HomeMy WebLinkAboutBLD2015-00159 SFR - BLD Permit / Conditions - 4/21/2015 Inspection Line(360)427-7262
06oK cop MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III
426 W. Cedar
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT
BLD2015-00159
OWNER: TAMARA VERMILLION RECEIVED: 3/6/2015
CONTRACTOR: EVG NORTHWEST 360-791-1062 Mark LICENSE: EVGNONL895CA EXP: 6/20/2015 ISSUED: 4/21/2015
SITE ADDRESS: 8404 ESTATE ROUTE 106 UNION EXPIRES: 10/21/2015
PARCEL NUMBER: 322344490001
LEGAL DESCRIPTION:
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR SR 106 TOWARD BELFAIR, TURN ON DRIVEWAY SOUTH SIDE OF ROAD
FROM 8371 E SR 106.
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 2 Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3, U Lot Size: Deck: 260
Type of Work: NEW Fire Dist.: 6 No. of Stories: 2 Occ. Load: Building:2,819 Garage-Attached 728
Valuation: $ 355,894.16 Building Height: Occ. Status: Basement: cov deck 344
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: W 60.0 Ft. Shoreline: Ft. Water Body:
SEPA?: No
Model: Width: Ft. Rear: E 2 .0 Ft. Slope: Ft. Shoreline Desi
Side 1: IN 25.0 Ft. 9.: Not Applicable
Year: Serial No.: Side 2: S 0.0 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 3/6/2015 $ 1,577.78 S2201500000001
Lavatories 3 Heat Pump 1 Planning Review Fee JBN 3/6/2015 $205.00 S2201500000001
Bath Tubs 1 Ventilation Fan 4 Fire Warden Review JBN 3/6/2015 $73.00 S2201500000001
Showers 1 Propane Tank 1 EH Plan Review JBN 3/6/2015 $205.00 S2201500000001
Water Heaters 1 Gas Outlets 2 Building State Fee RTB 4/21/2015 $4.50 S1201500000001
Clothes Washer 1 Woodstove 1 Building Permit Fee RTB 4/21/2015 $2,427.35 S1201500000001
Kitchen Sink 1 Exhaust Hood 1 Mechanical Permit Fee RTB 4/21/2015 $246.90 S1201500000001
Dishwasher 1 Dryer Vent 1 Mechanical Base Fee RTB 4/21/2015 $28.50 S1201500000001
Hosebibs 3 Plumbing Permit Fee RTB 4/21/2015 $ 110.60 S1201500000001
Plumbing Base Fee RTB 4/21/2015 $24.70 S120150000000i
Total $4,903.33
BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 1 of 7
CASE NOTES FOR
BLD2015-00159
CONDITIONS FOR
BLD2015-00159
1) Xppr� dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
2) All construction and demolition debris must be removed from the site after project completion. P o r i sal of construction debris must be on land in
such a manner that debris cannot enter or cause water quality degradation of State waters. X
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3) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacen te
r— or properties. Silt fencing, straw, or
surface matting must be installed and maintained until upland vegetation has become established. X /7
4) A Mason County 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 al*�4a
nsult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/connowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
5) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. All
applicable recommendations and specifications shall be applied to the development on this site. Any deviation requires stamped written approval from the
registered design professional responsible for the report/assessment, and may require special inspection by same. Structures and/or land modifications
(grading, cuts, fills, etc.) required in the geotechnical report/assessment, may require a separate permit. The geotechnical report/assessment shall
rem in hVd to the approved building plans.
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6) Con!/ �e and wash water must be contained during construction pouring, such that water quality degradation of adjacent waters does not occur.
X (
7) All property lines shall be clearly identified at the time of foundation inspection. /.
8) Landings n st irs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
'App &,,51an"to ensure these structures are shown and meet the setback conditions listed.
X
BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 2 of 7
9) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan" to ensure
these tructizes meet the setback conditions listed.
X -
10) Retaining walls needed to support a sur ge.s ' as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X
IF
11) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
12) 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 potefirtial risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-80 7 2. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
13) 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 ranted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
D n rior to any further inspections being performed or approvals granted.
14) Ownep t. responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X
15) 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. TFl�c
mit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
remIved documents will result in failure of required building inspections.
X
16) 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 4e granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Build i p ent prior to any further inspections being performed or approvals granted.
X
17) 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 addi io tlie fohlowing credits from R406.2 shall be completed as follows: 5b LP W.H. min. EF 0.82
X r
BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 3 of 7
18) 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 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 '/4 or'/2 sheets. The
Maso C Permit Center will also have some available.
19) A minimum of 7 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section
R404. .
X&4
20) 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.
4-z-
21) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical c c to ork exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X
22) 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 DWE LINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances),
repair r aildli
ns requiring a permit occur, or when one or more sleeping rooms are added or created.
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BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 4 of 7
23) 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 doguments are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
char shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
X
24) All construction m st meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of ashin on. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
perm r o n.
X <
25) 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 locat�in 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 projec
X
26) All changes to "pp oved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordina r lation, must be reviewed and approved by Mason County prior to construction.
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27) 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 i terna Vonal codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Insp r be made prior to requesting additional inspections.
X !s
28) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks filled
on site must be located a minimum of 10' from any possible source of ignition (electrical outlets, electrical fixtures, compressors, etc), mechanical system
air intake (direct vent appliance, ventilation air intake, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. Propane
tanks less than 125 gallons must also be located a minimum of 5'from any building opening (foundation vents, windows, doors etc). Setback to the public
way, or access easements shall be the greater of 25-ft or as specified in the Mason County Development Regulations. Setback to property lines shall be
the gre er of or as specified in the Mason County Development Regulations. If a propane tank is exposed to probable vehicular damage, protective
boll m s e installed.
X
BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 5 of 7
29) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All Propane tanks
between 125 and 500 gallons must be located a minimum of 10' from any building, possible source of ignition (electrical outlets, electrical fixtures,
compressors, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. Setback to the public way, or access easements
shall be the greater of 25-ft or as specified in the Mason County Development Regulations. Setback to property lines shall be the greater of 10-ft or as
specifie i t Mason County Development Regulations. If a propane tank is exposed to probable vehicular damage, protective bollards must be
in
i
X
30) All propane tanks piust be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks must
meet tzryzl
on requirements and minimum setbacks as listed in the Mason County Fire Marshal's Standards for the Installation of Propane Tanks.
X
31) Fuel piping shall be inspected after the installation of fuel piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the
time of' spection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall
Zt ntil the final inspection has been performed and approved by a Mason County building inspector.
X
32) The placement of small propane tanks are not normally subject to a permit review by the Planning Department; however, propane tanks are subject to
Planning Department regulations. Such regulat_i s primarily consist of setbacks from shorelines and features considered to be critical areas (streams,
wetlands, slopes, etc.) If you think su a r exist on or nearby your property, please contact the Planning Department so that exact setback
requirements can be determined. X
( I Z33) All property lines shall be clearly identified at the time of foundation inspection. X
34) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to requ t a fin I inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mas n ordinances and building regulations.
X
35) 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
actio f r a eriod not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
hol a evented action from being taken. No more than one extension may be granted.
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36) Pressu r t wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
conflashing. Install metal connectors approved for contact with the new types of pressure treated material.
X
37) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR R
X
BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 6 of 7
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
PERMg APPLICATION OF 18 AYS WILL INVALIDATE THE APPLICATION.
Signature ffite
,l
OWNER - REPRESENTATIVE - CONTRACTOR
int Name (Circle one to indicate)
BLD2015-00159 Please refer to the following pages for conditions of this permit. Page 7 of 7
PLANNING
NT5
� p
ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
PROJECTION OF THE BUILDING
.N
a �-
��e.
z
i
APPROVED
MA ON COUNTY DCD PLANNING
SI E PLAN REQUIRED TO BE ON SITE
HANGE UBJ CT TO APPROVAL
By Date
RECEIVED
MAR 0 6 2015 `PG
-g0001
426 W. CEDAR ST.
3�a3�1 � �Iy
1 i
2B� STq�
AY�
N
_. ---- SCALE- 1 INCH = 100 FEET
0 50 100
40
60
RECEIVED
MAR 0 6 2015
i
426 W. CEDAR T.
so
too _
120 EXIST
�\ OR11DF D
145.00FTt F FT
eRM-OSE
D SINCLE
70 FT / / \FAMILY RESIDENCE IOWT-
3 BD�
ROOF DRAIN OUTLET.
