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HomeMy WebLinkAboutBLD2008-00149 DDR2008-00094 Cancelled MFG Home - BLD Permit / Conditions - 12/16/2008 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 z r Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2008-00149 OWNER: BIGI LIZOTTE RECEIVED: 2/7/2008 CONTRACTOR: SOUTH SHORE CONSTRUCTION 360.275.0818 LICENSE: SOUTHSC016N2 EXP: 3/13/20 ISSUED: 6/16/2008 SITE ADDRESS: 4203 E GRAPEVIEW LOOP RD GRAPEVIEW EXPIRES: 12/16/2008 PARCEL NUMBER: 121082290120 LEGAL DESCRIPTION: LOT: 1 OF SP#562 PTN TR 12 OF NW NW PROJECT DESCRIPTION: DIRECTIONS TO SITE: MANUFACTURED HOME GRAPEVIEW LOOP ROAD AT AlN FOLLOW TO 4201 GRAPEVIEW LOOP ROAD, FOLLOW DRIVEWAY PAT XISTING HOUSE TO PROPERTY IN BACK General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: r-3 bont: Deck: Type of Work: NEW Fire Dist.: 3 No. of Stories: 1 Occ. Load: Valuation: Building Height: Occ. Status: rim Manufactured Home Information Setback Informa n Shoreline&Planning Information Make:CHAMPION Length: 71 t. Front: S 313.0 Ft. S reli Ft. Water Body: SEPA?: No Model:CHUCKARE Width: 27 Ft. A2: 10 Ft. lope: Ft. Shoreline Desi Si2210N. 9�� Not Applicable Year:2008 Serial No.: Si1 .0 Comp. Plan Desig.: Rural Plumbing Fixtures h ical Lures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee TAM 2/7/2008 $247,00 B12008000 Planning Review Fee TAM 2/7/2008 $190.00 612008000 Address Fee BLF 2/13/2008 $162.00 S22008000 Mobile Home Issuance Fee ARC 2/13/2008 $247.00 S22008000 Fire Warden Review DHS 2/15/2008 $68.00 S22008000 EH Plan Review ADR 6/12/2008 $100.00 S22008000 Water Adequacy Plan Review ADR 6/12/2008 $40.00 S22008000 Total $1,054.00 BLD2008-00149 Please refer to the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2008-00149 CONDITIONS FOR BLD2008-00149 1) 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. X , �"a. 2) 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. X F n'';� 3) 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 have prevented action from being taken. No more than one extension may be granted. X _E.X 4) 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 �ynty ordinances and building regulations. b 5) All property lines shall be clearly identified at the time of foundation inspection. X 6) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. 7) 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,sh�l be made prior to requesting additional inspections. X BLD2008-00149 Please refer to the following pages for conditions of this permit. 2 of 6 9) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance 0 .regulation, must be reviewed and approved by Mason County prior to construction. X ` ` /r T 9) 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. X 10) Permanent Address must be posted and visible from the road Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails must be in good condition and meet code for year built or current code if replaced. Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit Gutters and downspouts must be installed with splash blocks provided All exterior penetrations must be sealed HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24" above grade. The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4 panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection. All conditions on the original or issued permit must be met If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available It shall be the responsibility of the person requesting the inspection to provide the manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection. Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an inspection is requested and required items are not completed prior to the inspection being performed ENFORCEMENT PROVISION: Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action and subsequent violation and penalties pursuant to the Mason County Code. X 11) This permit is for the placeTent and installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X BLD2008-00149 Please referto the following pages for conditions of this permit. 3 of 6 12) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy (Final Inspection)will be granted for the residence. OWN ER/CONTRACTOR(indicate which) Signature XJ% 13) 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 revocal;ion._a> 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/contractol_.i5.agknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X ' 15) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. 16) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or installed. certification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X,_ 17) 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 Buildingg epaqment prior to any further inspections being performed or approvals granted. X 18) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X d , BLD2008-00149 Please referto the following pages for conditions of this permit. 4 of 6 19) 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 "AP PROVED",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 approved documents will result in failure of required building inspections. X •__. -._ 20) 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. X :L 21) 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 Department prior to any further inspections being performed or approvals granted. X �' c 22) 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. X 23) 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. X �, 24) 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 1-80Q-6�7-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X `a f., 25) Approve ,per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X_, 26) Completed site visit and found driveway not up to Mason County Building codes Chapter 14.17. Drive way too narrow.not enough clearance under trees and neegs compact surface material to suport load of Fire Equipment .Also will need to reinspect driveway for correct turn around at home site. X e '`¢ 27) OWNER MUST SHOW PROOF QF WELL LOG AND SATISFACTORY WATER SAMPLE PRIOR TO TEMPORARY/PERMANENT OCCUPANCY OF THE RESIDENCE. X 28) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X .S7 BLD2008-00149 Please referto the following pages for conditions of this permit. 5 of 6 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 and str a for reui"and inspection. OWNERO GENT•: _%� / DATE: <� 7 BLD2008-00149 Please refer to the following pages for conditions of this permit. 6 Of 6 W o CONCRETE MECHANICAL MANUFACTURED HOME N o _.----- C) Footings J Setbacks Date By Ribbons 0 90 Gas Piping o Intenor Date By interior-Date By Date By m Extenor Date By Exterior-Date By Set.up Point Load 1 Isolated Footings INSULATION _ Date By � BG/SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Wails Floors ~� Date. By Date By Data By DECKS FRAMING Walls . Date By Date By Data By PROPANE TANKS PLUMBING vault Data _._._._..._. By Date By OTHER Groundwork Attic Type- Date By Date By Date By D.w.v DRYWALL Type. InL Brace Wall Date By W Date ey Date By FINAL INSPECTION 0 w Water Line Fire Separation Date By Date By Date By p CD do Pass or Request E Inspect. ! c Type of Insp. Fail Date Date Done 6y Comments 0 to CD v a 8 _ Q 0 O S CA (D El (I E E 0 ACCESS & GRADE INSPECTION PERMIT 404 S--601LI ADDRESS INSPECTOR DATE: DRIVEWAY ACCESS Length: - C, Width: Surface: Size of turn-around: G Condition of shoulders: Vertical clearance: ��( � need post at end of driveway wit reflective address numbers C J* GRADE,OF DRIVEWAY "> %, OF ROAD ROAD ACCESS Length: Width• Surface: Condition of shoulders: Vertical clearance: ( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. ( ) LOT INSIDE SMZ, 4X4 FIRES ONLY. ( ) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES 2x3 FIRES. REMARKS (continue remarks on back) A 0 a5�, �71 �� l2/ 61;.2�2 `-V)20 Name �J Parcel# 2/0 2 BLD# Mason County Department of Community Development Small Parcel Department 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. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. ...:.:....................:............... .:: ...i.:.... ......:::::::...r:.�:::..::...::::::::::::::.::.�.:::................................. ... :: :I IY::.:::!::,:: � t!x .:P + :.; i:' " :.::::.i:.i:.i,:.i:.>:.::.....::!..... . .................. Surface Type Length X Width = Area 'All dimensions in feet Buildin s X = X Measurements for buildings are taken at the X = perimeter of the farthest projections (example: eaves/gutters) X = Ddvewa s X = X = Length of drive begins at the right of way X = Parking Areas X = X = T"IE Any paved, gravel or packed area per definition X above table Patios/Walks X X _ Any paved, gravel or packed area per definition X = above table iYYli'riiiiT::i?ii;{{?S'?:'i': i.Y'ti?iSi';'r,:i•i�::::?'iii?i v Others- X :::.:?:.,y.::.?•!,::??:.i'!`i:%:<.;'.r..?;:.rii:•i?:!.><::?:;!•?:•?><::::::::::iS::<:Y:::;ti.::::::;i..:.?:•rf•:r•Y:•::.:ii:;!.:::;:: Xi:i2F!ii °SVSAi'kS�:..;:.,.',;:::..i::;;y;::::. fl ....? .i:,u..•;.?.;.o-i•:.; ^<:v??:c .iii �;ys i��p,}� y.�:/��y. X _ ?`F .:r.?:v;=' ' J..^• �1 .:i;F*�"+33 � r4�!f F?ff :•?:`J.:{•i v:.:v:nh?:yi:!p:0:!.i?Y:?ry?'.?::.�::?:vii:???i:??i:v?i:•ii::!::.�:•. . � ?:?`:^' :i...?li'I'�'�•'.''.S�.i�.'kf'�.L �.�Y.•:.yy��'� •i:?:.?.. •:.:::::::.::.::::..:... .. .:::...::rrJ::ii'<.>?.:•:.,.::.�:::::.:::.�::-.>i?:.;.:::.•,..::::::::::.�:::!..:•?:?•:. ...::.:..�::.......................:.... 74...�51!I'.1?�k!Y.....'y1i.! I:I::j:: y�{µ,y �X :::3.'•'i:?;iit}i:�i:i isii({::ii�J.;;;.'•i:%�. 'r,'%�::�i:iiiiiii:iiiiiiiiii$>::iiir:rii:iJ':v:::...v..........::.:.:•:. :. .::.:...:...... j :::::::::::::::.:f:.?:•??i:. .:.;����'...... ri.:x:..:^Y:•?i?:??.?':::::::.'r?.?:�}i?'?•?: ...:..::;.:J..f..:::v... ,.r:.v.�:..J. : .v.:,.:..............:.......r.Y..........:.r.r. •..J......... ;:.,::.:::. ::: :i.�:•:x?Jil.•::.vY.'l.,n....., .. .......J.:::�v;i..:. V / ...::••:v:v::;v :?•$?S:iiii:::!::::.ri:.k:•'.r./r::.y,'rJ,.•;{?{ix;n..?i'n:�Y?:•::::::: n:�: :.,.....:,.^:::::::. v..+.r..::.:r.......:....:.:.+:.r,6;r;.:.:::::::r..::::.'r:::.�::•?,?:?•::iY::::i?......J.......1...::: If the Total Impervious.Surface Area is LESS THAN 2000 Square Feet,please read, acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owner's legal representative,or the contractor. I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: 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: 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 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 Aie 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 a informs' n provided is accurate and employees of Mason County are granted access to the above- described p erty fo ew ection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 MASON COUNTY PERM NO. O. BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 (� Shelton (360) 427-9670 - Belfair (360) 275-4467 • Elma (360) 482-5 69 On the web www.co.mason.wa.us APPLICANT—INFORMATION CONTRACTOR INFORMATION Owner 1 0 Company Name Snu>'� ,5.�©Y' Mailing Addres Mailing Add s 0 City—­'6-QQP_1J/6Rtate Zip Code City State4gZZE Zip Code Phone Other Ph. Phone © Other P Lien/Title Holder Contractor Reg.#SO xp. E mail address E Mail Addres Drivers Lic.# DOB Drivers Lic. DOB .% SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Con o Water System Name of Water System Wellnect Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digi Par el o. Fire D trigt Legal Description Site Address (Pleas in Jude street name, street number and city) Directions to site. Will timber be cut and sold in parcel preparation?Yes r400vie /n Iff e4c Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs >/o 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 Describe Work No. of Bedrooms No. of BathroomG Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make CAewovP1QP1 Model Year Length i th l�' Serial No. o. of Bedrooms No. of Bathrooms Type of Heat P chas Price $ e place ment Unit? Yes/ No Installer Name uv- 2r" 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 informaticn 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 i onstruction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OFA PROGRESS INSP N. T ITY OF THIS PERMIT APPLICATION OF 180 Q'AYS VYILL INVALIDATE THE APPLICATION. X / � Date: O Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: ' Date DEPARTMENTAL REVIEW APPR VED DENIED NOTES Building Department Planning Department _ LL fit. Environmental Health Department Fire Marshal FEES Building Permit Fee Z Site Inspection 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 i0 . Pre-Paid at Submittal Valuation $ TOTAL FEES � ro eF P-4 kcpr,N MASON COUNTY R� A ryF Fk DEPARTMENT OF COMMUNITY DEVELOPMENT � 411 N. Fifth Street/ P.O. Box 186, Shelton WA 98584 360.427.9670 ext. 352 D D R Rec'd by Request for Administrative Variance for Reduction in the Required Set acks ($105.00) 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. L Applicant/Owners: *6 iG i L_O2,v 4 e Mailing Address. �� p 11 Cl.zj ��IUD= Telephone : '7 - 6BI City��1f6Z State: WA Zip: ge6ZB If this reduction is tied to a building permit, please give permit case number. BLD " ("Y - )I L) 61 Parcel Number(s): 15), 1 '9() l Z;k C, Zoning -J Site Address: �� c�C' 9 Requested variance: Front/Rear Side Yard lease circle all that apply) Requested setback variance: 10' tlt�c' ' l�� ft. An illustrated site plan is required. Your site plan must show the following: north arrow, abutting street or easements, set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and driveway. Show all proposed new development. The following �Irnmstan_cts��must apply: FRONT AND R REAR YARJAZEQUIREMENTS: 1) Existing Io s or'd as of March 5, 2002; You must meet one of the following: (Please circle all that apply) One of the fo owip exists on the lot: a) teep slop ;we?t1aDd8,'or streams present; soils that res ilding 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. \\CLUSTERI HOME SERVER\HOME\COMMON\PLANNING\PAC\VARIANCES\Adminstrative.var.doc Created of SIDE YAR RE UIREMENTS: 1) isting lots of record as of March 5, 2002; ou must meet one of the following. (Please circle all that apply) 2) One of the foll exists on the Iot- a) steep slope 01.1an or streams present; b) soils that re s ilding or septic development; c) lot width at the front yard line of no more than 50 feet; d) lot size of no more than one-half acre; 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. We,f Iands '3ef law k wou10 1 ' Kt Ye f u�Q.s lO/rg a r ru d r .e_ UCkV0 Se�-[ Lack r'. Owne LAgent lease indicate) Signad date Official Use Only Approved Date Denied Date Reason for denial: \\CLUSTERI HOME SERVER\HOME\COMMON\PLANNING\PAC\VARIANCES\Adminstrative.var.doe Created of VZb6-06b-008-� :au04d V8986 VM `uo)104S PeOH ULMH 3S 0 SOMS u041a4S �) .a■LJI Im �IV. a- MOO Ili s I./�,�i��■�■■■■■on 1 •••• - �c■nl a■■■� —�liiiiiiiiiii 1` V ►•. 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