HomeMy WebLinkAboutBLD2006-01971 Final SFR - BLD Permit / Conditions - 4/15/2008 Inspection Line(360)127-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Shelton,WA 98584 '
RESIDENTIAL BUILDING PERMIT BLD2006-01971
OWNER: JEFF BRADY
CONTRACTOR: LICENSE: EXP: RECEIVED: 11/7/2006
SITE ADDRESS: 9986 E STATE ROUTE 106 UNION ISSUED: 1/2/2007
PARCEL NUMBER: 322365100027 EXPIRES: 7/2/2007
LEGAL DESCRIPTION: PEBBLE BEACH PARK PCL 1 OF BLA#98-15 PTN LOT: 27 &T.L.
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR HWY 106 FROM UNION, PAST ALDERBROOK,JUST IN FRONT OF MP 10
TURN R UP HILLLOT JUST ABOVE ON R
General Information Construction &Occupancy Information Square Footage Information
No.of Bedrooms: 3 Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3, U Lot Size: Deck: 248
Type of Work: NEW Fire Dist.: 6 No.of Stories: 3 Occ. Load: Building:2,291 Garage-Attached 576
Valuation: Building Height: Occ. Status: Primary Basement:1,029 Cov. Porch 682
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: S 10.0 Ft. Shoreline: 150.0 Ft. Water Body: HOOD CANAL
Rear: N 93.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: W 8.0 Ft. Shoreline Desig.: Urban
Year: Serial No.: Side 2: E 8.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 11/7/2006 $1,253.82 S12006000
Hosebibs 4 Furnace<100K 1 Planning Review Fee KS 11/7/2006 $155.00 S12006000
Kitchen Sink 1 Gas Outlets 2 Building State Fee JRN 11/13/200 $4.50 S12007000
Laundry Tray 2 Propane Tank 1 Building Permit Fee JRN 11/13/200 $1,923.35 S12007000
Lavatories 4 Ventilation Fan 4 Plumbing Base Fee JRN 11/13/200 $20.00 512007000
Showers 1 Woodstove 1 Plumbing Fee JRN 11/13/200 $110.00 S12007000
Water Closets (Toilets) 3 Heat Pump 1 Mechanical Base Fee JRN 11/13/200 $23.50 S12007000
Water Heaters 1 Propane Stove 1 Mechanical Fee JRN 11/13/200 $198.25 §12007000
Bath Tubs 1 Dryer Vent 1 ADJUST--Plan Check Fee JRN 11/13/200 -$3.64 S12007000
Clothes Washer 1 Address Fee BLJ 11/14/200 $140.00 S12007000
EH Plan Review TW 11/17/200 $75.00 S12007000
Public Works Review PMC 12/7/2006 $38.50 512007000
Total $3,938.28
BLD2006-01971 Please refer to the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
BLD2006-01971
CONDITIONS FOR
BLD2006-01971
1) This parcel i�located in a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information.
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2) 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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3) 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 roa s 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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4) 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
Departme t prior to any further inspections being performed or approvals granted.
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5) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads," all new structures that
require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the
access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background.
Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted
by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting
inspections.
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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
remova of approved documents will result in failure of required building inspections.
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7) All slabs within the heated space shall be insulated to a minimum R-10 for at least 24". Monolithic slabs shall be insulated around the perimeter from the
top of the slab to the bottom of the footing X 4z e�
BLD2006-01971 Please referto the following pages for conditions of this permit. 2 of 5
8) . THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
9) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, Compliance Method: IV, Window(Max U-Factor):0.40, Skylight (Max U-Factor):0.58,
Doors (Type/MaxU-Factor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10.
10) 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
BASIC WI SPEED (3-SECOND GUST)the wind speed for Mason County is 85 MPH.
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11) Per 2003 IRC - SECTION R905- REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in
accords with the applicable provisions of this section and the manufacturer's installation instructions.
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12) Concrete used for basement walls,foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
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13) 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
X charged ads hall be collected by the Building Department prior to any further inspections being performed or approvals granted.
