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HomeMy WebLinkAboutBLD2010-00139 Replace SFR, Remodel - BLD Permit / Conditions - 8/3/2010 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 lot$ Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2010-00139 OWNER: MARK BENDER RECEIVED: 3/2/2010 CONTRACTOR: LICENSE: EXP: ISSUED: 4/28/2010 SITE ADDRESS: 3760 E STATE ROUTE 302 BELFAIR EXPIRES: 10/28/2010 PARCEL NUMBER: 122212400100 LEGAL DESCRIPTION: TR 10 OF G.L. 2 & TAX 1113-B & 12-X-12 PROJECT DESCRIPTION: DIRECTIONS TO SITE: REPLACEMENT OF EXISTING CABIN WITH NEW LOG HOME"` ST RT 3, R ON NORTH BAY RD, TO SITE ADDRESS ON THE RIGHT SIDE REVISED REMODELING WITHIN ORIGINAL FOOT PRINT. PARITAL General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 1 Type of Constr.: VB Type of Use SF Insp.Area: No. of Bathrooms: 0 Occ. Group: R3 Lot Size: Deck: 0 Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:346 Valuation: Building Height: Occ. Status: Seasonal Basement: cov porch 75 Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft, Front: E 30.0 Ft. Shoreline: 28.0 Ft. Water Body: CASE INLET Rear: W 28.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: N 20.0 Ft, Shoreline Desig.: Unknown Year: Serial No Side 2: S 45.0 Ft, Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty, Type Qty. Type By Date Amount Receipt Clothes Washer 1 Ventilation Fan 1 Plan Check Fee GMM 3/2/2010 $74422 S12010000 Planning Review Fee GMM 3/2/2010 $205,00 S12010000 EH Plan Review KKK 3/2/2010 $103.00 S6201o000 Building State Fee DLC 3/19/2010 $4.50 S12010000 ADJUST--Plan Check Fee DLC 3/19/2010 $171.08 S12010000 Plan Check Fee LDK 4/22/2010 $326.53 S12010000 Building Permit Fee LDK 4/22/2010 $502.35 S12010000 Mechanical Permit Fee LDK 4/22/2010 $9.00 S12010000 Mechanical Base Fee LDK 4/22/2010 $28.50 S12010000 Plumbing Base Fee LDK 4/22/2010 $24.70 S12010000 Plumbing Permit Fee LDK 4/22/2010 $8.70 S12010000 Total $2,1127,58 BLD2010-00139 Please refer to the following pages for conditions of this permit 1 of 5 CASE NOTES FOR BLD2010-00139 CONDITIONS FOR BLD2010-00139 1) 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. X j. 2) 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. X 3) Demolition actitvities must conform with all State and local County regulations as a condition to the issuance of this permit. The applicant/owner is directed to conatct Olympic Air Pollution Control Authority(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 REMOVED FROM THE AREA TO BE DEMOLISHED. WORK SHALL NOT COMMENCE ON AN ASBESTOS PROJECT OR DEMOLITION UNLESS THE OWNER OR OPERATOR HAS OBTAINED WRITTEN APPROVAL FROM ORCAA, 2490 B LIMITED LANE NW, OLYMPIA WA 98502, 360-586-1044, 800-422-5623, WWU LPRCAA.ORG X i 4) 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. X 5) 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. X 6) 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 Xaspn/County ordinances and building regulations. BLD2010-00139 Please referto the following pages for conditions of this permit. 2 of 5 7) 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 r ads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X .. 8) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project/ X !! 9) 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 holde9 have prevented action from being taken. No more than one extension may be granted. X 10) 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 rempval of approved documents will result in failure of required building inspections. X 11) 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 Dep�rt ent prior to any further inspections being performed or approvals granted. X I 12) All property lines shall be clearly identified at the time of foundation inspection. X 13) 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 R-17-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 14) Per IRC - SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance with the applicable provisions of this section and the manufacturer's installation instructions. X 15) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASI�WIND SPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X BLD2010-00139 Please referto the following pages for conditions of this permit 3 of 5 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 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 9epartment prior to any further inspections being performed or approvals granted. X 17) 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 i�acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 18) Stress grading of structural log members of non-rectangular shape, typically used in log buildings, shall be in accordance with ASTM D 3957. Such log members shall be identified by the grade mark of an approved lumber grading or inspection agency. In lieu of a grade mark on the material, a certificate of inspection as to species and grade issued by a lumber grading or inspection agency, meeting the requirements of the applicable code, shall be perr7tt d. (IRC R602.1.3 & IBC 2303.1.10) 19) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric wall mount, Compliance Method: Prescriptive option IV, Window (Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Log walls min. 3.5" avg thickness, Wall insulation R-21where stick-framed, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the unde�si�e of the roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X 20) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED., FIRM, NATIVE SOIL. WHERE THE STRENGTH AND COMPRESSIBILITY OF THE SOILS ARE IN DOUBT THE BUILDING INSPECTOR WILL REQUIRE A SOILS ANALYSIS IN ACCORDANCE TO IBC SECTION 1802. X �, //l 21) Owr�FF,/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 22) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 23) 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. X ! i BLD2010-00139 Please referto the following pages for conditions of this permit. 4 of 5 24) All construction and demolition debris must be removed from the shoreline area after project completion. Proer disposal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degredation of State waters. X 11 25) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or properties. Silt fencing must be installed and maintained until upland vegetation has become established. X 26) The grinder pump/panel should be protected during any demolition/construction. If any component is going to be moved, replaced, or becomes damaged, Mason County Utilites MUST be notified as soon as possible. Utilities can be contacted at 427-9670, ext 283, 296, 566, or contact Bill VanBuskirk at the treatment plant directly at 275-7067. X 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 means of 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 access to the above described property and structure for review and inspection. OWN ER OR AGENT: DATE: BLD2010-00139 Please refer to the following pages for conditions of this permit. 5 of 5 co o CONCRETE MECHANICAL MANUFACTURED HOME m o Footings 1 Setbacks Gas Piping By Ribbons Q o Intenor Date By Interior-Date By Date By M Exterior Date S' B Exterior-Date By Setup 3 Point Load J Isolated Footings INSULATION Date By n Date By BG f SLAB INSULATION Data By FIRE DEPARTMENT A Foundation Walls Floors Date By Date By Data By DECKS FRAMING CpyO Walls —�s` /� Date By Date _1�-AO gy Data ey PROPANE TANKS PLUMBING vault Date By Date By OTHER Groundwork Attic Type Date By Date — Data By D.W.v DRYWALL Type—Int.Brace Wall pate By Date W Date By -0 FINAL INSPECTION p Water Line Fire Separation N CD Date By Date By Datea, 5 �� By (/*, .d m ©... Pass or Request Inspect. CD c Type of insp. Fail Date Date Done By Comments w S-2-10 y i 1f15�5 7—&1U ue>lz v o �� a 7D 0 o 014, 14-- r/� v ©�-GC'-v - mac. -�i&A I g 41 0 Q „ J Request To Revise AnApproved Plan Permit Number: + g2$(�- _ Name 41, ,8r&x— Parcel Number 661 DO Phone Nu ber daytime ( (p0) LOW (p(p ! Project Address pl- Mailing Address n6VJ Please pr ide a complete, detailed description of the proposed revisioV to the approved plans: VA �2knt_ Are two sets of the revised plans or addendum indicating the changes included? Yes ❑ NN Are the approved site plans included? ;-Y-e Ye ' ;Z1 Are the revisions clearly and accurately identified on the plans or addendum? s ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes [;I-<o If Yes, Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note:No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes [a'No If Yes, Is a revised site plan,with all new setback dimensions included with this request? ❑ Yes ❑ No Addition formation: D 20 Applicant's signat6re Date: =2--69C)k(f) Office Use Only Received by: Clmu Date Sent Assigned To Approved By Date .Original Valuation: $ Lipka KI"�,� Additional Valuation: $ Sq.Ft. x$ $ Sq. Ft. x$ $ r. Total New Valuation $ ❑ P W. (�1J,45 Additional Fees: Additional Planning Dept. $ Additional Plan Review $ Additional Conditions/Comm nts Additional Building Permit $ Additional Plumbing $ Additional Mechanical $ Additional E.H. Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 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 Tabled ffi. 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 elo .I declare that I am the owner,owner's legal representative,or the contractor.I further acknowle the informatio pr ded is accurate and employees of Mason County are granted access to the above- &cribed pr erty review sp ti 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 Name Parcel# BLD# 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: http//www.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 14.48 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 Stormwater 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 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/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: Page 2 of 2 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO.13� jU2O IO -00 PLEASE PRESS HARD BUILDING PERMIT APPLICATION _^ 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 A l I A h Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION J CONTRACTOR INF ATI N Owner e -+- �9M Company Name VC �a�✓ Mailing Address vL Mailin Address City e- Zip 9ZV"--/3zG City v 4 State�� Zip Code9fr3 S Phone Other Ph. Phone_34/Q M 0 6 yr' Other P !e 3 l/d L Contractor Reg. Lien/Title HolderP E mail address E Mail Address Drivers Lic.# DOB Drivers Lic. DOB / SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer Syste Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. j-Z•Z 12-!f 60 /'b© Fire District Legal Description 4 4- Site Address (Please include street name, street number and city) �� �;c eV4 Directions to site Will timber be cut and sold in parcel reparation?Yes o Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Ru ff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building escribe Work No. of Bedrooms No. of Bathrooms—L—Square Footage- 1st Floor 2nd Floor. 6o ZZ-- 3rd Floor Basement Deck '1-12- Covered Deck/0 Other Sq. ft. 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 Mason County access to the above described property and structure for review an inspection.This permit/application becomes null & void if work or authorized construction is not commenced with' 0 days or' constru 'o work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OFAP SINSPE O .IN fftITYOFTH PERMIT APPLICATION OF180 Y WILL INVALIDATE THE APPLICATION. X Date: /Owners a ese tativ ractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted b . l Da -2--260 DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee I State Fee Violation Fee Pre Paid at Submittal Valuation $ TOTAL FEES , FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. PLEASE PRESS HARD BUILDING PERMIT APPLICATION C;G 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 � '' S APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address Mailing Address City State - Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System , Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address(Please include street name, street number and city) Directions to site Will timber be cut and sold in parcel preparation?Yes/No Is property within 200' of Saltwater v Lake 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?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms - Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck * P -' Covered Deck Other Sq. ft. LE Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model YearLength 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 Mason County access to the above described property and structure 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 OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee / / EH Review Fee Plumbing & Base Fee C� 71 l D 10 Planning Review Fee Mechanical & Base fee a8 '� oZ !O 1�9 Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee IVOtl Pre-Paid at Submittal y Valuation $ / ' ` TOTAL FEES e C; L"ex r--3 0 qw s . zs ,� P5$� Le x 3g MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar- P.O. Box 186, Shelton,WA 98584 Shelton (360) 427-9670-Belfair(360) 275-4467- Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner VI Company Name Mailing Addres ' Mailing Address 4 City State Zip Code City - ` State Zip Code Phone Other Ph Phoneme /, Other Ph. Lien/Title Holder Contractor Reg ' � 1,L2 Exp.=` E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# ', ���l„ 4 e= DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. a A - -t J o Fire District Legal Description ;� ry' )t ' Site Address Please include street name, street number and city) Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New; Add Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floors— 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPC�_ Natural Gas— Heat Pump_ Toilets Y_,R Type of Unit No. of Units Fees Bathroom Sink ti Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/PelletStove Dishwasher Kitchen Exhaust Hood Hosebibs 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 conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner`/Owners Rpresentative/Contractor (indicate which one) FOR OFFICIAL USE BEYONDTHIS POINT Accepted by: Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Tyr)e Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES i SITE PLAN FOR MARK 8c TERI BENDER PARCEL 122212400100 3760 E STATE ROUTE 302, BELFAIRE, WA 98528 A TRACT OF LAND IN GOVERNMENT LOT 2. SECTION 2, TOWNSHIP 22 NORTH. RANGE 1 WEST. W.M. IVIC lip�o o c lip .0 8 2010 N 89'53'06'E 87.62' "1 cn 5' SIDE _ SETBACK N O o EXISTING GARAGE ^� a • O EXISTING TO REMAIN 1+ O ' J ,�o s BOAT LAUNCH f30'X2O' UNCOVERED �J. DECK r - NEW g6• RESIDENCE EXISTING 38'X26' BULK HEAD TO REMAIN COVEREPORCH RCHD< 3 \6 �J= EXISTING Cfil SEWER UNE---\i s / _ 5' SIDES SETBACK EXISTING _ DRIVEWAY S 89'53'06"W 104.51' // {- PI-AN I/ Y T fN.l M Nd,4 DAMS Dr oW YT7 w I-800-92�-5555 SITE PLAN FOR MARK & TERI BENDER PARCEL 122212400100 3760 E STATE ROUTE 302, BELFAIIR WA 98528 A TRACT OF LAND IN GOVERNMENT LOT 2, SECTION 2, TOWNSHIP 22 NORTH, RANGE 1 WEST, W.M. Ul I� N 89'53'06"E 87.62' co 5' SIDE — SETBACK -- N— p W 4h, 0 ; I EXISTING / GARAGE 3p. o EXISTING " TO REMAIN BOAT LAUNCH ±30'x20' n _ UNCOVERED DECK r NEW RESIDENCE EXISTING �8. 38'x26' BULK HEAD TO REMAIN COVERED PORCH 0 EXISTING SEWER LINE J �I J _ 5' SIDE SETBACK EXISTING DRNEWAY S 89'53'06"W 104.51' APPROVED N MASON COUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL By Date // T / Z- I/ \/ Gv.L c WOOU nnvs 1-800-42-4-5555