HomeMy WebLinkAboutBLD2016-00478 SFR - BLD Permit / Conditions - 7/18/2016 Inspection Line(360)427-7262
a°6�N COU�rp MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
1854 RESIDENTIAL BUILDING PERMIT
BLD2016-00478
OWNER: NICHOLAS & COURTNEY THOMAS RECEIVED: 5/27/2016
CONTRACTOR: LICENSE: EXP: ISSUED: 7/18/2016
SITE ADDRESS: 191 E STERLING DRALLYN EXPIRES: 1/18/2017
PARCEL NUMBER: 122185000051
LEGAL DESCRIPTION: LAKELAND VILLAGE#12 PHASE II LOT: 51
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR 4 BEDROOM, 3 BATH WA ST RT 3 N, LEFT HOMESTEAD DR, RT E OLD RANCH RD, RT
STERLING DR, LEFT TO STAY ON STERLING DR, SITE ON LEFT
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: 4 Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3, U Lot Size: Deck: 314
Type of Work: NEW Fire Dist.: 5 No. of Stories: 2 Occ. Load: 15 Building:3,159 Garage-Attached 794
Valuation: $ 397,696.89 Building Height: 28 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
:
y
Make: Length: Ft. Front: N 35.0 Ft. Shoreline: Ft. Water Body:
No
Rear: S 135.0 Ft. Slope: Ft.
Model: Width: Ft. Side 1: E 5.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: W 5.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 3 Furnace<100K 1 Plan Check Fee JBN 5/27/2016 $ 1,730.66 S2 2 0 1 600 00 0 001
Lavatories 5 Heat Pump 1 EH Plan Review JBN 5/27/2016 $205.00 S2201600000001
Bath Tubs 2 Ventilation Fan 4 Planning Review Fee JBN 5/27/2016 $205.00 S2201600000001
Showers 1 Fireplace 1 Building State Fee SLC 6/13/2016 $4.50 S2201600000001
Water Heaters 1 Exhaust Hood 1 Building Permit Fee SLC 6/13/2016 $2,662.55 S2201600000001
Clothes Washer 1 Dryer Vent 1 Mechanical Permit Fee SLC 6/13/2016 $ 167.70 S2201600000001
Kitchen Sink 1 Mechanical Base Fee SLC 6/13/2016 $28.50 S2201600000001
Dishwasher 1 Plumbing Permit Fee SLC 6/13/2016 $ 136.70 S2201600000001
Hosebibs 2 Plumbing Base Fee SLC 6/13/2016 $24.70 S2201600000001
Total $5,165.31
BLD2016-00478 Please refer to the following pages for conditions of this permit. Page 1 of 6
CASE NOTES FOR
BLD2016-00478
CONDITIONS FOR
BLD2016-00478
1) 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 -0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) 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
Dep4rttwt prior to any further inspections being performed or approvals granted.
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3) Owner//agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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4) 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 f,approved documents will result in failure of required building inspections.
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5) THE FOB. YDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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6) 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 Yepartment prior to any further inspections being performed or approvals granted.
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BLD2016-00478 Please refer to the following pages for conditions of this permit. Page 2 of 6
7) 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:
313-AIR-SOURCE HEAT PUMP WITH MINIMUM HSPF OF 8.5 (1.0 CREDITS)
5A- ELECTRIC WATER HEATER WITH A MINIMUM EF OF 0.93 (0.5 CREDITS)
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8) 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 IECCLWSEC 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 %or'/2 sheets. The
Mason County Permit Center will also have some available.
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9) 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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10) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the
manufacturer's installation instructions.
A drip edge
shall be provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5)
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11) A concrete encased grounding electrode must be installed and used at each new building or structure that is built upon a permanent concrete foundation.
In Mason County the electrical code is regulated by Washington State Department of Labor& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-4000.
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BLD2016-00478 Please refer to the following pages for conditions of this permit. Page 3 of 6
12) 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.
X. No f yandyntion drains within 30ft, down gradient of drainfield/reserve area.
13) A separate inspection in addition to the inspections required in IBC, Section 110 shall be required in accordance with the 2012 IBC, Section 1707.11.2.
The additional inspection is required when shear wall fastener spacing is required to be less than 4-inches.
The shear wall schedule shown on sheet S-2 designate walls type PORTAL with fastener spacing less than 4-inches.
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 & 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, 426 West Cedar St, Shelton WA 98584 and also available for inspectiop, I spection reports shall be completed and
submitted to the dept. in a timely manner and shall be submitted prior to the framing inspections.
14) 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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15) 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.
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16) 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 ro�cs�onnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
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17) 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 rev ocy ion.
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BLD2016-00478 Please refer to the following pages for conditions of this permit. Page 4 of 6
18) 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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19) The placement of buildings and structures on or adjacent to slopes steeper than one unit vertical in three units horizontal (33.3% slopes) shall conform to
the International Residential Code Section R403.1.7 for descending or ascending slopes.
Alternate setbacks may be approved subject to approval of the building official based upon the investigation and recommendations of a qualified engineer
licensed in the State of Washington. Such an investigation shall include consideration of material, height of slope, slope gradient, load intensity, and
erosion
,characteristics of slope material.
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20) Proposed structure(s) must maintain a minimum of a 5' setback from all property lines, easements and 25' from all County and State Road right of ways.
Setbacks are measured from the furthest projection of the structure.
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21) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinanpe,oyfegulation, must be reviewed and approved by Mason County prior to construction.
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BLD2016-00478 Please refer to the following pages for conditions of this permit. Page 5 of 6
22) 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 be made prior to requesting additional inspections.
23) All property lines shall be clearly identified at the time of foundation inspection. X—�
24) 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
Masorl County ordinances and building regulations.
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25) 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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26) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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27) Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X (J�
28) 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 ite Plan"to ensure these structures are shown and meet the setback conditions listed.
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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 TPLIC TION OF 180 AYS WILL INVALIDATE THE APPLICATION.
Signature Date
V �✓ l OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2016-00478 Please refer to the following pages for conditions of this permit. Page 6 of 6
SITE NOTES: _PRESCRIPTIVE ENER6Y COMPLIANCE
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Q E•• -'PLOT PLAN ������ ALLYNB�i�DIDrc. Ldr
rql
a SCALE. i/B'•I'O• MASON GOMIY OLCLK
616 W. Alder Streit
rear : 90 '
Name t i �" Parcel# Z 2 3 "SO- (ADD-->) BLD# ZOl(D ~ 00
Mason County BUILDING
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/'mdex.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)4 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/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 �l,L�+ �i wn4/Agent/Contractor(circle one)Date: ?�" CJ- _
Page 2 of 2
Name V -Q 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 surface2.
'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 X =
X Measurements for buildings are taken at the
perimeter of the farthest projections(example:
X = 94 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 review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
the information provided on page 2 of 2.
Page I of 2
MASON COUNTY COMMUNITY SERVICES DEPARTMENT B U I LD I N
WSEC/Ventilation Code Compliance Application
Submit with heating/cooling system size worksheet (see instructions #4)
Owner: Parcel#: Type of project:
I 2ZIR ows)
Total Sq. Ft. 2 + ,�/� 1 S Floor : 2" floor: Heated Basement:
of heated area:: JI g I 1(�2 ? 0
,Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace
6-Heat Pump with electric furnace O Heat pump with gas furnace O Ductless Heat Pump
O Boiler, specify fuel type: O Other: Specify:
Prescriptive Option Table R402.1.1
Compliance Method ❑ Component Performance, R402.1.3 — calculation worksheets required
Check one::
❑ Other (Specify):
Check one *0 Whole House Ventilation system ❑ Whole House Ventilation µ Other,
Ventilation using exhaust fans&window or Integrated with a Forced Air describe:
System wall fresh air vents (M1507.3.4) System (M1507.3.5)
Referencing Table R406.2, "Additional Residential Energy Efficiency Requirements," all residential units
must develop credits as specified in Table 406.2. Identify and describe which option(s)will be used to
comply. If the table is not attached to this form you can access the table on our website at:
hftp://www.co.mason.wa.us/forms/Community Dev/index.php.
Additional
Energy a) Description: Small dwelling units with less than 1500 sq. feet of heated or cooled
Efficiency space and less than 300 sq. ft fenestration (see definition below) or additions to an
Requirements existing building that is less than 750 sq. ft. of heated area. To use this option
Energy credits complete a window schedule in order to verify that the fenestration area does not
exceed 300 sq. ft. Fenestration is defined in the IECC as skylights, roof windows,
required: vertical windows, opaque doors, glazed-doors that include products with glass and
non-glass glazing materials. —0.5 points
b�9edium dwelling units not includes in a) above, or b) below— 1.5 points
c) Large dwelling unit is a dwelling unit that exceeds 5000 sq. ft. of heated or cooled floor
area. —2.5 points.
Describe Energy Credit Option(s):
Using Option number(s):
�� ` - t3 a-
FENESTRATION SCHEDULE
USE FOR ENERGY CREDIT, a) SMALL DWELLING OPTION & COMPONENT PERFORMANCE COMPLIANCE
List all windows, doors, skylights. (If needed, attach an additional sheet)
'Fenestration is defined in IECC Chapter 2 as skylights, roof windows, vertical windows, opaque doors, glazed-doors that
include products with glass and non-glass glazing materials.
Manufacturer Location U-Factor Size Quantity Total
(rough opening) Square Feet
9
Total Fenestration: windows, skylights and door area
MASON COUNTY COMMUNITY SERVICES
PERMITA55ISTA91/CE CENTER., Permit No:
• BUILDING• PLANNING• FIRE MARSHAL
Recv'd.
615 W. Alder St- Shelton, WA 98584 RECEIVED
I
Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798
is Phone Belfair. (360)275-4467 Phone Elma:(360)482-5269
BUILDING BUILDING PERMIT APPLICATION MAY 2 7 20�6
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: NAME:
MAILING ADDRESS: o v MAILING ADDRESS:
CITY: STATE: ZIP: CITY: STATE: ZIP:
PHONE#1: .2(gq�3 q72 C - PHONE: CELL:
PHONE#2: �21 Fes, q g 3 EMAIL :
EMAIL: p 2 LV A I a14 L&I REG# EXP.
-CONTACT PERSON : OWNER ❑ CONTRACTOR ❑ *OTHER/See Below ❑
*NAME: MAILING ADDRESS:
CITY: STATE: ZIP: PHONE: CELL:
EMAIL:
PARCEL INFORMATION: PL 1\1NI-;IC.
PARCEL NUMBER(12 Digit Number) 12 Z ) Q _ 50— 000 eJ ZONING-A-Nn W kA 9-1 P
LEGAL DESCRIPTION (Abbreviated) FIRE, DI TRICT
SITE ADDRESS 191 +er-) r CITY rl
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S) GREATER THAN 14%: YES[] NO±
IS PROPERTY WITHIN 200 FT: (Check all that appl)):
SALTWATER❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑
TYPE OF WORK: NEW ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)
IS USE: PRIMARY,K SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS_3
HEATED STRUCTURE? YES (Whole Bldg)XYES (Part[s]of Bldg) ❑ NO ❑ / p
DESCRIBE WORIC__�� ��
(Valuation/Project Bid Amount: S )
SQUARE FOOTAGE:
I ST FLOOR «D Z 5sq. ft. 2ND FLOOR i 5 3 sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. ft.
DECK sq. ft. COVEREP'DEC�{ .3 H sq. ft. STORAGE sq. ft. OTHER sq. ft.
GARAGE -7 9 4 sq. ft. Attached E Detached❑ CARPORT sq. ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MA I MODEL YEAR GTH
WIDTH BEDROOMS BATHS IAL 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 or owner's legal representative. 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 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 INSPECTION. INACTIVITY OF THIS PERMIT
APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42)
X
Signature of O Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
PERMIT SPECIALISTS Intak Approved&Ready for Pick-Up. -mil
Visit us on-line: http://www.co.i-nason.wa.us/community_dev/ Rev. 1/27/2016byJ8N
A60� C0U'i'A MASON COUNTY COMMUNITY SERVICES permit No:
r PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•FIRE MARSHAL
_ 615 W. Alder St-Shelton, WA 98584 RECEIVED
Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798 C W D
Phone Be/fair(360)275-4467 Phone E/ma:(360)482-5269
- 1854 MAY 2 7 2016
UILp I N(BLUMBING & MECHANICAL PERMIT APPLICATION r q. Alder Street
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: nV f K � - j4(�'1/1et .. �rna15 NAME:
MAILING ADDRESS: P6 )y, U 4 q I MAILING ADDRESS:
CITY: STATE:_ZIP:qY521 CITY: STATE: ZIP:
IS,
PHONE: (�1�=y 7 5 s PHONE: CELL:
2°d PHONE: EMAIL :
EMAIL: ORton L&I REG# EXP.
PARCEL INFORMATION: p
PARCEL NUMBER(12 Digit Number): J v� a i 4 Z(� D 00 J Zoning: 1111.n Y,6A .Q-1P
LEGAL DESCRIPTION(Abbreviated):
SITE ADDRESS: CITY:
DIRECTIONS TO SITE ADDRESS:
TYPE OF JOB
NEW ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS— 1 sr 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 Tyne of Unit No.of Units Fees
Bathroom Sink S Furnace /
Bath Tubs 2 Heat Pump
Showers Spot Vent Fan
Water Heater C '� 1 Propane Tank
Clothes Washer ( Gas Outlets
Kitchen Sinks / Wood/Gas/Pellet Stove e1ectr;c)
Dishwasher ( Kitchen Exhaust Hood
Hose bibs Z Dryer Vent /
Other Solar Panel
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
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 S WILL INVALIDA THE APPLICATION.
x 0A kk L;1 '" 2-
Signature of Appli nt ( Date
x I [)IIIFA J ner/0Wners Representative/Contractor
Print ame (Circle one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
L
Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev:1/27/2016 1BN