14) 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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15) 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 wil
l be granted to use an existing utility
and drainage easement dedicated for that specific purpose. For further
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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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16) 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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BLD2006-01971 Please referto the following pages for conditions of this permit. 3 of 5
1,7)' 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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18) 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), property line or
easement. If propane tank is exposed to probable vehicular damage, protective bollards must be installed.X��
19) 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, property line, public way, possible source of ignition (electrical outlets,
electrical fixtures, compressors, etc),and/or any weeds, grass, brush, trash or any other similar combustible materials. If a propane tank is exposed to
probable ve icular damage, protective bollards must be installed.
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20) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks must
meet the i I Nation requirements and minimum setbacks as listed in the Mason County Fire Marshal's Standards for the Installation of Propane Tanks.
21) 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 inspection 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
not be used until the final inspection has been performed and approved by a Mason County building inspector.
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22) 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 regulations primarily consist of setbacks from shorelines and features considered to be critical areas (streams,
wetlands, slopes, etc.) If you think such features exist on or nearby your property, please contact the Planning Department so that exact setback
requirements can be determined. X /1+2
23) All property lines shall be clearly identified at the time of foundation inspection. X O,
24) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration.
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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BLD2006-01971 Please referto the following pages for conditions of this permit. 4 of 5
25) 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 pre ented action from being taken. No more than one extension may be granted.
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26) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. Structures
and/or land modifications (grading, cuts, fills, etc.) required in the geotechnical report/assessment, may require a seperate permit. The geotechincal
report/assessment shall remain attached to the approved building plans. X 44i
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27) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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28) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X
29) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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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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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 owneror the agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to
the above described property and structure for review and i ection.
OWNER OR AGENT: DATE:_ 7 —
BLD2006-01971 Please referto the following pages for conditions of this permit. 5 of 5
o CONCRETE
MECHANICAL MANUFACTURED HOME
Footings i Setbacks Dat Z?�itTl is t Ribbons
CP Gas Piling
o Interior Date%, By Interior-Date By L I�� t3ale B
y.
Exterior Dat �'�� By��p Exterior-Date li 7 4 D-7 B Set-up rn
INSULATION "1
Point load I isolated Footings 1�r3tDti By -n
BG!SLAB INSULATION ---
�����P Date By _ Data d 7 By C<j FIRE DEPARTMENT
Foundation Walls Floors Date By
Date 3 ZS" (4A-Y Byl-At Data By DECKS
FRAMINO WattsCkw'K/w``t ,11 911WRY Date By
Date ' By Data g 01 By LV3 PROPANE TANKS
PLU BING vault Daft By
Deife rJ-( ey L41C OTHER
Groundwork Allic 01,1111, c `� '�`�`" 'flit
Type_
Date Z9—67 By L Date By Date By
EtMM DRYWALL _e. Type-
Date 4zo.D1 B L 01 Int Brace Wail Date By iA
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�_ pate By FINAL INSPECTION 0
Water Line Fire SeparationCD
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cPD Date By Date By Date 4 ),�- By p
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Pass or Request Inspect. c
s Type of Insp. Fail Date Date Done By Comments
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WSEC/VIAQ COMPLIANCE FORM Page 1 of-9
Owner: Brady Residence Telephone: I Parcel#:
Type of Project 0 New Residence ❑Addition ❑Remodel Date: 10/31/2006
Total Sq. Ft. of Heated Area. list Floor: 1,975 Loft: 316 Basement: 1,029
Heating System Type ❑Electric Wall Heater ❑Electrical Central Furnace ❑LPG Furnace ❑Heat Pump with Electric Furnace
❑Other(Specify): Q Heat Pump with Gas Furnace ❑Boiler,Specify Fuel Type:
Glazing Pctg. Compliance Method Prescriptive Option No. 1 4 1 ❑Systems Analysis,Chapter 4
23.66% Check One:
❑Component Performance,Chapter 5-Calculation Worksheet Required
Ventilation ❑ Whole House Ventilation System ❑ Whole House Ventilation System
System using exhaust fans&window or wall fresh air vents(VIAQ 303.4.1) using a heat recovery ventilation system (VIAQ 303.4.4)
0 Whole House Ventilation System ❑ Whole House Ventilation System
Check one: integrated with a forced air heating system (VIAQ 303.4.2) using an inline supply fan(VIAQ 303.4.3)
U- Quan- Size 112 114 Exe- Area UA
Windows Brand Window Type Room Value I tity w H Rd. Rd. Tri mpt (S.F.) Value
Milgard Vert. Slider AR/LE Bedroom 3 0.350 1 3 ° 4 6 ❑ ❑ ❑ ❑ 13.50 4.73
Milgard Horiz. Slider AR/LE Bedroom 3 0.350 1 6 ° 1 4 6 ❑ ❑ ❑ ❑ 27.00 9.45
❑ ❑ ❑ ❑
Milgard Casement AR/LE Recreation 0.330 1 3 ° 1 5 16 ❑ ❑ ❑ ❑ 1 16.50 5.45
Milgard Fixed AR/LE Recreation 0.310 2 311 111
❑ ❑1 ❑ ❑ 9.00 2.79
Generic SteeVWd. Frame-45%Glass Recreation 0.380 1 9 ° 6 8 ❑ DI ❑ ❑ 60.00 22.80
Generic SteelANd. Frame-45%Glass Recreation 0.380 1 3 ° 6 8 ❑ DI ❑ ❑ 20.00 7.60
❑ ❑ ❑ ❑
Milgard Horiz. Slider AR/LE Bedroom 2 0.350 2 6 ° 416 ❑ 54.00 18.90
Milgard Casement AR/LE Bath 0.330 1 2 ° 310 ❑ ❑ 6.00 1.98
❑ ❑ ❑ ❑
Milgard Horiz. Slider AR/LE Master Bedroom 0.350 1 9 ° 4 6 ❑ ❑ ❑ ❑ 40.50 14.18
Milgard Fixed AR/LE Master Bedroom 0.310 2 2 ° 416 ❑ ❑ ❑ ❑ 18.00 5.58
Milgard Fixed AR/LE Master Bedroom 0.310 1 4 ° 1 4 6 ❑I ❑ ❑ ❑ 18.00 5.58
Generic Steel=d. Frame-45%Glass Master Bedroom 0.380 1 3 ° 6 8 ❑ ❑ ❑ ❑ 20.00 7.60
❑ ❑ ❑ ❑
Milgard Casement AR/LE Great Room 0.330 2 3 t 6El ❑ El ❑ 33.00 10.89
Milgard Fixed AR/LE Great Room 0.310 1 6 6 ❑ ❑ ❑ El33.00 10.23
Milgard Fixed AR/LE Great Room 0.310 1 9 6 ❑ ❑ 01 ❑ 1 49.50 1 15.35
❑ <- Check Here if windows, skylights or doors are continued on an additional sheet
Target Weighted U-Value for Windows=0.40 Total Window Area/Total UA: 1 785.44 265.02
Weighted U-Value=Sum(UA)/Total Window Area (not including exempt windows) Weighted U-Value 0.337
Skylight U- Size Exe Area UA
Skylight Brand Model Number Room Value Quant. w H mpt (S.F.) Value
Target Weighted U-Value for Skylights= .58 Total Skylight Area:/Total UA
Weighted U-Value=Sum(UA)/Total Skylight Area (not including exempt Skylights) Weighted U-Value 0.000
Door U- Size
Exe Area UA
Brand Model Number Room Value Quant. w H mpt (S. F.) Value
Generic Steel/Wd. Frame- No Glass Htd Storage/Mechanical 0.160 2 3 ° 6 8 ❑ 40.00 6.40
Generic Steel/Wd. Frame-No Glass Entry 0.160 1 3 6 6 8 ❑ 23.33 3.73
Target Weighted U-Value for Doors =.20 Total Door Area/Total UA: 63.33 10.13
Weighted U-Value=Sum(UA)rTotal Door Area (not including exempt doors) I Weighted U-Value 0.160
Total window&door area 848.781(divided by)total sq.ft. of heated area 3320= 25.57% of glazing (&Doors)
Single glazed, ornamental or garden window or door up to 1% of floor area may be exempted
Foster and Williams Associates Analyst. Spencer Burnfield
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Y WSEC/VIAQ COMPLIANCE FORM Page 2 of 2
Single glazed, ornamental or garden window up to 1%of floor area may be exempted
U- Quan- Size 1/2 1/4 Exe- Area UA
Windows Brand Window Type Room Value tity w I H Rd. Rd. Tri I mpt (S. F.) Value
Milgard Fixed AR/LE Great Room 0.310 1 3 °1 2 8 ❑ ❑1 ❑ ❑ 8.00 2.48
Milgard Fixed AR/LE Great Room 0.310 1 6 ° 2 8 ❑ ❑ ❑ 16.00 4.96
Milgard Fixed AR/LE Great Room 0.310 1 9 2 ❑ ❑ ❑ ❑ 24.00 7.44
Generic SteeIANd. Frame-45% Glas Eating 0.380 1 12 ° 6 8 ❑ ❑ ❑ ❑ 80.00 30.40
Milgard Fixed ARILE Eating 0.310 1 12 0 1 10 ❑ ❑ ❑ ❑ 22.00 6.82
❑ ❑I ❑ ❑
Milgard Casement AR/LE Kitchen 0.330 2 2 6 3 10 ❑ ❑ ❑ ❑ 19.17 6.33
Milgard Fixed AR/LE Kitchen 0.310 1 2 ° 3 10 ❑ ❑ ❑ ❑ 7.67 2.38
❑ ❑ ❑
Milgard Casement AR/LE Pantry 0.330 1 2 ° 3 10 ❑ ❑ ❑ 7.67 2.53
❑ ❑ ❑
Mil and Horiz. Slider AR/LE Utility 0.350 1 6 ° 3 10 ❑ ❑ ❑ 23.00 8.05
Generic 1/2 glasE Steel/Wd. Frame-25% Glas Utility 0.280 1 3 ° 6 8 ❑ ❑ ❑ ❑ 20.00 5.60
❑ ❑ E]I ❑
Milgard Casement AR/LE Powder 0.330 1 2101 3 ° ❑ El ❑ ❑ 6.00 1.98
❑ ❑ ❑ ❑
Milgard Horiz. Slider AR/LE Den/Office 0.350 1 6101 4 ° ❑ ❑ ❑ ❑ 24.00 8.40
❑ ❑ ❑ ❑
Milgard Fixed AR/LE Entry 0.310 1 2 6 6 8 ❑ ❑ ❑ ❑ 16.67 5.17
Milgard Fixed AR/LE Entry 0.310 1 2 6 1 6 ❑ ❑ ❑ ❑ 3.75 1.16
Milgard Fixed AR/LE Entry 0.310 1 3 6 1 6 ❑ ❑ ❑ ❑ 5.25 1.63
❑ ❑ ❑ ❑
Milgard Awning ARILE Master Shower 0.330 1 2 s 1 6 ❑ 1 ❑ ❑ ❑ 3.38 1.11
Milgard Awning ARILE Master Shower 0.330 1 4 6 1 6 ❑ ❑ ❑ ❑ 6.75 2.23
❑ ❑ ❑ ❑
Milgard Casement ARILE Dressing 0.330 2 2 ° 316 ❑ ❑ ❑ ❑ 14.00 4.62
❑ ❑ ❑ ❑
Milgard Fixed AR/LE Loft 0.310 2 64
❑ ❑ El ❑ 20.00 6.20
Milgard Fixed AR/LE Loft 0.310 1 11 8 ❑ ❑ 0 ❑ 17.00 5.27
Milgard Fixed AR/LE Loft 0.310 2 5 ° ❑ ❑ El ❑ 12.70 3.94
Milgard Fixed AR/LE Loft 0.310 2 9 ' ❑ ❑ 0 ❑ 10.45 3.24
❑ ❑ ❑
❑ ❑ ❑ ❑
❑ ❑ 01 ❑
❑ ❑ Ell ❑
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
❑ELE
El
❑
Single glazed,ornamental or garden window up to 1%of floor area may be exempt
Skylight U- Size Exe Area UA
Skylight Brand Model Number Room Value Quant. w F H mpt (S. F.) Value
3.000 ❑
LI
Door U- Size Exe Area UA
Brand Model Number Room Value Quant. w H mpt (S. F.) Value
1 ° 18 ❑
0 8 ❑
PERMIT NO. �y(./U% w OK !1
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 web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner 6 (-1 Company Name
Mailing re -S -I Mailing Address
City �' State J,(.1FiZip Code City Mate Zip Code
Phone,-3h&-U2 "3t� /:3—,'U-0—the r Ph ! U Phone Other Ph.
Lien/Title Holder Contractor Reg.4 Exp.
E mail address JnL � U / E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic_ )K Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. — Fire District
Legal Description
Site Address (Please include street name, street nu�ber and city) '?
Directions to site AL
Is property within kY of Saltwater 1►- 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 Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric,�" LPCz,{-- Natural Gas— Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs �_ Heatpumps
Showers L Spot Vent Fan
Water Heater Propane Tank Y
Clothes Washer GG 0 is
Kithen Sinks oo a Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent
Otherl-`�►�,� Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
O VNER/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 parry 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 CONTINUATI OF R BY MEANS OF A PROGRESS INSPECTION.
X Dater
Ow / epresent e/Contractor (indicate which one)
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FOR OFFICIAL USE BEYOND THIS POINT
Accepted b . `flanning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbina & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
MASON COUNTY PERMIT NQ.-A-- IC 7
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
Owner ' Cf <_ Company Name
Mailing6A dress _ Mailing Address
City State 11 Zip Code City State Zip Code
Phone?JCL U-�k2 Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail addresses C()/ I E Mail Address
Drivers Lic.# J DOB Drivers Lic. # DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic X E isting Septi
Connect to Water System N_Name of Water System AI 14 S+- ". zc:Ze
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. — Fire District
Legal Description
Site Address (Please include street name,
et number and city)
Directions to site
f-
Will tiFnbdr be cut and sold in parcel prepa ation?Yes OJO
Is property within 200'of Saltwater .-' Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffer 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 BuildingDescribe Work
No. of Bedrooms No. of Bathrooms Z Square Footage- 1 st Floor 2nd Floor 24(0
3rd Floor Basement In 2,e Deck 12-5S'Covp ed Dec OtherLr"� �"Sq. ft. I
Garage J70 Attached ✓ Detached Attached —CCII Detached
MANUFACTURED HOME INFON - Make Model --"-Year
Length Width Serial RM O No. of Bedrooms No. -bathrooms
Type of Heat urchase Price$ _ Replacement Unit? / No
Installer Name Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a red rmit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owner ative, or the contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed in the applicati c are ha I h 0 obtained the permission from all
the necessary parties. If permission is required from any easement holder or any other partx,i�, Vet arding this application or the work
proposed in the application, I have obtained permission from them to apply for this permit a nduct the rjposed. The owner or
agent on owners behalf, represents that the information provided is accurate and grants employees o� �unty access to the above
described property and structure for review and inspection. This permit/application becom �R i work or authorized construction is
not commenced within 180 days or if construction work is suspended for a period of 180✓ AA)!' 'K6OF OF CONTINUATION OF WORK IS BY
MEANS OFA PROGRESS I SPECTION.IN TIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X Dater
Own rs esent ivektontractor (indicate which one)
FOR OFFICIAL USE BEYON THIS POINT Accepted by: I Date
DEPARTMENTAL REVIEW APPROYE4D DENIED NOTES
Building Department I
q ki
1
Planning Department
Environmental Health Department b
l
Fire Marshal
FEES
Building Permit Fee _ Site Inspection
Plan Review Fee '8 EH Review Fee
Plumbinq & Base Fee O— Planning Review Fee
Mechanical & Base fee Other
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
og�
99�
1
7�
_1