ABOVE GROUND PER /
GEOTECHNICAL REPORT--.,_J / 20 T APPROlDNTE sort
HEAD FOR WATER
140 SOURCE
PROPOSED DRAINFIELD
PROPOSED, WATER BNR-500
TREATMENTS
J PROPOSED 10DO-
160 ' PUMP CHAMBER
RANSPORT LI-
PROPOSED
DISTRIBUTION
BOX �4
ISO
PLANNING:
ALL SETBACKS ARE MEASUR ED
200 FROM THE FURTHEST
PROJECTION OF THE BUILDING
240 ___ LINE
PROJECT/ OWNER/ LOCATION
MARK VERMILLION
no
M VERMILLION
XXX NE NORTH SHORE ROAD
PARCEL 32234 44 90001
300 MASON COUNTY,
OUNTY WASHINGTON
ENGINEER+
ENVIROTECH ENGINEERING
PO BOX 984
320 BELFAIR, WASHINGTON 98528
360-275-9374
145.00FT± SITE PLAN
t
oo`,r MASON COUNTY PERMIT NO. 00159
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)275-4467 Belfair ext. 352
tires PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext. 352 ` vry
PLUMBING & MECHANICAL PERMIT APPLICATION
`a S
OWNER INFORMATION: CONTRACTOR INFORMATION: BUILDrNG
NAME: Ve-rM, /I n;j. . NAME: C✓is
T.;,�vt�,rc�
MAILING ADDRESS: p0 cicx Jfj"Z MAILING ADDRESS: r-0 evk 3 Z
CITY: 1"/n; STATE: j„/A ZIP. 4'f5S?'2 CITY: STATE: i,t//fi ZIP: n(i4-:?'L
PHONE: CELL: --',L;,,,'-79/-iu E Z PHONE: A11A CELL: -3 6•?-791-i 0C z.
EMAIL: EMAIL :
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER): 5 -- 2 3't -44 -;�qn o i
LEGAL DESCRIPTION(ABBREVIATED):
SITE ADDRESS: +� '— gwl?y LZ .5 PT 06CITY:
DIRECTIONS TO SITE ADDRESS: D
TYPE OF JOB 426 W, CEDAR ST.
NEW-X ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS— IT FLOOR 2'D FLOOR BASEMENT GARAGE ;r7 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 Furnace I
Bath Tubs I Heat Pump I
Showers Spot Vent Fan
Water Heater Propane Tank��0 `1 1
Clothes Washer Gas Outlets
Kitchen Sinks 1 Woo as/Pellet Stove. I
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
suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION F 180 DAYS WILL INVALIDATE THE APPLICATION.
X �� �j — (2 CI
Signaturree of�pplicant Date
X .- C/_ Owner/Owners Representative/Contractor
I�-mt Name (indicate which one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAiR (360) 275-4467 Elma (360) 482-5269
FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 279, SHELTON 98584
2012 International Energy Conservation Code, as amended by WAC 51-11 (IECC)
Effective July 1, 2013.
Ventilation code provisions are located in the 2012 International Residential Code (IRC),
2012 International Mechanical Code (IMC), & 2012 International Building Code
A complete energy code application form will include information that clearly identifies compliance methods for
heat sizing, thermal envelope, and whole-house ventilation. This form includes compliance instructions and
information needed. Energy code compliance information, forms, worksheets, and educational information is also
available on the Washington State University Extension Energy Program (WSU-EP) website. To access the
website go to http://www.energy.wsu.edu/BuildingEfficiency/EnergyCode/2012Ener.qyCode.aspx).
The website includes a heat system sizing calculator. Submit a completed heat sizing calculator worksheet when
the building permit is submitted. In addition to the heat sizing calculator the website has helpful compliance
information and worksheets for prescriptive and component performance options along with a glazing schedule.
INSTRUCTIONS: Complete the Mason County Energy Code application and submit with a heat sizing calculator
available on the WSU-EP website, see item #4 below:
1 Identify the compliance method. The most common and simplest approach is the prescriptive method for
energy code compliance. See prescriptive table R402.1.1 located at the end of the instructions. The
component performance approach referenced in IECC Section R402.1.4 may also be used for energy
code compliance. For more information contact Mason County building department staff at (360) 427-
9670 ext. 352 or WSU Energy Program at (360) 956-2042.
2 Identify the whole-house ventilation compliance method. A ventilation system shall be installed in
accordance with The International Residential Code, Section M1507. The most common ventilation
methods include a whole-house ventilation system using exhaust fans (M1507.3.4) and a whole-house
ventilation system integrated with a forced-air system (Ml 507.3.5). Other ventilation systems include
whole-house ventilation system using a supply fan (M1507.3.6) and whole-house ventilation system
using a heat-recovery ventilation system (M1507.3.7). If you need additional information we recommend
that you discuss with your heating and ventilation system professional. In addition Mason County staff
will be happy to discuss the options if you are not sure which compliance option will work for you.
3 Identify the Additional Energy Efficiency Requirements listed in Table R406.2. The drawings included
with the building permit application shall identify which options have been selected and the point value of
each option. Each one and two-family dwelling unit and townhouses are required to achieve the
following minimum number of credits:
a) Small dwelling units less than 1500 sq. feet of heated or cooled area and less than 300 sq. ft
fenestration area (skylights, doors, windows, etc), or additions to an existing building that is less
than 750 sq. ft. of heated area. — 0.5 points
b) Medium dwelling units not included in a) above {small dwelling}, OR c) below{large dwelling}— 1.5
points
c) Large dwelling unit is a dwelling unit that ex s 0 s f heated or cooled floor area. —2.5
points.
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/ Ventilation Code Compliance Application
Submit with heating/cooling system size worksheet (see instructions #4)
Owner: Va I I "', J Parcel#: Type of project: a/ r
t), , I 100 , bxlg�- -3-0?,3 q '16901'
Total Sq. Ft. p� 1-'Floor: 2" floor: Heated Basement:
of heated area:: ��\ \ I Z ,
Heating System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace
Or 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
complete a window schedule in order to verify that the fenestration area does not
Energy credits exceed 300 sq. ft. Fenestration is defined in the /ECC 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) 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):
r
WASHINGTON STATE ENERGY CODE, RESIDENTIAL PROVISIONS
TABLE 406.2
ENERGY CREDITS (DEBITS)
OPTION DESCRIPTION CREDIT(S)
la EFFICIENT BUILDING ENVELOPE 1 a: 0.
Prescriptive compliance is based on Table R402.1.1 with the following modifications:
Fenestration U=0.28
Floor R-38
Slab on grade R-10 perimeter and under entire slab
Below grade slab R-10 perimeter and under entire slab
or
Compliance based on Section R402.1.4: Reduce the Total UA by 5%.
1 b EFFICIENT BUILDING ENVELOPE lb: 1.0
Prescriptive compliance is based on Table R402.1.1 with the following modifications:
Fenestration U=0.25
Wall R-21 plus R-4
Floor R-38
Basement wall R-21 int plus R-5 ci
Slab on grade R-10 perimeter and under entire slab
Below grade slab R-10 perimeter and under entire slab
or
Compliance based on Section R402.1.4: Reduce the Total UA by 15%.
lc EFFICIENT BUILDING ENVELOPE lc: 2.0
Prescriptive compliance is based on Table R402.1.1 with the following modifications:
Fenestration U=0.22
Ceiling and single-rafter or joist-vaulted R-49 advanced
Wood frame wall R-21 int plus R-12 ci
Floor R-38
Basement wall R-21 int plus R-12 ci
Slab on grade R-10 perimeter and under entire slab
Below grade slab R-10 perimeter and under entire slab
or
Compliance based on Section R402.1.4: Reduce the Total UA by 30%.
2a AIR LEAKAGE CONTROL AND EFFICIENT VENTILATION 2a: 0.5
Compliance based on R402.4.1.2: Reduce the tested air leakage to 4.0 air changes per
hour maximum
and
All whole house ventilation requirements as determined by Section M1507.3 of the
International Residential Code shall be met with a high efficiency fan(maximum 0.35
watts/cfin),not interlocked with the furnace fan ventilation systems using a furnace
including an ECM motor are allowed,provided that they are controlled to operate at
low speed in ventilation only mode.
To qualify to claim this credit,the building permit drawings shall specify the option
being selected and shall specify the option being selected and shall specify the
maximum tested building air leakage and shall show the heat recovery ventilation
system.
f
5a EFFICIENT WATER HEATING 5a: 0.5
Water heating system shall include one of the following:
Gas,propane or oil water heater with a minimum EF of 0.62
or
Electric water heater with a minimum EF of 0.93.
and for both cases
All showerhead and kitchen sink faucets installed in the house shall be rated at 1.75
GPM or less.All other lavatory faucets shall be rated at 1.0 GPM or less.
To qualify to claim this credit,the building permit drawings shall specify the option
being selected and shall specify the water heater equipment type and the minimum
equipment efficiency and shall specify the maximum flow rates for all showerheads,
kitchen sink faucets and other lavatory faucets.
Sb EFFICIENT WATER HEATING 5b: 1.5
Water heating system shall include one of the following:
Gas,propane or oil water heater with a minimum EF of 0.82
or
Solar water heating supplementing a minimum standard water heater.Solar water
heating will provide a rated minimum savings of 85 therms or 2000 kWh based on the
Solar Rating and Certification Corporation(SRCC)Annual Performance of OG-300
Certified Solar Water Heating Systems
or
Electric heat pump water heater with a minimum EF of 2.0 and meeting the standards
of NEEA's Northern Climate Specifications for Heat Pump Water Heaters
or
Water heater heated by ground source heat pump meeting the requirements of Option
3c.
To qualify to claim this credit,the building permit drawings shall specify the option
being selected and shall specify the water heater equipment type and the minimum
equipment efficiency and,for solar water heating systems,the calculation of the
minimum energy savings.
6 RENEWABLE ELECTRIC ENERGY: 0.5
For each 1200 kWh of electrical generation provided annually by on-site wind or solar
equipment a 0.5 credit shall be allowed,up to 3 credits.Generation shall be calculated
as follows:
For solar electric systems,the design shall be demonstrated to meet this requirement
using the National Renewable Energy Laboratory calculator PV WATTs.
Documentation noting solar access shall be included on the plans.
For wind generation projects designs shall document annual power generation based
on the following factors:
The wind turbine power curve;average annual wind speed at the site;frequency
distribution of the wind speed at the site and height of the tower.
To qualify to claim this credit,the building permit drawings shall specify the option
being selected and shall show the photovoltaic or wind turbine equipment type,
provide documentation of solar and wind access,and include a calculation of the
minimum annual energy power production.
a. Interior Duct Placement.Ducts included as Option 4 of Table R406.2 shall be placed wholly within the heated
envelope of the housing unit.The placement shall be inspected and certified to receive the credits associated with this
option.
Exception: Ducts complying with this section may have up to 5%of the total linear feet of ducts located in the
exterior cavities or buffer spaces of the dwelling.If this exception is used the ducts will be tested to the following
standards:
Post-construction test: Leakage to outdoors shall be less than or equal to 1 CFM per 100 ft2 of conditioned floor
area when tested at a pressure differential of 0.1 inches w.g.(25 Pa)across the entire system,including the
manufacturer's air handler enclosure.All register boots shall be taped or otherwise sealed during the test.
b. Plumbing Fixtures Flow Ratings.Low flow plumbing fixtures(water closets and urinals)and fittings(faucets and
showerheads)shall comply with the following requirements:
1. Residential bathroom lavatory sink faucets: Maximum flow rate-3.8 L/min(1.0 gal/min)when tested in
accordance with ASME Al 12.18.1/CSA BI25.1.
2. Residential kitchen faucets: Maximum flow rate-6.6 Lmin(1.75 gal/min)when tested in accordance with
ASME Al12.18.1/CSA B125.1.
3. Residential showerheads: Maximum flow rate-6.6 Umin(1.75 gal/min)when tested in accordance with ASME
Al12.18.1/CSA B125.1.
Prescriptive Energy Code Compliance for All Climate Zones in Washington
Project Information Contact Information
Mark Vermillian Dolphin Quest Home Design
This project will use the requirements of the Prescriptive Path below and incorporate the
the minimum values listed. In addition, based on the size of the structure, the appropriate
number of additional credits are checked as chosen by the permit applicant.
Authorized Representative Date
All Climate Zones
R-Valuea U-Factors
Fenestration U-Factorb n/a 0.30
Skylight U-Factor n/a 0.50
Glazed Fenestration SHGCb e n/a n/a
Ceiling 49' 0.026
Wood Frame Wall9 k 21 int 0.056
Mass Wall R-Value' 21/21 ' 0.056
Floor 309 0.029
Below Grade Wall`k 10/15/21 int+TB 0.042
Slabd R-Value& Depth 10, 2 ft n/a
`Table R402.1.1 and Table R402.1.3 Footnotes included on Page 2.
Each dwelling unit in one and two-family dwellings and townhouses, as defined in Section 101.2 of the
International Residential Code shall comply with sufficient options from Table R406.2 so as to achieve the
following minimum number of credits:
01. Small Dwelling Unit: 0.5 points
Dwelling units less than 1500 square feet in conditioned floor area with less than 300 square feet of fenestration
area. Additions to existing building that are less than 750 square feet of heated floor area.
[212. Medium Dwelling Unit: 1.5 points
All dwelling units that are not included in#1 or#3, including additions over 750 square feet.
03. Large Dwelling Unit: 2.5 points
Dwelling units exceeding 5000 square feet of conditioned floor area.
❑4. Dwelling unit other than one and two-family dwellings and townhouses: Exempt
As defined in Section 101.2 of the International Residential Code
Table R406.2 Summary
Option Description Credit(s)
1a JEfficient Building Envelope 1a 0.5 ❑
lb Efficient Building Envelope lb 1.0 ❑
1c Efficient Building Envelope 1c 2.0 ❑
2a Air Leakage Control and Efficient Ventilation 2a 0.5 ❑
2b Air Leakage Control and Efficient Ventilation 2b 1.0 ❑
2c Air Leakage Control and Efficient Ventilation 2c 1.5 ❑
3a High Efficiency HVAC 3a 0.5 ❑
3b High Efficiency HVAC 3b 1.0 ❑
3c High Efficiency HVAC 3c 2.0 ❑
3d High Efficiency HVAC 3d 1.0 ❑
4 High Efficiency HVAC Distribution System 1.0 ❑
5a Efficient Water Heating 0.5 ❑
5b Efficient Water Heating 1.5 1.5
6 Renewable Electric Energy 0.5 *1200 kwh 0.0
Total Credits 1.50
*Please refer to Table R406.2 for complete option descriptions
http://www.energy.wsu.edu/Documents/Table 406 2 Energy Credits 2012 WSEC.pdf
Table R402.1.1 Footnotes
For Sk 1 foot .= 304.8 mm, ci .=continuous insulation, int .=intermediate framing.
a R-values are minimums. U-factors and SHGC are maximums. When insulation is installed in a cavity which is
less than the label or design thickness of the insulation,the compressed R-value of the insulation from
Appendix Table A101.4 shall not be less than the R-value specified in the table.
b The fenestration U-factor column excludes skylights.The SHGC column applies to all glazed fenestration.
Exception: Skylights may be excluded from glazed fenestration SHGC requirements in Climate Zones 1
through 3 where the SHGC for such skylights does not exceed 0.30.
"10/15/21.+TB" means R-10 continuous insulation on the exterior of the wall, or R-15 on the continuous
insulation on the interior of the wall, or R-21 cavity insulation plus a thermal break between the slab and the
basement wall at the interior of the basement wall. "10/15/21.+TB" shall be permitted to be met with R-13
cavity insulation on the interior of the basement wall plus R-5 continuous insulation on the interior or
exterior of the wall. "10/13" means R-10 continuous insulation on the interior or exterior of the home or R-
13 cavity insulation at the interior of the basement wall. "TB" means thermal break between floor slab and
basement wall.
d R-10 continuous insulation is required under heated slab on grade floors. See R402.2.9.1.
e There are no SHGC requirements in the Marine Zone.
f Basement wall insulation is not required in warm-humid locations as defined by Figure R301.1 and Table
R301.1.
s Reserved.
h First value is cavity insulation, second is continuous insulation or insulated siding, so"13.+5" means R-13
cavity insulation plus R-5 continuous insulation or insulated siding. If structural sheathing covers 40 percent
or less of the exterior, continuous insulation R-value shall be permitted to be reduced by no more than R-3 in
the locations where structural sheathing is used to maintain a consistent total sheathing thickness.
i The second R-value applies when more than half the insulation is on the interior of the mass wall.
J For single rafter-or joist-vaulted ceilings,the insulation may be reduced to R-38.
k Int. (intermediate framing) denotes standard framing 16 inches on center with headers insulated with a
minimum of R-10 insulation.
Log and solid timber walls with a minimum average thickness of 3.5 inches are exempt from this insulation
requirement.
Table R402.1.3 Footnote
a Nonfenestration U-factors shall be obtained from measurement, calculation or an approved source or as
specified in Section R402.1.3.
m M x a. '
x (D °' o
m 3 2 a
C C= y 3 < O
-0 � -a coo
C C C C C C C m G) :E 3 vcn
r r -a -0 -a _0 _0 _0 _0 c 3 v 3 = ;r
N Ill (D m 70 -d "D -0 -0 -0 -0 -p N (0
�' �' �' �' N m m m m m m m CD (D 7 �.
r r r r =r
m m m m —I —i m m m m m m m r �_ = C7 ,-•
< < < < < < < < < < < (D (D O (DO d
m m m m m m m tp (Do G
< < < < o c: < < < < < < < — mo
7 7 3 -n T1 0 3 N C]
-S O (D (n
Q Q Q 9- - — Q Q Q Q Q Q Q O 0 N (P S
<: o 0 0 0 0 0 0 0 ()
cn v> cn w m 0 0 ai v Q
-0 '
Q. o fl x c
O o a "
N cn o 3
(n x
3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3
m (D
0 0 0 o O C) 0 0 0 o C) o 0 o O C O (D C
-+, W N
CD C) (D C) (DC) C) CD C) CD C) CD C) O0 (D v O Oo pj
C) C)
O O
O
N Tlcy) I N I N
N O A I A W N O Ul N A I W I W - S N ro 71 < _
O
_ m
� J 0
Cn Cn A Cn W — A C)l Cr Cn Cn N CT d� CA T� = CP CD -77 = (D
m m (D m `�
ID m � cQ
0
D r
W �I CO c N rJ
0 0'O O O O O O O O O O O O O O O O O O O O N O co O O Cn O Co CD 0 0 0CDO �l
O O O O O O O O O O O O O O O O O O O O O O O O O O CD O O O (D O O O O O W
C) 0 0 0 (D 0 C) 0 0 0 0 C) 0 0 0 0 0 M CO A (3) O C:) W O N W (D N �1 N A CD CT W D W A >
0 0 (D C) 0 C) 0 0 C) 0 0 CD C) 0 0 0 0 C) 0 CO O O co O O A 0 C) Cn O A C) 0 o) o O cfl
O O O O O O O 0 O (D O O C)I O O O O O O O 0 O O 0 O O O O O O O O O O O O co
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.0 0.00
0.01 0.00
Sum of Vertical Fenestration Area and UA 1 575.01 172.10
Vertical Fenestration Area Weighted U = UA/Area 1 0.30
Overhead Glazing (Skylights)
Component Width Height
Description Ref. U-factor Qt. Feet Inch Feet Inch Area UA
1 0.01 0.00
0.01 0.00
0.0 0.00
0.01 0.00
0.0 0.00
&0 0.00
Sum of Overhead Glazing Area and UA &01 000
Overhead Glazing Area Weighted U = UA/Area 1 0.00
Total Sum of Fenestration Area and UA (for heating system sizing calculations) 1 602.8 180.08
Simple Heating System Size: Washington State
This heating system sizing calculator is based on the Prescriptive Requirements of the 2012 Washington State Energy Code(WSEC)and ACCA
Manuals J and S.This calculator will calculate heating loads only.ACCA procedures for sizing cooling systems should be used to determine cooling
loads.
