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HomeMy WebLinkAboutBLD2009-00610 SFR - BLD Permit / Conditions - 4/22/2010 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 L� RESIDENTIAL BUILDING PERMIT BLD2009-00610 OWNER: STEVEN DYKSTRA RECEIVED: 7/22/2009 CONTRACTOR: D LANE HOMES CO 1.360.830.2494 LICENSE: DLANEHC945LZ EXP:6/2/2010 ISSUED: 10/21/2009 SITE ADDRESS: 382 E RAUSCHERT RD GRAPEVIEW EXPIRES: 4/21/2010 PARCEL NUMBER: 121182400000 LEGAL DESCRIPTION: W 165' OF GOVT LOT 3 PCL 2 OF BLA#01-27 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Replacement of MFG home to Stick built ST RT 3, R ON GRAPEVIEW LOOP RD,. TURN R ON RAUSCHERT RD TO SITE ADDRESS ON THE RIGHT SIDE. SHARED DRIVEWAY WITH 380. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: VB Type of Use: SF Insp. Area: No. of Bathrooms: 4 Occ. Group: R3U Lot Size: Deck: Type of Work: NEW Fire Dist.: No. of Stories: 2 Occ. Load: Building:3,400 Garage-Attached 767 Valuation: Building Height: Occ. Status: Primary Basement: cov porch 660 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: NE 400.0 Ft. Shoreline: 105.0 Ft. Water Body: Case Inlet Rear:SW 105.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Shoreline Desig.: Urban Side 1: N 130.0 Ft. Year: Serial No.: Side 2: E 300.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee GMM 7/22/2009 $1,628.74 S12009000 Hosebibs 2 Fireplace 1 Planning Review Fee GMM 7/22/2009 $205.00 S12009000 Kitchen Sink 1 Furnace<100K 1 EH Plan Review GMM 7/22/2009 $103.00 S12009000 Laundry Tray 1 Gas Outlets 5 Building State Fee DLC 8/25/2009 $4.50 S12009000 Lavatories 6 Propane Tank 1 Building Permit Fee DLC 8/25/2009 $2,516.95 S12bb9bbb Showers 1 Ventilation Fan 6 Mechanical Permit Fee DLC 8/25/2009 $237.70 S12009000 Water Closets (Toilets) 4 Dryer Vent 1 Mechanical Base Fee DLC 8/25/2009 $28.50 S1200900o Water Heaters 1 Plumbing Permit Fee DLC 8/25/2009 $162.80 S12009000 Bath Tubs 2 Plumbing Base Fee DLC 8/25/2009 $24.70 S12009000 Clothes Washer 1 ADJUST--Plan Check Fee DLC 8/25/2009 $7.28 S12009000 Total $4,919.17 BLD2009-00610 Please refer to the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2009-00610 CONDITIONS FOR BLD2009-00610 1) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. Shoreline setback of roofl�rdinary high water mark shall be 105 feet. X 2) The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules, and the Mason County oreline Master Program. X S _ 3) All construction and demolition debris must be removed from the shoreline area after project completion. Proper disposal of construction debris must be on land much a manner that debris cannot enter or cause water quality degradation of State waters. X 4) The applic,�nt acknowledges that this development was sited such that further shore protection measures will not be required for protection of the facility. X 5) Temporary erosion control measures must be implemented to prevent water quality legradation of adjacent waters or properties. Silt fencing must be installed and maintained until upland vegetation has become established. X —� 6) 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- 982. The Dersogthiscondition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 7) All 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 Departmen n r to any further inspections being performed or approvals granted. X -- 8) Own�t' eke-pes�.thq. ned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X BLD2009-00610 Please referto the following pages for conditions of this permit. 2 of 5 9) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the 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 f proved documents will result in failure of required building inspections. X 10) The"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, then 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. X 11) Washington State Energy Code Compliance has been approved using the following: Heat Type: LP Furnace, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38. 12) Per 2003 IRC- SECTION 1609-WIND LOADS- 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIND SPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X 13) Per IRC -SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS- R905.1 Roof covering application. Roof coverings shall be applied in accord nce with th a licable provisions of this section and the manufacturer's installation instructions. X 14) 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 acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. K WK - 15) 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 roa s connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X BLD2009-00610 Please refer to the following pages for conditions of this permit. 3 of 5 16) 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 d shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X 17) All construction must meet or exceed all local ordinances and 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. X 18) 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. 