HomeMy WebLinkAboutBLD2006-00437 SFR - BLD Permit / Conditions - 5/8/2006 Inspection Line(360�427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2006-00437
` OWNER: LYN SAID RECEIVED: 3/23/2006
CONTRACTOR: HILINE HOMES LICENSE: HILINH`983BD EXP: 11/8/2007 ISSUED: 5/8/2006
SITE ADDRESS: 201 E AYCLIFFE DR SHELTON
EXPIRES: 11/8/2006
PARCEL NUMBE ' ` 1,4,8
LEGAL DESCRIPTION: LAKE LIMERICK 1 LOT: 145
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
SFR, STOCK PLAN #2003-0057 E LAKE MASON RD TO LEFT ON E BALLANTRAE DR TO RIGHT ON
AYCLIFFE DR TO SITE ON LEFT
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 3 Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U Lot Size: Deck:
Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:1,940 Garage-Attached 528
Valuation: Building Height: 14 Occ. Status: Primary Basement: Cov. Porch 40
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 65.0 Ft. Shoreline: Ft. Water Body: NONE
Rear: W 45.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: IN 9.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: S 9.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 3/23/2006 $246.91 S12006000
Hosebibs 2 Ventilation Fan 3 Planning Review Fee KS 3/23/2006 $155.00 S12006000
Kitchen Sink 1 Dryer Vent 1 Address Fee GMM 3/31/2006 $140.00 522006000
Lavatories 3 Building Permit Fee JRN 4/4/2006 $1,234.55 S22006000
Showers 1 Building State Fee JRN 4/4/2006 $4.50 S22006000
Water Closets (Toilets) 2 Plumbing Base Fee JRN 4/4/2006 $20.00 S22006000
Water Heaters 1 Plumbing Fee JRN 4/4/2006 $89.00 S22006000
Bath Tubs 2 Mechanical Base Fee JRN 4/4/2006 $23.50 S22006000
Clothes Washer 1 Mechanical Fee JRN 4/4/2006 $39.65 S22006000
Total $1,953.11
BLD2006-00437 Please referto the following pages for conditions of this permit. 1 of 4
CASE NOTES FOR
BLD2006-00437
CONDITIONS FOR
BLD2006-00437
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, C ntractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further informatioFording
n be obtained at
1-800-64 -0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor to WA state law.
2) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more gran 1 50'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
X cfj ra}ds connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
3) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at
(360)427-9670, ext. 450. The building permit will not be "finaled" until the permit holder can show proof that the access pennit from Public Works has
bee �'f� led" and approved.
4) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not availa le 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 b collected by the Building
Departm at prior to any further inspections being performed or approvals granted.
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5) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads," all new structures that
require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the
access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background.
Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted
by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting
inspectio s.
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6) 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
remoyal)f approved documents will result in failure of required building inspections.
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BLD2006-00437 Please referto the following pages for conditions of this permit. 2 of 4
7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X( )t
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8) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, Compliance Method: IV, Window (Max U-Factor):0.40, Skylight (Max U-Factor):0.58,
D�Ope/Max U-Factor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10.
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9) Stock Plan Identification number:2003-0057
This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department,
original building plans, and all attachments approved by the Mason County Building Department shall be available for the Mason County Building
Inspecto�at each required inspection.
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10) 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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11) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
charge and shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
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12) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation.
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13) 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 pro ect.
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14) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinaoce qr regulation, must be reviewed and approved by Mason County prior to construction.
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BLD2006-00437 Please refer to the following pages for conditions of this permit. 3 of 4
1 ;) 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
Xspecitor shall be made prior to requesting additional inspections.
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16) All property lines shall be clearly identified at the time of foundation inspection. X(aA
17) 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
Masor County ordinances and building regulations.
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18) 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.
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19) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connect°�s, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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20) Xhnarcel is located in a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information.
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21) 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 Site Plan" to ensure these structures are shown and meet the setback conditions listed.
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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.
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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 owneror 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 structure for review and inspection.
OWN ER OR AGENT: �� ,�/ � L— DATE:
BLD2006-00437 Please refer to the following pages for conditions of this permit. 4 of 4
o CONCRETE MECHANICAL PE�1kST-CIA! MANUFACTURED HOME' y
o Date Q
rn : Footings/Setbacks Gas Piping
By Ribbons
o Interior Date rc�G By 1 Interior-Date BY Date By r
�6 V/
W Exlerim Date D By Exterior-Date _.. - .,_ B Set-up Z
Point Load/Isolated Footings INSULATION Date By
BG/SLAB INSULATION
Date By Data By FIRE DEPARTMENT
Foundation Wails Floors Date By
Date By Data (j/ z�' ® gYRLS DECKS
FRAMING PR LUST N Walls Date By
Date By Data Oq 11 0& BY FtS PROPANE TANKS
PLUMBING Vault Date 13Y
Date BY OTHER
Groundwork Attic
Type.
Date By Date By Data By
DRYWALL RYWALLa Type:
Date ( Z D i (P By Int.Braca Wall r Date By W
Date to 01 By "J FINAL INSPECTION
a) Water Linter I� Fin Srpocn
rat
Date `s l Z $ 0(o By A C-C Date By Date pl G O_7 By o
Pass or Request Inspect. c
Type of Insp. Fail Date Date Done By Comments w
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General/Specialty Contractor
A business registered as a construction contractor with LEtl to perform construction work within the scope
of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
License Information
License HILINH"981BT
Licensee Name HILINE HOMES
Licensee Type CONSTRUCTION CONTRACTOR
602167453 Verify Workers_Comp Premium
UBI Status
Ind. Ins. Account 0
Id
Business Type CORPORATION
Address 1 11306 62ND AVE E
Address 2
City PUYALLUP
County PIERCE
State WA
Zip 98373
Phone 2538401849
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 1/30/2002
Expiration Date 2/10/2008
Suspend Date
Separation Date
Parent Company
Previous License
Next License HILINW"960BL
Associated
License
https://fortress.wa.gov/lnl/bbip/Detail.aspx?License=HILINH*981 BT 5/5/2006
1fi VICINITY MAP NORTH
NAME: SG 1L1
SITE ADDRESS: XZCZC `e
CITY:
ZIP:
MAILING ADDRESS:
CITY: Gly��p1G�
ZIP:
PARCEL NUMBER: 3Z1'Z`1SCXk�kq \
PHONE NUMBERS H: -6,50t-\
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MILES FROM HILINE SALES OFFICE: "Z
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MASON COUNTY
DEPARTMENT OF HEALTH SERVICES
March 30, 2006 PO BOX 1666 Shelton WA 98584
Shelton (360) 427-9670
Fax (360) 427-8442
LYN SAID Elma (360)482-5269
5831 DEVONSHIRE ST SE
OLYMPIA WA 98501 Belfair (360)275-4467
Case No.: BLD2006-00437 Parcel No.: 321275000145
Dear Applicant:
Your building permit cannot be approved by Mason County Environmental Health until the
following are completed and turned in:
[ Complete and accurate scaled plot plan which shows all building (actual and proposed),
driveways, location of septic system, location of reserve drainfield and wells.
Please call me at (360)427-9670, ext. 554 if you have any questions.
Sincerely,
Trish Woolett
Environmental Health
Mason County Health Services
Comments: EXISTING SITE PLAN SHOW HOME TO CLOSE/ON DRAINFIELD
3/30/2006 1 of 1 BLD2006-00437
INC. PARCEL#: 32 1 27-50-001 45 SOIL LOGS:
3 CUSTOMER: SHANE WOHL SL1-0-12"GLs SL2-0-12"GLS SL3-N/A
12-35"GS 12-35"GS
(Designer DRAWING: PLOT PLAN 3511+GT 35"+GT
9x(Drcefter� „_ Roos To 35" ROOTS To 35"
SCALE: 1 —30
[7 ATA, \-�ej
ANf?PUMP TANK ff0lNG3 -433' AW
PPIMAFY AWn W,5F-!?V� AC3OUf 59'60'
6O�
/ �o
010
/ \ /
000
/ \ /
\ �1oc�„OP� 4
90, ` 5 r
5FPTIC/PUMP
TANK LOCAWN
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H g4V65.
EXPI c
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Mason County Permit Assistance Center
Planning Intake Checklist
Owners Name: L_ o SA c, Date:
Project: '5e(z-
a Reviewed By:
Commercial Devefopment: YES Comments:
Planner: GBM TSC CMM KJM SNG PBC
Site Plan:
North Arrow
-ar-Property Dimensions:oX 1 S
Streets and Driveways Shown.Road name: C L i Fe e _D(LK*_
.zr- All Existing Structures shown with setbacks
,ate Well Location, Septic and Drain-field Shown with setbacks
,.a' Identify all surface water(streams,ponds, shoreline,wetlands, etc.)
,or'Topography(slopes)
o Proposed Structure Setbacks(Direction/Setback):
F: t_7- / 4-' R: kl / zz' S1:_t�J S2: S / q
Utility and Drainage Easements: Yes No (if yes enter condition#5022)
.a-Other Easements
,a- Accessory Appurtenances
,a- County Access Permit Needed(add condition#0010)
,,a--State Access Permit Needed(add condition#0020)
Standard Conditions to be added to all Building permits that planning reviews:#5019 and#0700
Are there any impediments that may restrict access to your site? (dogs/gates)
Shoreline and Planning Info
Setbacks: Shoreline: Slope:
Shoreline Designation: Comprehensive Plan: Rural Zonin
,Z'_Not Applicable El Agricultural ,a-RR 2.5 510 20
❑ Urban ❑ In-holding ❑ RMF
❑ Rural ❑ LTCFL ❑ RC 1 2 3 .
❑ Conservancy )a--Rural ❑ RI
❑ Natural ❑ RAC - ❑ RNR
❑ Unknown 0 RCC-Hamlet 0 RT
❑ Urban Growth Area ❑ MPR
❑ Unknown ❑ Unknown
Water Body(t e of water if unnamed): L(fA P 12 k c,k
SEPA: Yes No Unknown
Flood Plain: YES O kno ap#n
Aquifer Recharge: YES NO nl ap#
Tags/Cases:
RLC/SPI Case: 6-Year Dev. Moratorium: YES O
Eagle Nest Tag: YES NO Other YES O
Addressing: Check box if needed ❑ Reviewed by: GM"\,
Revised: 11-01-2005 I:\PLANNING\PAC\PLANNING INTAKE
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner: n g T le hone _ 73 arcel#: 3z I Z 71SO001`�
Type of project ( New Residence ( )Addition ( ) Remodel
Total Sq. Ft. 1 s Floor : 2 nd floor: Heated Basement:
of heated area:: 1 �{ f 1940 SP
Heating System Type: 0 Electric wall heater O Electric Central Furnace O LPG Furnace
O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type:
O Other: S ecif
Glazing Compliance ® Prescriptive Option see reverse side circle one: 1 ,' 11 IV
Percentage:
Method O Component Performance , Chapter 5— Calculation worksheets required
r, Check one::
_% O Systems analysis, Chapter 4
® Whole House Ventilation system O Whole House Ventilation using a Heat
Ventilation using exhaust fans&window or wall fresh air
Recovery Ventilation System (viAQ3o3.4.a)
System vents (VIAQ 303.4.1)
Check one
O 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:
M 11 0r-CJ iE r-)-t-r . 55 1'O X 5`O 2 i 0
t l r r Mosfcl- /3 c-d . 3S (o x 'q 'O ) ,Z
-4' X r I '
t tr4,n X
it Ir -t a ' '
11 !r c. l
41 � �
Windows: Total Sq. ft. 1 S�
Doors:
IMP i
Doors: Total Sq. Ft %r
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
2004 Washington State Energy Code (WSEC)
2003 Ventilation and Indoor Air Quality Code (VIAQ)
effective July 1, 2004
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. Complete the window and door schedule on the reverse side. Include all windows, skylights,
sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening
dimensions of the windows and doors. Information about the U-factor of the window will also help
to expedite the energy code review. If you are complying with the WSEC by prescriptive path and
are using the area weighted average method you must include your calculations.
3. On your building plans note the location and fuel type of water heater, location of exhaust fans
(bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and
slabs,
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. Additional
WSEC and VIAQ compliance information is available on the internet at:
http://www.energy.wsu.edu/code/
Prescriptive Requirements °, for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing U-factor Door Wall Wall Wall
Area %of Ceiling Vaulted Above interior' exterior Slab4
Option Floor Vertical Overhead" Factors 2 Ceiling3 Grade below 4 Below Floors on
12 grade Grade Grade
I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
IV Unlimited
Single
Family Res .40 .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.
FORM MUST BE COMPLETED IN INK PERMIT NO BL6 '�oV�JQ
PLEASE PRESS HARD MASON COUNTY 7
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 985B4
Shelton(3601427-9670 Belfair 360 275A467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATIO
Owner Lf/✓ SA/Q Contractor Name 1JW_NF F 6M,r
Mailing Arid:ess.r&3/ /JEI.t�.�isNiAe ST. S ce Maifin c�n AdrirP �"
CityrJ4-Y2#'I/J/A Stale wA -- Zip Cede ggSo 1 City S ate_ Zip Code J
Phone(go y,�-9737 Other Ph.(36o)LS't-t;91 Ph.(-J, �-}S -1�Q,ther Ph ( )
Lien/Title Heldel Contractor Reg.
Address __ Expirations_/�/ oS
SEPTIC/WATER SYSTEM INFORMATION-Connect to New SeplicX Existing Septic Connect to Sewer
System Name of Sewer System Well Water System_,>.eNatne of
Water System LAKN ( /i►IE►Z l G K
PARCEL INFORMATION-12 digit Tax Parcel No. Z 1 Z-7 I I c�v/YS Fire District
Legal Description ��a(o _ I f i�
Lv—
Site Address(Please Include street name, street number and City) ZOI C.lF<b l�l�. SUECTr7�.
Directions to site E Z.A tc J Al)rT oIA541 I � .� O„J Q OALLA.,J a,¢ To RI6Nr a,y
2.,-F T.
Will timber be cut and sold in parcel preparatbn? (Yes/No) Y_-_
Is your properly within 200' of the following: Body of Water (Name) Saltwater
Lake- _ River/Greek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
PERMANENT RESIDENCE t4 SEASONAL RESIDENCE❑
TYPE OF JOB New < Add Alt Repair Other Use of Building
Describe Woi k �v Ew_ .S F2 No. of Bedrooms 3 No. of Bathiooins ?— SQUARE FOOTAGE-1st Floor JY`LO 2nd Floor --
31d Fluor Lott Basement Deck Other sy ft
Garage.SZ.B Attached,>< Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heal Purchase Piice $ Replacement Unit ?(Yes/No)
Instal;er Naine Certification No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT CO N 8 OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 190 DAYS AT ANY TIME AFTER TH b ►-115 MENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on ow �QQ sents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
MASON COUNTY
OWNER AFFIDAVIT-1 ceilify tliat I am exempt from the requirements of the 'CONTRACTOR'S AFFIDAVIT-I certify that 1 am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all woik will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without lirst obtaining shall be done in conforraance therewith. No changes shall be made without
approval ;fist obtaini r
X Caleb-LLLOL— X
ate
FOR OFFICIAL USE BEYOND THIS POINT
Accep!vd by Date Submittal Amount Due Receipt No.
DEPARTMENTAL REVIEW APPROVED1 DENIED CONDITION CODES
Building Department
Type Constr.
Planning
—j�
Planningning Department �p -�
Environmental Health Department S
Public Works Department I RA P ;2M V
06 l
Fire Marshal
I I I
Valuation $
FEES
Building Permit Fee i Site Inspection
Plan Review Fee Eli Review Fee '
Plumbing& Base Fee � I Planning Review Fee
i ,[
Mechanical& Base Fee Cther i t `0 00
Wood/Gas/Pellet Stove Fee I State Fee
Violation Fee Pre-Paid at Submittal
TOTAL FEES
FORM MUST BE COMPLETED IN INK PERMIT NO 8L0 /���^(�Q
PLEASE PRESS HARD MASON COUNTY
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584
Shelton(3601427-9670 Belfair 360 275A467 Elma 360 482-S269 Seattle 206 464.696E
APPLICANT INFORMATION CONTRACTOR INFORrH1ATl0
Owner 4//tJ SAID
Contractor rp. e. A1F DMj
rn:lllin�� Addless,�3/ ,/>ElhaysNr� Si s E IMailinn ArirlrPs� `-' � S 2�-r-- 1
CltyaGYr7p/A Stale r�� Zip Cede q�,s, o! City �`M>_ 5 to c,Qc
Phane(36v y�-97.37 Other Ph.(3Ga JLs9- 8ql Ph.( -}R7-t�q - Zip Code-��LA
LieniTille Holder ther Ph.( )
Contractor Reg. # IN A
Address_ Expiration I) —/ p
7l�_
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic,?_Existin Se tic
Systelll__Name of Sewer System g P Connect to Sewer
Well Water System Name of
Water System LAK6 CI�'IEf2l G K
PARCEL INFORMATION-12 digit Tax Parcel No. 3L
Legal Descripliorl 1 L'7
Fire District
Site Address(Please include street name, street number and city) Zo( GLIF<d 0VIL. S CCT
Directions to site E L.e tcr. �Se.J rte� ro CEPt G,�J ,� ,Q,a , a�JTR.CE �R 1-0 ,Q1GNT' o,J /�yGciF�a p
--,f..[L�.off. Cr•F T.
Will limber be cut and sold in parcel preparation? (1 es/No) Ye'S
Is your property within 200' of the following; Body of Water (Name)
Lake__-_ River/Greek Pond—Welland—Seasonal Runoff Stream Slopes orBluffs
PERMANENT RESIDENCE SEASONAL RESIDENCE❑
TYPE OF JOB New X _Add Alt Repair Other Use of Building
Describe Woi k v& S FR No. of bedrooms .3 No of Bathrooms Z- SQUARE FOOTAGE-1st Floor /4cld 2nd Floor --
31d Floor_ Loft Basement Deck Other
GaraUe SL8 Attached Detached Car port Sy It.
! Attached Detached
MOBILE HOME INFORMATION-Make Model Model Year
Lellgfh _ Widlll Serial No. No, of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit ?(Yes/No)
InslaCer Name Certification No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT CO CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 190 DAYS AT ANY TIME AFTER TH b I{S IS 18 71hat
OR
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on ow►'Rh�t
the
intorellation provided is accurate and grants employees of Masorr County access to the above described property an huctur o
inspection of this project. Acknowledgment of such is by signature below:
TV
SON CUNTY
OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the 'CONTRACTOR'S AFFIDAVIT-1 certify yh at I am curren ly registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in confor nce therew h. No changes shall be made without
approval lirst obtaini r
X- Date, r �(
ate_
FOR OFFICIAL USE BEYOND THIS POINT
Accvp!cd by Date Submittal Amount Cue Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES
Building Department
Occ Groff Type Constr. I
Planning Department ; I�
—_ 1t r7
Environmental Health Department
rubric W Works De )ailment j
MASON COUNTY PERMIT NO.
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton,WA 98584
Shelton (360) 427-9670• Belfair(360) 275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner /A) SAIL) _ Company Name }r14/66e AcOvl S GF 641MA
Mailing Address A ri3/ 6 kAr S1 5 e Mailing Address 6-0 5"T'&4PX1fe 4,M, Stye.
City oLY1421.4 State J t A Zip Code City e4M'0 State Zip Code Tdnrii—
Phone360-Sen_•9 73 7 Other Ph. Phone360 - V8Z -/7So Other Ph.
Lien/Title Holder Contractor Reg.#Niti�►N'9B 14 7' Exp.Z.- /-ZD6
E mail address E Mail Address
Drivers Lic. B DOB 7- /'y3 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.3 Z/Z? Fire District
Legal Description 4A" 41AIik.ICK / rA /,/,SO
Site Address (Please include street name, street number and city) Z.O1 ALN ArcUFFE 14- .:W-647-0ti1
Directions to site G` A1.4Snni LIA Ei fkc) T 2 G.G FT Qv e ,SALGAN TRAE P2 1-o A GNT a2A!
5 A YG G jr6' D 1Z S i Tii' G� G
Is property within 200'of Saltwater Lake River/Creek — Pond --
Wetland Seasonal Runoff. — Stream `- Slopes or Bluffs > 15% ---
TYPE OF JOB - NeNe Add Alt Repair Other Use of Building �•
Location of Fixtures/Units - 1 st Floors 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric X LPCz_ Natural Gas— Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Z Furnace
Bath Z Heat um s 10,
Showers s f Spot Vent /
Water Heater Propane Tank e
Clothes Washer Gas Outlets „er
Kithen Sinks Wood/Gas/PelletStove 12r
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent /
Other Other
Base Fee WQ// f_CQ74C/~ Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other 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 CONTINU TION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
Date:
er/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group-Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
INC. PARCEL#: 32 1 27-50-00 1 45 SOIL LOGS:
CUSTOMER: SHANE WOHL SL1-412^GAS SL2-0-12"GLS SL3-N/A
1 2-35"GS 1 2-35'GS
CDeSigreo DRAWING: PLOT PLAN 3511+GT 3511+GT
'" ,55C CDIRfIe/� 30 SCALE: 1 ' ROOTS TO 35" ROOTS TO 35"
—
P Aff
f'AN[
? PUMP TAW FFFPING 3 -43,-5' ANP
0' PC;IMAW'Y ANP W5FM\V VOU1' S9'60'
APPROVED
MASON COUNTY DCD PLANNING f ��
SITE PLAN REQUIRED TO BE ON SITE �C 60,
CH N ES SUBJECT TO APPROVAL Z--
ey Date 67
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MAR 2, 2 11136
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