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HomeMy WebLinkAboutBLD2014-00851 SFR - BLD Permit / Conditions - 11/4/2014 Inspection Line (360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar Shelton, WA 98584 _1854 RESIDENTIAL BUILDING PERMIT BLD2014-00851 OWNER: FRED BADER RECEIVED: 9/12/2014 CONTRACTOR: PUGET SOUND CONSTRUCTION JOSEPH PANZERA LICENSE: PUGETSC887N3 EXP: 8/2 ISSUED: 11/4/2014 SITE ADDRESS: 90 E UNION HEIGHTS PL NORTH UNION EXPIRES: 5/4/2015 PARCEL NUMBER: 322327590123 LEGAL DESCRIPTION: TR 12-C OF SURVEY 5/59 TR 4 OF SP#610 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR BROCKDALE RD, MCREAVY RD, L ON UNION HEIGHTS DR, FOLLOW UP HILL R ON UNION HEIGHTS PL NORTH TO SITE ON THE CORNER OF UNION HEIGHTS PL NORTH, AND GARNET DR General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: V-B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: 148 Type of Work: NEW Fire Dist.: 6 No. of Stories: 1 Occ. Load: Building:1,344 Garage-Attached 576 Valuation: $ 177,394.48 Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: W 50.0 Ft. Shoreline: Ft. Water Body: Rear: E 45.0 Ft. Slop e: Ft. SEPA?: No Model: Width: Ft. Side 1: N 211.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: S 40.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 2 Furnace<100K 1 EH Plan Review GMM 10/7/2014 $200.00 S1201400000001 Lavatories 2 Heat Pump 1 Planning Review Fee GMM 10/7/2014 $205.00 S1201400000001 Bath Tubs 2 Ventilation Fan 3 Fire Warden Review GMM 10/7/2014 $73.00 S1201400000001 Showers 2 Exhaust Hood 1 Mechanical Permit Fee RTB 10/15/201 $85.70 S1201400000001 Water Heaters 1 Dryer Vent 1 Mechanical Base Fee RTB 10/15/201 $28.50 S1201400000001 Clothes Washer 1 Plumbing Permit Fee RTB 10/15/201 $ 110.60 S1201400000001 Kitchen Sink 1 Plumbing Base Fee RTB 10/15/201 $24.70 S1201400000001 Dishwasher 1 Building State Fee RTB 10/15/201 $4.50 S1201400000001 Hosebibs 2 Building Permit Fee RTB 10/16/201 $ 1,430.55 S1201400000001 Plan Check Fee RTB 10/16/201 $929.86 S1201400000001 Total $ 3,092.41 BLD2014-00851 Please refer to the following pages for conditions of this permit. Page 1 of 3 CASE NOTES FOR BLD2014-00851 CONDITIONS FOR BLD2014-00851 1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/Reserve requires a 1 Oft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. N2,foundation drains within 30ft, down gradient of drainfield/reserve area. X y f 2) On-site septic system final installation approval required prior to temporary/final occupancy. SWG2014-00157 3) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. x ,T f 4) All construction and demolition debris must be removed from the site after project completion. Proper disposal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X 1ie 5) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X S f 6) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or properties. Silt fencing, straw, or surface matting must be installed and maintained until upland vegetation has become established. X S,P 7) Concrete leachate and wash water must be contained during construction pouring, such that water quality degradation of adjacent waters does not occur. X 'T F BLD2014-00851 Please refer to the following pages for conditions of this permit. Page 2 of 3 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 DAYS WILL INVALIDATE THE APPLICATION. Lltu�L V 1, "JQk, C k //Z Z C� Sig ture Date OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2014-00851 Please refer to the following pages for conditions of this permit. Page 3 of 3 W o CONCRETE MECHANICAL MANUFACTURED HOME W R Date J 23-�S B VIA6v - v Footings/Setbacks Gas Piping Ribbons M o Interior Date By Interior-Date By Date By Exterw Date//„,47-/rr BY/jVAV Exterior-Date By Set-up Point toad t Isolated Footings INSULATION Date By p BG l SLAB INSULATION - -- Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By Dante JA/,p=/y B ygpg Data tl 7 I Y- BY 1.�) DECKS FRAMING Walls QC Date By Date �i 1 / By �01t Data I l� By AU PROPANE TANKS PLUMBING vault Date By DateId i:71 By OTHER Groundwork Attic Date By Date By Type Date By D.w_v DRYWALL Type. Date . 2?� -f Int Brace Wail pate q By ek% CA Water By FINAL INSPECTION Water Line I. Fin Separation N Date ,.v�J By Date By Date _� By m 4;h. Pass or Request Inspect. c Type of insp. Fail Date Date Done By Comments o -6 010 row. o Ae N O -,� Vl rn Z3 m �_ '/ >, N / CD rc- 0 0 Permi #/6i 12�Ssl MASON COUNTY BUILDING Ill 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been ound: Items listed below must be corrected to gain compliance ,u r r��� )C aw -Q- ��o F f "-1- ar,?,d You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Please contact our office 'A Make corrections, i ,emus will be che�cked on next inspection regarding possible structural �-OK ) to �/5U Cruet./ LJL7 /. as �l�".L��i�Tj Cfl� al4zn damage incurred by erecent natural/man made ❑ This is not a complete inspection disasters.This is NOT a Date 2- 23 - l 5"' Department 1CMD CORRECTION NOTICE. Inspector_ 20&d • v* 4 N* ,#T i rl* *4 ' ' THI T,&,- * mw Permit# ��� MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location % 1� 4-ts P1 K.- This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain compliance Ji. L✓rt�• t'ovK �� 4 0" v► t��� ate ze, Ir►sG sew �r : G ti,nt�l vl A -res Ct r.� �� I►-eti 1� �csT P .- t -t,44A <s rKeri 1�-t z-sr-- v -ta r s `r +t 11 t Qen I�L..t�� st t A � �a /'a►. ti'� ,s � r,/' tirc�+d1'� Ali Qec,v— 10,Lf (,, 5T 1J yubyt— 1� + Cam- L1 K/ & L-1L1+1J41. ►^4 PI -ry C0 1 C.,4- CO &-rttl•rd e— You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ® Call for re-inspection when corrections are made before continuing ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural1man made" ❑ This is not a complete inspection disasters.This is NOTa Date y��,-) Department CORRECTION NOTICE. Inspector LA) L-- N* �T P r 1* ,0 ; ' THIllb, TAa* mw MASON COUNTY PERMIT NO.-B02LL1 ]-WF'`- DEPARTMENT OF COMMUNITY DEVELOPMENT 1 BUILDING a PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 A im Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext.352 1854 Shelton,WA 98584 (360)482-5269 Elma ext. 352 BUILDING PERMIT APPLICATION *e;� � �` JO�- TION: CONTRACTOR INFORMATION: NAME: /� �' NAME:0-0---?*,/I;'��-4 ,Via . .�✓&�i�'���1� z'-�1/�y�l��� tip MAILING ADDRESS:qA2Erl a /_- v MAILING ADDRESS: 'I X, f'T 5;�. CITY: J&'1/'0V STATE: - ZIP: CITY: 9�-t150A? STATE: PHONE: CELL [ / `-7r'4 PHONE(.3�� Z. �= � - ELL:r'Z,/' 7-e� 1 � EMAIL: EMAIL : Sric � L&I REG# Z c Xf-7--5,--1-9 ��EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) -'✓ .. i © j FIRE DISTRICT LIP LEGAL DESCRIPTION(ABBREVIATED): SITE ADDRESS �//��/�`� f CITY LlyoA DIRECTIONS TO SITE ADDRESS Arai • `�'-- .E-£f i �*161.1f�JYI ��s c "�rl�*!lyi� 1�� �'7` �`'�"fr IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES[] NO ❑ TYPE OF JOB: NEW A ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) K E IIA54?-r IS USE: PRIMFARY ❑ SEASONAL❑ ER OF BEDROOMS NUMBER OF BATHROOMS DESCRIBE WORK Y1 E W S 1"C . SQUARE FOOTAGE: 1 ST FLOORJ� sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK -COVERED DECK_sq.ft.STORAGE sq.ft. OTHER sq.ft. G E sq. . ATTACHED Jg DETACHED ❑ CARPORT sq.ft. ATTACHED❑ DETACHED ❑ MANUFACTIMMHOME INFORMATION: *4 COPIES OF THE DEL AR 7LENGTHTH BEDROOMS SERIAL NUMBE 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 a to and gr loyees of Mason County access to the above described property and structure(s)for review,a ect his peysuend lication be mes null&void if work or authorized construction is not commenced within 180 days if const tion work is ed for a peri PROOF OF CONTINUATION OF WORK IS BY MEANS OF IN EC=IONCT ITY OF THI PERMIT APP [CATION OF 1 DAYS WILL INVALIDATE THE APPi IqATION. i natur of Ap cant _ ` Date OWNER/ REPRESENTATIVE /CONTRACTOR 2PI-int Na a (CIRCLE TO INDICATE) DEPAR VIEW APPROVED DATE DENIED DATE T '!'S BUILDING DEPARTMENT /G PLANNING DEPARTMENT OCT FIRE MARSHAL 426W.CEDAR ST. MASON COUNTY PERMIT NO.�U DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING• PLANNING• FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 _ Mason County Bldg. III,426 West Cedar Street (360)2754467 Belfairext.'352 1954 PO Box 279, Shelton, WA 98584 (360)482-5269 Elma ext.352 -PLUMBING & MECHANICAL PERMIT APPLICATION WWWORVATION: CONTRACTOR INFORMATION: NAME: / / "IS NAME: Z50,eL; Gd ��E. ��.J, �n✓iJ�?s5i�' ., MAILING ADDRESS: MAILING ADDRESS: CITY: 1,r111�� STATE: / ZIP: CITY: STATE: 6eZrZ= ZIP: ; PHONE: CELL: PHONEC-M �/ f CELL:(' EMAIL: EMAIL -1 r� -IgAecI4 41 �- L&I REG EXP. -1 la� PARCEL INFORMATION: PARCEL NUMMER(12 DIGIT NUMBER): : 7�s Z 8- �Z` 11.91 LEGAL DESCRIPTION(ABBREvum): SITE ADDRESS: �. �'_ CITY: DIRECTIONS TO SITE ADDRESS: 0� �J TYPE OF JOB NEW ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS-1 IT FLOOR 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNTf S TvDe.of Fixture No. of Fixtures Fees Fuel Type:Electric V LPG Natural Gas Ductless_ To` ets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump Showers _ Spot Vent Fan 3 Water Heater i Propane Tank Clothes Washer I Gas Outlets -~ Kitchen Sinks ! Wood/Gas/Pellet Stove --• Dishwasher i 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 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 INVALIDATE THE APPLICATION. X Signature of Applicant Date X Owner/Owners Representative/Contractor Print Name (indicate w v4hpI)MY) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAMPITUTrwrtm RHAWN S BUILDING DEPARTMENT OCT 0 9 2014 PLANNING DEPARTMENT FIRE MARSHAL r �22 31 - 35 -qo rZ Request To Revise An Approved Plan Permit Number: BLD G Name �6S � r" i-(� Parcel Number - - Phone Number daytime (��' ) J - 07 Project Address q 0' U �, ��h Ile���, �S (r'L Mailing Address /0.c', IF7C Please provide a complete, detailed description of the proposed revisions to the approved p1aECETVET1 � � Y�01 _ ADD 1 2015 Ly Cj&Co --c W. CEDAR ST.; Are two sets of the revised plans or addendum indicating the changes included? Q Yes ❑ No Are the approved site plans included? �4 Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? 11 Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? tN Yes ❑ No If Yes, Has the engineer or architect approved this revision? [IQ Yes ❑ No Is a stamped and signed approval included with this request? J� Yes ❑ No (Note:No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? g Yes ❑ No If Yes, Is a revised site plan, with all new setback dimensions included with this request? Yes ❑ No Additional Information: Applicant's signature Date: % Office Use Only Received by: Date Sent Assigned To Approved By Date Original Valuation: $ ! 7 U ❑ B. Additional Valuation: $ Wt Sq.Ft. x$ $ P. L`L 1S Sq. Ft.�x$ -3 $ - P yI2� is Total New Valuation $ d E.H. Additional Fees: W• Additional Planning Dept. $ Additional Plan Review $ 00 Additional Conditions/ Comments: Additional Building Permit $ $`0 _ q D Additional Plumbing $ Additional Mechanical $ Additional E.H. Dept. $ 7 S Other $ � Total Amount Due: $ / 11`c�p� l/• 0 Amount To Be Paid Up-Front$ • - t 84 PL Gam.. 3 o, O -Z;0 S L N-6 - -k,67 PLAN PLOT IkiifSIO j RECEIVED Audio-Visual Alarm DATE.Aorl, � Cleanout _ 1200 Gallon Septic Tank -Z 2 Compartment with Effluent liter 1000 Gallon Pump Chamber ', �( �°�"''t• O5 Valve Control Box N 00 ' -� tik O.C. o-'v, 4 � New �ec� IS�ti�fB' (r;vewa� �x2�' s o O I 6A6A A� P LAN I N MASON A �DCD PLANNING ALL SETBACKS ARE MEASURED SITE PLAN REQUIRED TO BE ON SITE FROM THE FURTHEST CHAN ES SUBJECT TOAPP v 4"x8" BEAM O i 5/8„ LEDGER LOGIC CONNECTION 4"x4" GROSS BRACE (2) 2x6 STUDS IN WALL 5/5" LEDGER LOGIC CONNECTION �fl FORGH PETA I L PLAN #2014-Oct 8 6734 R"GISTF-p THO;I.. S A. HEASTAD STATEF WASHINGTON 2$'/ Namef,eE1' e^/f 7t/1/ ,',4Y1Z-k'Parcel# L "" Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwaier 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: httD//"Aww.co.niason.,Am—us/c,ode/r,on=issiODers/'index.htn I L®� N G 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 Sinall.Lotsi-74,Small Parcel Stormwater Site Plan".This document will assist. you in preparing the necessary information and plans for lic Works to review and approve. Per Department of Public Works this dc►ctament'constitute an approved plan,if�.all-ofth evant details* are to be installed in their entir no part of a storm water system adversty affects any se tic stem(seg Envirorunental Health info on belo ). If an alternaxive system is to be used a plan will need to be s miffed to Public Works for approval. A sign 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 itormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE 1 A) ti The relevant delmis 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) e plan on si will be "tted to the ent of Pub' ks for r e system wrll be located as not to adversely affect any sep c systems on ,or any other,p 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. (S(-,ction 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT.450 Mail: P 0 Box 1850,Shelton WA 98584 Physical:415 N 6th St,Shelton WA 98584 If this development has, or will have, a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel. You may also wish to consult with the septic design professional involved with the project Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT.352 Mail:P 0 Box 1666,Shelton WA 98584 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site prior to a request for final inspection of the building permit Ownerauilder/Agent ADknowledges that submission of inaccurate information may result in a stop work order or permit 6 20 4 AcknowIiedgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the co , ED ST, further acknowledge that the information provided is accurate and employees of Mason County are granted access to t� C described propertyf�T6i—ew and inspection as may be rewired. X C �'��2 Owner/Agent/Contractor(circle one)Dal,—_ ( Z Page 2 of 2 Name 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,ODO square feet of impervious surface2. '`Redeveloament 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 maintendDCe activity,and land disturbing activities associated with stucfural or impervious redevelopment. 'Common iWeryious 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 o0ed,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detenhon facilities shaU not be considered as impervious surfaces. Teo=.ickct lete:lrii t riii vs S ces leas Coin' et :- his Surface Type Length X Width = Area *All dimensions in feet Bui1 ins X = 1 = 6 ,) Measurements for buildings are taken at the perimeter of the farthest projecfions(example: X = eaves/gutters) X = Driveways X = r i;/) 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 = PatiosMfalks X = X = Any paved, gravel or packed area per definition above gable X = Others X - X = "tf,the total impervious area of the proposed sit- 9 X = 1'developmei is.-greater thdn.ZDDO square feef a - SmaI1 Par�e1:Stomlwater:Site.Plari is required.: �� - Total urn oils.Sartace Area sum-af till ar = - _ If the Total Impervious Surface Area ' LESS THAN 2000 Square Feet, ease read,acknowledge and sign below. Based Upon the information you have pro ' er e 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,owneras 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 1 of 2 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPM WSEC/Ventilation Code Compliance Application IN U I L Lr%,; I IN G Submit with heating/cooling system size worksheet (see instructions #4) Owner: Parcel#: C, _ Type of project: �Fc Total Sq. Ft. 1 S Floor: 2" floor: Heated Basement: of heated area:: 1 1334 Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace • 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 O Component Performance, R402.1.3 — Calculation worksheets required Check one:: O Other (specify): Check one p Whole House Ventilation system O Whole House Ventilation O 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: http://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 05 non-glass glazing materials. —0.5 points b) Medium 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): D,G3 RECEWED OCT 0 5 2014 426 .W CEDAR st7. 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 gla ing materials. Manufacturer Location U-Factor Size Quantity Total rough opening) Square Feet II � n cd ), , �v Total Fenestration: windows, skylights and door area ACCESS & GRADE INSPECTION BLD J 2Dl y�Q�l`fSJ ADDRESS: !�D 7l'l�jjT� I E�rr'� INSPECTOR: /w fjr DATE OF INSPECTION: — FIRE SPRINKLER REQUIRED? (circle' YES IF fire sprinkler required, was notification letter mailed? DATE MAILED: DRIVEWAY ACCESS need post at access of driveway with reflective address numbers Length: Width: Surface: Size of turn-around: Condition of shoulders: Vertical clearance: GRADE OF DRIVEWAY %, OF ROAD % ROAD ACCESS Length: Width: Surface: Condition of Shoulders: Vertical clearance: BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. LOT INSIDE UGA—NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4 X 4 FIRES 2 X 3 FIRES PASSED ( ) FAILED ( ) ON HOLD ( ) REMARKS: