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Home My WebLink AboutBLD2023-00355 Final Garage - BLD Inspections - 3/8/2024 615 W.Alder St.Bldg 8,SHELTON,WA 98584 MASON COUNTY COMMUNITY SERVICES SHELTON:360-427-9670,EXT 352 BELFAIR:360-275-4467,EXT 352 Budding,Planning,Environmental Health,Community Health 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 hp Permit Number BLD2023-00355 Date Issued 05/19/2023 Issued Project NEW DETACHED GARAGE Site Address 2673 E MASON LAKE DR EAST �Jt Applicant SCHULBACH KARL A&ROBIN Contractor Contractor Phone Primary Code UPC IBC,IRC,IFC,IEC,IMC,& Type Permit Type GARAGE/STORAGE 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 Building Official: Community Services Designee Department Concrete Setbacks Slab Footing Perimeter Point load Footing Footing Interior Footing Decks/Porches Foundation Stem Walls ,_L_ Other Rough-In Groundwork Plumbing Framing Groundwork Mechanical Plumbing Groundwork Gas Pipe Mechanical Gas Piping Shear Wall Nailing Underfloor (' -ZUt IANO-�CS O Other Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Interior Wall Brace Panels Fire Walls Nailing Other Final Building 6 Manufactured Setbacks Setup Home Concrete Foot/Runners Final Other Mason County Mason County - Division of Community Development iqp 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BL 22023-00355 GARAGE/ STORAGE PROJECT DESCRIPTION: NEW DETACHED GARAGE ISSUED: 05/19/2023 SITE ADDRESS: 2673 E MASON LAKE DR EAST GRAPEVIEW EXPIRES: 11/15/2023 PARCEL: 222335200057 APPLICANT: SCHULBACH KARL A&ROBIN OWNER: SCHULBACH KARL A&ROBIN 2673 E MASON LAKE DR E 2673 E MASON LAKE DR E GRAPEVIEW,WA 98546 GRAPEVIEW, WA98546 1.360.545.1001 VALUATIONS: FEES: Paid Due U VB Utility, miscellaneous 864.00 $57,438.72 Plan Check Fee $495.31 $0.00 Planning Review Fee $240.00 $0.00 Change in Tenant- Minor EH $130.00 $0.00 Plan Review State Fee-Residential $6.50 $0.00 Technology Surcharge $25.15 $0.00 Building Permit Fee $762.02 $0.00 Total: $57,438.72 Totals : $1,658.98 $0.00 REQUIRED INSPECTIONS Setback Inspection Shearwall Inspection Footing Inspection Framing Inspection Foundation Wall-Pre-Pour Inspection BLD-Final Inspection CONDITIONS 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. * The foundation/footing must be placed on undisturbed, firm-native soil. Proper frost depth shall be observed below grade in undisturbed soils. Printed by:Amber Selby on:05/19/2023 09:28 AM Page 1 of 5 Mason County Mason County - Division of Community Development 615 W. Alder St.MFBuilding 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov GARAGE/ STORAGE BLD2023-00355 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. * 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. * 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. * 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. * 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. * 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. * 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. * All property lines shall be clearly identified at the time of foundation inspection. * 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. * 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. Printed by:Amber Selby on:05/19/2023 09:28 AM Page 2 of 5 Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov GARAGE/ STORAGE BLD2023-00355 * 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. * 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). * 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 county road(s), a Road Access Permit or Approval must be granted by the Mason County Department of Public Works. 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. 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. * 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. * 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. * 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 contact the Mason County Public Works Department prior to construction at Ext 450. * 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. * 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. * 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. * 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. Printed by:Amber Selby on:05/19/2023 09:28 AM Page 3 of 5 Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov GARAGE/ STORAGE BLD2023-00355 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. 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. * 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. * 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. * 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. * This structure is approved as unheated space. To be considered unheated space the area may be provided with a heating system that does not exceed maxium output of 1 watt per square foot., or 3.4 Btu/h per square foot. A permit and approval is required prior to installation of any heating system. When a heating system exceeds 1 watt per sq.ft (or 3.4 btu/h per sq. ft)the heated space shall be insulated in accordance with the energy code in effect at the time of permit application. * Setbacks are measured from the furthest projection of the structure. * 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. Printed by:Amber Selby on:05/19/2023 09:28 AM Page 4 of 5 Mason County Mason County - Division of Community Development 615 W. Alder St. .�. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov GARAGE/ STORAGE BLD2023-00355 I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws nd Ordinan s governing this type of work will be complied with whether specified here' or no . The gr nt'7 f a permit does not presume to give authority to violate or cancel the provisio f ny they st2lte/ I law regulating construction or the performance of construction. Issued '11 4 Contrac or or Authorized Agent: ✓11 . Y-,c"At-t Date: lGi f�i� Printed by:Amber Selby on:05/19/2023 09:28 AM Page 5 of 5 RR5 Zoning Existing Tanks NAP Front Yard Setback. 25'. p� 4j Side& Rear Yard Setbacks. Residential dwelling N and accessory structures is 20'. New dition � �2( '� OR 10%width of lot if not more than 100'wide ti OR approved ADV o m s �rylO r3td2c�23- to3 5 h �ry �� ryry Power Line � �\ 05/01/2023 ro Y $ 14 Water Line APPROVED r \p \ / r/ -Weil MASON COUNTY DCD PLANNING 5007T RUEDY,Atop \ se 1 New Garage 41 4 Digitally P signed y` , Scott Ruedy b Scott t / �\ 23�j Ruedy \Se,v 1 /r ..� I sve;4 it Se/4 C lC Eac/s se 't? / \ e t/79 Oyye s G\ `� / \ �O. Existing House / w P Existing Garage- c\B ay s `\ / \�4/4 EH APPROVED Rhonda Thompson 05/16/2023 \ Se/C !�\ \aS\ / 58 EH Setbacks __ _ s A.) Drainfield/Reserve requires 10'setback from footing/foundations —— -_ \ e -! L 4- B.)Septic tank(s)requires 5'setback from all footing/foundations Set Sack Lines \-- e/d C.)No foundation/Perimeter Drains within 30ft,downgradient of Se Drainfield/Reserve area Property Line— /� r Redo 8• D.)No Cut Bank(s)(greater than Sft and over 45 degrees)within \ A;tie 50ft,down gradient of Drainfield/Reserve area sewer Line Se/� *,y 235' �'�a 4 of Site Plan Scale: 1 " = 40' Site Address: 26'73 East Mason Lake Drive East Parcel #22233-52-0005'7 A �o SELBY DE51ON LTD OPSION FOR: i7 Address: 2613 E. Mason Lake Dr. E 5 w � POg6 P.O.150> 113 Belfair,vqa 98528 Kar! 8e Robin SGhuibaeharch 24, 2023 �]G unuw.selbydesignitd.com 360-649-1826 Grapeview, NaWa 98546 C w ` Name )<u t- 1 S��l y�b u�� Parcel#_I-L- 3 3 S Z 0 00( s J BLD# � '61) Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment', with more than 2,000 square feet of impervious 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 g X = 106fI- 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) 12— 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 �? — wn Agent/Contractor(circle one)Date: 2b M4:v' zo 2^--3 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. Pagel 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: http//www.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 Mail:P 0 Box 1850,Shelton WA 98584 Physical:415 N 6th St, 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. 352 Mail:P 0 Box 1666,Shelton WA 98584 Physical:426 W Cedar St,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 SON Coup MASON COUNTY COMMUNITY SERVICES 7 err. ll rt PERMIT ASSISTANCE CENTER: Permit No:}� L%c D •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone APR 0 3 2023 Belfair.(360)275-4467•Phone Elma:(360)482-5269 IXu BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAMEA AN I Sc li d b a e,11 NAME: K c4 t,.l SCW b u c l MAILING ADDRESS: 167 3 E t4&U,, L K 06 E MAILING ADDRESS:2E7 3 - MNf'o:,% LIC OV CITY:C L e p o y i a w STATE: ZIP:q CITY��o u i C w STATE:lei[ 1A ZIP: `/�' PHONE#l:r3,6 D +73` 741-4- PHONE:-36h f:4F5-100 CELL:3Uo 4'73-74q24 PHONE#2: 60 45" 0o1 EMAIL: l<AF,(-3 4 47 r@ L1V(.C.yM EMAIL: I(A RL 14+:1 R L I U C_-. C-OAA L&I REG# EXP. PRIMARY CONTACT: OWNER® CONTRACTOR❑ OTHER❑ NAME I -1 EMAIL 1<el t.1 1-4. 4- (9 L 1 V CbM MAILING ADDRESS -167 3 C fAuj r LK Qc CITY .Y Fv cw STATE t-h ZIP 9BS+;I� PHONE 340 4-71 y24- CELL �• PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 'L-L .i 7- q0oS7 ZONING R uLItl R P_fe A-h LEGAL DESCRIPTION(Abbreviated) tgt 57 a Q A.4 t t FIRE DISTRICT -5- SITE ADDRESS Z d`j :7 G A4�I Ste,. Lk D t- C- CITY v w DIRECTIONS TO SITE ADDRESS 3 ti~b /V►��;� a>4{ I i�t+ 6I. E N1ct,,Ty llL D� C �h_c4el,arai�S_On !Q IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO% IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE N RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW® ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) CILI,% I IS USE: PRIMARY R SEASONAL❑ NUMBER OF BEDR66MS 0 NUMBER OF BATHROOMS b HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part[s]of Bldg)❑ NO DESCRIBE WORK SOUARE FOOTAGE:(propose+existing) I ST FLOOR bq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK -' sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE t5g- sq.ft. Attached❑ Detached k CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE tJ/A. MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC® SEWER❑ / NEW❑ EXISTING[X] PLUMBING IN STRUCTURE? YES❑ NO If yes,attach completed Water Adequacy Form PERIMETERIFOUNDATION DRAINS PROPOSED? YES fi NO[] EXISTING SQ.FT. 564- EXISTING BEDROOMS 0 PROPOSED BEDROOMS 0 TOTAL BEDROOMS O 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 decare 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 stnicture(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�*4�e A&&:c Z,v A-►e-,t- Z01L3 Signature of OWNER(Musl be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENTDEC- Y•to-Z3 PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH