HomeMy WebLinkAboutBLD2021-00968 SFR ADV2021-00145 - BLD Permit / Conditions - 9/27/2021 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
B DD2021-00968 NEW SINGLE FAMILY RESIDENCE
PROJECT DESCRIPTION: NEW SFR ISSUED: 09/27/2021
SITE ADDRESS: 81 NE DAVEY JONES PL BELFAIR
EXPIRES: 03/26/2022
PARCEL: 123305000043
APPLICANT: RJ PEABODY INC OWNER: RJ PEABODY INC
PO BOX 565 PO BOX 565
BURLEY,WA 98322 BURLEY,WA98322
1.253.514.3915
GENERAL CONTRACTOR'S LICENSE: RJ PEABODY INC License: RJPEAP1861DU
P O BOX 565 Expires: 11/18/2021
BURLEY,WA98322
360-895-3235
VALUATIONS: FEES: Paid Due
R-3 VB Residential, one- 1410.00 $174,388.80 Building Permit Fee $1,678.32 $0.00
and two-family Building Plan Review/Change of $120.00 $0.00
U VB Utility, miscellaneous 400.00 $19,516.00 Use-Onsite Sewage
Uncovered Deck 96.00 $1,440.00 Plumbing Base Fee $25.00 $0.00
Planning Review Fee $240.00 $0.00
Plan Check Fee $1,090.91 $0.00
Mechanical Base Fee $30.00 $0.00
State Fee-Residential $6.50 $0.00
Technology Surcharge $60.34 $0.00
Mechanical Fees $78.00 $0.00
Plumbing Fees $115.00 $0.00
Total: $195,344.80 Totals : $3,444.07 $0.00
FIXTURES
Qty Mechanical Fixtures (sty Plumbing Fixtures
1.0000 Dryer Vent(s) 1.0000 Number of Hose Bibs
1.0000 Furnace(s) 1.0000 Number of Bath Tubs
1.0000 Heat Pump(s) 1.0000 Number of Clothes Washers
Printed by:Genie Mcfarland on:09/27/2021 11:43 AM
Page 1 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 RESIDENCEBLD2021-00968
f3ty Mechanical Fixtures Qty Plumbing Fixtures
3.0000 Spot Vent Fan(s) 1.0000 Number of Dishwashers
1.0000 Number of Kitchen Sinks
1.0000 Number of Showers
1.0000 Number of Water Heaters and or Vent
3.0000 Bathroom Sink
3.0000 Number of Toilets
REQUIRED INSPECTIONS
Setback Inspection Framing Inspection
Footing Inspection Rough Plumbing Inspection
Foundation Wall-Pre-Pour Inspection Mechanical Inspection
Underfloor Inspection Insulation Inspection
Shearwall Inspection BLD-Final 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.
* The foundation/footing must be placed on undisturbed,firm-native soil.
* 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.
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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 RESIDENCEBLD2021-00968
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).
" 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.
* 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.
* 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.
* 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.
Fuel Normalization Credits: Table 406.2
V-Heat pump
Table 406.3—Energy Credits (Single Family)
1.2- Prescriptive compliance is based on Table R402.1.1 with the following modifications:
Vertical fenestration U =0.20
,2f�Compliance base on Section R402. 1.2: Reduce the tested air leakage to 2.0 air changes per hour maximum at 50
Pascals or for R-2 Occupancies, optional compliance based on Section R402.4.1.2: Reduce the tested air leakage to 0.25
cfm/sf maximum at 50 Pascals and
All whole house ventilation requirements as determined by Section M1507.3 of the International Residential Code or Section
403.8 of the International Mechanical Code shall be met with a heat recovery ventilation system with minimum sensible heat
recovery efficiency of 0.65. 1
5.5-Water heating system shall include one of the following: Electric heat pump water heater meeting the standards for Tier
III of NEEA's advanced water heating specification or For R-2 Occupancy, electric heat pump water heater(s), meeting the
standards for Tier III of NEEA's advanced water heating specification, shall supply domestic hot water to all units. If one
water heater is serving more than one dwelling unit, all hot water supply and recirculation piping shall be insulated with R-8
minimum pipe insulation. 5
* 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.
* 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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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 RESIDENCEBLD2021-00968
" 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.
" 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.
* All property lines shall be clearly identified at the time of foundation inspection.
" 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.
* 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 handler and all ducts are located within the heated space.
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Page 4 of 7
Mason County
Mason County - Division of Community Development
'°h r 615 W.Alder St. Bldg.8
Shelton,WA 98584
360-427-9670 ext 352
www.co.mason.wa.us
NEW SINGLE FAMILY RESIDENCEBLD2021-00968
* 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.
* 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.
* 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.
* 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.
* Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the
structure.
* 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.
* 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.
* 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.
* 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.
* 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.
* 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.
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Page 5 of 7
Mason County
x
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 RESIDENCEBLD2021-00968
' 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.
* 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.
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.
* 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.
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.
" 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.
" 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.
" 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.
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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 RESIDENCEBLD2021-00968
* 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 S3 designate GARAGE PORTAL WALL
(5/D1)and MUD SILL ATTACHMENT 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,
WA98584 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.
" T1-11 TO BE USED AS SHEAR PANELS MUST BE RATED AND STAMPED (APA RATING) FOR SUCH USE. PLEASE
REVIEW NOTE 15 UNDER SHEAR WALL NOTES FOR ADDITION INFORMATION. DOCUMENTATION MUST BE
AVAILABLE ONSITE AT TIME OF SHEAR WALL INSPECTION STATING COMPLIANCE OR APA STAMPS MUST BE
VISIBLE. PLEASE CONTACT THE ENGINEER OF RECORD FOR ADDITIONAL INFORMATION OR APPROVAL OF
ALTERNATE MATERIALS.
IF DOCUMENTATION IS NOT PROVIDED OR STAMPS NOT VISIBLE INSPECTION WILL RESULT IN A FAIL UNTIL
COMPILANCE IS MET.
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 not. The granting of a permit does not presume to give authority to violate or cancel
the provisions of any other�state/local law regulating construction or the performance of construction.
er
Issued By: C% _.n '
Contractor or Authorize A ent: Date: Z- ` Z
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Page 7 of 7
Name ] PQc�(i� Parcel# j
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Mason CountyDING
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Department of Community Development
Small Parcel Stormwater Management Application/V icAsheet (page 1 of 2)
Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development, or redevelopment',with more than 2,000 square feet of impervious 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.
'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 3y X 1002O
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways 52 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) qq J
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 Storinwater Site Play: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 Zttg f==7 Owner/Agent/Contractor(circle one)Date:
If the Total Imp rvious 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
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MASON COUNTY COMMUNITY SERVICES Permit No:, [l rL<a,-009(,OT
PERMIT ASSISTANCE CENTER: pg. " r---' ,' +
.BUILDING•PLANNING•PUBLIC HEALTH.FIRE MARSHAL RE�E +L` =�
615 W.Alder Street,Shelton,WA 98584 (�ryq
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone J U N 2 2 2021
4D Beltair:(360)275-4467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLI6A*I&NdC", S`;
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: ►�� �QQbo LXl NAME
MAILING ADDRESS: MAILING ADDRESS: VO
CITY: STATE:11311PI ZIP:01z CITY: STATE: ZIP: 'a
PHONE#1: -s 3a PHONE:Of _Z 5 3 Zu -Vzol S it
PHONE#2:90,o gag 4S 1 I'1 EMAIL:� "Gt eS4Q YY�S 1fl•C.&T%n
EMAIL: L&I REG*4 EXP.
