HomeMy WebLinkAboutBLD2016-00513 SFR - BLD Permit / Conditions - 7/11/2016 Inspection Line (360)427-7262
�P60P Cor, MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT
BLD2016-00513
OWNER: ANDERSON SONS/BELLA HOMES RECEIVED: 6/7/2016
CONTRACTOR: BELLA HOMES 206.595.0385 LICENSE: BELLAH*8896L EXP: 1/13/2018 ISSUED: 7/11/2016
SITE ADDRESS: 541 E SODERBERG RDALLYN EXPIRES: 1/11/2017
PARCEL NUMBER: 122185000054
LEGAL DESCRIPTION: LAKELAND VILLAGE#12 PHASE II LOT: 54
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW 5 BEDROOM 3 BATH SFR WITH ATTACHED GARAGE IN LAKELAND VILLAGE (ALLYN, WA) RIGHT ON STELLAR, LEFT ON
SODERBERG, SITE ON RIGHT (ADDRESS: 541 E SODERBERG RD)
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: 5 Type of Constr.: VB
Type of Use: SF Insp.Area: No.of Bathrooms: 3 Occ. Group: R-3 Lot Size: Deck: 170
Type of Work: NEW Fire Dist.: 5 No. of Stories: 2 Occ. Load: Building:2,221 Garage-Attached 633
Valuation: $ 281,367.44 Building Height: Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 25.0 Ft. Shoreline: Ft. Water Body:
2 Shoreline Desi SEPA?: No
Model: Width: Ft. Rear: W 2.0 Ft. Slope: Ft.
Side 1: N 2.0 Ft. 9.'. Not Applicable
Year: Serial No.: Side 2: S 5.0 Ft. Comp. Plan Desig.: Urban Growth Area
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 617/2016 $ 1,308.42 S2201600000001
Lavatories 4 Heat Pump 1 EH Plan Review JBN 6/7/2016 $205.00 S220160000000i
Bath Tubs 3 Ventilation Fan 5 Planning Review Fee JBN 6/7/2016 $205.00 S220160000000i
Showers 1 Gas Outlets 2 Building State Fee JTL 6/27/2016 $4.50 S1201600000001
Water Heaters 1 Dryer Vent 1 Building Permit Fee JTL 6/27/2016 $2,012.95 S1201600000001
Clothes Washer 1 Plumbing Base Fee JTL 6/27/2016 $24.70 S120160000000i
Kitchen Sink 1 Plumbing Permit Fee JTL 6/27/2016 $ 136.70 S1201600000001
Dishwasher 1 Mechanical Base Fee JTL 6/27/2016 $28.50 S1201600000001
Hosebibs 2 Mechanical Permit Fee JTL 6/27/2016 $96.70 S120160000000i
Total $4,022.47
BLD2016-00513 Please refer to the following pages for conditions of this permit. Page 1 of 6
CASE NOTES FOR
BLD2016-00513
CONDITIONS FOR
BLD2016-00613
1) Co ractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
Th e pot tial risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-8 982. 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 app ved 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 b 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
Depa t prior to any further inspections being performed or approvals granted.
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3) Owner 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 re i w 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
Officit
holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removd documents will result in failure of required building inspections.
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5) THE FSYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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6) The "approv ite 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 n 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 Depa t prior to any further inspections being performed or approvals granted.
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BLD2016-00513 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:
1 B- Efficient Building Enevelope
3B- h Efficient HVAC System
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8) A perm Yntcertificate, 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 %or'/2 sheets. The
MasorNcounty Permit Center will also have some available.
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9) A minimu 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) A Mason unty 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 o consult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contractor is wledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
BLD2016-00513 Please refer to the following pages for conditions of this permit. Page 3 of 6
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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12) A separat 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 S3 designate walls type 3 and Portal Framing walls 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 eports shall be submitted to the Mason
County Building Department, 426 West Cedar St, Shelton WA 98584 and also available for inspection. Ins ction reports shall be completed and
submitted to the dept. in a timely manner and shall be submitted prior to the framing inspections. X
13) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufactu r 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, additions requiring a permit occur, or when one or more sleeping rooms are added or created.
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14) All constructi must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Was ngton. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revoca
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BLD2016-00513 Please refer to the following pages for conditions of this permit. Page 4 of 6
15) 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 sting is not required if the air handler and all ducts are located within the heated space.
