HomeMy WebLinkAboutBLD2020-01339 Final SFR - BLD Permit / Conditions - 9/10/2021 615 W.Alder St.Bldg 8,SHELTON,WA 98584
MASON COUNTY
P SERVICES
360-427-9670, EXT 352
COMMUNITY `7ERVICES BELFAIR: 360-275-4467,EXT 352
Buildingg Planning,[nuironmenmtt9ealth.CnmmunityllealUi ELMA:360-482-5269,EXT 352
www.co.mason.wa.us
INSPECTION CARD AND CERTIFICATE OF OCCUPANCY**
To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bid-inspection.php
Permit Number BLD2020-01339 Date Issued 01/05/2021 IssuedN�k
Project COVAL HOMES: NEW SFR WITH ATTACHED GARAGE
Site Address 1473 NE Mission Creek Rd
Applicant KEESLER JEFF&MIRANDA
Contractor COVAL HOMES
Contractor Phone
Primary Code UPC IBC, IRC,IFC, IEC,IMC,& Type
Permit Type NEW SINGLE FAMILY RESIDENCE Occupancy
-APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS.
-DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED.
-THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION, FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY.
-ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION.
-OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION.
**THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.**
PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET
Public Works Access/Driveway Other
Health Septic Well
Deptartment
Planning Site Inspection
Department
Fire Marshall Fire Apparatus Access Fire Sprinkler
Auto Fire Alarm Hood and Duct
Other Final
Building
Department Building Official: Community Services Designee
Concrete Setbacks 7 / -Zp Z/ J Slab
Footing Perimeter -7- ?pz( J7_ Point load Footing
Footing Interior --!?-7✓z( J Footing Decks/Porches
Foundation Stem Walls'&- Other
Rough-In Groundwork Plumbing Framing V -1-zr
Groundwork Mechanical Plumbing 'Z 'z ,
Groundwork Gas Pipe Cl_t -2t ELM Mechanical'S-2A--ZAATd
Gas Piping Shear Wall Nailing
Underfloo
Other
Insulation Slab Ceiling
Floor Vaulted Ceiling
Walls -11_i l `.�Ca Vapor Barrier
Other
Wallboard Interior Wall Brace Panels Fire Walls
Nailing
Other
Final Building to
Manufactured Setbacks Setup
Home
Concrete Foot/Runners Final
Other
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MASON COUNTY 360-427-9670 Shelton ext.352
360-275-4467 Belfair ext.352
COMMUNITY SERVICES 360-482-5269 Elma ext.352
Building,Planning,Environmental Health,Community Health
615 W.Alder St.Bldg.8 - Shelton,WA 98584 www.co.mason.wa.us
CORRECTIONANSPECTION REPORT
PERMIT/CASE NUMBER: '7-0
ADDRESS/LOCATION: L-n i ve c
FINDINGS:
1K 01 16RCAOn - .
Items listed above must be corrected to gain compliance.
THIS IS NOT A COMPLETE INSPECTION
This structure gas been inspected by Mason County Building Department and the items listed
e are in VIOLATION of Mason County laws and/or ordinances.
all for re-inspection when corrections are made before proceeding with any further work.
Make corrections, items will be checked on the next inspection.
OK to `
Date: S` 1�'� ❑ Please contact our office regarding possible
Department: % structural damage incurred by recent
Inspector: Dv 1 "natural/man made"disasters.This is NOT a
CORRECTION NOTICE.
DO NOT REMOVE THIS TAG
MCC14.12
MASON COUNTY 360-427-9670 Shelton ext.352
360-275-4467 Belfair ext.352
COMMUNITY SERVICES 360-482-5269 Elma ext.352
n�41�wa
Building, Planning, Environmental Health,Community Health
615 W.Alder St. Bldg.8 - Shelton,WA 98584 www.co.mason.wams
CORRECTIONANSPECTION REPORT
PERMIT/CASE NUMBER�_�2-02.0-0\
ADDRESS/LOCATIONA'-�-A,:,j IV Fi rd
FINDINGS•
Items listed above must be corrected to gain compliance.
❑ THIS IS NOT A COMPLETE INSPECTION
❑ This structure has been inspected by Mason County Building Department and the items listed
above are in VIOLATION of Mason County laws and/or ordinances.
❑ Call for re-inspection when corrections are made before proceeding with any further work.
,,®'Make corrections, items will be checked on the next inspection.
❑ OK to
Date: - ❑ Please contact our office regarding possible
Department: structural damage incurred by recent
Inspector: Js� f "natural/man made"disasters.This is NOT a
CORRECTION NOTICE.
DO NOT REMOVE THIS TAG
MCC14.12
s s
Mason County
Irf'nu
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
F
0-01339 NEW SINGLE FAMILY RESIDENCE
DESCRIPTION: COVAL HOMES: NEW SFR WITH ATTACHEC ISSUED: 01/05/2021
ESS: 1473 NE MISSION CREEK RD BELFAIR EXPIRES: 07/04/2021
PARCEL: 223254491090
APPLICANT: KEESLER JEFF&MIRANDA OWNER: KEESLER JEFF &MIRANDA
1473 NE MISSION CREEK RD 1473 NE MISSION CREEK RD
BELFAIR, WA98528 BELFAIR, WA98528
360-550-8519
CONTRACTOR: COVAL HOMES OWNER'S REP: LAND 2 HOME
205 117th ST S 15333 RAINIER VIEW LANE SE
TACOMA, WA98444 YELM,WA98597
360.662.1520 360.480.8752
GENERAL CONTRACTOR'S LICENSE: COVAL HOMES License: COVALHL894QD
2023 125TH ST EAST Expires: 11/04/2021
TACOMA, WA98445
VALUATIONS: FEES: Paid Due
R-3 VB Residential, one- 1662.00 $205,556.16 State Fee-Residential $6.50
and two-family Plumbing Fees $113.00
U VB Utility, miscellaneous 506.00 $24,687.74 Plumbing Base Fee $25.00
Covered Deck/Carport 169.00 $3,718.00 Mechanical Fees $170.00
Building Permit Fee $1,912.40
Technology Surcharge $64.21
Mechanical Base Fee $30.00
Planning Review Fee $240.00
Plan Check Fee $1,243.06
Building Plan Review/Change of $110.00
Use - Onsite Sewage
Total: $233,961.90 Totals : $3,914.17
FIXTURES
Printed by:Kati Dooley on:01/05/2021 10:57 AM Page 1 of 7
Mason County
x � Mason County - Division of Community Development
615 W. Alder St. Bldg.8
�.1411,4 Shelton, WA 98584
—" 360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-01339
City Mechanical Fixtures City Plumbing Fixtures
1.0000 Gas Outlet(s) (1-5) 1.0000 Number of Clothes Washers
1.0000 Dryer Vent(s) 1.0000 Number of Dishwashers
1.0000 Kitchen Exhaust Hood(s) 1.0000 Number of Kitchen Sinks
1.0000 Furnace(s) 1.0000 Number of Water Heaters and or Vent
1.0000 Propane Tank(s) 2.0000 Number of Hose Bibs
4.0000 Spot Vent Fan(s) 2.0000 Number of Bath Tubs
2.0000 Number of Toilets
3.0000 Bathroom Sink
REQUIRED INSPECTIONS
Setback Inspection Rough- Plumbing Inspection
Footing Inspection Mechanical Inspection
Foundation Wall-Pre-Pour Inspection Insulation Inspection
Underfloor Inspection BLD-Final Inspection
Framing Inspection
CONDITIONS
* 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.
* 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.
* The foundation/footing must be placed on undisturbed, firm-native soil.
* 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.
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Page 2 of 7
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton,WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-01339
* 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.
* 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'/2 sheets. The Mason County Permit Center will also have some available.
* 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.
* Concrete used for basement walls, foundation walls, exterior walls, porches,carport slabs, steps exposed to the weather,
garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of
3000 psi (IRC Table R402.2).
I
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Page 3 of 7
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-01339
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.
2a AIR LEAKAGE CONTROL AND EFFICIENT VENTILATION2a:
Compliance based on R402.4.1.2: Reduce the tested air leakage to 3.0 air changes per hour maximum
and
All whole house ventilation requirements as determined by Section M1507.3 of the International Residential Code shall be
met with a high efficiency fan (maximum 0.35 watts/cfm), not interlocked with the furnace fan. Ventilation systems using a
furnace including an ECM motor are allowed, provided that they are controlled to operate at low speed in ventilation only
mode.
To qualify to claim this credit, the building permit drawings shall specify the option being selected and shall specify the
maximum tested building air leakage and shall show the qualifying ventilation system.
3a HIGH EFFICIENCY HVAC EQUIPMENT3a:
Gas, propane or oil-fired furnace with minimum AFUE of 94%, or Gas, propane or oiled-fired boiler with minimum AFUE of
92%
5a EFFICIENT WATER HEATING5a:
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.
5c EFFICIENT WATER HEATING5c:
Water heating system shall include one of the following: Gas, propane or oil water heater with a minimum EF of 0.91
or
Solar water heating supplementing a minimum standard water heater. Solar water
heating will provide a rated minimum savings of 85 therms or 2000 kWh based on the Solar Rating and Certification
Corporation (SRCC)Annual Performance of OG-300
Certified Solar Water Heating Systems
or
Electric heat pump water heater with a minimum EF of 2.0 and meeting the standards of NEEA's Northern Climate
Specifications for Heat Pump Water Heaters
* 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.
* 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.
* 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 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.
* 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.
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Page 4 of 7
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-01339
* All property lines shall be clearly identified at the time of foundation inspection.
* 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.
* 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 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 INVALIDATE THE APPLICATION.
* 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 181 B-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.
* 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.
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Page 5 of 7
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-01339
* 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.
* 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.
* 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/agent/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.
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.
* 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 use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not
allowed without the approval of the Mason County Fire Marshal.
* 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.
* 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.
* 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.
* Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the
structure.
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Page 6 of 7
Mason County
Mason County - Division of Community Development
615 W. Alder St. Bldg.8
Shelton, WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCE BLD2020-01339
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.
* When parcel development requires direct access to county road(s), 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.
* 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.
* When parcel development requires direct access to state road(s), 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.
* 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.
* 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.
* On-site Septic System final installation approval required prior to temporary/final occupancy of the residence.
* Horizontal setbacks per WAC246-272A-0210 must be maintained, unless prior approval is obtained
* Applicant/Owner assumes all responsibility if On-site Sewage Components are encumbered.
A.) Drainfield/Reserve requires a 1 Oft setback from all footing/foundations.
B.) Septic tank(s) requires 5ft setback from all footing/foundations.
C.) No foundation/ Perimeter Drains within 30ft, down gradient of Drainfield/Reserve area.
D.) No Cut Bank(s) (greater than 5ft and over 45 degrees)within 50ft, down gradient of Drainfield/ Reserve area.
* 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.
I hereby certify that I 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 The granting of a permit does not presume to give authority to violate or cancel
the provisionfo h ther sta ocal law regulating construction or the performance of construction.
Issued By.
Contractor or Authorized Agent: Date:
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Page 7 of 7
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PAULA Joy JOHNSON
Printed from Masan County DMS PLANNING
Name Parcel# ZZ 3 2S -?D BLD#
Mason County
BUILDIfMartment of Community Development S EP 14 20
Small Parcel Stormwater Management Application/Worksheet (page416f
Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is et
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 j X = rGD
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 =
X = Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X =
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) d
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 review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date: 7
I 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
Name Parcel# BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website:
httpHwww.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document
entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the Stormwater system adversely affects any septic system (see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at:
Phone: 360-427-9670 ext 450
100 W. Public Works Dr
Shelton.WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact 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. Mason
County Division of Environmental Health can be reached at:
Phone: 360-427-9670 ext 400
415 N. 6th St—Bldg#8 lower level
Shelton.WA 98584
A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
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 review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
Authenllslgn lD:C 9 -@D57<502-A4CJASONS M COUNTY COMMUNITY SERVICES Permit No: 00 —6't-�/�
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH.FIRE MARSHAL 41 1�w
015 W.Alder Street,Shelton,WA 98584 �`^
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
BeHair.-(360)275-W7•Phone Elms:(360)482-5269
BUILDING PERMIT APPLICATION v O
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
Q-
NAME: � ��2$4/ NAME: fftc `& Of f DNA
MAILING ADDRESS: *05716A MAILING ADDRESS: �Z
CITY: STATE:WA ZIP: gS693 CITY: y kAn STATE: W ZIP:gt!65 0.
PHONE#I: �`(o..0y50- 155 lot PHONE: CELL:
PHONE#2: EMAIL: ko�'
EMAIL: L&I REG to 'ErMsatt EXP. /_/_
PRIMARY CONTACT: OWNER❑ CONTRACTOR V OTHER❑
NAME EMAIL #
MAILING ADDRESS CITY STATE
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) ��23 w+ l d ZONING
LEGAL DESCRIPTION(Abbreviated)'f F % S E t�a OF �P'M���FIRE�DIS j 1CT
SITE ADDRESS 14n!b Ne m iW4 ii r `e /1 CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO❑ SNOW LOAD:_psf
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 V ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) MaI�Q�._„Q
IS USE: PRIMARY jg SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(whole Bldg)a YES(partial ojBldg)❑ NO❑
DESCRIBE WORK JV10 NM1Sb'Uf.'hm cZFR
SQUARE FOOTAGE:(proposed)
1ST FLOOR sq.ft. 2ND FLOOR sq.fL 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK U _sq.R STORAGE sq.ft. OTHER sq.ft.
GARAGE 15D!D sq.ft. Attached&(Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIItONMENTAL HEALTH: 51�124 ( ;i
SEWAGE/SEWER SOURCE: SEPTIC� SEWER❑ / NEW❑ WEXISTING❑
PLUMBING IN STRUCTURE? YES V NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS-_I
OW NER 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 permit/application becomes null$void if work or authorized construction is not commenced within 180
days or I 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
rF4
tLmir COUNTY CODE 14.08.42)
�e6� 08/18/2020
Sign '(Must be slaved by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT L-I -W
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
Authenlls*ID:C39A9BFE-9D57-4502-A4C3-A495084D256F
MASON COUNTY COMMUNITY SERVICES Permit No:
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL ��� V`/
�D
615 W. Alder St-Shelton, WA 98584 S>�P
• www.co.mason.wa.us
Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 , 4 2��,�
Phone Belfair. (360)275-4467• Phone Elma:(360)482-5269 615 W.
Ald
PLUMBING & MECHANICAL PERMIT APPLICATION er Street
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: e t' NAME: rrr ro-wo,
MAILING ADDRESS:IW Nf /IMi,nW-. fro& JU MAILING ADDRESS:1552 Qo ier J;e a L&44L SE
CITY: ���'�' —STATE: IIJA ZIP: q8 23 CITY: YeA^ STATE: wA ZIP: 485a-7
I"PHONE: 3100- 560- $ I� PHONE: CELL: S+ -"Q- R157
2"'PHONE: EMAIL :,P1�(,,, d, Me•ac!'Nt
EMAIL: caM L&I REG# LANX1 =6($01 EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): =2)25Lf4'Q%M Zoning: QAwp
LEGAL DESCRIPTION(Abbreviated):-11L T & Q I/?_ eE SE 5 dr SP#dnS
SITE ADDRESS: CITY: 'BalFa-Ze
DIRECTIONS TO SITE ADDRESS:
DUILDINU
TYPE O g JOB:
NEW ADD ALT REPAIR OTHER USE OF BUILDING `PP,
LOCATION OF FIXTURES/UNITS—I"FLOORS 2ND FLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric LPG_ZNatural Gas Ductless_
Toilets 2 Type of Unit No.of Units Fees
Bathroom Sink 13 Furnace
Bath Tubs Z Heat Pump
Showers Spot Vent Fan _
Water Heater I Propane Tank 1
Clothes Washer I Gas Outlets
Kitchen Sinks I Wood/Gas/Pellet Stove
Dishwasher I Kitchen Exhaust Hood —�
Hose bibs 2 Dryer Vent 1
Other Solar Panel
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 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 OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INV L/ DJTE THE APPLICATION.
X— PW Xe"&% 08/18/2020
fgK&Wdldf 0WHbr Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT /C-L'f Zri
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN