HomeMy WebLinkAboutBLD2009-00433 Final Cabin Damaged by Tree - BLD Permit / Conditions - 6/10/2010 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
Shelton, WA 98584
IP10
RESIDENTIAL BUILDING PERMIT BLD2009-00433
OWNER: JOHN MCGEE RECEIVED: 5/28/2009
CONTRACTOR: LICENSE: EXP: ISSUED: 6/24/2009
SITE ADDRESS: 51 NE TIGER COVE LN BELFAIR EXPIRES: 12/24/2009
PARCEL NUMBER: 123055100001
LEGAL DESCRIPTION: TIGER LAKE TRACTS#2 TR 1
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
CABIN DAMAGED BY TREE, REPAIR AND EXTENSIVE REMODEL GO UP BEAR CREEK DEWATTO RD TO TIGER LAKE TURN RIGHT GO 2
MILES TO TIGER COVE LANE FOLLOW DOWN TO 52 NE PROPERTY IS
ON THE LAKE CABIN AT THE WATER
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 1 Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck:
Type of Work: REP Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:
Valuation: Building Height: Occ. Status: Seasonal Basement: repair rem 1,002
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 370.0 Ft. Shoreline: 10.0 Ft. Water Body: TIGER LAKE
SEPA?: No
Rear: W 10.0 Ft. Slope: Ft.Model: Width: Ft. Side 1: N 70.0 Ft. Shoreline Desig.: Urban
Year: Serial No.: Side 2: S 10.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Hosebibs 1 Ventilation Fan 1 Plan Check Fee TW 5/28/2009 $636.84 S22009000
Lavatories 2 EH Plan Review TW 5/28/2009 $103.00 S22009000
Water Closets (Toilets) 1 Planning Review Fee TW 5/28/2009 $205.00 S22009000
Water Heaters 1 Building State Fee RTB 6/11/2009 $4.50 S22009000
Bath Tubs 1 Building Permit Fee RTB 6/11/2009 $979.75 S22o0900o
Mechanical Permit Fee RTB 6/11/2009 $9.00 S22009000
Mechanical Base Fee RTB 6/11/2009 $28.50 S22009000
Plumbing Permit Fee RTB 6/11/2009 S49.70 S22009000
Plumbing Base Fee RTB 6/11/2009 $24.70 S220o9000
Total $2,040.99
BLD2009-00433 Please refer to the following pages for conditions of this permit. 1 of 4
CASE NOTES FOR
BLD2009-00433
CONDITIONS FOR
BLD2009-00433
1) 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
2) Owne 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
J
3) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X���
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
Deplartinent prior to any further inspections being performed or approvals granted.
X ,�
5) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X�
6) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
removal of approved documents will result in failure of required building inspections.
X
7) All exterior all cavities exposed during construction or remodeling work shall be insulated to the full depth of the wall cavity and inspected prior to
covering. i
8) 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.35 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,
enIar.9,9d or relocated openings these installations must meet all current codes.
X X/
BLD2009-00433 Please referto the following pages for conditions of this permit. 2 of 4
9) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, 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, Wall insulation R-21, 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
unde4, e of the roof sheathingis less than 12-inches and there is 1-inch vented airspace above the insulation.
P
X �
10) 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
cha, i-and shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
X /'�
11) 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 'k
12) 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 projiect.
X�.
13) 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 AP=,_
14) 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__r
15) All property lines shall be clearly identified at the time of foundation inspection. X
BLD2009-00433 Please referto the following pages for conditions of this permit. 3 Of 4
16) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason County ordinances and building regulations.
X
17) 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.
18) 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.
X 1Q/
19) 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 47-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
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20) Approved per dimensions and setbacks on submitted site plan to locate rebuilt cabin on old footing locations. Setbacks are measured from the furthest
projection of the structure.
21) The proposed project must be consiste with all applicable policies and other provisions of the Shoreline Management Act, its rules, and the Mason
County Shoreline Master Program.X
22) Prior to final approval, all upland areas disturbed or n�l*created by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X �Z
23) The applicant ac owledges that this development was sited such that further shore protection measures will not be required for protection of the
structure. X__
24) Temporary erosion control measures must be implemented to prevent water�quality degradation of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established. 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 own r 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 r and ins tion.
OWN ER OR AGENT: DATE: (5 Z ��
BLD2009-00433 Please referto the following pages for conditions of this permit. 4 of 4
o CONCRETE MECHANICAL MANUFACTURED HOME
C) Date ^2� '`Cf� B y Q.
C) Footings I Setbacks��� F ` Gas Piping Ribbons m
o Intenor Date By v Interior-Date By Date By I'n
W Exterax Date .6 `L��/Z By Exterior-Date By
Set-up up O
Point Load I Isolated Footings INSULATION Date By _ z
BG I SLAB INSULATION - -
Date By Data By FIRE DEPARTMENT
Foundation Walls / Floors Date By
Dote �y beta -L _o2 By DECKS
FRAMING ails Date By
Date , `^ ZO^ %� By Data By IPROPANE TANKS
PLUMBING vault tL Date By
Date By OTHER
Groundwork Attic
Date By Type.
Date By Date By
D.W.'v DRYWALL Type-
Int Brace Wall Date By
Date I/—/�- BY Date BY FINAL INSPECTION 0
m Water Line Fire Separation` L By C
m
� Date By Date By Date '` / J O
m tD
Pass or Request Inspect. c
Type of insp. Fail Date Date gone By Comments w
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UMP TO BE ADDED 425.640 APPROVED
MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
CHAN ES SUBJECT TO APPROVAL
By Date �.
4120109
DATE: 4120/09 RAllOS CLIENT NAME: REV. # DESCRIPTION DATE C
DESIGN BY: NMR Plats Plus og F John G Ma Ge e
DRAWN BY. CDH Engineering LLC
., DC
CHECKED BY: NMR M N&S CIVIL ENGINEERING z CLIENT ADDRESS: P,Q, Box 442 0 OC
SHEET# 1950LOST 1 CREEKLANE Bremerton, WA. 98312 BRWMWRTON,WA
98312 329
PHONE:(360)990-7555 sj CLIENT PHONE: (360) 275-9211
FAX:(360)692-3802
?ROJECT# 2023 PROJECT SUPERVISOR: NELS ROSENDAHL CLIENT FAX., SCALE: 1 1f = 40'
(9/25/2009) Debbera Coker- special inspection reports BLD 2009-00433 Page 1
From: Mark Core n /�
To: nets@platsplus.net V I
Date: 9/25/2009 9:18 AM
Subject: special inspection reports BLD 2009-00433
Attachments: Mark Core.vcf
Nels,
As we spoke before. It is ok for the engineer of record to perform special inspections. You had inquired about the
footing/foundations and the framing. I told you it was ok however we still were required to come out prior to the placement of
concrete to verify setbacks and prior to insulation to inspect any plumbing, mechanical,windows,trusses,seal package and
verify electrical is signed off. Any insulation installed prior to this will be required to be removed.
I received your special inspection reports however there is information lacking. Reports are required to be stamped and
signed per WAC 196-23-020.
Please resubmit your special inspection reports with the following information:
Bld 2009-00433, John McGee 51 NE Tiger Cove Lane, Belfair WA.
Include engineers wet stamp seal and signature.
WAC 196-23-020 Agency filings affecting this section
Seal/stamp usage.
The use of the seal/stamp must be in accordance with chapter 18.43 RCW or as otherwise described herein:
(1) Final documents are those documents that are prepared and distributed for filing with public officials, use for
construction,final agency approvals or use by clients.Any final document must contain the seal/stamp,signature and date
of signature of the licensee who prepared or directly supervised the work. For the purpose of this section"document'is
defined as plans,specifications, plats,surveys, as-built documents prepared by the licensee,and reports.
Thank you,
Mark Core
Permit Center Manager/B.O.
Manager, DCD
Mason County
P.O. Box 186
Shelton,WA.98584
(360)427-9670 Ext.357
The information transmitted is intended only for the person or entity to which it was originally addressed and may contain
confidential and/or privileged material.Any review, retransmission,dissemination or other use of,or taking of any action in
reliance upon,this information by persons or entities other than the intended recipient is prohibited. If you received this in
error, please contact the sender and delete the material from any computer.
Mar 02 10 11:15a John McGee 3602755415 P.1
FAX COVER SHEET
10: n4"ON COUAVTr
FROM: John G. McGee
Phone Ws: 360-275-9211 (home), 360-731-4855 (cell), 360-275-5415 (fax)
DATE: Mkz Z , 10)D
PAGES: (incl this sheet) — 2 —
RE: 3LDl-3 PERMIT 3t 13LD6 ZO05 --U0433
PA-KCE_L it t L3 055( 000O 1
Remarks:
PER C01( VEQ SR-7-1bAI W1 E &e RE 6,9eO tNC FA-I L U/ZE D !I F-
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Mar 02 10 11:15a John McGee 3602755415 p.2
WAC 196-23-020- Seal/st=p usage. Pa i of 1
WAC 196-23-020
seaUstamp usage.
The use of the seaUstamp must be in accordance with chapter 18.43 RCW or as otherwise described herein:
(1)Final documents are those documents that are prepared and distributed for filing with public offcials, use for
construction, final agency approvals or use by clients.Any final document must contain the seal/stamp,signature and date of
signature of the licensee who prepared or directly supervised the work.For the purpose of this secton"docurrenV is defined
as plans,specifications, plats,surveys,as-built documents prepared by the licensee,and reports,
(2)Preliminary documents are those documerts not considered final as defined herein,but are released ordis;ributed by
the licensee.Preliminary documents must be clearly identified as-PRELIMINARY"or Contain such wording so it may be
differentiated from a fined document. Preliminary documents mist be stamped,but need not be signed or dated by the
licensee.
