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HomeMy WebLinkAboutBLD2016-01077 SFR - BLD Permit / Conditions - 12/22/2016 Inspection Line (360)427-7262 `°`�T� MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County 615 W Alder St Shelton, WA 98584 /Aid RESIDENTIAL BUILDING PERMIT BLD2016-01077 OWNER: DENNIS & MARTHA ELLER RECEIVED: 10/31/2016 CONTRACTOR: KOBZA HOME BUILDERS INC 360-507-3068 LICENSE: KOBZAHBO15CQ EXP: 2/18/2018 ISSUED: 12/22/2016 SITE ADDRESS: 146 E PIRATES DR GRAPEVIEW EXPIRES: 6/22/2017 PARCEL NUMBER: 121187590230 LEGAL DESCRIPTION: TRACT 23 OF GOVT LOT 1 &TAX 1433-ATR 4 OF SURVEY 7/3 & SP#571 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR WA ST RT 3 N, RT E GRAPEVIEW LOOPRD, RT E RAUSCHERT RD, LT E PIRATES COVE DR General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: 240 Type of Work: NEW Fire Dist.: 3 No. of Stories: 1 Occ. Load: Building:1,775 Garage-Attached 400 Valuation: $ 221,537.27 Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: E 25.0 Ft. Shoreline: Ft. Water Body: Case Inlet SEPA?: No Model: Width: Ft. Rear: W 44.0 Ft. Slope: Ft. Shoreline Desi Urban Side 1: W $.0 Ft. g.. Year: Serial No.: Side 2: E 8.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 2 Furnace<100K 1 Plan Check Fee AMP 10/31/201 $ 1,090.02 S1201600000001 Lavatories 3 Heat Pump 1 Planning Review Fee AMP 10/31/201 $205.00 S1201600000001 Bath Tubs 1 Ventilation Fan 3 EH Plan Review AMP 10/31/201 $205.00 S120160000000i Showers 1 Propane Tank 1 Building State Fee JTL 11/21/2011 $4.50 S1201600000001 Water Heaters 1 Propane Stove 1 Building Permit Fee JTL 11/21/201, $ 1,676.95 S1201600000001 Clothes Washer 1 Gas Outlets 5 Mechanical Permit Fee JTL 11/21/2011 $237.90 S1201600000001 Kitchen Sink 1 Exhaust Hood 1 Mechanical Base Fee JTL 11/21/201, $28.50 S1201600000001 Dishwasher 1 Dryer Vent 1 Plumbing Permit Fee JTL 11/21/201i $ 101.90 S120160000000i Hosebibs 2 Plumbing Base Fee JTL 11/21/201i $24.70 S1201600000001 Total $3,574.47 BLD2016-01077 Please refer to the following pages for conditions of this permit. Page 1 of 6 CASE NOTES FOR BLD2016-01077 CONDITIONS FOR BLD2016-01077 1) Water u lity ' of to be degraded to the detriment of the aquatic environment as a result of this project. X 2) ALL RFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT PROP/EIFTIES,NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM OR fD W X 3) 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 1-800-64 098 The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 4) All ap oved 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 Departm pri to any further inspections being performed or approvals granted. X 5) OwneAreview responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 6) The pcheck 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. T e 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 pp ed documents will result in failure of required building inspections. X 7) THE F ATI N SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL. X 8) The"aprrovedl"'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 pa ent prior to any further inspections being performed or approvals granted. X BLD2016-01077 Please refer to the following pages for conditions of this permit. Page 2 of 6 9) 2012 IECC/Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine -4C, Window(Max U-Factor):0.30, Skylight (Max U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation min. R-49, Vault Insulation R-38, and Slab Insulation R-10. In addition the following credits from R406.2 shall be completed as follows: 1d- Efficient Building Enevlope 2a-Air Leakage Control and efficient Ventilation 3a-High Efficency HVAC 5a- Efficient Water Heating 5b-Effi * nt Water Heating X A/1 J1, 10) A p ane t certific te, completed by the owner, builder or registered design professional, shall be posted within three feet of the electrical distribution panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 105.4, and air leakage results if a blower door test was conducted. Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 5 air changes per hour when tested with a blower door in accordanve with IECC/.WSEC Section R402.4. The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is not required for additions less than 750 square feet. Reference IECC/WSEC R401.3 & R101.4.3 Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2012 Certificate" and are available in '/4 or'/z sheets. The Mason County Permit Center will also have some available. X I- ./,W/o fie 11) A mil?of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section R404.1 X 4jx 12) A Ma n C 7unt�y 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'isaa cknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X BLD2016-01077 ease refer to the following pages for conditions of this permit. Page 3 of 6 13) A separate inspection in addition to the inspections required in the IBC, Section 110 shall be required in accordance with the 2015 IBC, Section 1705.12.2 and Section 1707.1. The additional inspection is required when shear wall fastener spacing is required to be 4 inches or less. The shear wall schedule shown on sheet A3 designate wall(s) type 2 with fastener spacing 4 inches or less. The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified to inspect lateral connections, the Engineer of record (EOR), or an authorized representative of the (EOR). The special inspectors duties and responsibilities shall be as specified in Chapter 17. When a third party inspector is used to perform the inspection, special inspection reports shall be submitted to the Mason County Building Department, 615 W Alder St, Shelton, WA 98584 and also available on site for review by the Building Official. Inspection reports shall be completed and subm' ed the Mason County Building Department in a timely manner and shall be submitted prior to the framing inspection of said project. X 14) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer specifications and in accordance with IRC Section R315. Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level of the dwelling. EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances), repairs, or additions requiring a permit occur, or when one or more sleeping rooms are added or created. X -)4 15) 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 ravoc 'on. X BLD2016-01077 Please refer to the following pages for conditions of this permit. Page 4 of 6 16) Installation of heating equipment in a single-family residence shall meet the requirements of the current IECC/WSEC R403, applicable sections of the IRC, and IMC. Heating equipment shall be sized in accordance to ICC/WSEC, Section R403.6. Heating and design load calculations for the purpose of sizing HVAC systems are required and shall be calculated in accordance with accepted practice, including infiltration and ventilation. Design calculations shall be available for inspection during inspection. Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous glass ducts shall comply with UL181Aand shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape. Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened. Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal ducts shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or rivets equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation instructions. Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8 DUCT TIGHTNESS TESTING shall be conducted by person(s)trained to perform such testing. A signed affidavit documenting test results in accordance to IECC/WSEC Section R403.2.2 shall be provided to the Mason County Building Department prior to the final occupancy inspection. Affidavit forms are available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit" or"Duct Leakage Testing Results (Existing Construction)." Duct tightness esting is not required if the air handler and all ducts are located within the heated space. X 17) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinanc r r gulation, must be reviewed and approved by Mason County prior to construction. X 18) CON RUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND 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 Inspe t r sha I• a made prior to requesting additional inspections. X 19) The lacement of small propane tanks are not normally subject to a permit review by the Planning Department; however, propane tanks are subject to Planning Department regulations. Such regulations primarily consist of setbacks from shorelines and features considered to be critical areas (streams, wetlands, slopes, etc.) If you think such feat r s exj t on or nearby your property, please contact the Planning Department so that exact setback requirements can be determined. X 20) All property lines shall be clearly identified the time of foundation inspection. X BLD2016-01077 Please refer to the following pages for conditions of this permit. Page 5 of 6 21) 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 C my o dinances and building regulations. X 22) All per its 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 hav re ted action from being taken. No more than one extension may be granted. X 23) Press treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connector , and f hing. Install metal connectors approved for contact with the new types of pressure treated material. X 24) Must s mit report from installer or O&M provider showing system is working properly. XOA OWNER/ BUILDER ackno ledges 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 APP,7;=WILL INVALIDATE THE APPLICATION. - /-'-';7 Signature Date OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2016-01077 Please refer to the following pages for conditions of this permit. Page 6 of 6 4 1 Kobza Home Builders Inc Q.PN4B 164 Ue 1� q S 7 Lacey, WA 98503 360-507-3068 Fax 360-923-2396 MULDING CONSTRUCTION CONTRACT 11is agreement is made this_13_day of.—October 2016 and effective the 13�day of_October , 2016 byand bet%veen Kobza Herne Builders Inc and Martha and Dennis Eller to perform the Work identified i RECEIVEDArticle Two in accordance with the Project's Contract Documents. OCT 3 1 2016 PROJECT: 146 East Pirates Drive 615 W. Nder Street OWNER: Martha and Dennis Eller 1-217-972-6656 ENGINEER: Thompson Engineering CON-TRACTOR: Kobza Home Builders Inc ARTICLE I CONTRACT PAYMENT.The Owner agrees to pay the Contractor for satisfactory performance of work the surn. of two hundred eighty tNvo thousand fifty eight. Dollars and no/100's(S_28 .€358_) includes WSST An initial payment of 2% (two percent) will be paid to Kobza Hone Builders Inc before the commencement of construction. .Progress payments shall be made to Contractor for Work satisfactory performed no later than the ten(101')day of the following month for any invoice submitted prior to the first(l') unless disputed. Invoices are subject to 1.5% per month interest charges if unpaid and over due as of the 1511 of the month. ARTICLE H SCOPE OF WORK.Contractor agrees to commence Work herein described upon notification by Owner and to perform and complete such Work in accordance with Contract Documents and under the general direction of the Engineer in accord with Contractor's schedule. This shall ARTICLE X OCCUPANCY OF PREMISES Unless othem7ise negotiated in writing III this Agreement, Clients shall not occupy the premises until the following are done: A. Completion B. Final inspection or certificate of occupancy issued by the Appropri.aae govermnental authorities C. Completion of Walk Through, "punch list", and completion of "punch list" D. Payment in full of all monies due the Contractor, including budget overages and change orders ARTICLE XI SPECIAL PROVISIONS. Schc;dulcs Bid Porposal as attached are part of this contract and all items as listed on same per plans and specifications. in witness whereof, the parties have executed this Agreement under the Seal, the day and year first written.above_ —Kobza Home Builders Inc— Dennis and Martha Eller Conwactor(Company Name) OW Signature Signature Jay Kobza Dennis and Martha Eller— Bv (Print signer's name and title) By(Print signer's name and titbel f { Name�0.r�LjQ t©e/lnl� ��le> rcel# /2178�q o23 o BLD# ul�v o f d l-? Mason County Department of Community Development B i L D I N V 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 2. '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. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings C X = Z O(7 X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways X Z O = / 0 0 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 b X 2. Y = gQ 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) 80 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- describe property for revifivp and inspection as maybe required. X IVOwner/A t/Contract (circle one)Date: If th otal mpervious urface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. 1 of 2 Name G�e� Parcel# /I$7 15?0 2-3 d 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: httn//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 ackn wledge that the information provided is accurate and employees of Mason County are granted access to the above- described p erty for re d inspection as may be required. X 2 Owner/Agent! �ncto�rircle one)Date:G�` Page 2 of SOON CoL1r MASON COUNTY COMMUNITY SERVICES Permit No: ez 1 Y/ ` 01077 } r PERMIT ASSISTANCE CENTER: •B ILDING•PLANNING•FIRE MARSHAL - Ilan: V E I\ E D Alder St-Shelton,WA 98584 ` �+ (360)427-9670 ext.3S2- Fax(360)427-7798 Phone ���U t ir.(360)275-d467- PhoneOrne:(3W)4825269 OCT T-+ 1( BUILDING PERMIT APPLICATION 615 W. AJd r Street OPERTY OWNER ^ I INFORMATION: CONTRACTOR /N�FORMATIO,N/: NAME:MQrf D kt G/j/LS 451 kly- NAME: kZ'1�[oAl1t:- �/�P�'S A?G MA LING ADDRESS: MAILING ADDRESS:PAS I toy- V S-7o AviF we$e � CITY: STATE: ZIP: CITY: G G STATE—4 ZIP:Y-Yo 3 PHONE#I: I-Z - Q'12-G6 Ste, PHONE. _ D - 06VLL: PHONE#2: EMAIL:sJkDR Z A @ ReRch CAIe. GO/-- EMAIL: --:z tp r-mf tSt.Ale L&I REG# WCOSAK89a!C7 EXP.2 I CONTACT PERSON: OWNER[I CONTRACTOR'® OTHER❑ NAME: ✓0.V Kollo ew MAILING ADDRESS:PM 816 S=/$70 A✓�/�yl.�i �� CITY: (-Ace STATE: ZIP:_ SQ3 PHONE:360-Sol-"i3g EMAIL: I J K OR Z A®R EAcllaAln C o,44 PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 12- 7 5 9 b 2.3 o ZONING LEGAL DESCRIPTION(Abbreviated) 2 3 o f GeV 6-0 FIRE DISTRICT SITE ADDRESS r y East P,✓�f few D r v CITY DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESZ' NO❑ IS PROPERTY WITHIN 200 FT: (check di dw,apply): SALTWATER' LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW e ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Rd.,Ga'age,Commercial Bidg,Etc.) IS USE: PRIMARY)g SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)`$ YES(Part[s]of Bld ❑ No❑ DESCRIBE WORK �V e/ti �Cll_ _ ll�/ eSiCl QOt L� a —/(Valuation/Project Bid Amount:S Z0P CXDO S UARE FOOTAGE• I ST FLOOR sq.ft. 2ND FLOOR sq.& 3RD FLOOR sq.ft BASEMENT sq.R DECK !f Z sq.R COVERED DECKYF_sq.ft. STORAGE sq.R OTHER sq.ft. GARAGE_YOD sq.R Attached] Detached❑ CARPORT sq.R Attached❑ Detached❑ MANUFACTURED H ORMATION: *4 THE FLOOR P D* MOD YEAR LENGTH WID EDROOMS BATHS SERIAL NUMBER OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMR PUCATION OF 0 DAYS OF MORE WILL CAUSE THE APPLICATION TO B EXPIRED.(MASON COUNTY CODE 14.08.42) X Sig E (Mu by the OWNER) Date DEPARTMENT REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDTI'IONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS take , �' lanner: pproved&Readv for Pick-Um Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev.1127/2016 by JBN *1R54 MASON COUNTY COMMUNITY SERVICES Permit No: 4/y'�[/o )�-'0/077 PERMITASSISTANCE CENTER: .BUILDING •PLANNING.FIRE MARSHALp !, /C615 W.Alder St-Shelton,WA 98584 R1 V Gwww.co.mason.wa.us OCT 3 12016 Phone She/ton:(360)427-9670 ext. 352• Fax:(360)427-7798 Phone Belfair. (360)275-4467• Phone E/ma:(360)482-5269 615 W. Alder Street BUILINUG3 & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:M q e th a f�nn.,S &(ee NAME:K o&ziq ff-am a B-,i Id es In c W MAILING ADDRESS: MAILING ADDRESS: PM B 16 5Y `IS70 A yer-y4t C CITY: STATE: ZIP: CITY: 4 a ee y STATE: _ZIP: `l 8So 3 Is'PHONE: 7-1-2 -`I7Z- G(oS(o PHONE:3(60-f507-30&*LL. 2°d PHONE: EMAIL :J KOB-1A RF.A�fi�ONE 4L'oM EMAIL:e 1 J eve_ v/!/l L&I REG#fit'D 8 Z fl tf_!� EXP.Z. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number):1 2. UeF 7 6-9 o Z 3 o Zoning: I�� LEGAL DESCRIPTION(Abbreviated):TPgcG 23 0VT Lof SITE ADDRESS: y 6 EQ gf past-f C SQC CITY: cs e DIRECTIONS TO SITE ADDRESS: TYPE OF JOB: NEW ADD ALT REPAIR OTHER USE OF BUILDING LOCATfON OF FIXTURES/UNITS—I sT FLOOR 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_ Toilets Z... Type of Unit No.of Units Fees Bathroom Sink Furnace I — Bath Tubs Heat Pump I Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kitchen Sinks Wood/ AsYellet Stove Dishwasher Kitchen Exhaust Hood Hose bibs 't- Dryer Vent Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or contractor.I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INV (DATE THE7 jP JATION. X -1grratupd of Ow&r Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT Y-214 PLANNING DEPARTMENT FIRE MARSHAL Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev:1/27/2016 JBN k 5 - _ p: 97 ? e � la 201 l --o 1 o-7-7 PLANNING � _ .� RECEIVED OCT 3 1 2016 615 W. Alder Street PL NNI m ALL SETBA S ARE EASURED FRWA HE FUR HEST F�E�r_IECiI OFTii BUILDING I Q R136* OVl 64 Cd i rZ APPROVED r a: t9 '��7►lJN rY DGD PLANNING .�I rE PLAN REQUIRED TO BE ON SITE CHANG S SUBJET TO APPROVAL - _ Date t l Z�t