HomeMy WebLinkAboutBLD2013-00704 Replace Upper and Bottom Floor - BLD Permit / Conditions - 10/30/20137 i In5peCUU11 Ulle tJOUJ4L/-ILOG
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 279
too Shelton, WA 98584
too RESIDENTIAL BUILDING PERMIT BLD2013-00704
OWNER: STEVE HAWKINS RECEIVED: 8/16/2013
CONTRACTOR: MORGAN BUILT HOMES 1.360.830-5065 LICENSE: MORGABH876LC EXP.- 6/3/2015 ISSUED: 10/30/2013
SITE ADDRESS: 12781 NE NORTH SHORE RD BELFAIR EXPIRES: 4/30/2014
PARCEL NUMBER: 322345000001
LEGAL DESCRIPTION: MADRONA MORNINGSIDE BCH TRACTS TR 1 &T.L.
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
REPLACE BOTTOM FLOOR AND ADD UPPER FLOOR BELFAIR DRIVE ON NORTH SHORE RD BELFAIR APPROX 12 MILES,
PROPERTY IS ON LEFT ON WATERSIDE
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: 2 Occ. Group: R3 Lot Size: Deck: 144
Type of Work: ADD Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:1,544
Valuation: $ 166,490.64 Building Height: Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W 5.0 Ft. Shoreline: 12.0 Ft. Water Body: HOOD CANAL
Rear: E 2.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: N 5.0 Ft. Shoreline Desig.: Urban
Year: Serial No.: Side 2: S 12.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 3 Heat Pump 3 Plan Check Fee TW 8/16/2013 $915.30 S220130on0000i
Lavatories 3 Ventilation Fan 4 Planning Review Fee TW 8/16/2013 $205.00 S220130000000i
Bath Tubs 1 Exhaust Hood 1 EH Plan Review KKK 8/16/2013 $ 103.00 S6201300000001
Showers 1 Dryer Vent 1 Building State Fee DLC 10/2/2013 $4.50 S120130000000i
Water Heaters 1 Building Permit Fee DLC 10/2/2013 $ 1,368.95 S1201300000001
Clothes Washer 1 //^Mechanical Permit Fee DLC 10/2/2013 $ 112.80 S1201300000001
Kitchen Sink 1 Mechanical Base Fee DLC 10/2/2013 $28.50 S1201300000001
Dishwasher 1 J 1 j Plumbing Permit Fee DLC 10/2/2013 $ 110.60 S1201300000001
Hosebibs 2 `, ` Plumbing Base Fee DLC 10/2/2013 $24.70 S120130000000i
`„ ADJUST--Plan Check Fee DLC 10/2/2013 $-25.48 S1201300000001
j Total $2,847.87
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BLD2013-00704 Please refer to the following pages for conditions Is permit. Page 1 of 6
` CASE NOTES FOR
BLD2013-00704
CONDITIONS FOR
BLD2013-00704
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) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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3) This project is approved to raise the existing dwelling structure and add a new foundation system in accordance with the Mason County Flood
Damage Ordinance and the 2012 International Residential Code Section R322. The location of the structure is identified as an "A"zone in
accordance with FEMA standards. Minimum construction criteria are as follows:
The floor of the structure shall be elevated at least one-foot 1'0" above the base flood elevation (BFE).
The BFE shall be clearly marked in order for the Mason County Building Inspector to verify that the structure has been raised to the proper
elevation.
The crawlspace shall be provided with at least 2-openings on each side of the enclosed crawl space and be equal to at least 1 sq. inch for each
sq. ft. of enclosed area. The openings shall allow for the automatic entry and exit of floodwaters and be placed such that the bottom of each
flood vent is not more than 1-foot above the lowest adjacent exterior grade. The interior grade of the craw/space below the BFE must not be
more than 2-ft below the lowest adjacent grade.
The attached carport, entirely open on two(2)sides, located at or below the BFE, shall be provided with openings to prevent flood damage
where surrounded by walls as required above.
Electrical systems, equipment, heating, ventilation, air conditioning,plumbing appliances and plumbing fixtures, duct systems, and other
similar systems shall be located at or above the BFE unless designed to prevent water from entering or accumulating within the components
and to resist hydrostatic and hydrodynamic loads and stresses. (IRC R322.1.6)
All building materials used below the BFE shall be pressure-preservative treated in accordance with AWPA U1 or be naturally resistant to
decay. In addition materials and installation methods used for flooring and interior and exterior walls and walls coverings shall conform to the
provisions of FEMA/FIA-TB-2. (IRC R322.1.8)
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BLD2013-00704 Please refer to the following pages for conditions of this permit. Page 2 of 6
4) 1 his project is approved in accordance with the approved site plan. wnere exterior walls, projections, or openings are located less than 5-teet
from the property line those elements shall be protected in acordance with the Washington State amendment to the 2012 International
Residential Code(IRC), Section R302.1 and associated tables.
When any element of the structure is located 5-feet or less from the property line one-hour fire resistive construction shall be required. Before
construction submit for approval fire resistive construction information and details to the Mason County building department for review and
approval.
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5) 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
Department prior to any further inspections being performed or approvals granted.
6) 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 of approved documents will result in failure of required building inspections.
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7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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8) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then
approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Building Department prior to any further inspections being performed or approvals granted.
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9) Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option 4C, Window (Max U-Factor):0.30, Skylight (Max U-Factor):0.50, Doors
(Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-49 standard, Vault Insulation R-38, and Slab Insulation
R-10.
In addition the following credit from 406.2 shall be completed using options 3D and 5A
Ductless split system used with zonal electric heat
Electric water heater min EF 0.93
All showerheads and kitchen faucets 1.75 GPM or less. Lavatory faucets 1.0 GPM or less.
Maximum heat output 24,623 BTU/Hr, or 7.2 W, or 7200 KW
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10) WIND LOADS - Roof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic wind speed for Mason County is 85
MPH.
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BLD2013-00704 Please refer to the following pages for conditions of this permit. Page 3 of 6
11) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the
manufacturer's installation instructions.
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12) 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 also wish to consult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contractor is acknowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X S/-/
13) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such roads connect 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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14) 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
charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
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15) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permit revocation.
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16) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency (ORCAA).
It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos containing materials have been
identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or
operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623 www.orcaa.org
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BLD2013-00704 Please refer to the following pages for conditions of this permit. Page 4 of 6
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/) rrovisions Tor surrace/suosurrace ararnage control must ue implementea witn new consuucuon ur uevewpfnent un site anu muz)r ivu i auverseiy unpacr
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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18) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
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19) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspector shall be made prior to requesting additional inspections.
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20) All property lines shall be clearly identified at the time of foundation inspection. X S 171-
21) 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
Mason County ordinances and building regulations.
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22) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have prevented action from being taken. No more than one extension may be granted.
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23) 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 ROAD WAY.
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24) Approved er dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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25) 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 S,//
26) 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 -�1-
BLD2013-00704 Please refer to the following pages for conditions of this permit. Page 5 of 6
27), 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 l-/,
28) The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules, and the Mason
County Shoreline Master Program.
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29) 1. First habitable floor must be elevated at least 2 feet above surrounding grade.
2. Foundation or skirting vents must be within 1 foot of grade.
3. An elevation certificate must be completed by a licenced land surveyor certifying the as-built elevation of the first floor to the nearest 10th of a foot prior
to final inspection. X S.//
30) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed.
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31) 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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32) All windows and doors shall be installed and flashed in accordance with the manufacturers written installation instructions and shall be available during
inspections.
In addition to other inspection(s), an inspection of the flashing shall be required for projects located in an area with a wind exposure of C or D, reference
IRC R301.2.1.4 & IBC 1609.4. The design criteria for this project is established at 85 mph wind speed, exposure D.
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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 for a 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 me,4ns,W a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate
and grants employees of Mason County c e t he above described property and structure for review and inspection.
OWNER OR AGENT: DATE: /.3
BLD2013-00704 Please refer to the following pages for conditions of this permit. Page 6 of 6
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o CONCRETE MECHANICAL MANUFACTURED HOME _D
C� ate BY� ice/ ��{
w Footings /Setbacks DasPlpin3d / Ribbons
Interior Date Z /3 By interior-Date BY Date B Z
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0 Exterior Date I/ By �"' Exterior-Date B Set-up y
Point Load/Isolated Footings INSULATION Data By I
BG!SLAB INSULATION Ill
Date ►t Zs rj By LQI Data By FIRE DEPARTMENT <
Foundation Wails Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date 7 I q By t, jti Data 3 3 By l PROPANE TANKS
PLUMBING Vault Date By
Date By OTHER
Groundwork Attic
Date S L / By Type.
Date By DRYWLL Date By
D Type:
Date �"1 By V Int.Brace Wall Date By W
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Permit# '�j'=� MASON COUNTY
BUILDING 111 426 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
found: Items listed below must be corrected to gain compliance /
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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
Q Make corrections, items will be checked on next inspection /f regarding possible structural
0 OK to .1NSh(U� � e� �� 4, CA !�►Jt?►� COVA 'IGLU' damage incurred by recent
"natural/man made"
❑This is not a complete inspection disasters.This is NOT a
Date ZLZ H/i H Department CORRECTION NOTICE.
Inspector !A) U
■ 4k 01 N�"T ' '1-19 0 ' THImix T" *.•
Permit'# i 3 770 MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location i aT7 l /y 6- N,"A SGwvc- V-J
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
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
W Make corrections, items will be checked on next inspection regarding possible structural
OK to �V"tD 0C.� l�G Ly S damage incurred by recent
"natural/man made"
❑This is not a complete inspection disasters.This is NOT a
CORRECTION NOTICE.
Date 'A) Department ��✓
Inspector
■ 4 i N� ,OT , r l�, O4 ' ' THImlh, T,,,vm �lmv
MASON COUNTY PERMIT NO. 70 .3--0D-]0q
BUILDING 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
APPLICANT INFORMATION CONTRACTOR INFORMATION 6
Owner STa'F-� iA9oi*A RAWe-wS Company Name M096AN- 1321"LY tOAA65
Mailing Ad ress / 1 NC 1113E[-64II@ I>Eu1 9D Mailin Address i0`L33 A•TE$ LA
City EL-FAi State VIA Zip Code . 5' City 9P�C—��M State I Zip Code
Phc 2 255" 2 I Other Ph.a5 11v1-'C15 `� Phone � eQI 14140 Other Ph.
Lien/Title Holder LLA Q� u Contractor Reg. # MOW 087k -6 Exp. i
E mail address Q6 AP-5 G 021, C614 E Mail Address 6r—�� 5& ff16 - 13,41C-r COM
Drivers Lic.# 15 C4 L9 ti'�7 DOB 7 Drivers Lic.#AAoI FI��' u�` � DOB 2 j O
�AW
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System 44A-0)26' ,'
Well Water System.X_ Name of Water System AA6PW I UG Si 0 E $ e ! W S �,
PARCEL INFORMATION - 12 Di it Parcel No ire i rict �
Legal Description 7931 OF 5u2Ug�)( 5"/G5W&& F60WR KV L-WE 146l C�dc -4 -r RF*0-75735
Site Address(Please include street name, street number and city) /29S/ "074 5hbW /Zo P,EL-FAIR
Directions to site i.c _r1k)6 t30t' c WILLIE od AJ627 S E ScxlTl/tvES`T-
f P x r �- c t�s PE2 r O� F-r t T�2S/0,E 7" /ems .
Will timber be cut and sold in parcel pre ration? Yes No
Is property within 200' of Saltwater N I ake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YeS62 \
TYPE OF JOB - New Add Alt Y Repair Other PRIMARY RE IDENCE SEASONAL ❑
Use of Building I Describe Work � D�CL Ao0 w�OAToN�R�D Lo -r
No. of Bedrooms No. of Bathrooms Square Footage- 1 st Flo r g I 2nd Floor
3rd Floor Basement Deck Covered Deck -'Other Sq ft-2 1 y
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/No
Installer Name Certification No.
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 MasoDGounty access to the above described property and structure for review and inspection.
PROOF OF CONTINU ON O WORK IS B NS OF A PROGRESS INSPECTION.
X Dater
Owner/O er epresenta Contractor (indicate which one
FOR OFFICIA SE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW AP RROVED DENIED NOTES
Building Department fo-1► L _ C b '
Planning Department opp 75,n- c - Zbtjec
Environmental Health Department
Public Works Department
Fire Marshal
FEES
Building Permit Fee 3 Site Inspection
Plan Review Fee G25 8) jr EH Review Fee
Plumbing & Base Fee jq L7 4- AD. 60 Planning Review Fee
Mechanical & Base fee 5-0 - xq P6 Other
Wood/Gas/Pellet tove Fee State Fee
Violation Fee "Le— 16?r Pre-Paid at Submittal /s 3
Valuation $ TOTAL FEES
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PERMIT NO.
MASON COUNTY
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 we www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION C-4SG�
Owner ride 4 LA-ooWA t11 Company Name m6gr�- BUILT'
Mailing Address I fA(P i UJ Mailin Address 1E323 3 "A 66 1-61J C
City t State VJP1 Zip Code � City � State -� Zip Code 4�3t 2
Phone 253 Z5 " 12- 1 Other P 3 I• -5 '7 Phone O(_ I4d other Ph.
Lien/Title Holder iI O Contractor Reg. # MO 6A 6LGE p
E mail address A L2G1 s C,6,4A E Mail Address �' �ih[ ^ "8cu( , eOM'
Drivers Lic.# A4U*,5 C 14I O N6 DOB 7 5 Drivers Lic.# A�DRC G(� GS�� DOB 2,17 f�
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION- 12 Digit Parcel N Fire Distr''ct
Legal Description I IZ3I OF SYP-V6V 15-65--66 Boupo,49V LII� �4&R66AQjT 4 !q`7573S—
Site Address (Please include street name street number and city) 12791_NoM S f 0611r, PIP t OCL.t=RW
Direptions to site L6AVIA)6 6E1,FA iL i E 0%.► o&:04 5'AtW-45 RP
Is property within 200' of Sallwater 4 Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 150/-
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units- 1 st Floor _ 2nd Floor_-X— Basement Garage 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 3_ woe of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs �_ Heatpumps au-
Showers Spot Vent Fan .
Water Heater Propane Tank
Clothes Washer �— Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove
Dishwasher I Kitchen Exhaust Hood . 1
Hosebibs a- Dryer Vent
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 duct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants mployees o ason County access to the above described property and structure for review and inspection.
PROOF OF CONTIN TIO F/ OR BY MEANS OF A PROGRESS INSPECTION.
X �" Date: v
Owner/ ers Repre#ilative Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
'-Ilumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/ Pellet Stove Fee Other
Violation Fee TOTAL FEES
25 5 + �� -y Ili ' ± �v_vLu
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New Bay Window
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Move Exist. Se tic
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Tank to 5 from New � Exist. �
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Name 5'i'C-u6 ° L V.,1j V A Parcel# 37Z.$�' BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management ApplicationlWorksheet (page 1 of 2)
Per Mason County Code, Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment', with more than 2,000 square feet of impervious surface2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
'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 stonnwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
:'T�o= alcirlate impervious Surfaces ease: This T5b7�;:
Surface Type Length X Width = Area All dimensions in feet
Buildings X 31 _ qU
_ Measurements for buildings are taken at the
T .. (i4el X v perimeter of the farthest projections(example:
X = eaves/gutters)
X =
Driveways O 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 p oposed site
X = development is greater than 20D0 square feet a
Small ParceLStomiwater Site Plan is Required
Total impervious Surface Area(hum of all areas) Gt
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 LS 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 inspecti as may be required. pr
X Owner/Agent/Contractor(circle one)Date: U
Tf the Total ImperFio Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
e information provided on page 2 of 2.
Page 1 of 2
I
Namesykwl - I-kDONPA Parcel# .3Zz24— q7— QO j(O BLD#
�gwktus
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
httT>//,A,ww.co.mason.wa—us/code/commissioners/'index.htm
Please follow the links to "Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.49.section 14.48.70).You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE PiITUL 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 their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT.450
Mail:P 0 Box 1850, Shelton WA 98584
Physical:415 N 6th St, Shelton WA 98584
If this development has, or will have,a septic/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 plan will be met
prior to a request for final inspection of the building permit.
Owner/Euilder/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/Conb-actor(circle one)Date:
Page 2 of 2
r
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31, 2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name STEVEN&LADONNA HAWKINS Policy Number:
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAICA bar.
12781 NE NORTH SHORE ROAD
City BELFAIR State WA ZIP Code 98528
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 1,Madrona Morningside Beach Tax Parcel No.32234-50-00001IAI
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential � �C�
A5. Latitude/Longitude:Lat.47.359567° Long.-123.037100* Horizontal Datum: ❑ NAD 1927 C�7 983§
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. O `
�7'
AT Building Diagram Number 8 O
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: Q
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sg(
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NAP Community Name&Community Number 82.County Name 83.State
MASON COUNTY,WASHINGTON 530115 MASON COUNTY WASHINGTON
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
530115 0120 C 12-8-1998 Effective/Revised Date Zone(s) AO,use base flood depth)
5-17-1988 A 9.8
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ❑ FIRM ❑ Community Determined ® Other/Source:LOMC 13-10-0302A
B11. Indicate elevation datum used for BFE in Item B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: E Construction Drawings' ❑ Building Under Construction' ❑ Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item AT In Puerto Rico only,enter meters.
Benchmark Utilized:WSRN Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a)through h)below. ®NGVD 1929 ❑NAVD 1988 ❑Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 8.5 E feet ❑meters
b)Top of the next higher floor 11.0 ®feet El meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters
d)Attached garage(top of slab) N/A.
❑feet El meters
e) Lowest elevation of machinery or equipment servicing the building 11.0 E feet ❑meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent(finished)grade next to building(LAG) 8.5 E feet ❑meters
g)Highest adjacent(finished)grade next to building(HAG) 10.1 E feet ❑meters
h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 8.5 E feet ❑meters
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation
information.1 certify that the information on this Certificate represents my best efforts to interpret the data available. ..........•.,l�
l understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code,Section 1001. OF
E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �,1:r,�Q' �O:•�
❑ Check here if attachments. licensed land surveyor? E Yes ❑ No
Certifier's Name Daniel B.Johnson License Number 28408 a
Title Managing Director Company Name Aspen Land Surveying LLC FJ,% ,Q 2"A J�
Address P. x 124 City Vaughn State WA ZIP Code 98394 `rr� FCISI�G�,;�J�
�S
Signature Date 10-9-13 Telephone 253-303-0270 NAL LAty
FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number.
12781 NE NORTH SHORE ROAD
City BELFAIR State WA ZIP Code 98528 Company NAIC Number.
SECTION D—SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner.
Comments
SET TEMPORARY BENCHMARK ON SITE: REBAR&CAP IN BACK OF BULKHEAD,NEAR WEST END. ELEV.=8.47
71929=NAVD 1988-3.44'
Signature Date 10-9-13
SECTION E—BUILDINb ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items El—E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C.For Items E1—E4, use natural grade,if available.Check the measurement used.In Puerto Rico only,enter meters.
Ell. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3_ Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here if attachments.
SECTION G—COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G
of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8—G10.In Puerto Rico only,enter meters.
G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3.❑ The following information(Items G4—G10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued [Z-6.—Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑New Construction ❑Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters Datum
G10.Community's design flood elevation: ❑feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments.
FEMA Form 086-0-33(7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3
Building Photographs
Building Street Address: 12781 NE NORTH SHORE ROAD, BELFAIR, WA 98528
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SOUTH SIDE 10-3-13 (BUILDING TO BE DEMOLISHED)
WEST SIDE 10-3-13 (BUILDING TO BE DEMOLISHED)
ELEVATION CERTIFICATE, page 3
Building Photographs
Building Street Address: 12781 NE NORTH SHORE ROAD, BELFAIR, WA 98528
R q4W.0""."'W "
SOUTH SIDE 5-26-14
WEST SIDE 5-26-14