PRIMARY CONTAC : OWNER❑ CONTRACTOR❑ OTHER
NAME EMAIL
MAILING D SS CITY STATE ZIP
PHONE-47!)n -_!)IL4 villi CELL Y)N0--i -
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) ZONING
LEGAL DESCRIPTION(Abbrcviatcd) FIRE DISTRICT
SITE ADDRESS \ �� d CITY LP
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOW-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 YY. ADDITION❑ ALTERATION❑ REPAIR❑ OTHER El
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) f_S
IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(Nhole Bldg)0 YES(Part(sl of 8hig)❑ NO❑
DESCRIBE WORK(I�i i_-) PjfiA S F�Z
SQUARE FOOTAGE: (propnced)
1 ST FLOOR��sq.ft. 2ND FLOOR'%10 sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK_sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGELJ00___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
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTI SEWER❑ / NEW VL EXISTING❑
PLUMBING IN STRUCTURE? YES NO❑ Ijves,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER acknowledges that submission of Inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such Is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This 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 ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x A2 r.l1.1 f 2O21
Si ature of OWN (Must be signed by the OWNER) �� Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT -iJ-xi
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit,No�l� 1 -00 �
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL
615 W.Alder St- Shelton, WA 98584 JUN 2 2 2021�. ��
c4i:l www.co.mason.wa.us I L D Y`�
Phone Shelton:(360)427-9670 ext. 352• Fax:(i9619j4 ' °71@r Str
Phone Belfair. (360)275-4467• Phone Elma:(360)482-5269
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: NAME: C.,
MAILING ADDRESS: MAILING ADDRESS: S
CITY: 1 h STATE:W\q- ZIP: $3aa CITY: g STATE: W V} ZIP:g 3 aa�
Is`PHONE: '56o %A-5 3235 PHONE: aagS it12"d PHONE:ZO� aaq rjtl-1 EMAIL :tj 1rC � ELL:01b(o
St•aFt V-nsn• cc,,
EMAIL: rem\{5 YYlStr1 ,CCJrvi L&I REGI EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): 0 •QC)Q L4 S Zoning:
LEGAL DESCRIPTION(Abbreviated): C
SITE ADDRESS: CITY: 2)R L9 CA "
DIRECTIONS TO SITE ADDRESS. i-n Iri
onn
TYPE F JOB:
NEW NQ ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS— I ST FLOO�2ND FLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_
Toilets Type of Unit No.of Units Fees
Bathroom Sink 'S Furnace 1
Bath Tubs I Heat Pump
Showers t Spot Vent Fan
Water Heater 1 Propane Tank
Clothes Washer 1 Gas Outlets
Kitchen Sinks I Wood/Gas/Pellet Stove
Dishwasher I Kitchen Exhaust Hood I
Hose bibs 1 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 1 am entitled to receive this
permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of
interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of
Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void
if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION.
X (o(Ig I 2021
Signature of ner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE I TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT I/
PLANNING DEPARTMENT
FIRE MARSHAL
Rev: 112712016 IBN
1 MASON COUNTY Mason County Permit Center Use:
COMMUNFIP
ADV
Building,Planning,EnvironmentalHea&:;C muniryHealth
615 W.Alder St.—Bldg.8,Shelton,Wa 98584 Date Rcvd JUN 2 2 2021
Phone:(360)427-9670 ext.352♦Fax:(360)427-7798
Fee: $130.00
Request for Administrative Variance for
Reduction in the Required Setbacks
For administrative review,the minimum variance on a setback request is 5 feet.from the side yard lot
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.
ff
Applicant/Owners: �� ��� � l P'1
Mailing Address:
� � c
City: 272AI State: IJU Zip:
Telephone: '
Email: ay) Oa ry)C IC < < C CND
If this reduction is tied to a building permit,please give permit case number.
BLD c)CQk -�n4
Parcel Number(s): U " �J Zoning
Site Address: I V1 (F
Requested setback variance:
ft. ❑ Front ❑ Rear Side
ft ❑ Front Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ 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.
FRONT AND OR REAR YARD REDUCTION REQUESTS:
For existing 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;
❑ d) lot size of no more than one-fourth acre;
❑ e) existing improvements of buildings, septic systems, and well areas.
SIDE YARD REDUCTION REQUESTS:
For existing lots of record as of March 5, 2002;
You must 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;
Cl c) lot width at the front yard line of no more than 50 feet;
❑ d) lot size of no more than one-half acre;
✓' 'e) existing improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal from meeting the
setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
c� yCO� LC nC-L
Owner/Agent(please indicate) I
Signature Date
Official Use Only
Approved by: c Date
Denied by: Date
Reason for denial: