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HomeMy WebLinkAboutBLD2012-00072 Addition, Remodel Final - BLD Permit / Conditions - 5/9/2014 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 lot RESIDENTIAL BUILDING PERMIT BLD2012-00072 OWNER: JOHN CHALLMAN RECEIVED: 2/7/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 3/22/2012 SITE ADDRESS: 70 E OLD RANCH RD ALLYN EXPIRES: 9/22/2012 PARCEL NUMBER: 122205700004 LEGAL DESCRIPTION: LAKELAND VILLAGE 9 LOT: 4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: ADDITION/REMODEL TO EXISTING RESIDENCE (Add 22x20 addtn to LAKELAND VILLAGE garage, remodel existing dining. living room & kitchen, addition & rem existing master bedroom 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: 1 Occ. Group: R3U Lot Size: Deck: Type of Work: ADD Fire Dist.: 5 No.of Stories: Occ. Load: Building:1,907 Garage-Attached 1,019 Valuation: $ 142,309.85 Building Height: Occ. Status: Seasonal Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: W 30.0 Ft. Shoreline: Ft. Water Body: Rear: E 45.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Shoreline Desig.: Side 1: N 5.0 Ft. Year: Serial No.: Side 2: S 5.0 Ft. I Comp. Plan Desig.: Urban Growth Area Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 1 Heat Pump 1 Plan Check Fee TW 2/7/2012 $641.39 S1201200000001 Lavatories 2 Ventilation Fan 3 Planning Review Fee TW 2/7/2012 $205.00 S1201200000001 Showers 1 Gas Outlets 1 EH Plan Review MRB 2/7/2012 $ 103.00 S5201200000001 Clothes Washer 1 Fireplace 2 Building State Fee DLC 3/12/2012 $4.50 S1201200000001 Dryer Vent 1 Building Permit Fee DLC 3/12/2012 $ 1,234.55 S1201200000001 Mechanical Permit Fee DLC 3/12/2012 $206.40 S1201200000001 Mechanical Base Fee DLC 3/12/2012 $28.50 S1201200000001 Plumbing Permit Fee DLC 3/12/2012 $43.50 S1201200000001 Plumbing Base Fee DLC 3/12/2012 $24.70 S1201200000001 ADJUST--Plan Check Fee DLC 3/12/2012 $ 161.07 S1201200000001 Total $2,652.61 BLD2012-00072 Please refer to the following pages f&conditions of this permit. Page 1 of 6 CASE NOTES FOR BLD2012-00072 CONDITIONS FOR BLD2012-00072 1) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at (360)427-9670, ext. 450. The building permit will not be"finaled" until the permit holder can show proof that the access permit from Public Works has been "finale " and approved. X 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. X 3) Owner/ - ent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 4) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 5) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands. Silt fencing or straw/ matting must be installed and maintained until upland vegetation has become established. X 6) 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 7) 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). X1-1 8) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Appry d 'ite Plan"to ensure these structures are shown and meet the setback conditions listed. X 9) 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. x � BLD2012-00072 Please refer to the following pages for conditions of this permit. Page 2 of 6 "i'd) 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. . X 11) 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 Xmova�pproved documents will result in failure of required building inspections. 12) All replacement windows shall be installed per manufacturer's specifications and be flashed per IRC section R703.8. All installations shall meet requirements for guards per R613 and safety glazing per R308.4. WSEC requires a U-factor of.30 or less in all heated spaces. Existing, non-conforming, egress window openings are not required to be enlarged, but it is highly recommended. Egress windows replaced in an existing opening shall be brought into compliance with current codes if a product is available for this application. Building plans/permit are required for windows in new, enlarged or relocated openings these installations must meet all current codes. X 13) Washington State Energy Code Compliance has been approved for heated addition as follows: Heat Type: Existing air source heat pump, Compliance Method: Prescriptive option 11, Window(Max U-Factor)as follows: 0.30- 4)6-ft picture windows, U-0.32 2) 6050 horizontal sliders, and U-0.35 5-ft patio door in master bedroom, No Skylights (Max U-Factor):0.50, No doors, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-49 standard, and Vault Insulation R-38. Existing wall cavities exposed during construction shall be insulated to full depth of cavity as noted on construction plans; min R-21 in 2x6 cavities and R-15 in 2x4 cavities. In addition the following credit from Table 9-1 shall be completed: Option 6 addition less than 750 sf. X 14) 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. X ,�� 7T 15) 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. X� BLD2012-00072 Please refer to the following pages for conditions of this permit. Page 3 of 6 1v) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Uesign, 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 owledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 17) 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 charge shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X 18) 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 remcation. X 19) 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 X l 20) 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 21) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or a uI tion, must be reviewed and approved by Mason County prior to construction. X BLD2012-00072 Please refer to the following pages for conditions of this permit. Page 4 of 6 22) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADUN I EU 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 be made prior to requesting additional inspections. X 23) 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 til the final inspection has been performed and approved by a Mason County building inspector. X �—� 24) Epoxy grout required and specified on the approved building plans shall require a special inspection. The special inspector shall be the engineer of record or their authorized representative, a WABO Certified special inspector, or certified testing laboratory. In addition a Mason County Building Inspector may perform the inspection provided holes are prepared in accordance to manufacturer specifications that are available on-site during inspection. Special inspectors shall inspect the installation of grouted construction anchors as stated in the manufacturers specifications. An inspection report shall be prepare -and submitted to the Mason County Building Department prior to the framing inspection of the project. X 7 25) All property lines shall be clearly identified at the time of foundation inspection. X 26) 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 Co t ordinances and building regulations. X r 27) 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. Xi 28) 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 ROA)7, Y. X 29) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or installed in or around swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps). Referen.ce WSEC 505. X BLD2012-00072 Please refer to the following pages for conditions of this permit. Page 5 of 6 au) Installation of heating equipment in a single-family residence shall meet the requirements of the current Washington State Energy Code, applicable sections of the IRC and IMC. Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous glass ducts shall comply with UL181A and shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape. Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened. Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal ducts shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or rivets equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation instructions. Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8 DUCT TIGHTNESS TESTING shall be conducted by person(s) trained to perform such testing. A signed affidavit documenting test results in accordance to WSEC Section 503.10.3 shall be provided to the Mason County Building Department prior to the final occupancy inspection. Affidavit forms are available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit"or"Duct Leakage Testing Results (Existing Construction)." Duct tightness testing is not required if the air handier and all ducts are located within the heated space. All heating equipment shall meet the requirements of the National Appliance Energy Conservation Act(NAECA) and be so labeled. (WSEC503.4) or in accordance to WSEC Section 1411. 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. OWNER OR AGENT: .� DATE: BLD2012-00072 Please refer to the following pages for conditions of this permit. Page 6 of 6. q--l[w— -I,K - o CONCRETE MECHANICAL MANUFACTURED HOME _ C) Date N Footing/Setbacks Gas Piping By Ribbons r o Interor Date By Interior-Date j0'IU'I?_ BY �`L sate By 3 4 Exteno(Date _ _ � B Exterior-Date B Set-up � Z Point Load I Isolated Footings,S7) NSULATION Date Eau L BG I SLAB INSULATION Date — By Data By FIRE DEPARTMENT X Foundation Walls Floors Date By Z Date _) >L By Data By DECKS FRAMING walls Date By Date Z1S_ By Data l� —�`/ By PROPANE TANKS PLUMBING vault Date By Date By OTHER Groundwork Attic Dale By Date By Type- Date fay D.W.V DRYWALL .��____ Type- -0 Brace Wall Date By W C Dare 1 U /U I Z By L/Jl/ CD Date By FINAL INSPECTION p 0 Water Line ('f{� Fire SeparationCD r N CD Date v BY Date By Gate 6j BY (�A�l p N g Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments o e�T !CD _)- ch n 0 s ,may s Cn CD v 3 OKI Fyl � n�iL ' 411 i v 3244 /--S`/Z 3 +t I 3. !N v 1,1�1 P �63 S Iq U01 0 Building Permit # ZD/L- 22- MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 70 el)(05;7 �*�c-ff � This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been und: Items Listed below must be corrected to gain code compliance 7-0 i4L�'o,s l i 1'�r; 712 r -lz,,- N9 fir- G .►/ )v_ AI Aff0969a1.4i4t(- S- c 66IG 1,067 Sl % Yo are ereby, notified t at the abrrections�� II be made z �� ove co .j. � �rv�RCiG�E G�rEi✓ h`c c- Hr c 1�o�iv ��Y�'S /l7�}i��y �f}/f L�. T cC21f'7,PIT ❑ Call for re-inspection when corrections are made before continuing bi Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department 0 /I Date /-2 - Inspector i moos NOOT ► @mMnV THI , k T ' ,* Ri ,Permit# � ? 7� MASON COUNTY BUILDING III 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 fo nd: Items listed below must be corrected to gain compliance Wiz: le 4 r, c,T Fes,�n , �tra��sF CIA Tl-c r ^fj Ct /4 C You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ please contact our office Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is no,.,tla complete inspection � disasters. This is NOTa Date 3 S / 1 Department �,� CORRECTION NOTICE. Inspector �(� 00 ,0 NCOT , Mt ,#V ' THImmh, TAG , viio3dSN1 b®J 311S 8®(341 NO /04 F aF At wo— ALI 7 . w f _ a NEW ARCH,GRADE Comfo. SHINGLE FROOPING ONALL 5USFACE5 NELU CH IMNET' Mill ,A Nam , Ysc1 ) Parcel#32219'--7-6'9U11 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 Stormmater 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.hbn 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 ro erty for review and inspection as may be required. (Ow X e�'Agerrt/Contractor(circle one)Date: 0�"'0� 4� Page 2 of 2 ���� Namec, 4 r ' l Parcel#322A ' 75' 90112 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 2. '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. 2Common 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 stormwat r. pe ,µ covered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area `All dimensions in feet Buildings X = $2g 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) �28 If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- describe perry for review and inspection as may be required. X OOwne/Agent/Contractor(circle one)Date: 0� d 7- /;7 If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 MASON COUNTY PERMIT NCRUD I� �Z 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 1 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner T© h ri C h.a Company Name Mailing Address a 7 a C Mailing Address City- �'Y�%p V- State JdZiL Zip Code .98 0 3 City State Zip Code Phond�`O,) 6_8-�-,9116 Other P42062 &��-22o 3 Phone Other Ph. Lien/Title Holder_Or-ch^J v NAwcr ChraZIA",41y Contractor Reg. # Exp. E mail address J C C/'7 p // tD C..r1 c.t'I ve v� E Mail Address Drivers Lic.#C/fAIL J8,�48f3KS DOB C S---IO 5 aZ I Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System_A,9 A-e br,va/ PARCEL INFORMATInN - 12 Diait Parcel No, , ZZ� '- 7_7 Fire District s L Legal Description ' ' e L�-t,V t IV1 j(kC:c�,e_ -4.11 L�j+ILf Site Address (Please include street name, street number and city) 70 0/W R,4-c/z 2M, ' Directions to site l-s4wLe/ram-val l/://•use cro/ r-,",Se Will timber be cut and sold in parcel preparation? Yes No Is property within 200'of Saltwater /b" Lake River/Creek Pond 1� 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)K Use of Building ate" fHCrae- Describe Work i?,Pmr. alp / No. of Bedrooms_P No. of Bathrooms f3L_Square Footage- 1st Floor -3,5 3 2nd Floor A,',/.,9 3rd Floor ^*//� Basement / �' At Deck—Covered Deck z y 2 Other — Sq. ft. / /i`} Garage. Attached 3L Detached __&4i Carport 1v,114 Attached Detached MANUFACTURED HOME IN MATION - Make Model 'Sfe'ar Length Width erial No. No. of Bedrooms No�l�rooms Type of Heat %''~ Purchase Price$ Replacement Unit? Y /No Installer me 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. PROOf,�ONTINUA ON OF ORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Oa OJ-- /d2 caner Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date - DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department I,- Planning Department Environmental Health Department a Public Works Department Fire Marshal FEES Building Permit Fee '55S Site Inspection Plan Review Fee T (p t 0-1 EH Review Fee Plumbing& Base Fee "haq Planning Review Fee Mechanical & Base fee O O F c;Z&-'O Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal (p 4 1 39 Valuation $ / a D TOTAL FEES 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 APPLICAN INFOR TION CONTRACTOR INFORMATION Owner -3&P4-' r + Company Name Mailin AddresG 2-2-72c� [-'c� d Mailing Address City - ri'--� State lJ A Zip Code cl 8C3L City State Zip Code Phone 5E25 -5g2-9719' Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic. # DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System V PARCEL INFORMATION - 1� D) it Parcel No Fire District Legal Description Q S -2302- Site Address(Plea$e include street name, street number and ity) 0 O d � 0 Directions to site K W 3 /__' �` �,�kr\.C�_ r'i L*0-1--O r i' c.� d . Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add--ZAlt Repair Other Use of Building Sat Location of Fixtures/Units- 1 st FlooLIL 2nd Floor 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 ► Type of Unit No. of Units Rej04,,.F ees Bathroom Sink Z Furnace ,. Bath Tubs Heatpumps �,11 Showers Spot Vent Fan To%/ct ,►, Water Heater Propane Tank Clothes Washer l Gas Outlets Kithen Sinks Wood/Gas,/Pellet Stove — Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent 1 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. PROD NTI UA OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: 6a � a7 - /oZ Owne /Owners Representative/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 Grou Type 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 oo/ O/ NCO / s anL G�� � ky AOP � 7 -2, NA t ua LOT 5 M•-!A• SM YAMLM _ MA/hlMq W Imo•-- i do — I I II ___— I A°°m°w 1 Ali is 1 I I I--aOWB taus 1 I I I LOT 4 1 1 ` 1 ►emu erx o ` ! , 1 ca�, to man II 1 1 i I ACOMCKI 1 map dpdlpwowoop !' w exac GM Y, ac, LSE 1 ow I .,�.• 1 1 I -- 1 1 1 LOT 3 70'ggiT YARD 1 Site Plan 1 Seale: I• . z0'-0• mom PARCEL NO.: I2220-51-00004 LEGAL DESCRIPTION: LAKELAND VILLAGE S LOT: 4 SITE ADDRESS- 10 E OLD RANCH ROAD ALLYN,WASH WITON b � �s .,�' �-; '�'� �+:�r} {`'S�.Sty �� `.!" �' t. � ..