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16) All changes to roved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or reg ion, must be reviewed and approved by Mason County prior to construction.
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17) CONSTRUCTION CESS 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 internati codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector shall be for to requesting additional inspections.
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18) All property lines shal be clearly identified at the time of foundation inspection. X
19) All building permits shall have a final inspection performed and approved by the Mason C my Building Department prior to permit expiration. The failure
to request a fin 1 inspection or to obtain approval will be documented in the legal property r cords on file with Mason County as being non-compliant with
Mason County antes and building regulations.
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BLD2016-00513 Please refer to the following pages for conditions of this permit. Page 5 of 6
20) 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
hol%rave prevented action from being taken. No more than one extension may be granted.
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21) Pretreated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, ashing. Install metal connectors approved for contact with the new types of pressure treated material.
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22) Landing qnds s must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approve Plan"to ensure these structures are shown and meet the setback conditions listed.
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23) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIIN NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD
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OWNER/ BUILDER ackn ledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by
signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction Vork is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT AP ICATION 180 DAYS WILL INVALIDATE THE APPLICATION.
Signature % Date
OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2016-00513 Please refer to the following pages for conditions of this permit. Page 6 of 6
- 005)e c.
RECEIVED
JUN 0 7 2016
Atty Q A e) 4 6-48 W Alder Street
PUNNING
North
PPROVED
MASON UNIX DCD PLANNING
SITE PLA REQUIRED TO BE ON SITE
CHANG SUBJET TO APPRqVAL
N
3Y Date&
pollp
IMF
c\j
ff PLANNING:
ALL SETBACKS AC IMEASUtitu
FROM THE FURTHEST
f"l-RC.""CTION OF THE BUILDING Driveway
in I
LY
All ;r\ SPA 6A-Ck- Aft eA-
14 8'-3"
50DERBURG RQA=P wal
Name �,y� 01-6 Parcel Z I 8 50 " Q(,Q57 BLD#
I �^"O 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:
hap//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 Lou, 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) VSE 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 re ' and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
Name 44 rsVAS Parcel# ?Z /R — �c.(�y BLD#
Mason County
Department of Community Development BUILDING
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14, Chapter 14.48 a stonnwater site plan is required whenever a building application is
made for residential development, or redevelopment',with more than 2,000 square feet of impervious surface 2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity, and land disturbing activities associated with structural or impervious redevelopment.
2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area 'All dimensions in feet
Buildings X =
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X `70 60C
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 A �LESS AN 2000 Square Feet, p ase 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 su s by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I
further ac nowledge that nformation provided is accurate and employees of Mason County are granted access to the above-
described ope for revie d inspection as may be required.
X Owner/Agent/Contractor(circle one)Date: C,, e /
If the Total a ions Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign
the informatio rovided on page 2 of 2.
Page I of 2
MASON COUNTY COMMUNITY SERVICES �016
�L
PERMITASSISTANCECENTER. Permit No:
i I Recv'd.
4. - • BUILDING. PLANNING• FIRE MARSHAL
615 W. Alder St - Shelton, WA 98584 RECEIVED
Phone Shelton:(360)427-9670 ext 352 Fax:(360)427-7798
85 Ph elfair.�(360)275-4467 Phone Elmo:(360)482-5269 JUN 0 7 2016
BU LDII '
BUILDING PERMIT APPLICATION E; vV. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: G NAME: �k �'1F7v�rP L ti
MAILING ADDRESS: Z F<'A*4 p 0Z1 J MAILING ADDRESS: 545 S11,4mr Lr Veu S t2o(
CITY: 01-yr►%Pto, STATE w.A, ZIP: 15o 1 CITY: &V pup„a STATE: \.eta ZIP: 3d t
PHONE#1: 2o6 -5h7-039S PHONE: CELL:'Lo_ 6- 5
PHONE#2: EMAIL :
EMAIL: L&I REG# ALA* 3L EXP.
CONTACT PERSON : OWNER ❑ CONTRACTOR X *OTHER/See Below ❑
*NAME: AZ'r CJ2k DNS MAILING ADDRESS:_} 5 t /��� y�✓,� t �
CITY: STATE:\NA- ZIP: ) PHONE: CELL: 5.& ,
EMAIL:_ t tlabD �S �ahs- a^'it��nlJ �,ma�t Cow
PARCEL INFORMATION: I:'UANNE'R. _..- ..
PARCEL NUMBER(12 Digit Number) �'Z'L 18_ — 'S� ZONING All qn U64 Q— I P
LEGAL DESCRIPTION(Abbreviated)LAU-f to uto \-/(Lt,4te VCA-f r9- tZ P�-Ae Z FIRE DISTR T
SITE ADDRESS ( C4f e 6e CITY
DIRECTIONS TO SITE ADDRESS Ca,ti-,r nra 'ST4—UA,(7 t L.5Pr- at-k
mr3' oti( �Mt Wr
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\A ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) >L►9W V. �\c er>C2
IS USE: PRIMARY❑ SEASONAL El NUMBER OF BEDROOMS 1�>' NUMBER OF BATHROOMS
HEATED STRUCTURE e Bld ❑ YEAS (Partfsj of Bldg) ❑ NO ❑
DESCRIBE WORK
(Valuation/Project Bid Amount:$ )
SQUARE FOOTAGE:
1ST FLOOR C 7 Z sq.ft. 2ND FLOORAV49 sq.ft. 3RD FLOOR ---- sq. ft. BASEMENT sq.ft.
DECK�Q_ E D sq.ft. COVERECK_sq.ft. STORAGE —sq. ft. OTHER sq.ft.
GARAGE (�; sq. ft. Attached Detached❑ CARPORT---_sq.ft. Attached❑ Detached❑
MA UFACTU OME INFORMATION: *4 COPIES OF THE FLOOR PLAN RE,QIUIRED*
MAK MODEL YEAR
BEDROO BATHS SERI ER
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 permit/application becomes null &void if
work or authorized construction is not commenced within 186 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 0 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14-08.42)
X
S f OWNER Date
DEPART TAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING&PARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL _
PERMIT SPECIALISTS Approved&Ready for Pick-Up:
1/7
Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev. 112 712016 by JBN
r MASON COUNTY COMMUNITY SERVICES
Permit No:t6LQZO)6—�j13
CO
PERMITASSL5TANCE CENTER:
•BUILDING•PLANNING•FIRE MARSHAL RECEIVED
615 W. Alder St-Shelton, WA 98584
- -- Phone Shelton: (360)427-9670 ext. 352 Fax:(360)427-7798
- V1. Phone Belfair. (360)275-4467 Phone Elma:(360)482-5269 JUN 0 7 2016
I8S4
B U .D I N GLUMBING & MECHANICAL PERMIT APPLICATION I to W. Alder Street
OWNER INFORMATION: ))� CONTRACTOR INFORMATION:
ME NA : d w o Q(Ja 4"5 NAME: &pJ1,6 me-�3 Z,&C
MAILING ADDRESS:5Zl5rt. r L/�l.ca Ska L�Zot MAILING ADDRESS: 5LI5 LA 56W 1lz[
CITY: 04:�v M-7)IL STATE: UVA ZIP: 65/ I CITY:OLymplo, STATE: v j ZIP: 155 7Z4
I-PHONE: 030 5 PHONE: Zob-�'7► '7- abA CELL:_
2na PHONE: EMAIL :
EMAIL: L&I REG EXP.'
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): '2Z 8 ' ' �D0�� Zoning. ��n U��' 12-1P
LEGAL DESCRIPTION(Abbreviated): JA-r I PhG2SC 2
SITE ADDRESS: &WAI WA ITY:
DIRECTIONS TO SITE ADDRESS:
f -STell 0Z L- ✓ �,r� t
TYPE OF JOB
NEW ADD ALT REPAIR OTHER USE OF BUILDING �,« �P
LOCATION OF FIXTURES/UNITS- I sr FLOOR_&2 'FLOOR_BASEIv1ENT 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 Type of Unit No.of Units Fees
Bathroom Sink L) Furnace
Bath Tubs Heat Pump i
Showers � Spot Vent Fan t- S
Water Heater Propane Tank
Clothes Washer i Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher 1 Kitchen Exhaust Hood
Hose bibs 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
suspend d for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT PLICATION ZDAYS WILL INVALIDATE THE APPLICATION.
x �-
ooff Applicant Date
x 7�t itVe Owner/Owners Representative/Contractor
Print Name (Circle one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT JT� (r27-f b
PLANNING DEPARTMENT
FIRE MARSHAL
Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev:1/27/2016 JBN