The glazing(window)and door portion of this calculator assumes the installed glazing and door products have an area weighted average U-factor of
0.30. The incorporated insulation requirements are the minimum prescriptive amounts specified by the 2012 WSEC.
Please fill out all of the green drop-downs and boxes that are applicable to your project.As you make selections in the drop-downs for each section,
some values will be calculated for you.If you do not see the selection you need in the drop-down options,please call the WSU Energy Extension
Program at(360)956-2042 for assistance.
Prolect Information Contact Information
Mark Vermillian Dolphin Quest Home Deign
Heating System Type: ()II Other Systems meat Pump
To see detailed instructions for each section,place your cursor on the word"Instructions".
Design Temperature
LShelt Design Temperature Difference(AT) 47
on � AT=Indoor(70 degrees)-Outdoor Design Temp
Area of Building
Conditioned Floor Area
Instructions Conditioned Floor Area(sq ft) 2,819
Average Ceiling Height Conditioned Volume
Average Ceiling Height(ft) 8.0 22,552
Glazing and Doors U-Factor X Area = UA
0.30 603 180.90
Skylights U-Factor X Area = UA
0.50 0 ---
Insulation
Attic U-Factor X Area = UA
Instructions R-49 - 0.026 1,697 44.12
Single Rafter or Joist Vaulted Ceilings U-Factor X Area UA
select R-value . No selection 0
Above Grade Walls(see Figure 1) U-Factor X Area UA
�w"I'u`"t"'o, R-211ntermediate 0.056 2.880 161.28
Floors U-Factor X Area UA
Instructions 0.029 1,697 49.21
R-30
Below Grade Walls(sa•Fwum 1) U-Factor X Area UA
Instructions �W R_value `- No selection ---
Slab Below Grade(aw Figure 1) F-Factor X Len th ---
UA
Instruti cons No selection
Select conditioning _
Slab on Grade(see Figure 1) F-Factor X Lenpth UA
-selectR-value __ No selection f� J ---
Location of DUAL
Instructions ------ Duct Leakage Coefficient
Unconditioned Space l
1.30
Sum of UA 435.52
Envelope Heat Load 20,469 Btu/Hour
Fi ure 1. SumofuaxeT
Air Leakage Heat Load 11,447 Btu/Hour
Volume X 0.6 X AT X.0 18
Above Linde Building Design Heat Load 31,917 Btu/Hour
Air Leakage+Envelope Heat Loss
Building and Duct Heat Load 35,108 Btu/Hour
Ducts in unconditioned space:Sum of Building Heat Loss X 1.10
Duds in conditioned space:Sum of Building Heat Loss X 1
Maximum Heat Equipment Output 49,152 Btu/Hour
Building and Duct Heat Loss X 1.40 for Forced Air Furnace
Buiiding and Dud Heat Loss X 1.25 for Heat Pump
(07101113)
Name r ( f ► Parcel# "J / 1 / ��y� I BLD# U o i
Mason County (-00� Gq 7
Department of Community Development 2S0Z
Small Parcel Stormwater Management Application/Worksheet (p o
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/index.ht3n
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 Siormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in eir 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� }thtlpy�e;E D
described prope fo review and msp ion as y be required. RIVE 1 �/
Owner/ ent/Contractor(circle one)Date: MAR 0 6 2015
Page 2of2 426 W. CEDAR ST.
Name Parcel# Y —� 9uU J 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 surface-'.
'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.
-'Common 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
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 1 of 2