19) 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. 20) 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. X 21) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks must meet the installation requirements and minimum setbacks as listed in the Mason County Fire Marshal's Standards for the Installation of Propane Tanks. X 22) All property lines shall be clearly identified at the time of foundation inspection. X 23) All building permits shall have a final inspection performed and approved by the 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. X b BLD2009-00610 Please refer to the following pages for conditions of this permit. 4 of 5 24) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder ave prevented action from being taken. No more than one extension may be granted. A This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property a d structure for review and inspection. OWN ER OR AGENT: ST R-C--Z— DATE: /'a BLD2009-00610 Please referto the following pages for conditions of this permit. 5 of 5 00 o CONCRETE MECHANICAL MANUFACTURED HOME � o Date �f (0 By Ft _--- X CD Footings l Setbacks Ribbons � Gas Piping o Inters Date By Interior-Dots L -1-'�� By%3 Data By Extenor Date )D � `t B Li o I !� Y Iii�` Exterior-Date �� - (� Set-up � Point Load I Isolated Footings INSULATIONNDate By -I BG f SLAB INSULATION M Date By Data By FIRE DEPARTMENT IG Foundation Walla Floors 9``�GJ tu'ti,� 1-1 -iQ Date BY Z Date By Data By c DECKS FRAMING wads Date By Date Z-V 'l0 8y jr Data -%(- /O BY l J PROPANE TANKS PLUMBING vault Datu By Date // - /J By J OTHER Groundwork Attic Date By Date By Type Date By D V DRYWALL Type_ Date 2 �-�� BY Int Brace Wail Date By to v Date By FINAL INSPECTION 0 w Water Lane Fire Separation / ON 9 Date Z - By Date By Date �' Z Z -�!� BY lc/ O CD to Pass or Request Inspect. :;>; c s Type of Insp. Fail Date Date Dane By Comments CD 0 j rr. 'P�ss 1d u 01 o O`r L-4/L cy�s d 1-0twr z , v 8 Q LPG=3 En J0,1S 40-l0 3a11-/a sA� L s er-F f/ti4 C %1 -,,1 a - 0 0 (4/16/2010) Debbera Coker- Re: SFR 382 E Rauschert Rd Grapeview- Porch Page 1 A' From: Debbera Coker To: hodge, john Date: 4/16/2010 1:06 PM Subject: Re: SFR 382 E Rauschert Rd Grapeview - Porch Footings Attachments: carport detail.doc, Coker, Debbera.vcf Hi John, The correction list included 9 items so it will be essential that a final re-inspection be performed. The building inspector will accept the system provided a letter prepared, stamped, and signed by you indicating that the installation is approved will need to be available during the re-inspection. The inspector's correction notice specified as follows, " at covered porch install footings per plan or provide engineer alternative." Since the "S" prepared by Hodge Engineering did not address the covered porch the plans examiner made a note concerning the footings and connection at the covered porch referencing the alternate method created by the Olympic Chapter several years ago. A copy of the detail is attached to this e-mail. Debbera Coker Mason County Building Department Building Inspector IV/Code Enforcement Phone: (360)427-9670 ext 510 FAX: (360) 427-7798 e-Mail: dlc@co.mason.wa.us PO Box 186 426 West Cedar Street Shelton, WA 98584 >>> "john hodge" <john ,hodgeengineerinq.com> 4/16/2010 9:25 AM >>> Debbera, Steve Brett of D Land Homes has asked me to review the prescriptive requirement for a 24"x24"x30" reinforced footing to support the covered porch on the single family residence at 382 E Rauschert Road in Grapeview (see attached). He has placed (13) 12x12 deck pier blocks and failed his final inspection because he didn't follow the porch block requirement on his approved plan set. I've attached the detail that was added to his plan. As it typical he needs to close the sale tomorrow. and does not have time to follow the approved plan so he wants to change the plan. And of course he has "built it this way a dozen times". I provided lateral engineering only but from an engineering standpoint the piers have enough bearing capacity and the mono trusses are attached at two locations so uplift is not a concern. Frost heave is not an issue because of the flexibility of the porch and cover. (4/16/201`0) Debbera Coker- Re: SFR 382 E Rauschert Rd Grapeview- Porch Page 2 I don't like the pier blocks but I don't see an engineering reason to not write a letter accepting his pier blocks. However, the detail was added during plan review so there may be other issues I don't know about. Do you see a problem with his use of pier blocks to support his porch and cover. John John Hodge P.E. Hodge Engineering, Inc. 2615 Jahn Ave NW Suite E5 Gig Harbor, WA. 98335 253-857-7055 fax 857-7599 Logo p- ,U ry FOUNDATION F1 Von R I i_Ou DigASSE�Y 1RC,18C ror�deman4 QD 6tRQ IglIN AT QpARZ0 1O 01!liCR(f19J RPFigt'S7� 2lIA7t C$iJi iltb CO tog P40M 7� wry , LNVERFLOG wpm j %M ram 00 A W MM ELM t�6• FOUNDATION FLOOR 5WARE i•. L itiwi 150 8"xl6" SOREENED FOUN EQUALLY 5PAGED AROUI (4/16/2010)ebbera Coker-Herstad 2009-081 Model (1).pdf _ Page 1 ti ,Y4 N'O nw' WO' V4 I eo� ec �A9 • a eoee e�wt ww se a .....60%_ s a a eae x.oR F a.� 'luilijull as i a11THA T11TWITIlliffil aaaero $ 3 e vt mac• „W „W ola I— --......_ar_ ------ ea I yr�uiRcis I a I i � I L_ I e I I F I D I �I I a a aa'1e� a a _L._........_...............___._._.._......__ .................. ............ h � O N O \. 0- �. N \ -------- _ �. r— —1 (D n N w r O LP 4,1zLo ; k LIJm o- -a- Y y i El nr-ail �2 R F i N (4/16/2010) Debbera Coker- Herstad 2009-081 Model(1).pdf Page 3 O I F Name ��'lG,)-5,--r Parcel# I ;U 1 g' y,4 "M©LV_) BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface'. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table ` ' Surface Type Length X Width = Area *All dimensions in feet Buildings X = 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 3S = S� X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition X _ above table 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) 70f . . 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.1 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: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 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: httl2Hwww.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 prop rty for review and inspection as may be required. X Owner/Agent/ ontractor ircle one)Date: C Page 2 of 2 c � SMALL PARCEL STORMWATER SITE PLAN WRITTEN DESCRIPTION Owner: Steven & Cheryl Dykstra Mason County Tax ID: 12118-24-00000 The site is a waterfront site located at the northern end of Pickering Passage. The lot is a 5 acre parcel 2/3`d of the property is forested with 1/3`d cleared and planted in mature lawn and grasses. '/2 the site general slopes gently (approx5%-15% slope) to the west toward the bay. The site will not require any clearing for the new home since the site was cleared for the a mobile home back in the 60s. The family has been using the property as a summer home for the entire time. The site has an existing and functional 3 bedroom septic system installed in the 1987 and a drilled well installed in 1997 The new home will replace the existing mobile home. The new home will be 104 feet from the normal High Water Line on the water front. The driveway will be 10 feet wide by 440 feet long. All 440 feet is existing driveway used to access the existing residence on the property (a single wide mobile home brought in the 60s will be removed). The new impervious surfaces are: Roof(2820 sq ft) Parking Pad (1050 sq ft) Total new impervious surface 3870 sq ft. All stormwater flows will be dispersed through vegetation. All stormwater will remain on site. All downspouts for roof runoff will be directed to a Dispersion Trench downhill of the new home and drainfield. All parking pad and roof drainage will be hard piped to a type one catch basin then directed to three 20 foot dispersion trenches, laid in along the slope contours(slope less than 3%) in an area below the new home. All dispersion trenches will be set a minimum of 100 feet from the normal high water line of the waterfront. The existing driveway runoff will be allowed to sheet off to the northwest, as it has been, into the existing grasses along the driveway. The entrance road is an existing easement (several thousand feet from subject site, that accesses off E Rauschert Rd. E Rauschert is a Mason County maintained Road with a county maintained drainage ditch and proper driveway culvert. In order to prevent erosion and trap sediments within the project site, the following BMPs will be used approximately as shown on the site plan. 1. Clearing limits are not required. The site is cleared and stabilized with grass vegetation. 2. The existing driveway will have a new layer of inch crushed rock laid down 3"-4" thick and mechanically compacted to create an all-weather driveway. 3. The only exposed dirt will be the area immediately around the new home foundation. This is a relatively small area. The area is over 100 feet from the shoreline and is a relatively flat area. The dirt will be mechanically compacted to minimize erosion. And a air dried straw mulch will be laid down 6"thick. c � 4. The construction entrance and easement road at E Rauschert Rd is existing. The easement road bed is 1 '/2 " crushed rock compacted. This road runs for several thousand feet to the subject site. x t t At oo ao yP pl- I �, Ol f j t J� ; + ! ;fir p °• G � t i .>•\ v i /j 4 � �l,a,� ,�+ C�RAs �S t I < Ia QJ FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO.�bld2W' -C_OLO1 n PLEASE PRESS HARD BUILDING PERMIT APPLICATION A I I.An 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATJQN CONTRACTOR INF RMATION Owner ST Ev+=-nc V-- C H CRY Z 1J Y/zsrQA Company Name C o Mailing Address 379 A1W CRNYON Rp Mailing Address q-+4/S RZPEA1Lm oW Q2NW CityBrtewe..,rayai state WA Zip Code 9 31 City $(2eni%t2rzWState 1A Zip Code ': eYeYSU Phone,I&O'L/79—yy-C`-/ Other Ph. Phone 2&0-50-7 —Y31/ Other Ph. Lien/Title Holder 5Qs").7 P" As aaoyk_= Contractor Reg. # � Exp. ., a+ a-Q/5 E mail address --- E Mail Address R LIT Drivers Lic.