HomeMy WebLinkAboutBLD2018-01105 Final Demo DDR2018-00159 FLD2019-00007 - BLD Permit / Conditions - 11/26/2019 Mason County
MASON COUNTY Mason County Community Services
COMMUNITY SERVICES
615 W.Alder St. Bldg. 8
Shelton,WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
r
018-01105 NEW SINGLE FAMILY RESIDENCE
CT DESCRIPTION: DEMO EXISTING SFR AND DETACHED ISSUED: 02/06/2019
E&CONSTUCT NEW SFR WITH ATTACHED GARAGE (FLOODD AREA AE BFE OF 14FT) EXPIRES: 08/05/2019
DDRESS: 230 N AYOCK BEACH DR LILLIWAUP
PARCEL: 323035001014
APPLICANT: RICHARD CHESTER OWNER: RICHARD CHESTER
230 N AYOCK BEACH DR 230 N AYOCK BEACH DR
LILLIWAUP,WA 98555 LILLIWAUP,WA 98555
425-359-5224
LEGACY-UNKNOWN: JOHNSON BROTHERS License: UNKNOWN
Expires:
(360)426-0353
VALUATIONS: FEES: Paid Due
U VB Utility, miscellaneous 528.00 $25,238.40 State Fee-Residential $6.50 $0.00
R-3 VB Residential, one- 3037.00 $366,717.75 Planning Review Fee $240.00 $0.00
and two-family Building Permit Fee $2,651.35 $0.00
Change in Tenant- Minor EH $110.00 $0.00
Plan Review
Plan Check Fee $1,723.38 $0.00
Mechanical Base Fee $28.50 $0.00
Plumbing Fees $149.10 $0.00
Plumbing Base Fee $24.70 $0.00
Mechanical Fees $328.90 $0.00
Total: $391,956.15 Totals : $5,262.43 $0.00
FIXTURES
(sty Mechanical Fixtures (sty Plumbing Fixtures
1 Gas Outlet(s)(1-5) 1 Number of Bath Tubs
1 Dryer Vent(s) 2 Number of Showers
1 Kitchen Exhaust Hood(s) 3 Number of Hose Bibs
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Page 1 of 8
i
- Mason County
MASON COUNTY Mason County Community Services
COMMUNITY SERVICES
615 W. Alder St. Bldg. 8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
City Mechanical Fixtures
1 Wood/Gas/Pellet Stove(s)
2 Propane Tank(s)
REQUIRED INSPECTIONS
Setback Inspection BLD-Final Inspection
Footing Inspection Foundation Wall-Pre-Pour Inspection
Foundation Wall Inspection Shearwall Inspection
Shear Wall Nailing Framing Inspection
Framing/Plumbing/Mechanical Rough- Plumbing Inspection
Exterior Gas Inspection Mechanical Inspection
Insulation Inspection
CONDITIONS
Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the
structure.
Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site
plan. Please check your"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed.
" Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and
MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either
private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an
existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance
and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting
from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any
construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that
office to review future planned work which may affect your project.
" A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance
with IECC/WSEC Section R404.1.
" CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING
DEPARTMENT AND THE ADOPTED BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All
construction must be in conformance with the international codes as amended and adopted by Mason County. Any
corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting
additional inspections.
* All property lines shall be clearly identified at the time of foundation inspection.
" All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor
increase the velocity flow entering or abutting to any state or county culverting/ditching system or road way.
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Page 2 of 8
Mason County
MASON COUNTY Mason County Community Services
COMMUNITY SERVICES
615 W. Alder St. Bldg. 8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
All building permits shall have a final inspection performed and approved by Mason County Building Department prior to
permit expiration.The failure to request a final inspection or to obtain approval will be documented in the legal property
records on file with Mason County as being non-compliant with Mason County ordinances and building regulations.
" The plan review check list and corrections are part of the approved plans and must remain attached. It is the responsibility
of the applicant, owner or contractor to make the required corrections indicated on the plans. Once the plans are marked
"APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is
responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of approved documents will result in failure of required building inspections.
" Installation of heating equipment in a single-family residence shall meet the requirements of the current IECC/WSEC
R403, applicable sections of the IRC,and IMC.
Heating equipment shall be sized in accordance to ICC/WSEC, Section R403.7. Heating and design load calculations for the
purpose of sizing HVAC systems are required and shall be calculated in accordance with accepted practice, including
infiltration and ventilation. Design calculations shall be available for inspection during inspection.
Referencing IRC M1601.4, all ducts, air handlers,filter boxes, and building cavities shall be sealed. All joints of duct
systems and seams shall be made substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other
approved closure systems. Closure systems used with rigid fibrous glass ducts shall comply with UL181A and shall be
marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape. Closure systems used
with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-
sensitive tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings
shall be mechanically fastened. Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B
and shall be marked 181B-C. Crimp joints for round metal ducts shall have a contact lap of at least 1-1/2 inches (38 mm)
and shall be mechanically fastened by means of at least three sheet-metal screws or rivets equally spaced around the joint.
Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation
instructions.
Duct tape is NOT permitted as a sealant on any ducts.When ducts are located in unheated spaces the ducts hall be
insulated to R-8
DUCT TIGHTNESS TESTING shall be conducted by person(s)trained to perform such testing. A signed affidavit
documenting test results in accordance to IECC/WSEC Section R403.3.3 shall be provided to the Mason County Building
Department prior to the final occupancy inspection. Affidavit forms are available on at the WSU-Energy Program website
titles, "Duct Leakage Affidavit"or"Duct Leakage Testing Results(Existing Construction)." Duct tightness testing is not
required if the air handier and all ducts are located within the heated space.
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Page 3 of 8
Mason County
MASON COUNTY Mason County Community Services
'COMMUNM SERVICES
615 W. Alder St. Bldg. 8
Shelton, WA 98584
m 360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
* A permanent certificate, completed by the builder or registered design professional, shall be posted on a wall in the space
where the furnace is located, a utility room, or an approved location inside the building.When located on the elctrical panel,
the certificate shall not cover or obstruct the visibility of the circuit directory label, service disconnect labek, or toher reqyired
Iabels.The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls,foundation (slab,
basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the
solar heat gain coefficient(SHGC)of fenestration. Where there is more than one value for each component, the certificate
shall list the value covering the largest area.The certificate shall list the type and efficiency of heating, cooling, and service
water heating equipment, duct leakage rates including test conditions as specified in WSEC Section R401.3&R402.4.1.2,
and air leakage results if a blower door test was conducted.
Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 5 air
changes per hour when tested with a blower door in accordanve with IECC/.WSEC Section R402.4.1.2.
The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution
panel. Air leakage testing is not required for additions less than 500 square feet. Reference IECC/WSEC R402.4.1.2.
Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2015 Certificate"and are
available in or'/z sheets. The Mason County Permit Center will also have some available.
" A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more
information contact Public Works, at(360)427-9670, ext.450 or 100 W Public Works Dr. Shelton. The building permit will
not be finaled until the permit holder can show proof that the access permit from Public Works has been finaled and
approved.
* REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable
provisions of the current code and the manufacturer's installation instructions.
A drip edge shall be provided at eaves and gables of shingle roofs.
" All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or
any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
" Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries,
Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an
unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either
the homeowner, agent for the owner or a registered contractor according to WA state law.
" The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more
than 150'from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards
for Fire Apparatus Access Roads up to the point where such roads connect with a county maintained public road or to
another fire apparatus access road which connects to a county maintained public road.
" All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building
Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration.
Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No
more than one extension may be granted.
* The stamped approved site plan is required to be on-site for inspection purposes. If an inspection is requested and the
approved site plan is not on site, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule,
minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being
performed or approvals granted.
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Mason County
MASON COUNTY Mason County Community Services
COMMUNITY S RVICES
615 W.Alder St. Bldg. 8
Shelton,WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
* Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer
specifications and in accordance with IRC Section R315.
Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level
of the dwelling.
EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of
fuel burning appliances), repairs, or additions requiring a permit occur, or when one or more sleeping rooms are added or
created.
* WIND LOADS- Roof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic
wind speed for Mason County is 85 MPH.
* Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly
corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of
pressure treated material.
* The foundation/footing must be placed on undisturbed,firm-native soil.
* All construction must meet or exceed all local and state ordinances in addition to the International Codes requirements as
adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted
classification. Any non-approved change of use or occupancy would result in permit revocation.
* All RED stamped approved plans are required to be on-site for inspection purposes. If an inspection is called for and
plans are not available on site,then approval will not be granted. In addition, a re-inspection fee (refer to current fee
schedule, minimum 1 hour)will be charged and must be collected by the Building Department prior to any further inspections
being performed or approvals granted.
* Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance
with Mason County Title 14.28 and 14.17.
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Mason County
MASON COUNTY Mason County Community Services
COMMUNITY SERVICES
615 W. Alder St. Bldg. 8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
" Adopted IECC/Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C, Window(Max U-
Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less,Wall insulation R-21, Floor insulation
R-30, Ceiling Insulation min. R-49,Vault Insulation R-38, and Slab Insulation R-10. 3b-HIGH EFFICIENCY HVAC
EQUIPMENT:
Air-source heat pump with minimum HSPF of 9.0
4-HIGH EFFICIENCY HVAC DISTRIBUTION SYSTEM:
All heating and cooling system components installed inside the conditioned space.This includes all equipment and
distribution system components such as forced air ducts, hydronic piping, hydronic floor heating loop, convectors and
radiators.All combustion equipment shall be direct vent or sealed combustion.
For forced air ducts:A maximum of 10 linear feet of return ducts and 5 linear feet of supply ducts may be located outside the
conditioned space.All metallic ducts located outside the conditioned space must have both transverse and longitudinal joints
sealed with mastic. If flex ducts are used,they cannot contain splices. Flex duct connections must be made with nylon straps
and installed using a plastic strapping tensioning tool. Ducts located outside the conditioned space must be insulated to a
minimum of R-8.
Locating system components in conditioned crawl spaces is not permitted under this option.
Electric resistance heat and ductless heat pumps are not permitted under this option. Direct combustion heating equipment
with AFUE less than 80% is not permitted under this option.
5a-All showerhead and kitchen sink faucets installed in the house shall be rated at 1.75 GPM or less. All other lavatory
faucets shall be rated at 1.0 GPM or less.
5b-EFFICIENT WATER HEATING 5b:
Water heating system shall include one of the following: Gas, propane or oil water heater with a minimum EF of 0.74
* A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit
application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the
responsibility of the owner/agent of the developed parcel. It is the owner/age nt/contractor's responsibility to ensure that
Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement
of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled"Managing Storm Drainage on Small Lots, The Small Parcel
Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the
development has, or will have, a septic/drainfield system you are responsible for contacting Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this, or any other,
parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final
inspection of the building permit the owner/agent/contractor is acknowledging that all components of the stormwater
management system have been installed as approved on the stormwater site plan.
* By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your
"Approved Site Plan"to ensure these structures meet the setback conditions listed.
* Concrete encased grounding electrodes must be installed and used at each new building or structure that is built upon a
permanent concrete foundation. In Mason County the electrical code is regulated by Washington State Department of Labor
& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-
4000.
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Mason County
MASON COUNTY Mason County Community Services
COMMUNITY SERVICES
615 W.Alder St. Bldg. 8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
" A separate inspection in addition to the inspections required in the IBC, Section 110 shall be required in accordance with
the 2015 IBC, Section 1705.12.2 and Section 1707.1. The additional inspection is required when shear wall fastener
spacing is required to be 4 inches or less. The shear wall schedule shown on sheet designate wall(s)type and
with fastener spacing 4 inches or less.
The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified
to inspect lateral connections,the Engineer of record (EOR), or an authorized representative of the(EOR). The special
inspectors duties and responsibilities shall be as specified in Chapter 17. When a third party inspector is used to perform the
inspection, special inspection reports shall be submitted to the Mason County Building Department, 615 W Alder St, Shelton,
WA 98584 and also available on site for review by the Building Official. Inspection reports shall be completed and submitted
to the Mason County Building Department in a timely manner and shall be submitted prior to the framing inspection of said
project.
* 3000 PSI CONCRETE WILL REQUIRE SPECIAL INSPECTION IF THE QUANTITY EXCEEDS 50 CUBIC YARDS<
LESSER AMOUNTS WILL REQUIRE AN APPROVED CONCRETE SUPPLIER TO PROVIDE YOU WITH A BATCH
TICKET THAT WILL BE REQUIRED TO BE SUBMITTED TO THE SITE INSPECTOR FOR THE VERIFICATION OF
MATERIAL USED. X
* Attic Ventilation: IRC section R806
Enclosed attic and rafter area shall be supplied with cross-ventilation. The net area shall not be less than 1/150 of the area
of the space to be ventilated. If 50% and not more than 80%of the ventilating area is provided from the upper portion of the
space to be ventilated,then 1/300 is allowed.
* In buildings of unusually tight construction,fuel-burning appliances (excluding cooking appliances and domestic clothes
dryers)shall obtain combustion air from outside in accordance with the International Codes.
* Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to
the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of
the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In
addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Department prior to any further inspections being performed or approvals granted.
* Fuel piping shall be inspected after the installation of gas piping is complete, and before the attachment of fixtures,
appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than
15 minutes. Appliances to be attached to the fuel piping system shall not be used until the final inspection has been
performed and approved by a Mason County building inspector.
X
* All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County
ordinances. All propane tanks filled on site must be located a minimum of 10'from any possible source of ignition (electrical
outlets, electrical fixtures, compressors,etc), mechanical system air intake(direct vent appliance, ventilation air intake, etc),
and/or any weeds, grass, brush, trash or any other similar combustible materials. Propane tanks less than 125 gallons must
also be located a minimum of 5'from any building opening (foundation vents,windows, doors etc). Setback to the public
way, or access easements shall be the greater of 25-ft or as specified in the Mason County Development Regulations.
Setback to property lines shall be the greater of 5-ft or as specified in the Mason County Development Regulations. If a
propane tank is exposed to probable vehicular damage, protective bollards must be installed.
* Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate
building permit and approval prior to construction of the retaining wall.
* Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or
given an equivalent type of erosion protection (silt fencing or straw matting).
* Height of structure not to exceed 35'
* Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel.
RR5
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Page 7 of 8
Mason County
NASON COUNTY Mason County Community Services
COMMUNITY SERVICES
615 W.Alder St. Bldg. 8
Shelton,WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2018-01105
" A Road Access Permit or Approval must be granted and approved by the Washington State Department of Transportation.
For more information contact Washington State Department of Transportation, at(206)357-2620, ext. 630.
" Adopted IECC/Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C,Window(Max U-
Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation
R-30, Ceiling Insulation min. R-49, Vault Insulation R-38, and Slab Insulation R-10.
I hereby certify that 1 have read and examined this application and know the same to be true and correct.
All provisions of Laws and Ordinances governing this type of work will be complied with whether
specified herein or not. The granting of a permit does not presume to give authority to violate or cancel
the provisions of Iny other state/local law regulating construction or the performance of construction.
Issued By:
Contractor or Authorized Agent: f Z Date: Z-A
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Page 8 of 8
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OPTIONAL
HEAT PUMP OUTDOOR UNIT - NARROW PROFILE: EXTERIOR
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ENCLOSURE
APPROVED CONC. WALK
MASON COUNTY DCD PLANNING ACE of Ex1sr.
SITE PLAN REQUIRED TO BE ON SITE \ � '4
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UIL®ING
WSEC PRESCRIPTIVE COMPLIANCE FORM- Marine Zone Washington State Energy Code 2012
Owner/Project: lChester Residence I Project No.:1 2016025 Telephone: Parcel#::I I Date:18 8,2018
Type of Project:I DwellingAnalyst:Rachel Weber Foster&Williams Architects
Total Heated Area: 3,037 S.F.) 1' Floor: 1,305 2 Floor:1 1,732 8smt./Other:
Heating System Type: UElectric wall Heaters U ElecGic Furnace U Boiler-Specify fuel Heat Sizing Sheet
❑Gas Furnace ®Air Source Heat Pump ❑Ductless Heat Pump ❑other(specify): Required
Options: ❑ Small Dwelling Unit: 0.5 Points 0 Medium Dwelling Unit: 3.5 Points ]�'large Dwelling Unit: 2.5 ('I L P �01`J(Select One) Dwelling<1,500 sf W/<300 sf fenestration Dwelling units that are not included In#1 or#3. ling units exceeding 5,000 S.F.of tinnedL .1Additions<750 sf Additions over 750 S.F.
Ventilation ❑ Exhaust Fan &Fresh Air Vents (M1508.4) EnergyCredits Tar et R-Value&U-Value Table Requirements
System: ®Integrated with Forced Air System(M1508,S) Tar eb> 3.5 R-Val. U-Val. R-Val. -Val.
(Select One) ❑Heat Recovery Venulation System (M3508.7) 3b 1 Fenestration u° n/a 6.36 Mass Wall R-Value' 21/21" 0.056
❑other(Specify): 4 1 Skylight U Ma 0.50 Floor 301 0.029
Actual Average Weighted U-Values 5a,5b 1,5 Ceiling 49' 0.026 Below Grade Wall`" 1015/21 int 0.029
Fenestration 0.256 lConforms Total 3.5 Wood Fr.Wall"u' 21 int. 0.056 Slab R&De th 10,2 ft n/a
Skvliqhts 0.000 lConforms Conforms Footnotes are located below Window Schedule
WINDOW SCHEDULE Shapes:R=Round.H=Hall Round, Q=Quarter Round. 1 =Triangle, 1-=Exempt, Blank=Rectangular 44
Windows or Door Window or Door Room U- Quan-1 Size 1 y 1 Area UA
Codel Brand Type Name Value I tity W D H7 shape S.F. Value
Note:Substitutions are allowed if approved by owner and substitutions meet or exceed U-value pertormances in this schedule.
4 Mil and Tuscany or Montecito Casement- SCM/AR/EG/DG 0.28 14 3 0 50 210.0 58.80
4 Mil and Tuscany or Montecito Casement- SCWAR/EG/DG 0.28 4 23 50 45.0 12.60
5 Mil and Tuscanv or Montecito Awning- SCWAR/EG/DG 0.28 8 2 0 1` 21.3 5.97
4 Mil and Tuscany or Montecito Casement- SCM/AR/EG/DG 0.28 10 3 0 4. 120.0 33.60
4 Mil and Tuscanv or Montecito Casement- SCM/AR/EG/DG 0.28 4 1 6 50 30.0 8.40
18 IMilaard Tuscany or Montecito Sl.G.Door- SC/AR/EGMlfG 0.22 1 4 60 68 160.0 35.20
73 ITherma Tru Fiberglass Door No Glass 0.14 1 30 68 20.0 2.80
75 ITherma Tru Fiberglass Door 1/2 lass/Insulated Glass 0.22 1 3 0 68 20.0 4.40
74 Therma Tru Fiberglas Doors 1/4 Glass/Insulated Glass 0.18 1 30 68 20.0 3.60
78 Therma Tru Fiberglass Door Sidelight 3/4 Insulated Glass 0.28 1 1 2 68 7.8 2.18
79 Therma Tru Fiberglass Door Transom Insulated/ lass 0.23 21 3 0 1 4 84.0 19.32
79 Therma Tru Fiberglass Door Transom Insulated/ lass 0.23 1 4 2 3 1 4 12.0 2.76
3 Mil and Tuscany or Montecito Fixed- SCWAR/EG/DG 0.29 8 20 20 32.0 9.28
5 Mil and Tuscany or Montecito Awning- SCM/AR/EG/DG 0.28 4 3 0 2 6 30.0 8.40
3 Mil and Tuscany or Montecito Fixed- SCWAR/EG/DG 0.29 2 30 28 16.0 4.64
Target Weighted U-Value for Windows= 0.30 Total Window Area,Total UA: 828A 211.95
Weighted U-Value=Sum(UA)I Total Window Area (not including exempt windows).... »»» 0,256
Simple Heatin System Size: Washington State (Based on 2012 Washington State Energy Code Worksheet)
Owner/Project IChester Residence I Proj.No.: 2016025 1 Parcel#:1 0 1 Date: 8/8/2018
Type of Project: I Dwelling Analyst: Rachel Weber Foster&Williams Architects
Total Heated Area:(3,037 sq.ft.) 1 Floor: 1,305 2-Floor: 1,732 Bsmt./Other:1 0
Q All Other systems
Heating System Type
QQ Heat Pump
Design Temperature
Closest City: Shelton Design Temperature Difference(AT) 47
,IT=Indoor(70 degrees)-Outdoor Design Temp
Area of Building
Conditioned Floor Area 3,037 sq.ft.
Volume: 27.333 cu. Ft
Average Ceiling Height 9.00 ft.
UA Calculation a e
o e system I Insulation Description a ue Area or Feet
----- Glazinq and Doors U-Value Prescriptive @ 0.030 0.300 828.1 248.43 (U-Value Prescriptive,Area From Schedule)
----- Skylights U-Value Prescriptive @ 0.050 0.050 0.0 0.00 (U-Value Prescriptive,Area From Schedule)
1 Attics R-49 0.026 1732.0 45.03 (U-Value From DataSelection Table,Area From Sol
4 Vaulted Ceilings No Vaulted Ceilings in this Project ----- ----- (U-Value From DataSelection Table)
5 Above Grade Walls R-21 Intermediate 0.056 ----- (U-Value From DataSelection Table)
6 Floors R-30 0.029 1305.0 37.85 (U-Value From DataSelection Table,Area From Scl
10 l8elow Grade Walls 1 No Below Grade Walls in this Project ---- ----- (U-Value From DataSelection Table)
12 ISlabBeiowGrade I No Slab Below Grade in This Project ----- ----- (U-Value From DataSelection Table)
15 Slab on Grade No Slab on Grade in this Project ----- (U-Value From DataSelection Table)
Duct Conditions
18 Location of Ducts I No Ducts in this Project Duct Leakage Coefficient
Sum of UA 331.31
Envelope Heat Load 15,572 Btu/Hr
Sum ofUAxdT
Air Leakage Heat Load 13,874 Btu/Hr
Uolume x.6 x,8T x.018
Building Design Heat Load 29,446 Btu/Hr
Air Leakage+Envelope Heat Load
Building and Duct Heat Load 29,446 Btu/Hr
Ducts in uncondition space:Building Heat Loss x 1.10
Ducts in condition space:Building Heat Loss x 1.00
Maximum Heat Equipment Output 36,807 Btu/Hr
Building and Duct Heat Loss x 1.4 for Forced Air Furnace
Building and Duct Heat Loss x 1.25 for Heat Pump
Heat Type from Window Schedule
Name Richard& Kathryn Chester Parcel# 32303-50-01014 RLD# �q.M'fJ
Mason C I L® N N G SAP 2 8 20�$
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (pWJeJ- d JJ)treet
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 surface2.
'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.
2Common 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 _ Inaddition to ewst.
10 S.F.
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections (example:
eaves/gutters)
X =
Driveways X = Existing
X = Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved. gravel or packed area per definition
above table
X =
Patios/Walks X = In addition to east.
7695.F. Any paved, gravel or packed area per definition
X 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) 809
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-
described property for revie and inspection as may be required.
X Owner gen ontractor(circle one)Date: 8/16118
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
MASON COUNTY Permit No:D 161 o1 a -
l~' DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL (360)427-9670 Shelton ext.352
httpJ/www.co.mason.waus1community Kiev/ (360)275-4467 Belfai t-3
426 W Cedar Street,Shelton WA 98584 (360)482-5269 Elrv` 5 bVED
�® BUILDING PERMIT APPLICATION SEP 2 8 2018
�® PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: C G t
NAME: Richard 8.Kathryn Chester NAME: Johnson Brothers Custom Homes V'S AID r �''`:4'til
MAILING ADDRESS:20429 Weld,Rd. MARLING ADDRESS: 2935 W Snokomish valley Rd
CITY:Snohomish STATE: WA ZIP:98296 CITY: Shelton STATE: WA ZIP: 985M
PHONE: CELL:(360)668-7806 PHONE: (360)426-0353 CELL:
EMAIL: chesterkathryn@outlook.com EMAIL:
L&I REG# EXP.
CONTACT: OWNER a CONTRACTOR❑ BELOW❑
NAME: MAILING ADDRESS:
CITY: STATE: ZIP: PHONE: CELL:
EMAIL:
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 32303-5M1014 FIRE DISTRICT_
LEGAL DESCRIPTION(ABBREVIATED):AYOCK BEACH BLKI LOT:14 SEE SURVEY 30/66
SITE ADDRESS 230 N.AYOCK BEACH DR. CITY Lilliwaup,WA 98555
DIRECTIONS TO SITE ADDRESS Take Hwy 10 N.R on N Pebble Beach Dr R on Ayock Beach Dr.
IS PROPERTY WITHIN 200 FT:
SALTWATER N LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO IR
TYPE OF JOB: NEW N ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(RESIDENCE.GARAGE ETC.) SFR w1h attached era ere adn exi FR and detached ara e
IS USE: PRIMARY❑ SEASONAL X NUMBER OF BEDROOMS NUMBER OF BATHROOMS-3--
DESCRIBE WORK Demo ebsting SFR and detached gargge build new SFR w/attched gar ge
SOUARE FOOTAGE:
I ST Fi,00R 1305 sq.ft. 2ND FLOOR 1732 sq.ft. 3RD FLOOR sq.ft. BASF.MF.NT sq.ft.
DECKAII under 301q,ft. COVERED DECK t55 sq.ft.STORAGE sq.ft. OTHER sq.ft.
GARAGE U sq.ft. ATTACHED❑ DETACHED❑ CARPORT sq.ft. ATTACHED❑ DETACHED❑
MANUF RED HO ORMATIO *4 COPIES THE FLOOR PL RE UIRED
M _MO YEAR ENGTH
IDTH BEDROOMS BATHS SERIAL NUM
— 77-
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 or owner's legal representative.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 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 OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL AUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42)
x -
nature of OWNER Date
DEPARTMENTAL REVIEW APPROVE ATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT S P I ZO I -0331aa
FIRE MARSHAL
FEE'S TOTAL VALUATION:
BUILDING PERMIT FEE. FIRE ACCESS AND GRADE
PLAN REVIEW GF.O-TECH REVIEW
PLUMBING&BASE FEE STORMWATER REVIEW
MECHANICAL&BASE FEE TOTAL FEES
WOOD/GAS/PELLET STOVE VIOLATION INVESTIGATION FEE
PLANNING REVIEW FEE VIOLATION FEE
MASON COUNTY PERMIT NO. Ia -61IDLJ
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING• PLANNING• FIRE MARSHAL
i
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. III, 426 West Cedar Street (360)275-4467 Belfair ext.352
1854 PO Box 279, Shelton, WA 98584 (360)482-5269 Elma ext.352
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Richard 8 Kathryn Chester NAME: Johnson Brothers Custom Homes
MAILING ADDRESS: 20429 welch Rd. MAILING ADDRESS: 2935 w Snohomish Valley Rd
CITY: Snohomish STATE: WA ZIP: 98296 CITY: Shelton STATE: wA ZIP: 98584
PHONE: CELL: (3s0)668-7806 PHONE: (360)426-0353 CELL:
EMAIL: chesterkathryn@outlook.com EMAIL :
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER): 32303-50-01014
LEGAL DESCRIPTION(ABBREVIATED): AYOCK BEACH BLK:1 LOT:14 SEE SURVEY 30/66
SITE ADDRESS: 230 N.AYOCK BEACH DR. CITY: Lilliwaup,WA 98555
DIRECTIONS TO SITE ADDRESS:Take Hwy 101 N,R on N Pebble Beach Dr.,R on Ayock Beach Dr.
TYPE OF JOB
NEW X ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS— 1ST FLOOR x 2ND FLOOR x BASEMENT GARAGE OTHER
L PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric LPG Katural Gas Heat Pump x
Toilets 3 Type of Unit No.of Units Fees
Bathroom Sink 4 Furnace
Bath Tubs t Heatpump 1
Showers 1 Spot Vent Fan 5
Water Heater 1 Propane Tank 2
Clothes Washer 1 Gas O s 3(2 for gas stove below)
Kitchen Sinks 2 Wood/>jia�lPellet Stove 2 ?
Dishwasher t Kitchen xhaust Hood 1
Hosebibs 3 Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or 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
permittapplication 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 IS BY MEANS OF INSPECTION.INACTIVITY OF THIS
PERMIT APPLICATION OF 180J4 YS WILL INVALIDATE THE APPLICATION.
X �i -b I b
Signature of A licant Date
X �a�-lt�e L I�y,�6.�r Owner wners Representativ Contractor
Print Name One)
.DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PLANNING
MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES DDR
Building Planning,Environmental Health,Community Health
615 W.Alder St.—Bldg.8,Shelton,wa 98584 Date Rcvd ,L t
Phone:(360)427-9670 ext.352 ♦Fax:(360)427-7798
Request for Administrative Variance for RffCEiD
Reduction in the Required Setbacks SEP 2 8 2018
For administrative review,the minimum variance on a setback request is 5 feet from t16,16 aAd* Street
lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction
requires a standard variance. Setbacks are measured from the furthest projection of the structure,
including roof eaves and gutters.
Applicant/Owners IG hCi (Cj C,h 6 6A(
Mailing Address: Zr ,' 29
City: 6 h/)ho VY) I,e)I-) State: WA Zip: 2-G(.Q
Telephone: G qu LP
Email:
If this reduction is tied to a building permit, please give permit case number.
BLD 'LD I b - 0 110,15
Parcel Number(s): 3:A6 3 — `JQ Q l L I`—� Zoning I
Site Address: �Q
Requested setback variance:
ft. )(Front ❑ Rear ❑ Side
y, I I A
.� ft ❑ Front ❑ Rear �i Side
ft. ❑ Front ❑ Rear X Side
ft ❑ Front ❑ Rear ❑ Side
Front Setbacks—From access easements and road right of ways. Minimum 10 feet.
Rear Setbacks—From the rear property line. Minimum 10 feet.
Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or easements, and set backs to all
property lines and existing buildings; slopes, surface water, wetlands, critical areas, septic, well and
driveway. Show all proposed new development.
FRO AND OR REAR YARD REDUCTION REQUESTS:
For isting lots of record as of March 5,2002;
You must meet one of the following:
1) One of the following exists on the lot(check all that apply):
❑ a) steep slopes,wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ ) lot size of no more than one-fourth acre;
existing improvements of buildings, septic systems,and well areas.
/11DDE Y REDUCTION RE UESTS:
or existin lots of record as of March 5, 2002;
st meet one of the following:
2) One of the following exists on the lot(check all that apply):
❑ a) steep slopes, wetlands, or streams present;
❑ b) soils that restrict building or septic development;
❑ c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-half acre;
Xe) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
sel standard for Rural Residential 2.5, 5, 10, or 20 zones.
5 - A a rp J L ,/
It
Owner/Agent (please indicate)
Signature Date
Official Use Only Approved by: Date 0
Denied by: Date
Reason for denial:
I
MASON COUNTY Mason County Permit Center Use:
COMMUNITY SERVICES FLD Zo I°t -oc�0"l
4 Building,Planning,Environmental Health Community Health
615 W.Alder Street—Bldg.8,Shelton,WA 98584 Date Rcvd (23
Phone:(360)427-9670 Ext.352 ♦ Fax:(360)427-7798
Fee: $300.00
No fee if w/other permits
FDPO Development Permit Application
Applicant: Contractor:
(WA f VPR P��N �,k4eY A,�Pn
Mailing Address: Mailing Address:
City, State, Zip City, State, Zip
L,1' I I I uv cl P °t Vol
Phone: ( ) Phone: ( )
Email: Email:
Parcel Number: Property Address:
0 -3 lc-�A&A,
I understand I am making application for a permit to develop in a designated flood hazard area. The
undersigned agrees that all such work shall be done in accordance with the requirements of the County Flood
Damage Prevention Ordinance, building codes and all other applicable Local, State and Federal regulations.
This application does not create liability on the part of the County or any officer or employee thereof for any
flood damage that results from reliance on this application or any administrative decision made lawfully
thereunder.
Applicants Signature: L� Date:
it
Official Use:
A. Description of Work (complete for all work):
1. Proposed Development Description:
X New building/Addition ❑ Manufactured home ❑ Fill/grade ❑ Other:
❑ Commercial (see section D)
❑ Remodel/repair to existing building (see section C)
2. The parcel has been identified in the following Flood Hazard Area:
❑ A XAE ❑ AO ❑ VE
3. Are any other Federal, State or local permits required? Must attach copies of permits.
❑ Yes 'Z�No If yes, list type:
4. Is the proposed development in an identified floodway?
❑Yes >(No
5. If yes to#4, a No Rise Certification must be attached.
❑ Yes 11 No
B. Complete for New Structures and Building Sites:
1. A FEMA Elevation Certificate is required, must be completed by a Washington State licensed Surveyor.
Must attach a copy of certificate.
2. Base Flood Elevation at the building site: r feet NAVD 88
3. Required lowest floor elevation (including basement floor): c feet NAVD88
4. In flood hazard areas without a base flood elevation (BFE), what is the highest adjacent
Grade? (HAG)
Structure must be a minimum of two (2) feet above the HAG.
The required finish floor height is
C. Complete for Alterations, Additions, or Improvements to Existing Structures:
******(See attache Substantial Improvement & Substantial Repair)*******
1. What is the estima market value of the existing structure? $
2. What is the cost/valuation the proposed construction? $ Percentage
3. If the cost or valuation of the pro ed construction equals or exceeds 50 percent of the market value
of the structure, then the substantial provement/repair provisions shall apply.
Is the proposed work a substantial repair/improvement ❑ Yes ❑ No
D. Complete for Non-Residential Flood roofed Construction:
1. Type of floodproofi method:
2. The required floodproofin%bya
ion is: feet NAVD88
3. Floodproofing certificationgistered engineer is attached:
❑ Yes ❑ No
E. Complete for Subdi 'sions and Planned Unit Developments:
1. Will the subdivision o other development contain 50 lots or 5 acres?
❑ Yes ❑ No
2. If yes, does the plat or prop sal clearly identify base flood elevations?
❑ Yes ❑ No
3. Are the 100 Year Floodplain and Floodway delineated on the site plan?
❑ Yes ❑ No
Administrative
1. APPROVED: —T-C&) DENIED: statement attached
2. Elevation Certificate attached: &Yes ❑ No
3. As-built lowest floor elevation: 15 feet NAVD88
Comments/Conditions:
Mason County Flood Damage Prevention Ordinance #41-17 & International Building Codes
U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30. 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important:Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and(3)building owner.
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O.Route and
Box No. Company NAIC Number:
2�o �/ 4 Yo Ck
City State ZIP Code
L1 ��� !:✓R-v � GtJA- G� S
A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) .
A5. Latitude/Longitude: Lat. (+:2, 50 7 d-2— Long.113,06�5-27 Horizontal Datum: ❑ NAD 1927 TAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8A sq in
d) Engineered flood openings? es ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garage sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade
c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? ❑Yes ❑ No
SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2.County Name B3. State
/►?Aso 600AI-rY
84, Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s)
Number ate Effective/ Zone AO, use Base
�Vi SE Revised Date Flood Depth)
1Z0 :.e�►m /�Ao 4
-3i -7-019 `q, co
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9:
❑ FIS Profile FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 g?'NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area(OPA)? ❑Yes 210
Designation Date: -__� ❑ CBRS ❑ OPA
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30,2018
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
2 0 Yo cK �3 C)a-cam/ 94
City State ZIP Code Company NAIC Number
L e WA b,/A S
SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction" ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR, AR/A,AR/AE,AR/A1—A30,AR/AH,AR/AO.
Complete Items C2.a—h below according to the buildin diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: /V C•sS S Ha!D�SU� Vertical Datum: MA
Indicate elevation datum use or the elevations in Items a)through h)below.
❑ NGVD 1929 UKNAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor(including basement, crawlspace, or enclosure floor) Cpfeet ❑ meters
b) Top of the next higher floor CD C:> 2-feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) ❑ feet ❑meters
d) Attached garage(top of slab) ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building ❑ feet ❑ meters
(Describe type of equipment and location in Comments)
-f-
f) Lowest adjacent(finished)grade next to building(LAG) [feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) --f�. �� ❑ feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ feet ❑ meters
structural support
SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Sectionna1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? L_1 Yes ❑No ❑Check here if attachments.
Certifl,r',NamT)A
License Number �J; ,Yr� f�-
Title ' Ityl/ /l L S l S(.S >`t :R1:;�. F. ri r�r
Company Name
t
Address re i< ;;
2,31
City State ZI Code
Signature Date Telephone 4_ 1MAt-J N C) *Z& V
Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and(3)building owner.
Comments(Including type of equipment and location, per C2(e), ifapplicable)
�) e:-r F-11,1. 1--4_z)0P' a M, co /yoo
P1 k-e- /ti P P Ale�7- TO
h o has
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6
o.
ELEVATION CERTIFICATE Expiration ionlDaO-OOovvember 30, 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
i Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
2'3v N� A YvcK %3Acf� -2 ,
City State ZIP Code Company NAIC Number
SECTION E—BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO AND ZONE A (WITHOUT BFE)
For zones AO and A(without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, Band C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below
the highest adjacent grade(HAG) and the lowest adjacent grade(LAG).
a) Top of bottom floor(including basement,
crawlspace, or enclosure) is ❑feet ❑meters ❑above or ❑below the HAG.
b) Top of bottom floor(including basement,
crawlspace, or enclosure) is ❑feet ❑meters ❑above or ❑below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions),
the next higher floor(elevation C2.b in
the diagrams) of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage (top of slab) is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is [:]feet ❑meters ❑above or ❑below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A(without a FEMA-issued or
community-issued BFE) or Zone AO must sign here.The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTANT: in these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
Cry State ZIP Code Company NAIC Number
SECTION G—COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sections A, B, C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement
used in Items GB—G10. In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,
engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation
data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO.
G3. ❑ The following information(Items G4—G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate of
Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)
of the building: ❑ feet ❑ meters Datum
G9, BFE or(in Zone AO)depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. Community's design flood elevation: ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments(including type of equipment and location, per C2(e), if applicable)
❑ Check here if attachments.
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No, Policy Number.
� A- a L Ct4 Pk
City State ZIP Code Company NAIC Number
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If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructions for Item A6. Identify all photographs with date taken- "Front View"and "Rear View and, if required, "Right Side View"and
"Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or
vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
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Photo One Caption
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Photo Two Caption
FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
2-3 /kY&G/- -,0v-14
City State ZIP Code Company NAIC Number
S9r-�5,
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and 'Rear View"; and, if required, 'Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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Photo One
Photo One Caption -er 5! C ' l/ I-LP—
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Photo Two
Photo Two caption
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6