HomeMy WebLinkAboutBLD2010-00413 SFR - BLD Application - 5/26/2010 � l
MASON COUNTY PERMIT t � �0
BUILDING PERMIT APPLICATION 'jj ,�e c A V. _i P
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670• Belfair(360) 275-4467 • Elma (390)482-5269 11 f)( -Wr A
On the web www.cO.m
APPLICANT INFORMATION CONTRACT—OR IN MATION,
c Owner ,'r;1. i`.. ompany Name �4�h� �� �tG
Mailing Address PC', ac"u ailing Address
o city! f titr.l..,.. , �.� r.:j�
Stated Zip Code-`��� ^- 3 City State Zip Code
Phone - ► - �0(r Other Ph. Phone 3 LAG"` ��`f Z yhl er Ph.
Lien/-ftfe-Ha!der Contractor Reg. # Exp.
E � E Mail Addr ss s —r
# _.peg D ' ic. DOB
SEPTIC i WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Water System Name of Water System
° PARCEL INFORMATION- 12 Digit Parcel No, do re";C, t Fire District
Legal Description
Site Address(Please include street name, street number and city) 3 0ti= �'�inv
Directions to site
Will timber be cut and sold in parcel preparation?Yes Now'
Is property within 200' of Saltwater TLSltip_��Slopes
River/Creek Po
Wetland Seasonal Runoff or Bluffs > 15%
Is this permit submittal th result of a Stop Wor oti ,Correction Notice or other enfor ent o . Ye
TYPE OF JOB - New Add Alt Repai Other PRIMARY RESI CE SEASONAL ❑
Use of Building '� � Describ W U1t=1 L
oNo. of Bedrooms No. of Bathrooms• ua Footage- 1 st Floor — d Floor :a `
3rd oor Basement — Deck Covered Deck h Sq.ft.
Garage r ! Attached D ched Carport NARA Detached
MANUFACTURED HOME INFOR N - Mod Year
Length idth Serial No. N dro No. of Bathrooms
I Heat Pur rice$ la en nit? Yes/No
I, aller Name 'fica o.
/BUILDER owledges s of inRburate information m#result in a st order or p/eao wledgement of
h is by signature be .I declare th I owner,owners rep to' the ctor.I furthtitled to receive this
it and to do the wo as the lion.I dec have fain fission from allp s.If permission is
uired from any ease nt holier o other party in inte r this licat a work proposeca' ,I have obtained
ission from them apply is and conduct th work own or agent on owners that the information
rate gran a Ioy Mason Coun to the abov property and struand inspection.
OOF OF ON OR S BY MEANS OF ROGRESS INS N.
C"
hr' Date-
Owner Fu rs Re res Contractor indicate whic eIf 4
FOR FFICIAL BEYOND THIS POINT % Accepted by Date,5.2LV-Zol0
DEPARTMENTAL RLVW APPROVED DENIED rf O S
Building Department
Planning Department
Environmental Health Department to E
Public Works Department
Fire Marshal
FE
Building Permit Fee ':; Site Inspection TA
Plan Review Fee -
,A/�` — Xod d EH Review Fee
Plumbing& Base Fee l -10 t Planninq Review Fee
Mechanical& Base fee O r Other
Wood i Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal 0�3• Cow
Valuation$ 411,:? J/. TOTAL FEES
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MASON COUNTY PERMIT NO.$IAZOID Cby 13
PLUMBING/MECHANICAL PERMIT APPLICATION ?I i be.e.eA
426 W.Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670-Belfair(360) 275-4467- Elma (360) 482-5269 ! A I I t j-1 -001>d,
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner o v��3 Company Name
Mailing Address Mailing Address
City State Zip Code City State Zip Code
Phone Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic. Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. i 17o !J .S QG'Oc' Fire District
Legal Description
Site Address (Please include street name, street number and city) I E 1-�- T-)V—A a t:
Directions to site
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units - 1 st Floor. 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric,� LPC�_ Natural Gas_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace A
Bath Tubs _ Heatpumps
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove 1
Dishwasher Kitchen Exhaust Hood'
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OJIINER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X .,. k Date:
Owner/Owners Representative/Contractor (indicate which one)
r. FOR OFFICIAL USE BEYONDTHIS POINT
Accepted by Planning Pd Ck# Date /'" Bld Pd Receipt No.
2
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group-Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/ Pellet Stove Fee Other
Violation Fee TOTAL FEES
CEIVED
n6e4i— PLANNING RE , . - Zolo
_: r
ASON COUNTY
PLANNING:
ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
�- PROJECTION OF THE BUILDING
waft
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122175000052
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A P P Irt4 .-� ►'
MAS N COUNTY DCD PLANNING 48,1
SI PLAN REQUIRED TO BE ON SITE
ANGES UBJECTTO APPROVAL
By Date 0
122175000054
NameT)p r r10!�) Parcel# !ZZ 1-1-50 — U005 BLD#2610 + OQ y 13
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website:
http//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document
entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) /The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT.450
Mail: P 0 Box 1850, Shelton WA 98584
Physical:415 N 6th St, Shelton WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other,parcel. You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for ceWewd inspection as may be required.
X Owner/Agent/ oritractor circle one)Date:
Page 2 of 2
Name _a) Parcel# BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface'.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area * All dimensions in feet
Buildings X =
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X =
X = Length of drive begins at the right of way
X =
Parking Areas X =
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)
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 r iew d inspection as may be required.
72X Owner/Agent/(on at> ctorxcircle one)Date: 2 (b
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
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/ VIAQ Compliance Application
Owner: Telephone: = UU 5Parcel#:
Type of project ( ew Residence ( ) Addition ( ) Remodel
Total Sq. Ft. 1 s Floor : 2 floor: Heated Basefnent:
of heated area:: 3 h7 ( --3 4
Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace
Jt Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type:
O Other: Specify
Glazing O Prescriptive Option see reverse side circle one: 1 II IV
Percentage: Compliance
Method O Component Performance , Chapter 5— Calculation worksheets required
Check one::
% O Systems analysis, Chapter 4
O Whole House Ventilation system O Whole House Ventilation using a Heat
Ventilation using exhaust fans&window or wall fresh air
Recovery Ventilation System (VIAQ 303.4.4)
System vents (VIAQ 303.4.1)
Check one
b Whole House Ventilation Integrated O Whole House Ventilation using an inline
with a Forced Air System (VIAQ 303.4.2) supply fan. VIAQ 303.4.3)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windows:
00
Windows: Total Sq. ft.
Doors:
Doors: Total Sq. Ft
Total window and door area
Total window & door area /(divided by) total sq. ft of heated area %of glazing
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)275-4467 Elma (360)482-5269
FAX: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2006 Washington State Energy Code (WSEC)
2006 Ventilation and Indoor Air Quality Code (VIAQ)
Effective July 1, 2007
Code Compliance Application Form
The following information will be required for the WSEC and VIAQ plan review:
1. Complete the Washington State Energy Code/Ventilation and Indoor Air Quality Code (WSEC/VIAQ)
application located on the reverse side.
2. The window and door schedule should include all windows, skylights, sliding glass doors, french doors and
any other door with 50% glass or more. Use rough opening dimensions of windows and doors to calculate
size. It is always helpful to list the u-factors of windows and doors, if known. If you do not know u-factors,
the plan reviewer will assume all window & door glazing will have a u-factor of .35 or less. When using the
area weighted average method to comply with the prescriptive path include calculations with submittal
documents.
3. On your building plans note the location and fuel type of heating system, water heater, location of exhaust
fans (bathroom, laundry, kitchen, etc.) and R-factor of proposed insulation for walls, floors, ceilings, and
slabs. Outdoor lighting, permanently mounted to a residential building or to other buildings on the
same lot shall be high efficacy luminaires or motion sensor with integral photocontrol photosensor.
All linear fluorescent fixtures must be fitted with T-8 or smaller lamps, but not T-10 or T-12 lamps.
To verify compliance, provide lighting information on plans.
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. Additional WSEC
and VIAQ compliance information is also available on the WSU-Energy Program website at:
http://www.energy.wsu.edu/code/
Prescriptive Requirements for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing Ul-factor Vaulted Wall Wall Wall
Area %of Door Ceiling Ceiling3 Above interior exterior Slab s
Option Floor U e 2 See note Grade 4 below ° Below Floor 5 on
10 Vertical Overhead Factor below 12 grade Grade Grade
I 10% .32 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
II* 15%* .35 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
IV Unlimited
Single
Family Res .35 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
(R-3)Only
*Reference Case/Call (360)427-9670 ext. 352 for footnote information. Log &solid timber wall with a min. avg.thickness of 3.5"are
exempt from the above grade wall insulation requirements.Vaulted ceilings shall be limited to 500 sq.ft. of ceiling area for any
one dwelling unit.