# DOB Drivers Lic.# D SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. eo Fire District Legal Description - la_i4TT A C"i;-� Site Address(Please include street name, street number and city) fl&4.A:C14C—r1 &IAPF U: Fay Directions to site Gi'r-lPi' L'1 E w LQoL� Rc_:> o r iznLt<r'NE T 2u TJ A9 tOrIE S a6/ a Will timber be cut and sold in parcel preparation?Yes ALOD Is property within 200' of Saltwater _ Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o TYPE OF JOB - New_"_Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑ Use of Building --S_P(Z. Describe Work /ol�'i c,/ G_ No. of Bedrooms—No. of Bathrooms —?%2 Square Footage- 1st Floor 14428 2nd Floor t 3rd Floor Basemen 7 Deck Covered Deck�0Other Sq. ft. Garage `� _ Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/ No Installer Name Certification No. 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 the contractor. I further declare that 1 am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other parry in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure 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 OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF MSILL INVALIDATE THE APPLICATION. X - p F�/ Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: e4 U Date -22-09 DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department 5E�2-co G)nO20 ' S P I Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES F MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar- P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670- Belfair(360) 275-4467- Elma (360) 482-5269 On the web www.co.mason.wa.us F T INFORMATION CONTRACTOR INFORMATION t_ a Company Nameres !VW OSE A/ Mailin Address Qcu Dt2 Nr' MEA10ALState Zip Code City �R4=t, State — Zip Code Phone 3Cv0- y 731-&'y5fj Other Ph. Phone 3CvU-SGx7 "'4-�/l Other Ph. Lien/Title Holder S41mr= A--, )430uP_a Contractor Reg.#tUAWENC gYSL - Exp. - E mail address E Mail Address Drivers Lic.# --- DOB Drivers Lic.# - - DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. t -LSO 00 Fire District Legal Description zSPP_ gT-r-Ar t-/Ef'�% _ Site Address (Please include street name, street number and city). S& L 12 AU Sc Fi fL- f i- , C-jfi-40,_:, Directions to site. (2— 7'd E 24ur g. 149= t2� y� l�barz ,. ^��.� Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units - 1st Floor. 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture 4p. of Fixtures Fees Fuel Type:Electric_ LPC_ Natural Gas_ Heat Pump_ Toilets \ Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs �_ Heatpumps Showers ,� f Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other jcti6ti Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other parry in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. t2 Date: X Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYO DTHIS POINT Accepted by: Planning Pd Ck# Date ` 72 U`-' Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group-Type Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO.fAK 1 PLEASE PRESS HARD BUILDING PERMIT APPLICATION 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 Shelton (360)427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner .1 ; Company Name Co . Mailing Address ?`/ 0 M(' Mailing Address "r`' 7 Q Nw Cityrvt +.7r✓�r State� �Zip Code City i4 c r, o p. r0% State Zip Code :Y �l_,,./�t7'1 1'7'_. y.�'"x. 1,-0 5y :i/ Phone _" J Other Ph. Phone /}L Other Ph.� ���� - Lien/Title Holder Contractor Reg. ,- = Exp. o>< . OiC' E mail address E Mail Address/? 17f acAd ' Drivers Lic. # DOB "" Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well " Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. -Fire District Legal Description �& C -'} W r I- ==Site Address (Please include street name, street number and city) E 12gr�t C Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200'of Saltwater _ Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 115% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New _Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building F& Describe Work No. of Bedrooms No. of Bathrooms //" Square Footage- 1 st Floor ; =} 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/ No Installer Name Certification No. 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 the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure 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 OFAPROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. T7"" aw '""" J X yrf=,..,f,r=�/,.� Date: Owner/Owners Representative/;Contractor. (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department kkO J Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee �O Plumbin & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES