HomeMy WebLinkAboutBLD2015-01061, BLD2003-01513 Addition - BLD Permit / Conditions - 2/22/2016 Inspection Line (360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427 9670, ext. 352
Mason County Bldg. 8
615 West Alder Street
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT
BLD2015-01061
OWNER: BRANDON LEACH RECEIVED: 12/23/2015
CONTRACTOR: LICENSE: EXP: ISSUED: 2/22/2016
SITE ADDRESS: 530 E COULTER CREEK RD BELFAIR EXPIRES: 8/22/2016
PARCEL NUMBER: 122092400100
LEGAL DESCRIPTION: N1/2 SE NW * ELY OF COULTER CREEK RD
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
ADDITION OF LIVING AND REC ROOM. BEING BUILT WA ST RT 3 N, E NORTH BAY RD, WA-302 E, LEFT ONTO E COULTER
BETWEEN/CONNECTING HOUSE AND GARAGE. *HOUSE NEEDS TO CREEK RD, SITE ON LEFT
BE FINALED: SEE BLD2003-01513*
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: VB
Type of Use: SF Insp. Area: No. of Bathrooms: Occ. Group: R-3 Lot Size: Deck: 96
Type of Work: ADD Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:1,080
Valuation: $ 121,662.00 Building Height: 24 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: W 70.0 Ft. Shoreline: Ft. Water Body: Coulter Ck
Rear: E 170.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: IN 400.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: I Side 2: S 150.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Heat Pump 1 Plan Check Fee GMM 12/23/201 $722.00 S1201500000001
Plan Check Fee GMM 12/23/201 $4.02 S2201600000001
Planning Review Fee GMM 12/23/201 $205.00 S120150000000(
EH Minor Plan Review GMM 12/23/201 $ 100.00 S120150000000i
ADJUST--Plan Check Fee JBN 1/12/2016 $7.28 S2201600000001
Building State Fee SLC 2/16/2016 $4.50 S220160000000i
Building Permit Fee SLC 2/16/2016 $ 1,116.95 S2201600000001
Mechanical Permit Fee SLC 2/16/2016 $ 18.20 S2201600000001
Mechanical Base Fee SLC 2/16/2016 $ 28.50 S220160000000i
Total $2,206.45
BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 1 of 7
CASE NOTES FOR
BLD2015-01061
CONDITIONS FOR
BLD2015-01061
1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/ Reserve requires a 1 Oft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. No four drains within 30ft, down gradient of drainfield/reserve area.
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2) Approved pe imensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X
3) Application ackrLGwledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Rural Residential 5 zone.
x
4) All construction and demolition debris must be removed from the site after project completion. Proper dis al of construction debris must be on land in
such a manner that debris cannot enter or cause water quality degradation of State waters. X
5) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent watem or properties. Silt fencing, straw, or
surface matting must be installed and maintained until upland vegetation has become established. X_�
6) Concr le chate and wash water must be contained during construction pouring, such that water quality degradation of adjacent waters does not occur.
X� 72
7) All surface water and potential runoff from the proposed development will be controlled on site in drywells and infiltration trenches, and shall
not adversely affect any adjacent properties, cause sediment deposits, nor increase the velocity flow entering or abutting to any state or
county culvert or dit s stem or road way.
X
BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 2 of 7
8) 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 isj etp 4edging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X / :-_-
9) All property lines shall be clearly identified at the time of foundation inspection. X
10) Landings and stairs must meet the same setback conditions as any permitted structure: and, must be shown on your site plan. Please check your
"Approv its Plan" to ensure these structures are shown and meet the setback conditions listed.
X L�
11) 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.
XL
12) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0982. Tperson signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
13) 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 o any further inspections being performed or approvals granted.
X
14) Owner/Agent is respqnsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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15) 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 of approved documents will result in failure of required building inspections.
X
16) All slabs within the heated space shall be insulated t ,minimum R-10 for at least 24". Monolithic slabs shall be insulated around the perimeter from the
top of the slab to the bottom of the footing X
17) THE FOUNZTI N SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 3 of 7
18) 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,B p rtment prior to any further inspections being performed or approvals granted.
X ll
19) 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:
3c-closed loop ground source heat pump (2.0 CREDITS)
3d- ductlesskeat pump (1.0 CREDITS)
X
20) A permanent certificate, 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 ''/2 sheets. The
Mason County Permit Center will also have some available.
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21) A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section
R404.1.
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BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 4 of 7
22) To perform an inspection the Mason County Building Inspector will need to access the interior of the structure. An electrical permit completed and
approved by Washington State Labor & Industries must be available on-site during the inspection.
The Mason County Building Inspector will inspect the following:
Verify that the system is installed in accordance with manufacturer specifications;
The inspector will check to make sure that the exterior unit is permanently installed and supported,
the exterior unit complies with required setbacks to property lines,
fuel tanks are located at least 10-ft from the system, a source of ignition,
all exterior penetrations are properly sealed,
condensate lines are installed and are properly supported, including proper material, slope, and that the condensate line terminates to a proper location
outside of the foundation,
copper refrigerant lines are insulated with '/2" thick continuous closed-cell foam insulation or better,
indoor units are located at least 3-ft from smoke and carbon monoxide alarms,
and that modifications made to the structure, to install the unit, does not affect existing structural members.
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23) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/ Reserve requires a 10ft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. No found 'on drains within 30ft, down gradient of drainfield/reserve area.
X
24) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
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25) 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, orA
additions requiring a permit occur, or when one or more sleeping rooms are added or created.
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26) 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 road�ognect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
X
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27) 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. Occ ncy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation.
X I&C-1
BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 5 of 7
28) 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 UL181A and shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape.
Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive
tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened.
Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 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 testing is not required if the air handler and all ducts are located within the heated space.
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29) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance,�rregulation, must be reviewed and approved by Mason County prior to construction.
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30) 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 de prior to requesting additional inspections.
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31) All property lines shall be clearly identified at the time of foundation inspection. X
32) 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 Co oldinances and building regulations.
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BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 6 of 7
33) 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 In nted action from being taken. No more than one extension may be granted.
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34) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectols, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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35) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approvede P n"to ensure these structures are shown and meet the setback conditions listed.
X
OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by
signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The -
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DA LL INVALIDATE THE APPLICATION.
Z-z2 �2o/�
Signa re Date
&/I�Jd� ��i�1 OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2015-01061 Please refer to the following pages for conditions of this permit. Page 7 of 7
LName Parcel# 122og-0qq _W)Vd BLD#C> t
Mason County
BUILDING
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 =
X = Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X =
X = Any paved, gravel or packed area per definition
above table
X =
Others X
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area(sum of all areas) dqol
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. n
X Owner/Agent/Contractor(circle one)Date: 2 Z
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-
htti)//www.co.mason.wa—us/code/commissioners/*Mdex.htn
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 RECEIVED
Physical: 415 N 6th St, Shelton WA 98584
nFr 7 70%
If this development has,or will have,a septic/d rain field system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other,parcel.You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner, owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required.
X Owner/Agent'Contractor(circle one)Date:
Page 2 of 2
a..:. RECEIVED
PLANNNGJAN 0 6 2016
-4-2,6 W. CEDAR ST.
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SITE PLA REQUIRED TO BE ON SITE` - c•
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M=
;► ��°'�, MASON COUNTY BUILDING PERMIT NO. ���
DEPARTMENT OF COMMUNITY DEVELOPMENT O
BUILDING•PLANNING.FIRE MARSHAL �Ll
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. III, 426 West Cedar Street (360)275-4467 Belfair ext. 352
PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext. 35�ECEIVED
BUILDING PERMIT APPLICATION Ay'v',�
J0
2
OWNER INFORMATION: CONTRACTOR INFORMATION: 426 W. CEDAR ST
NAME: Gam-co N NAME:
MAILING ADDRESS: PO. soar C9V MAILING ADDRESS:
CITY: 17&Lr41Yt STATE: t yk ZIP: Ipszje CITY: STATE: ZIP:
PHONE: •ooV7 CELL:16o-4o-ooY-' PHONE: CELL:
EMAIL: EMAIL :
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) /,Z:Z D q,Zy 0d/o D FIRE DISTRICT 5—
LEGAL DESCRIPTION(ABBREVIATED): sE Y.l ,✓; ✓ sarr&y 1 s+LZ e►aetrf eMuaE/ I,r6sT
SITE ADDRESS S3o E Cvwi+-L-ti CtteEc 20 CITY fLFOLA-
DIRECTIONS TO SITE ADDRESS Thy.0 tlyw 3b2 To zov%TEo_ 4`r-e&tc- Roko. r.stw ten ? s o E .-If 0%
e (1r��y�„ �7 tl�•r 64 L.,,}t, AnoKC51' Ao fTE'r o^f C of dir �a�•F•
IS PROPERTY WITHIN 200 FT: ;)0
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES[] NO(�
TYPE OF JOB: NEW ❑ ADDITION * ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) IWS0 E^r4C8_ uFw ('=VSN�� �pw•� P(.V g fl`
IS USE: PRIMARY PF SEASONAL❑ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS 0
DESCRIBE WORK q,,;1eL wE�✓ L'c��Q !loop-- RNv REL 2a�- i3Er�EE�✓ E,�r*.ti, a.�I
SQUARE FOOTAGE:
1ST FLOOR S_VO sq. ft. 2ND FLOOR ry0 sq.ft. 3RD FLOOR A8)r- sq.ft. BASEMENT m9- sq.ft.
DECK_ sq.ft. COVERED DECK VS sq.ft.STORAGE sq.ft. OTHER -6L- sq.ft.
GARAGE_ sq. ft. ATTACHED❑ DETACHED❑ CARPORT sq.ft. ATTACHED❑ DETACHED❑
MANUFACTURY HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN
MAKE MODEL YEAR GTH
BEDROOMS BATHS MBER
OWNER I 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 1 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 permitlapplication 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 j
INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature of Applicant Date j
i X A1tVVffl 'e LCFAC" OWNER/REPRESENTATIVE /CONTRACTOR
Print Name (CIRCLE TO INDICATE)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT zx_ Z
PLANNING DEPARTMENT
FIRE MARSHAL
MASON COUNTY BUILDINGPERMIT NO.
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING.FIRE MARSHAL O j o
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext.352
«u PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext. 352 RECEIVED
PLUMBING & MECHANICAL PERMIT APPLICATION DEC 2 3 2015
OWNER INFORMATION: CONTRACTOR INFORMATION: 426 W. CEDAR ST.
NAME: ICRAWI06 PJ LEAut NAME:
MAILING ADDRESS: ", ap)c Vpbt MAILING ADDRESS:
CITY: J?C—J~ STATE: byl? ZIP: ?&2J' CITY: STATE: ZIP:
PHONE: 366 2 4 00 V-gCELL: 36 0-Z J?6-o0Y 4 PHONE: CELL:
EMAIL:_ Oa fp•r s s L;vE.Ca•M EMAIL:
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER): /2 2 D 9 2.S/D0/0
LEGAL DESCRIPTION(ASBREVL4TED): SF h . NW &r-SftmW 9 TWr� LZ AIot7 , /lRw(o62
SITE ADDRESS: S3# e- Co,.14-►i LrA4 k 4�k CITY: /3SLfo s
DIRECTIONS TO SITE ADDRESS: T 44 /,IWy ?d z Ta CoyLTL-.t eeeeg zo Tvan/cE�l' /!nd
Aa Adif" evinf, pin anclr ;c ae, itn>f.s r-,,yL g 2e✓ _e-rJ A C115? er✓ ssdL1�i— PN mc-
TYPE OF JOB
NEW ADD_ ALT REPAIR OTHER USE OF BUILDING ►JCS t�`rT^'�� eQ0`"' `• P��7 Ar
T_,OCATTON OF FIXTURFS/UNITS-1sT FLOOR 2NOFLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric_( LPG Natural Gas -Heat Pump
Toilets Type of Unit No.of Units Fees
Bathroom Sink Furnace
Bath Tubs -t'J�� Heatpump
Showers �� Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas,Pellet Stove
Dishwasher -�� Kitchen Exhaust Hood —_
Hosebibs Dryer Vent _
Other 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 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
perm itlappli cation becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is
suspended for a pen of 180 da ROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS
PERMIT APPLIC 1WODS WILL INVALIDATE THE APPLICATION.
X
i atur f Applicant Date
X Ze�tc4 Owner/Owners Representative/Contractor
Print Name (indicate which one)
DEPARTMENTAL REVIEW APPROVED DATE DENTED DATE TAGS/N'OTES/CONT)ITIONS
BUILDING DEPARTMENT Z
PLANNING DEPARTMENT
FIRE MARSHAL