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HomeMy WebLinkAboutBLD2007-00015 Final SFR DDR2007-00052 - BLD Permit / Conditions - 12/18/2007 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 1&�� RESIDENTIAL BUILDING PERMIT BLD2007-00015 OWNER: CHRIS LINCOLN RECEIVED: 1/4/2007 CONTRACTOR: EARL LINCOLN (360) 275-1600-275-1605 LICENSE: LINCOBD962RF EXP: 12/6/2008 ISSUED: 3/21/2007 SITE ADDRESS: 240 NE KATCHEMAK LN BELFAIR EXPIRES: 2/15/2008 PARCEL NUMBER: 123211300060 LEGAL DESCRIPTION: TR 5 OF SW NE, NW Y OF RR.R/W PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR �` J I y Q- I 1 HIGHWAY 3 TOWARDS BREMERTON, TURN LEFT ONTO LOG YARD /I ROAD TO LEFT ONTO KATCHEMAK TURN RIGHT TO LOT ON RIGHT 1V � I, 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: 2 Occ. Group: R-3, U Lot Size: Deck: 128 Type of Work: NEW Fire Dist.: No. of Stories: 1 Occ. Load: Building:1,712 Garage-Attached 587 Valuation: Building Height: Occ. Status: Primary Basement: Cov. Porch 40 Manufactured Home Information Setback.Information Shoreline&Planning Information : y Make: Length: Ft. Front: N 10.0 Ft. Shoreline: Ft. Water Body: No Model: Width: Ft. Rear: S 10.0 Ft. Slope: Ft. Side 1: Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side : Ft. Comp. Plan Desig.: Urban Growth Area BLD2007-00015 Please referto the following pages for conditions of this permit. 1 of 5 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 i Shelton,WA 98584 L� RESIDENTIAL BUILDING PERMIT BLD2007-00015 OWNER: CHRIS LINCOLN CONTRACTOR: EARL LINCOLN (360)275-1600-275-1605 LICENSE: LINCOBD962RF EXP: 12/6/2008 RECEIVED: 1/ SITE ADDRESS: 240 NE KATCHEMAK LN BELFAIR ISSUED: 3/21/2007 07 1/2 PARCEL NUMBER: 123211300060 EXPIRES: 9/21/2007 LEGAL DESCRIPTION: TR 5 OF SW NE, NWLY OF RR.R/W PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR HIGHWAY 3 TOWARDS BREMERTON, TURN LEFT ONTO LOG YARD ROAD TO LEFT ONTO KATCHEMAK TURN RIGHT TO LOT ON RIGHT 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: 2 Occ. Group: R-3, U Lot Size: Deck: 128 Type of Work: NEW Fire Dist.: No.of Stories: 1 Occ. Load: Building:1,712 Garage-Attached 587 Valuation: Building Height: Occ. Status: Primary Basement: Cov. Porch 40 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: N 10.0 Ft. Shoreline: Ft. Water Body: Rear: S 20.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: Ft. Comp. Plan Desig.: Urban Growth Area Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 1/5/2007 $740.58 S12007000 Hosebibs 4 Furnace<100K 1 Building Permit Fee KS 1/5/2007 $1,139.35 S12007000 Kitchen Sink 1 Ventilation Fan 3 Building Permit Fee KS 1/5/2007 $1,139.35 522007000 Lavatories 2 Heat Pump 1 Planning Review Fee KS 1/5/2007 $155.00 S12007000 Water Closets (Toilets) 2 Dryer Vent 1 Building State Fee JRN 1/8/2007 $4.50 522007000 Water Heaters 1 Plumbing Fee JRN 1/8/2007 $75.00 S22007000 Bath Tubs 2 Plumbing Base Fee JRN 1/8/2007 $20.00 S22007000 Clothes Washer 1 Mechanical Base Fee JRN 1/8/2007 $23.50 S22007000 Mechanical Fee JRN 1/8/2007 $65.10 S22007000 ADJUST--Plan Check Fee JRN 1/8/2007 $14.56 S22007000 Address Fee BLJ 1/9/2007 $140.00 S22007000 EH Waiver Review CMH 3/15/2007 $100.00 B12007000 Building Permit Fee CMH 3/20/2007 $22.40 S22007000 Total $3,639.34 BLD2007-00015 Please referto the following pages for oonditions of this permit. 1 of 5 _ I CASE NOTES FOR BLD2007-00015 CONDITIONS FOR BLD2007-00015 1) 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. X CIL 2) 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 CQjjntty ordinances and building regulations. X LL IL 3) All property lines shall be clearly identified at the time of foundation inspection. X C . 4) 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 IInspect r shall be made prior to requesting additional inspections. 5) 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 t IL 6) 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 G�'(� BLD2007-00015 Please referto the following pages for conditions of this permit. 2 of 5 7) 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 perm m X tion. 8) 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). X (7—L 9) Per 2003 IRC -SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance with the applicable provisions of this section and the manufacturer's installation instructions. X C n. 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 WIND SPEED (3-SECOND GUST)the wind speed for Mason County is 85 MPH. x G77- 11) 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/Max U-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. X G*L 12) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 13) 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 ('JL 14) 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. X GX 15) 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 Depart�nt prior to any further inspections being performed or approvals granted. BLD2007-00015 Please referto the following pages for conditions of this perrnit. 3 of 5 16r) 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 Xc roa�Fonnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. 17) 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 _6M 18) Fire Warden Review--Chapter 14.17 Standards for Fire Apparatus Access Roads must be met before Final Inspection is approved.Note 14.17.030,14.17.040,14.17.060,14.17.11014.17.150 because of the extreme Rail crossing.Must contact Fire Marshal. x C 77, 19) 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 20) Water quality is not to be degraded to the detriment of the aquatic environment as a result of this project. X cy" , 21) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X C.rZ 22) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X (rL 23) 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 G 1'L 24) 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. X C I-/- 25) OWNER MUST SHOW PROOF OF SATISFACTORY WATER SAMPLE AND WELL LOG PRIOR TO TEMPORARY/PERMANENT OCCUPANCY OF THE RESIDENCE. X CM 26) This P is located in a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information. BLD2007-00015 Please referto the following pages for conditions of this permit. 4 Of 5 r 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 anytime 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 insp 'on.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 pro rtY a r cture for nd inspection. OWNER OR AGENT: DATE: BLD2007-00015 Please referto the following pages for conditions of this permit. 5 of 5 o' CONCRETE MECHANICAL MANUFACTURED HOME r— Date -��Q7 gYfjf�Z,� n Postings / 1 b Gas Piping Ribbons O o Interior Date OLD r�S� gr4 Interior-Date By Date r By Z Extenor Date ,, By 7-2 Exterior-Date BSot_� INSULATION Point load/Isolated Footings Date By BG t SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Waifs Floors Date By h�4E W Date S,,_o By A Data 2' 642 By DECKS FRAMI G Walt* Date By Date p Bye Data 0 7 BY 6T,,� PROPANE TANKS PLU BI G vault Date By Date By OTHER w Groundwork Attic Date By Date _ By Type:Date By D,W.V DRYWALL Type: `/ l� By Date Int Brace Waii Date ByW / ,,...� Date By FINAL INSPECTION p CD Lin / � Fin separation CD �/ By Date By Date I�U7 gyjJ) O � V CD Pass or Request inspect. o s Type of Insp. Fail Date Date Done By Comments o s v �2 CD 8 f CD 17-1 ire h � Z0//)db r lY b 4 A> 1 Z'7.02 rP. q-i 1 � :4'11)(4,1 .07 011,04 '2 0 Us ivo as �� � JN LSd3W��d S�d1d cu DNINIVVId aL Alhin am ddV 1voww PLANNING ALL SETBACKS ARE MEASURED FROM THE FURTHEST APPROVED PROJECTION OF THE BUILDING Li-a- W MASON COUNTY -CD, PLANNING SITE PLAN REQUIVRED TO BE ON SITE CHAN ES S CT TO APPROVAL By -- Date 10 ,460 2-1 4 ACCESS & GRADE WORKSHEET DATE: ADDRESS INSPECTOR �J' 6LD DRIVEWAY ACCESS Len the OCR -t- Width: a "Add— Surface: Size of turn-around: /v C9 T Condition of shoulders: Vertical clearance: --� N . 111--rreed Dost at end of driveway with r ctive addrPas umbers. GRADE,OF DRIVEWAY i 3 % OF ROAD oho ROAD ACCESS Length: Width: Surface• Condition: Vertical clearance: ( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. ( ) LOT INSIDE SMZ, 4X4 FIRES ONLY. LOT INSIDE'UA, NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES. REMARKS v'1 continue remarks on back P�oN.STA?-, � MASON COUNTY c DEPARTMENT OF COMMUNITY DEVELOPMENT 4 MO oNUPlanning Division 7 N Y y P O Box 279, Shelton, WA 98584 1864 (360)427-9670 NOTIFICATION OF INCOMPLETE APPLICATION January 17, 2007 CHRIS LINCOLN PO BOX 415 BELFAIR WA 98528 Parcel No.: 123211300060 Project Description: NEW SFR Dear Applicant: You have submitted a permit application (case no. BLD2007-00015) for proposed construction or development in the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. If the additional information is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. Please contact me at (360) 427-9670, ext. 294 if you have questions. Sincerely, 4) Charles Mead McCoy III Land Use Planner Ma son County Planning Department Comments: A site visit was conducted on 1/12/07. It was determined that you will need to submit a request for reduction in required front yard setback. Enclosed is the application and information explaining the setback requirements in R - 3 zoning in the Belfair Urban Growth Area. Please pay $100 in fees for the Administrative Variance. 1/17/2007 Page 1 of 1 BLD2007-00015 04/18/2007 10 :43 FAX la 002/004 WATER WELL REPORT a• i„;l Origin■IAA copy—Ecofoq,2'd copy—owner.3t°copy—driller CURRENT ECOLOGY Construction/Decommission (•'x••in circle) Notice of Intent No.WE06260 Construction Unique Ecology Well ID Tag No.APA514 ❑ Decommission ORIGINAL INS7AI CATION Water Right Pcrmit No, Notice of Inlenl Number W M2 PRorosm USE_ 0 Domestic ❑ industrial ❑ Municipal Property Owner Name LINCOLN.CHRIS ❑ peR'ater ❑ Irrigtttioa ❑ Test Wet1 ❑ Otter 7:j Well Strcct Addres< NE T MECH E TYPE OF WORK: ormcr's nnmlxT of wcli(if more than one) ® New well CI Rceondltioned Afethnvl:❑ Dug [I Bond ❑ Drlven City BELrAIR Courtly MASON ❑ Deepened ❑ Cable 0Rotary Q JettedLocation M/4-1/4 NEI/4 Sec�1 Twn R 1 lllbTE-NSItr•.NFiONS: nnmererofwell5 inches,drifled137ft. eNN O Depth of complctod well 1 ft. Or CONSTRUCTION DETAILS Lat/Long wwM Casing ® Wctdcd 6— Diam.from 0 ft,to 125 A. (s,t,r Still Lat Deg Lilt Min/Sec installed: Q Liner installed " Diam.front R.to n. RF,QUIRLD) Long Deg Long Min/See ❑ Threaded Diam.From a,to �n, 'raK Parcel No.123211300060 Perforations: Lj Yes Cg No Type ofperrrnador used CONSTRuCT10N OR DUCOMMiSSION PROCEnfIRF Formation:Describe by color,cha ial racter,sine Of mffter and Nructuro,and the kind and SIZP of perf5 min,by In,and no.Of perfs from R.to—ft. nature of the material in each stratum penetrated,with at IMI one entry fnr each change Scrceus: ® Yes ❑ No ® K-Pae t,ocation 125 of information, (tisr,ADDITiONAi.SHEE7 S IT NECESSARY.) Manufacturer's Name JOHNSON MATERIAL FROM I TO Type 22 Model Nrn, IIELES PiPE STICKUP 0 1 Diam.6SIor size 1Z from=ft.to 130 ft. BROWN SAND 1 15 Diam.651ot siz;12 from 0 a,rn 9 ft. BROWN SAND GRAVEL 15 51 CraveMlier packed: ❑ Yes ® No Sizo er`ravefisaad BROWN SAND WE Z51 73 Materials placed fmm ft,to R, BROWN GRAVEL SAND 73 101 Sarfare Seal: ® yes ❑ No To what depth? BROWN SAND WATER 101 137 Material aced in scat BEN'ONiTE Did any Ornta contain unusable water? ❑ Yes ® No Type of water') Ucpthofstrata Method of sealing strata oft" PUW; Manutichrcer's Name T,pe H.P, WATER LEVELS: Land-surface elevation above mean tea level ft. Statte level--ft.below top ofwcll Date MAR07 Artesian preisure Ibc,per square inch Date Artesian water is corilmlled by cap,valve,pc.) WELT.TESTS: Dnwdown Is amount water level is imvered below static level Was n pump test made? ❑ Yes ❑ No If yea,by whom? Yield: with 11.drawdowru n0cr firs Yiefd: rif./min,whh_ft.drawdown after Yield; igal,/Min,with_A.,drawdown after lure Rerovcrt•tiara(rlme la[cn as zero when pump Cured o,(n(wmer lo-d mearurrd front well lop ry water kwl) Timm Water Le of Time Water Level rime Water Level Date of test Aailer test 10 gal lmin.wltl,11.5ft,draw,k,wn after a in, Airtest pl./min,with stem set at n,for Imo, Artesian flow r_.p.m, bare Temperature ofwater Was a chemical,nalysls made? ❑ Yes CI No Start Date J§MARQ7 COO] feted Date 22MAR07 WELL CONSTRUCTION CERTiFIC.ATIOIN: I constructed nruUor accept responsibility for construction of this well,and its compliance with all Waahinglon well onnstmction standards_ Materials used anti the information reported above arc true to ray best knowledge and Wier Drillcr Fngincer Q Trainee Name.(re,r)JOUN,SULLIVAN Drilling Company NICHOL,SUN DRTt LING 1NC Driller/En-ineer/Trainee,Signature 4-1 �- Address PO 13OX 123 Dttitler or trninee License No.221$ J J IF TRAINEE-Drillcr's License No; City,Ste,Zip PORT ORCHARD WA9836$ Miter's Si aturc: Contractor's Registration No,N1CHOD11370M Data 26MAR07 ECY 050-1-20(Rev 3105) EcoMgy is an Equal pptartttairy Employer 04/18/2007 WED 11: 45 [JOB NO. 56271 Z002 04/18/2007 10 :44 FAX Z 003/004 NICHOLSON DRILLING, INC. 1-360-876-4421 P.O.BOX 123 1800-894-4421 PORT ORCHARD,WA9836G PUMP TEST FAX 1-360-876-5601 NAME CHRIS LINCOLN SITE: 240 KATCHAMECH LANE DATE I March 26, 2007 BELFAIR, wa TIME 1:30 PM il WELL DEPTH ---L-36-1 Feet WELL DIAMETER PUMP MAKE GRUNDFOS 6 inches TANK MAKE PUMP MODEL 15 SQE10-250 TANK MODEL Time Depth Draw Rate Time Depth Draw Rate Time Depttl To Down gpm to Down Draw Rate Water gpm to Down gpm Static 95.4 0.0 Water Water 40 123.2 27.8 660 1 105.5 10.1 45 123.2 27.8 0.0 2 112.7 17_3 720 0 0 2 2783 116.8 21.4 20 60 123.2 27.8 50 12320 780 0.0 4 118.1 22,7 70 840 0.0 0.0 900 0.0 5 119.5 24.1 80 0.0 980 6 120.4 25-0 90 0.0 7 120.9 25.5 100 0-0.0 0 1080 1020 Q.0 8 121.4 26,0 20 120 0.0 9 121.6 26.2 0.0 1140 0.0 150 0.0 1200 10 121.8 28.4 180 0.0 11 122.1 28.7 0.0 1260 0 0 210 0,0 1320 12 122,2 26.8 240 0.0 13 122.3 26 9 0 0 1380 0-0 270 0.0 1440 14 122.4 27.0 300 0.0 15 122.5 27.1 20 360 0-0 1500 0.0 20 122.7 27.3 0.0 1560 0.0 420 0.0 1620 0.0 25 122.9 27-5 480 30 123.0 27.6 0.0 1680 0.0 540 0.0 1740 35 123.1 27.7 800 0.0 °'0 RECOVERY lsoo o.o Time Depth Draw Time Depth Draw to Down Time Depth Draw to Down Water Water to Down 1 0 0 11 Water 2 0.0 2 0.0 45 0.0 3 0.0 13 0.0 50 0.0 4 0.0 14 0.0 60 0.0 5 0.0 0.0 70 0.0 15 6 0-0 15 0.0 80 0.0 0.0 90 0.0 7 0-0 25 8 0-0 30 0.0 100 0.0 9 0.0 35 0.0 120 D.0 10 0.0 40 0.0 0.0 150 0.0 180 0.0 SIGNED BY: StevLY-6I56n, Mupervisor 04/18/2007 WED 11- 45 [JOB NO. 56271 U003 04/18/2007 10 : 44 FAX 1a004/004 • - r q cccc :,iY ANA.LX'I'ICA'I-e'XNC.' 2b276 Twelve Tres Lauo,'Sui:c C. Poatsbo,WA 98370 r. (360)779.51d1 COLIFORM BACTERIA ANALYSIS' Date Semple Collected Time Sam e , f I " Collected County Month Day Year O OAM VjkS�.ri r, Type Of Wafer 5yStem(check only one box) ❑Group A Public QPrivele Household `d ❑Group B Public Other GroupA and Group'B systems—Provide from Water Fecilitles fnoeritory(IiYFi):• �. System Name: !r'O7 Contact Person: 2 4 C KATU.- ' �EC;4. TIv `vim Day Cell Phone y. Eve,Phone:( ) FAX :( Sand fosulls to:{Pdn lull t '.);•;.. '�- 5IttING. INC:.'. :. (?.BOX 123 . . PORT ©RCH;,iAtR9� SAMPLE INFORMATION. : ' x. '." 'Sample Collected by(name): ; Nicholson I3ri 114* ' w Specific ICGatlon where sample collected(address or selnple sHe,and typ'9 of lquFa 1r ,;Speciellnstrucibnsorcomments: - 'TYPO OfSampla.,(must check Only one box of#1 threugh#4 listed below) ~ 1.[]Roulfna pletribution Semple 2.[3 Repeat Sample(follow•up ' Provide Information bebw, to an unsatisfactory sample) s: Chlorinated:Yes No Provide Information below, Chlorine Reslduaf:Totali Free `Lx Unsatisfactory routine lab number: 3-I]ROW Water Source Sample - Required for Surface Water,GWI,and Unsatitisfactory routine collect date- some Spring Sources S Chlorinated:Yes . No ,. nDnc4ln(V FO Chian Residual;$O*a Free <3 Sample Collected for ln(ornsation t)nfy p Consbucttpn� Repalrs Private Residence�� ❑Unsatisfactory atlsfactory lblaf coliform Praseht and ' []E.coll present ❑f.cofi absent ❑Fecal Colifomn proSent []Fecal coliform absent ❑'Replacement Sample Required Sample not tested because: Test unsuitable because 0 Semple too old(p30 hours) ❑TNTC = , ❑Improper Container ❑Turbid witiro to a o 9acMdal Densay Results:Male Count yml l:pot Total Coilforn " /loom). Fecal Cott' /loom). Method Code: MICR- 7 3 Dale and Time Recelved "r Q Date Analyzed`_ Z Date Reported: i— Lab Use Only: ,. ' 9empfo Number Dom number Nue u q egs61 J 71.0 ' DO Farm 31.31,IW., msJ - L� V WA7FA:cl 1Cb:.rrn .,..... 04/18/2007 waD 11: 45 [JOB NO. 5627] IZ004 .o MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 426 W. Cedar • FO. 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 APPLICAKI INFORM TION CONTRACTOR INFORMATION Owner � lf j S Company Name Mailing Address-- ��r—�/� Mailing Address City State �Zip Code . 2,� City State Zip Code Phone.:;4--�2,r45.7�_Other Ph. Phone Other Ph. Lien/Title Holder r- 04 4 Contractor Reg. ti-A 4 �^-1�--Exp. s9 Al 2P6P A . / E Mail Address I rAli^_ �t Q ; E mail address� � ��^ � � � _ .�- � nr ' z-�-,-�-�--n-�` Drivers Lic.# DOB Drivers Lic.# DOB U SEPTIC /WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Water System fume of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description '< ' Site Address (Please include �reet name, street number and city) Directions to site Will timber be ca an sold iriparce p`repa a ion. Yes N l,J /f J 4 r c p,, Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff :ti 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 - Newer_Add Alt Repair Other PHI ARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No.of Bathrooms L Square Footage - 1 st Floor 1-7 /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. i 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 permis- sion from all.the necessary parties.If permission is required from any easement holder or any other party in interest regarding this applica- tion or the wdrk proT�ed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. X ✓,- Date:T� -7- Owner/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 18 07 Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee - PlanningReview Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ S TOTAL FEES .. ��/y(1� "••. MASON COUNTY RERMIT 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 INFORMATIO Owner Company Name �- •• •�� /cf�'�S��E'✓C'/ Mailing Address ` / _ Mailing Address City - Ire r Slate(.✓� Zip Code City Mate Zip Code Phone�'2 7 " 6 Other Ph Phone Other Ph. Lien/Title Holde "-' -,C% �' Contractor Reg. x _Exp. E mail address AIc. - E Mail Address Drivers Lic.# '..T 0'0('t l cl G(W DOB r& Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic z� Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. " f = > Fire District Legal Description !/ rk 5 L.) /L IV E 2 / - S 3 - / Site Address (Please include street name, street number and city) DirectiQns to ite r; r d e -ry o a k r r - _ a c + Is property within 200'of Saltwater Lake River/Creek Pond r Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building C1 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 1(-/ Type of Unit No. of Units Fees Bathroom Sink ��- + it Furnace 1 Bath Tubs 2 i Heatpumps Showers lit Spot Vent Fan Water Heater I 7"GCS Propane Tank Clothes Washer I _? Gas Outlets Kithen Sinks I 7 Wood/Gas/Pellet Stove Dishwasher I Kitchen Exhaust Hood Hosebibs —� Dryer Vent Other Other Base Feed Base Fee TOTAL PLUMBING i TOTAL MECHANICAL ONNER/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 CO I ATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: r Owneo 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 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 � J C" MASON COUNTY 7 DEPARTMENT OF COMMUNITY DEVELOPMENT 411 N. Fifth Street/P.O. Box 186, Shelton WA 98584 360.427.9670 ext. 352 D D R Rec'd by Request for Administrative Variance for Reduction in the Required Setbacks ($99. 0) For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction requires a standard variance. Setbacks are measured from the furthest projection of the structure including_ roof eaves. Applicant/Owners: �� (�` I s L Mailing Address: �1-0 , '�s on, �'!� 6e ,fit c i I— WA 9 8-5' Telephone : 3� r) City: �� /f'�G �' State: W Zip: C3 If this reduction is tied to a buildinq permit, please give permit case number. BLD tea/ - 0 00 / Parcel Number(s): 1732/ 3000j6o Zoning UL24,b,, Site Address: -QT-� -,CSC c� L � v Requested variance(Front Rear/ Side Yard (please circle all that apply) Requested setback variance: ft. An illustrated site plan is required. Your site plan must show the following: north arrow, abutting street or easements, set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and driveway. Show all proposed new development. The following circumstances must apply: FRONT AND OR REAR YARD REQUIREMENTS: 1) Existing lots of record as of March 5, 2002; ou must meet one of the following: (Please circle all that apply) 2) One of the following exists on the lot: a) steep slopes, wetlands, or streams present; b) soils that restrict building or septic development; c) lot width at the front yard line of no more than 50 feet; d) lot size of no more than one-fourth acre; rj existing improvements of buildings, septic systems, and well areas. IAPLANNING\PAC\DDR.doc Created on 07/03/06 3:58 PM SIDE YARD REQUIREMENTS: 1) Existing lots of record as of March 5, 2002; You must meet one of the following. (Please circle all that apply) 2) One of the following exists on the lot: a) steep slopes, wetlands, or streams present; b) soils that restrict building or septic development; c) lot width at the front yard line of no more than 50 feet; d) lot size of no more than one-half acre; e) existing improvements of buildings, septic systems, and well areas. Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2.5, 5, 10. or 20 zones. I - 1 r _a ('l1/? D -E On �1 �O-tee /S(3 L_�, ,be toa ✓ fie//. �,)oa r- / k 41 Owner/Agent (please indicate) Signature and date Official Use Onlv Approved Date Denied Date Reason for denial: IAPLANNING\PAC\DDR.doc Created on 07/03/06 3:58 PM