for final deck grade.
• PoolUMaterials delivered to site
• Prep ground
• Set steel pool walls/Entry Steps
• Shape bottom approx. (3'6"depth shallow end w/up to 5'6"in deep end)
• Vermiculite bottom of the pool
• Includes entry steps (white) in shallow end(corner steps to take as little room as possible)
• Customer choice of custom vinyl pattern (customer to choose). Customer to choose pattern
from Plastimayd liner brochure
• Aqua Rec's to custom measure and install custom fit liner
• Plumb pool skimmer, drains, and return lines on pool
• 2 skimmer's
www.aquarec.com
Fircrest Tacoma Gig Harbor Bonney Lake Puyallup
1221 Regents BLVD, 1407 Puyallup Ave., 2123 56th St Nw 20880 SR 410, 14019 Meridian St E.,
Fircrest Wa. 98466 Tacoma Wa 98421 Gig Harbor Wa 98332 Bonney Lake Wa. 98390 Puyallup Wa. 98375
Phone 253-565-4763 Phone 253-682-1792 Phone 253-649-4593 Phone 253-826-2547 Phone 253-770-9447
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Spas Fireplaces Stoves New Pool Construction . Pool Renovations
• Drains/bottom suction (VGB)
• 3 returns
• 2 light niches(2 LED Glo Brite Pool Lights)
• Plumb pool to equipment
• Bond all electrical(done by electrician)
• Pool lights(2) (2 LED Pool Lights)
Equipment(Cleaning):
• Telescopic Pole
• Leaf skimmer
• Vacuum Head(for vacuuming)
• Vacuum Hose
• Thermometer
• Manuals&Instructions
Equipment(Operating)
• Pool Heat Pump (Aqua Cal or Pentair)
• Pool Gas Heater(L.P.) 266,000 BTU Heater
• Pump; 314 H.P. (Pentair Whisper-Flo)
• Filter, Cartridge (Pentair Clean N'Clear)
• Solar Blanket
• Back FilUCompaction (customer to grade for deck)
• Grade around pool for concrete
• Concrete (deck and coping):
• Concrete Coping. 14'W 8"coping: Travertine coping(color TBD later)
• Concrete Deck: Customer to do their own deck. No deck done by customer.
• Includes lifetime water analysis at our store locations.
• Includes 1 S% off any future chemical purchases for the pool or spa (or accessories)
• Chemically balance pool upon completion &fill
• Includes Auto Cover(included in belowprice) (includes vault, tracking, cover, labor,
mechanics, motor)
• Includes BullfrogA8 hot tub/spa: Customer installing on the concrete (not in-ground or
vault) (colors TBD at later date).
Price: (In-ground Finyl Liner: ]0'X 24'X(3'6" to 5'6" with depth to be determined)
with all above options): 581,479.00 plus tax.. 8.S% Belfair...(Total w/tax: 588,404.72)
www.aquarec.com
Fircrest Tacoma Gig Harbor Bonney Lake Puyallup
1221 Regents BLVD, 1407 Puyallup Ave., 2123 561h St Nw 20880 SR 410, 14019 Meridian St E.,
Fircrest Wa. 98466 Tacoma Wa 98421 Gig Harbor Wa 98332 Bonney Lake Wa. 98390 Puyallup Wa. 98375
Phone 253-565-4763 Phone 253-682-1792 Phone 253-649-4593 Phone 253-826-2547 Phone 253-770-9447
Spas Fireplaces Stoves New Pool Construction . Pool Renovations
Includes in above price: Bullfrog "A8"
A Series
Full Five Year Warranty
Waterfall (upgraded)
LED Lighting (upgraded)
Enduraframe, Endurbase
JetPak technology
6 JetPaks to choose from
Stainless steel Jetpaks
1 Lounge
2 Pumps
Includes spa
Includes solar Blanket
Includes hard cover
Includes freight from Utah
Customer choice of interior color
Customer choice of exterior color
*** Customer responsible for all electrical to spa
(Aqua Rec's to provide electrical specs)
Options (Pool):
1.) Auto cover: Included in above price
2.) Salt system @ $1,890.00 plus tax
3.) If customer wants steps at both ends, add $2,240.00 plus tax for second set of steps
4.) Solar blanker Reel (Rock Roller): installed at $820.00 plus tax... (instead of auto cover)
Customer/Homeowner responsible for the following (as per conversation):
1. Permits: Pool , Plumbing, Final will be obtained by Aqua Rec's and customer will refund Aqua
Rec's for the actual "costs" of the permits. No labor charged for permits.
www.aquarec.com
Fircrest Tacoma Gig Harbor Bonney Lake Puyallup
1221 Regents BLVD, 1407 Puyallup Ave., 2123 56th St Nw 20880 SR 410, 14019 Meridian St E.,
Fircrest Wa. 98466 Tacoma Wa 98421 Gig Harbor Wa 98332 Bonney Lake Wa. 98390 Puyallup Wa. 98375
Phone 253-565-4763 Phone 253-682-1792 Phone 253-649-4593 Phone 253-826-2547 Phone 253-770-9447
r
'J
qua Rec s '
SINCE 1
Spas Fireplaces Stoves New Pool Construction . Pool Renovations
2. Pump House for the pool equipment(if desired).
3. Customer will be responsible for capping and relocating any and all underground utilities or
sprinklers, as discussed (if applicable).
4. Fencing: all fencing is the responsibility of the homeowner.
5. Electrical to be paid by customer directly to the electrician. Customer is responsible for all/any
electrical costs (paid directly to the electrician).
6. Gas line for gas heater: customer responsible for gas line. If Aqua Rec's runs the gas line, there
will be additional costs(discussed and agreed prior to start)
Payment Schedule:
• Due at time of acceptance and contract signing: 15% of contract price to SCHEDULE
• Due at time when pool is dug and materials are delivered to site: 25% of contract price
• 30% when pool walls are installed, plumbing is done and vermiculite troweled
• 20% due when equipment is set and the coping is installed
• 10% balance when concrete deck is poured and liner is dropped. Pool is operating and
the pool is balanced.
• Pool Finished: paid in full!
If anything comes up during the project that is unexpected and is not covered in the above bid,it will
come to the attention immediately from Ryan or Chris to the customer and any additional costs will/
would be discussed before moving on,as a"change order". Although this is unexpected and unusual,
sometimes things happen(I do not foresee any of this,but just want to mention it out of respect for one
another).
Thank you,Tom& Shawn: It was great meeting the two of you and please let me know if you
have any questions. Thank you for the opportunity to earn your business and trust in Aqua
Rec's, and we sincerely count it an honor to work with you and be your choice of business. We
will work hard,with integrity, and will do this job as if we were building it in our own back yard.
Job to start as soon as we both agree on the above (please let me know if there are any issues you
need to discuss in the above contract) and then meet at the site to get a game plan moving on
starting the pool.
www.aquarec.com
Fircrest Tacoma Gig Harbor Bonney Lake Puyallup
1221 Regents BLVD, 1407 Puyallup Ave., 2123 56th St Nw 20880 SR 410, 14019 Meridian St E.,
Fircrest Wa. 98466 Tacoma Wa 98421 Gig Harbor Wa 98332 Bonney Lake Wa. 98390 Puyallup Wa. 98375
Phone 253-565-4763 Phone 253-682-1792 Phone 253-649-4593 Phone 253-826-2547 Phone 253-770-9447
Spas Fireplaces Stoves New Pool Construction . Pool Renovations
Shearer,Tom & Shawn Date:
Chris Kovacs; Aqua Rec's, Inc. Date:
If you have any questions, let me know ASAP. If you want to get moving,we are extremely busy
and there are a lot of either in progress OR already on the schedule....We will get moving as
quickly as we can and we schedule on a "first come, first serve" manner(as we feel that is the
fairest way to get our customers taken care of).
Have a great rest of the week! If there is anything I can help with on the fireplace end of things for
your new home, please let me know that as well!
Sincerely In Service,
Chris Kovacs
Aqua Rec's, Inc.
Aqua Rec's Fireside Hearth N' Home
1407 Puyallup Ave.
Tacoma, WA. 98421
chris(&aquarec.com (e-mail)
www.aguarec.com
Office: (253) 682-1792
Cell: (253) 227-2001
"Enjoyable Home Comfort... One Family A t A Time
"Quality & Integrity Since 19 76"
Tacoma Fircrest Bonney Lake Pub allup Woodinville Gig Harbor
www.aquarec.com
Fircrest Tacoma Gig Harbor Bonney Lake Puyallup
1221 Regents BLVD, 1407 Puyallup Ave., 2123 56th St Nw 20880 SR 410, 14019 Meridian St E.,
Fircrest Wa. 98466 Tacoma Wa 98421 Gig Harbor Wa 98332 Bonney Lake Wa. 98390 Puyallup Wa. 98375
Phone 253-565-4763 Phone 253-682-1792 Phone 253-649-4593 Phone 253-826-2547 Phone 253-770-9447
oN `UUT MASON COUNTY COMMUNITY SERVICES
- f PERMIT ASSISTANCE CENTER: Permit No:—bled l -
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL G
615 W.Alder Street,Shelton,WA 98584 D��U �v bmQ
x MtJ
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
Belfair. (360)275-4467•Phone Elms:(360)482-5269 C�
854
BUILDING PERMIT APPLICATION
*(to�A
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: C--fP °Z041 t
NAME: S E,ALF NAME: AQUA Ads � tCJL•
MAILING ADDRESS: tJ.6.-riHZEAtOG ba, MAILING ADDRESS: Iyo-1 -R-04 N"-t2 i je
CITY: (3G-k;A i(L STATE:Wk ZIP: !98 CITY: TAcc>t STATE: GOA • ZIP: �3- L(Z
PHONE#1: 36a Z�Q -- 3 PHONE: Zs3�2-�1�iz CELL/is Z L--260 �
PHONE#2: EMAIL: Gh
EMAIL: l pcj -tb M %3 ( C oc\- L&I REG # (ncz,-6e--t-S o`Z EXP.c�i-/t - a t
PRIMARY CONTACT: OWNER❑ CONTRACTORS OTHER❑
NAME kis kWAC-6 u-LOA V-(Y-L 1 1, EMAIL C 0 f t-5� tLC rcC-•�0-0 e'0�4-
MAILING ADDRESS OZ U-AC -6, CITY i ACoriA STATE U)A - ZIP G94z-(
PHONE-l 2-,3\ h-2Z- Z �J CELL 2' 22-1-ZOO
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) o�J - 3�- 600 30 ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DIS T 2
SITE ADDRESS �In I VIP- I P h�� I�� CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO ❑
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑
TYPE OF WORK: NEW❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER tM
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) -TfJ-C�K �iNftiUb (L' -V!5- -?so L'
IS USE: PRIMARY SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES (Whole Bldg) ❑ YES(Parils/of Bldg) ❑ NO❑
DESCRIBE WORK
SQUARE FOOTAGE: (propose+existing) SW M1Uc-A- fODL- —� G 10 X Zq
I ST FLOOR sq.ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. SEMENT sq. ft.
DECK sq. ft. COVERED DECK sq. ft. STORAGE sq. ft. HE Z sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
KE MODEL Y �N��
BEDROOMS BA SERIAL ER ---
ENVIRONMENTAL HEALTH:
SEWA E/SEWELDA
CE: SEPT SEWER❑ / NEW ❑ EXISTING
PLUM G IN SRE? ES ❑ NO❑ yes, attach c leted Water equacy For
PERIMETE RAINS PROPOSED? YE NO❑ ISTING SQ.FT,
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER acknowledges that 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 and I further declare that I am entitled to receive this permit and to do the work as proposed. I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permitlapplication becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
COUNTY CODE 14.08.42)
X
Signature of O ER(Must be sinned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT 2-12
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
�PgoN Co MASON COUNTY COMMUNITY SERVICES Permit No: l.f/ -0/ w�
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL
615 W. Alder St-Shelton, WA 98584
www.co.mason.wa.us RECEIVED
J Phone Shelton: (360)427-9670 ext. 352• Fax:(360)427-7798
Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269
U �L D�N Ap't NOV - 6 ZOtl
PLUMBING & MECHANICAL PERMIT APPLICATION 615 W. Alder Street
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: TOM SHEARER NAME:
MAILINGADDRESS: NE 70 DAYBREAK DRIVE MAILING ADDRESS:
CITY: BELFAIR STATE: WA ZIP: 98528 CITY: STATE: ZIP:
1st PHONE: 360.340.3011 PHONE: CELL:
2°d PHONE: EMAIL :
EMAIL: LOGBUYERTOM@AOL.COM L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): 12320-34-00030 Zoning:
LEGAL DESCRIPTION(Abbreviated): PCL 3 OF BLA#12-13 PTN OF SE SW,SW SE S 38239,S 43/80
SITE ADDRESS: 401 NE TIMBERLINE DR CITY: BELFAIR
DIRECTIONS TO SITE ADDRESS:
TYPE OF JOB:
NEW X ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS-I IT FLOOR 2ND FLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Tyne of Fixture No. of Fixtures Fees Fuel Type-.Electric LPG Natural Gas Ductless_
Toilets 4 Type of Unit No. of Units Fees
Bathroom Sink 5 Furnace
Bath Tubs Heat Pump 1
Showers Spot Vent Fan 67
Water Heater 1 Propane Tank __'L ,�
Clothes Washer 1 Gas Outlets 4`•O
Kitchen Sinks „ Wood/Gas/Pellet Stove
Dishwasher 1 Kitchen Exhaust Hood 1
Hose bibs — 4 Dryer Vent 1
Other P /I Solar Panel
29-EA Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge 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 contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of
interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of
Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WIL N DATE THE A ATION.
.'. - / /_ 6 - C?(//)
Signature o Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
Visit us on-line: http://www.co.mason.wa.us/community_dev/