(3)Plan sets: Every page of a plan set must contain the seat/stamp,signature of the licensees)who prepared or who ha�
direct supervision over the preparation of the work,and date of signature.
(a)Plans/plats containing work prepared by or under the direct supervision of more than one licensee should be
sealedistamped and dated by each licensee and shall clearly note the extent of each licensee's responsibility-
(b)As provided for in subsections(1)and(2)of this section, each page of a plan set must contain the seal/stamp of the
licensee who prepared or who had direct supervision over the preparation of the work.
(e)PlarVplat sheets containing and/or depicting background and/or supporting information that is duplicated from other
plans need only be sealed/stamped by the lioensea(s)who prepared or was in direct supervision of the design The origin of
the background information-Shall be noted on the plan sheet.
(d)All design revisions to final planlplat sheets shall clearly identify on each sheet;the revisions made and shall contain the
name and seal of the licensee,and signature of the licensee with the date the sheet was sealed.
(4)Specifications:Specifications that are prepared by or under the direct supervision of a licensee shall contain the
seaUstamp,signature of the licensee and the date of signature. If the specifications prepared by a licensee are a portion of a
bound specification document that contains specifications other than that of an engineering or land surveying nature,the
licensee need only seaUstamp that portion or portions of the documents for which the licensee is responsible. Nothing herein
should be construed to require that each page of an engineering or land surveying specification be seaied/stampod by the
licensee.
(5)Document review-When a licensee is required to review work prepared by another professional engineer or land
surveyor,the reviewing licensee shall fully review those documents and shall prepare a report that d iscusses the findings of
the review with any•supporting calculations and sketches,The reviewing licensee would then seal/stamp,sign and date the
report.The report would make reference to and/or be attached to the subject documents)reviewed_
(Statutory Authority:RCW 16 43.035.08-10-009,§196.23-020,fired 4124/09,cf%cuve 7/110B:06-22•o3s,§196-2.3-020 riled 1012S106,efre.tive
11125M:99-15-055.§196-23-0,20,filed 7115r99,eRecUve 3/15199.)
3� �c ,00 cji - d 04"33
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hrtp--%/app5.Jeg.wa._l;ovr'wac/default.aspx?Cite==96-23-020 2/4/2010
FAX COVER SHEET
TO:
FROM: John G. McGee
Phone Ws: 360-275-9211 (home), 360-731-4855 (cell), 360-275-5415 (fax)
DATE:
PAGES: (ind this sheet)
RE-
Remarks:
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Plats Plus Engineering
Civil Engineering Services and Land Surveying
Date: 3 /August 2009
Subject: Magee Remodel
Project No.: 09-0043
Made on site inspection this date. Framing, was installed in a manor consistent with standard practice&
Code.
The contractor has used the proscribed straps and nailing patterns.
Pictures are on file.
Nels Rosendahl P.E.
�rfr 1.�"►'\\`�`� tit ,�
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Plats .Plus Engineering
Civil Engineering and Land Surveying Services
1950 Lost Creek Lane. Bremerton, WA 98312
360-830-4634 Voice FAX 360-830-4634 email: ncls@platsplus.net
Date: 16 October 2009
Subject: Magee Remodel
Mason County
Shelton, WA
To whom it may concern:
L the undersigned Professional Engineer, have inspected the installation of the subject
project, and certify the final project.
Enclosed are two inspection reports for the footings and Framing.
Nels Rosendahl P.E.
cc: File 2023
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Plats Plus Engineering
Civil Engineering Services and Land Surveying,
Date: 29 June 2009
Subject: Magee Remodel
Proiect No.: 09-004>;
Made on site inspection this date. Rebar was installed in a manor consistent with standard practice.
The contractor has used #6 inst of#4 which is acceptable .
Pictures are on tile_
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Jan 21 10 04:02p John McGee 3602755415 p.2
Plats Plus Engineering
Civil Engineering Services and Land Surveying
Date: 3 August 2009
Subject: Magee Remodel
Project No.: 09-00433
or consistent with standard practice &
installed in a man
Made on site inspection this date. Framing was ms
Code.
The contractor has used the proscribed straps and nailing patterns.
Pictures are on file.
Nets Rosendahl P.E.
ROS-
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i
Jan 21 10 04.02p John McGee 3602755415 p.3
Plats Plus Engineering
g g
Civil Engineering and Land Surveying Services
1950 Lost Creek Lane, Bremerton, WA 98312
360-830-4634 Voice FAX 360-830-4634 email: nels@platsplus.net
Date: 16 October 2009
Subject: Magee Remodel
Mason County
Shelton, WA
To whom it may concern:
I, the undersigned Professional Engineer, have inspected the installation of the subject
project, and certify the final project.
Enclosed are two inspection reports for the footings and Framing.
Nels Rosendahl P.E.
cc: File 2023
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Jan 21 10 04:03p John McGee 3602755415 p.4
Plats Plus Engineering
Civi] Engineering Services and Land Surveying
Date: 29 June 2009
Subject: Magee Remodel
Project No.: 09-00433
Made on site inspection this date. Rebar was installed in a manor consistent with standard practice.
The contractor has used #6 inst of#4 which is acceptable .
Pictures are on file.
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MASON COUNTY PERMIT NO.�0�� '
BUILDING PERMIT APPLICATION
Shelton (3 SCANNED 482-5269
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner n, Gi PACG E-E. Company Name
Mailing Address PO, Gay 44 Z'V Mailing Address
City &#_rv^er*&j State_Se A Zip Code 98312- City State Zip Code-
Phone-740- 3Yo- 6,02.2 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 a
Legal Description TTE,Ck L4k•_ TRACT S -A TM2
Site Address (Please include street name, street number and city) $3 /Vd T'T<-?t-4 LN. 8CU'/420C
Directions to site .4% Qcj- +-* ..k.. }
t , IIJ s.*jry -6 AIZ Pr. o.v LttAWAt. C. 4-1-.
Will timber b4 cut and sold in parcel preparation?Yes
Is property within 200' of Saltwater Lake X e s River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair_ Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building N Describe Work"*'+• re-St -rkfo. h fv,�� Gb;��
No. of Bedrooms No. of Bathroom Square Footage- 1 st Floor 0 2 2nd Floor
3rd Floor -- Basement Deck— Covered Deck - Other Sq. ft.
Garage Attached - Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ 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 informaticn 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.INACTIVITYOF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION.
X Date:
Owner fi wn rs epresentative 7Contractor (indicate which one) .--�
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: tt� r Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Fire Marshal
FEES
Building Permit Fee 9 Site Inspection
Plan Review Fee y EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee 0 S Other
Wood/Gas/ Pellet Stove Fee State Fee 41. S�10
Violation Fee !� - ll' a Pre-Paid at Submittal
Valuation $ 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
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner /1' , 7EC Company Name
Mailing Address P6, Lai ` VZ 7 Mailing Address
City "-z State Zip Code 9R 3/L City State Zip Code
Phones J '�� �z`� 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. x Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. /13oSS`�Dd�v1 Fire District
Legal Description , ;,-, L a k& Taa e-T S -r-L Z j 2 -2_
Site Address (Please include street name, street number and city) 57 N� T. ��� Coe- Z,✓ 11e, 9Xtz2Y
Directions to site � per- , � 4, — T --�
4 ! ./ /3 � �.-c.c le D �T/ a T.^.*1 Ll}/� T-,,.. ���6�9 e�I
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 Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPQ Natural Gas_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink d' Furnace
Bath Tubs % Heatpumps
Showers Spot Vent Fan /
Water Heater r 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
04NNER/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.
�_ Date:
X Owner/Owners Representative/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-Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Ins ection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
Request To Revise An Approved Plan
Permit Number: BLD200_9_- Na F-!R'??7x� 4'�
Parcel Number 6 - =,_OOW I Phone Number da time -) Q 1 .-
Project Address Mailing Address
Please provide a co le e, detailed description jaf the proposed revisio to the approved plans`1
6
Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes No
Are the approved site plans included? ❑ Yes o
Are the revisions clearly and accurately identified on the plans or addendum? o Yes
Does the plan contain an engineer's or architect's lateral or vertical analysis? >( Yes ❑ No
If Yes,Has the engineer or architect approved this revision? Yes ❑ No
Is a stamped and signed approval included with this request? sj 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 No
If Yes, Is a revised site plan,with all new setback dimensions included with this request? / ,
❑ Yes ❑ No
Additional Information:
Applicant's signature A VC)Q d-� --3 09
Date:
Office Use Only Received by-IrA)
Date Sent Assigned To Approved By Date
Original Valuation: j
B Additional Valuation: 5x g3 $
Sq.Ft. 74 x$ qCo -- $
Sq.Ft. j I rX$;_- ,la�=- $
Total New Valuation $ ( Qg
❑ P W Additional Fees:
Additional Planning Dept. $
Additional Plan Review $ a
AdSVitional Conditions/Comments: Additional Building Permit $
Additional Plumbing $
Additional Mechanical $
f to Additional E.H.Dept. $
o
Other $
no -- 5 _
Total Amount Due: $ kJ1 1:1 . S
L/ Amount To Be Paid Up-Front$
q X