HomeMy WebLinkAboutBLD2006-01123 SFR - BLD Permit / Conditions - 8/11/2006 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 BLD2006-01123
OWNER: DICK JENNINGS RECEIVED: 6/23/2006
CONTRACTOR: HILINE HOMES 360-598-1849 LICENSE: HILINH981BT EXP: 2/10/2008 ISSUED: 8/11/2006
SITE ADDRESS: 5232 W SHELTON MATLOCK RD SHELTON EXPIRES: 2/11/2007
PARCEL NUMBER: 420167500010
LEGAL DESCRIPTION: TR 1 OF SURV 14/108
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
New SFR (4 bedroom and den) Shelton Matlock Rd. to address.
Stock Plan#2003-0002
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-3U Lot Size: Deck:
Type of Work: NEW Fire Dist.: No.of Stories: 2 Occ. Load: Building:2,776 Garage-Attached 624
Valuation: Building Height: 33 Occ. Status: Primary Basement: COVPORCH 228
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W 36.0 Ft. Shoreline: Ft. Water Body:
Rear: E 152.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: N 55.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: S 385.0 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 KKK 6/23/2006 $314.11 S22006000
Hosebibs 3 Furnace<100K 1 Planning Review Fee KKK 6/23/2006 $155.00 S22006000
Kitchen Sink 1 Ventilation Fan 4 EH Plan Review TW 7/20/2006 $75.00 S12006000
Lavatories 5 Heat Pump 1 Building State Fee ARC 8/7/2006 $4.50 51200600o
Showers 1 Dryer Vent 1 Building Permit Fee ARC 8/7/2006 $1,570.55 S12006000
Water Closets (Toilets) 3 Mechanical Fee ARC 8/7/2006 $72.35 S12006000
Water Heaters 1 Mechanical Base Fee ARC 8/7/2006 $23.50 51200600o
Bath Tubs 2 Plumbing Fee ARC 8R/2006 $11o.0o S12006000
Clothes Washer 1 Plumbing Base Fee ARC 8/7/2006 $20.00 S12006000
Total $2,345.01
BLD2006-01123 Please refer to the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
BLD2006-01123
CONDITIONS FOR
BLD2006-01123
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
1-800-647-0982. 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) 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
sucMconnect 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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3) Wat= not to be degraded to the detriment of the aquatic environment as a result of this project.
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4) Prior to final approval, all upland areas disturbed or n=-file-
5) d by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
Temporary erosion control measures must be implemented to prevent water qu ation of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established. X Mtff
6) 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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7) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Apprpv mm t Plan"to ensure these structures are shown and meet the setback conditions listed.
8) Ow r assumes all responsibility if drainfield/reserve area is encumbered. The septic system is only approved for 4 bedrooms.
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9) Appr imensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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BLD2006-01123 Please referto the following pages for oonditions of this permit. 2 of 5
10) 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
Xepa t prior to any further inspections being performed or approvals granted.
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11) 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
inspe
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12) 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 ed documents will result in failure of required building inspections.
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13) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X i. j
14) 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
Xuildi jJgp ment prior to any further inspections being performed or approvals granted.
15) 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,
Doors (Type/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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16) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the
minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609
BAST IN PEED (3-SECOND GUST)the wind speed for Mason County is 85 MPH.
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17) Per 2003 IRC - SECTION R905- REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in
acco� the applicable provisions of this section and the manufacturer's installation instructions.
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BLD2006-01123 Please refer to the following pages for conditions of this permit. 3 of 5
18) Stock Plan Identification number: 2003-0002
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
Ineptp�at ch required inspection.
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19) 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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20) 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
cha�hall be collected by the Building Department prior to any further inspections being performed or approvals granted.
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21) 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
per on.
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22) 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 project.
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23) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinancp�,or regulation, must be reviewed and approved by Mason County prior to construction.
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24) 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
Inspcjm�l(� made prior to requesting additional inspections.
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25) All property lines shall be clearly identified at the time of foundation inspection. X
BLD2006-01123 Please referto the following pages for conditions of this permit. 4 of 5
26) 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
Xwon County ordinances and building regulations.
27) 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
hold�r,t�vg prevented action from being taken. No more than one extension may be granted.
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28) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
con, rs,aad flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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29) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"ApvS+;e Plan"to ensure these structures are shown and meet the setback conditions listed.
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30) 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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31) FIRE WARDEN REVIEW: THIS PARCEL REQUIRES A BURN OR ANY LAND CLEARING FIRES. CONTACT THE FIRE WARDEN FOR
FURTHER INFORMATION. (360)427-9670 EXTN. 459. X
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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 fora 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 pr ss 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 pr pe. nd ructure for review nspection.
OWN ER OR AGENT: DATE: C—v
T----7- 16 J4
BLD2006-01123 Please refer to the following pages for conditions of this permit. 5 of 5
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o CONCRETE MECHANICAL MANUFACTURED HOME m
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rn Footings!Setbacks Gas Piping Ribbons Z
InteriorUate Interior-Date By D By
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wExterior Date ly Exterior-Date BSot_� fA
Point load r Isolated Footings INSULATION Date By p
BG t SLAB INSULATION —— -- n
Date By Data By FIRE DEPARTMENT
Found atl Is Floors Date By
Date / - U Data By DECKS
FRAIVINd Walls Date By
Date (MCI By Data I BYLAI PROPANE TANKS
PLUMBING Vault Date By
Date By OTHER
Groundwork
Attic
Date B Date By Type- ( lt,�''tti
Y Date (7i1 f1W By(��
O.W.V l0 DRYWALL Type:
Date ( 3 07 Y By L41, Inc Brace wall Date By W
Date j-�jj sy FINAL INSPECTION 0
Water Line Firm Separation o
Date 3 D7 By Dana By Date - 7 By C)
Pass or Request Inspect. b
Type of Insp. Fail Date Date Done By Comments
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FORM MUST BE COMPLETED IN IN
K PERMIT NO: BLD /(O
PLEASE PRESS HARD MASON COUNTY
BUILDING PERMIT APPLICATION
426 W.Cedar/P.O.Box 186,Shelton,WA 98584 V
Shelton(360)427-9670 Belfair 360 275•d467 Elma 360 482-5269 Seattle 206 464-6968
APPLICAAT INFORMATION RMATION CONTRACTOR INFQR11fIATIO
Owner l _ e yi n jW S, Contractor Name NE
Mailing Address 1 Mailino AddrPt.c; SVfl Z�_ i
City ia State v3A Zip Cede _ City 1= `n S ate Zip Code
Phone( . 111--nQ Other Ph.(�)�I_a'�S Ph. ,they Ph.( �
Lien/Title Holder( �ynV Contractor Reg. # kiLIMIJAIA
Address_ Expiration_(L/_p 7 _/_p5 _
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic _Existing Septic Connect to Sewer
System Name of Sewer System Well—)� _Water System Narne of
Water System
PARCEL INFORMATION-12 di it Tax Parcel No. / / Fire District
Legal Descriptiun li — 1_ C 4
Site Address(Please include street name, str t number and city)
Directions JR site
Will timber be cut and sold in parcel preparat;on?—( 'es o) OLIO
Is your properly within 200' of the following: Body cf Water (Name) Saltwater
Lake___ River/Creek Pond Wetland Seasonal Runoff / Stream Slopes or
Bluffs
PERMANENT RESIDENCE SEASONAL RESIDENCE❑
TYPE OF JOB New X Add Alt Repair Other Use of Building
Describe Woik Ao�YIQ
No. of SediooilldlW No. of Bathrooms-_ SQUARE FOOTAGE-1st Floor i _2nd Floor�g2
31d Fluor o t Basement Deck Other COVWd derle _sq It. _
Garage 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 Price $ Replacernent Unit ?(Yes/No)
InstaCer Name Certification No.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 190 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents 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:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the 'CONTRACTOR'S AFFIDAVIT-1 certify that I 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 work will be done in requirements regulating the work for which this permit is issued and all work
Lc�Dnformance therewith. No changes made without first obtaining shall be done in conformance therew h. No changes shall be made without
roval
first oL•taini r
Dale i� 06 x
ate
FOR OFF CI USE BEYOND THIS POINT
A.ccpp!ed by Late Submittal Amount Due
Receipt No.
DEPARTMENTAL REVIEW . APPROVED DENIED CODES
CONDITION CEs
Building Department
Occ Group Type Constr.Planning Department I,
S
Environmental Health Department t �
Public Works Department i
Fire Marshal I
tA
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Valuation $
{ FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee '
I
Plumbing&Base Fee f ( ?j o , o p I Planning Review Fee
J
Mechanical& Base Fee g�, Cther
Wood/Gas/Pellet Stove Fee State Fee 4�•SO
Violation Fee D CIUF, Pre-Paid at Submittal t
TOTAL FEES
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
APPLICMT�INFORMATII,ON CONTRACTOR INFORMATION.
Owner Company Name
Mailin Addres 1 Maili ddre
City I tateZip Code City fate Zip Code
Phone Other Ph.� ��-IRI Phone Oth r Ph.
Lien/Title Holder Contractor Reg. * Exp.
E mail address Ca ft4ddress
Drivers Lic. DOB D ' .# DOB
SEPTIC INFORMATION - Connect to New Septic \ xisting Septic. Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District
Legal Description
Site Address (Ple include street name, street number nd 'ty) a 3
Directio ite
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New "1 Add Alt Repair Other Use of Building
t Location of Fixtures/Units - 1 st Floor Q 2nd Floor 2 2. Basement Gara a _Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric— LPG Natural Gas,_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heatpumps
Showers Spot Vent Fan
Water Heater I Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks I Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood i
Hosebibs Dryer Vent I
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or 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.
PR0,Qfg- 00VnNL1ATI0N OF IS BY MEANS OF A PROGRESS INSPECTIOON�N..�"" � �
X - Date: aQZQ
Owner/Owners Represen t e/Cont�(Cindicateich one)
FOR OFFICIAL USE BEYONDTHIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group-Type Constr.-
Planning Constr.-
Planning Department
Environmental Health Department
FEES
Plumbina & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
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�-� APPROVED
MASON COUNTY DCD PLANNING
`M SITE PLAN REQUF ED TO BE ON SITE
CHANGES SUBJECT TO APPROVYAL.
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MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)275-4467 SEATTLE (206)464-6968
ELMA (360)482-5269 FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2001 Washington State Energy Code (WSEC)
effective July 1, 2002
2000 Ventilation and Indoor Air Quality Code (VIAQ)
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
(WSECNIAQ)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. 284. Additional
WSEC and VIAQ compliance information is available on the internet at:
www.energy.wsu.edu/buildings/
Prescriptive Requirements 0,1for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing Ll-factor Door Wall Wall Wall
Area% of Ceiling Vaulted Above interior° exterior Slab"
Option Floor „ Ll 9 z 3 ^ s
Vertical Ceiling Grade below Below Floor on
�oOverhead Factor ty
grade Grade Grade
I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
ll* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
III 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. 284 for footnote information. Log & solid timber wall with a min. avg. thickness of 3.5"are
exempt from the above grade wall.insulation requirements.
H�L Window Schedule for
HOMES plan 2776
Manufacturer: Milgard Windows Inc.
Type: Vinyl
Model: Style Line Series
U-Value = 0.35
Window SIZE GLAZING TOTAL LOCATION
Quantity widthxhei ht AREA SQUARE FT.
2 6'Ox5'0 30 60 Living Room
1 4'Ox4'0 16 16 Bathroom
*1 6'Ox4'0 24 24 Master Bedroom
1 4'Ox3'6 14 14 Kitchen
1 3'Ox3'0 9 9 Utility Room
1 6'Ox5'0 30 30 Dining Room
1 2'Ox5'0 10 10 Entry
3 6'Ox4'0 24 72 Upstairs Rooms
1 2'Ox3'0 6 6 Upstairs Bathroom
2 6'Ox4'0 24 48 Upstairs Rooms
1 4'Ox4'0 16 16 Stair Case
1 6'Ox6'10" SGD 41 41 Country Kitchen
Total Window Area = 346 SQ.FT. JTotal Glazing Area = 346 SQ.FT.
(346 , / 2776) 0.124 x 100 = 12%
(Glazing Area / Conditioned Floor Area) x 100 = Glazing Percentage
* If a sliding glass door option was chosen, switch the appropriate window with
the slidinq qlass door and use the calculation below.
1 16'Ox6'1 0 SG 41 41 Appropriate Room
(363 / 2776) 0.13 x 100 = 13%
(Glazing Area / Conditioned Floor Area x 100 = Glazing Percentage
*All other doors,windows and skylights do not need to be calculated because they
meet all minimum requirements
Updated 5/5/05
EHiL ICE VICINITY MAP NORTH
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NAME: C 1( 1 �Pu a� C,v1vi S
SITE ADDRESS: 7cXxx �;� I ,. �k_. W,
CITY:
ZIP: `7353-f
MAILING ADDRESS: -<2
CITY:
ZIP:
PARCEL NUMBER:
PHONE NUMBERS H:
W: 3c 725 >z� L jy
C:
MILES FROM HILINE SALES OFFICE: 5-5
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------ Detach And Display Certificate --�
DEPARTMENT OF LABOR AND INDUSTRIES
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
i � REGIST.
# EXP. DATE
CC01 HILINH*981BT 02/10/21
EFFECTIVE DATE 01/30/2002
HILINE HOMES
11306 62ND AVE E
PUYALLUP WA 98373
! I
`---- Detach And Display Certificate ----------- --- =
HiL INE - Building Permit Information Form - 2776 Plan
This form contains the information you'll need to complete your building permit packet. We've included information for all counties,
some of it may not apply to yours. If you have any questions, please give us a call at 360-807-1849
Applicant/Owner/Contact Information: Your name, address, phone number
Contractor Information: Name: HiLine Homes of Elma
Address: 50 Enterprise Ln Ste 215
Elma WA 98541
Phone: (360)482-1750
License# HILINH*981BT
Expiration: 01/30/06
Tax Parcel#/Assessor's Acct.#: This will be with your property information.
Job Site Address: Your new home address(example:xxx Filmore St.)
Legal Description: This will be with your property information. (example:Lot xx Large Lot Sub Division xxx in Lewis County etc.)
This will be a New Single Family Residence
Describe work/Type of Job: New Home construction
Home Information: Floor Area: (sq.footage)
Main/1st: 1484 #of stories: 2 Carports: 0
Second: 1292 Bedrooms: 3 Decks: 0
Basement: 0 Bathrooms: 21/2 Porches: 228
Total: 2776
Garage: 624 (Attached)
Construction Method: Wood frame
Heating System:
Be sure to choose the information below that correlates with the heat system you have ordered.
HVAC/Mechanical Contractor is the company installing your heat system.
Cadet/Wall Mount/Zone Heaters: Standard heats stem
Installer: North Pacific Electric Contact: Bernie/Kim
License#: NORTHPE994JB Phone: 360-943-6020
Expiration: 04/01/04 Location: Olympia
Manuf: Marley Brand:
Module M KW: 14
WHF: AMPS: 20
On permits,for the#of wall heaters,put 1,or you'll be charged extra for every one.
Heat Pump w/furnace w/HWH:
Installer: Chehalis Sheet Metal Contact: Dave Pyles
License M CHEHASM252MH Phone: 360-748-9921
Expiration: 07/02/04 Location: Chehalis
Manuf: Trane Module: 2TWB0042A1000A KW: 15
Tonnage: 3.5 HSPF: 7.4 Seer: 10
LRA: 92 Efficiency: 100%
Natural Gas or Propane furnace w/HWH
Installer: Chehalis Sheet Metal Contact: Dave Pyles
License M CHEHASM252MH Phone: 360-748-9921
Expiration: 07/02/04 Location: Chehalis
Manuf: Trane Module: TDE080A945 Watts: 1046.5
BTU: 80,000 Efficiency: 80%
Spot Vent Fan: I Kitchen Exhaust Fan: 1 _ Dryer Vent:_ Wood/Gas/Pellet Stoves:_0 Gas Outlets:_
Plumbing System: Installer: Allied Plumbing Contact: Roger
License M ALLIEP*986KC Phone: 360-289-4114
Expiration: 05/31/06 Location: Rochester
Toilets:_3 Bathroom Sinks:_ Bath Tubs: 1 Showers:_ Kitchen Sinks:_1_ Water Heater:_
Clothes Washer:_1_ Dishwasher:_1 Hose Bibs:_1 (first 4 enter quantity of 1, every home has 2)
Energy Compliance Information:
Compliance Method/Path: Always#3(Per Washington State Energy Code)
Total sq.ft of glazing(glass): Standard home: 346. w/sliding glass door option: 363 divided by
total sq.ft.of heated area: 2776_equals a glazing percentage of 12% standard or 13% w/sliding glass door option.
Swinging doors and skylights are not counted in this configuration because they meet all requirement minimums.
Window Schedule: See attached form.
Ventilation System:
Jntermittently operating Whole House Ventilation System using exhaust fans&window fresh air vents. (VIAQ 303.4.1)
House Fan Specifications: Whole house fan: Qty: 1 Manuf:Whisper Ceiling Module#: FV-15VQ3 CFM: 150
Bathroom One-Bulb Heater/Fans: Qty 3 Manuf: Solitaire Ultra Silent Model M 162 CFM: 70
Copyright 2003 HiLine Homes
tv/ z 3
ACCESS & GRADE WORKSHEET DATE: O
ADDRESS ;2, ?jO
INSPECTOR
DRIVEWAY ACCESS
Length: I CAL' Width: Surface:
Size of turn-around:
Condition of shoulders:
Vertical clearance:
---�� need post at end of driveway with reflective address numbers.
GRADE,OF DRIVEWAY % OF ROAD oho
ROAD ACCESS
Length: Width: urface:
Condition:
Vertical clearance: /
( BURN PERMIT REQUIRED FOR LAND CLEARING FIRE.
( ) LOT INSIDE SMZ, 4X4 FIRES ONLY.
( ) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED.
LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES.
REMARKS
4T �
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