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HomeMy WebLinkAboutBLD2008-00135 Final Replace MFG Home - BLD Permit / Conditions - 7/14/2008 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. Boxk86 Shelton, WA 98584 r RESIDENTIAL BUILDING PERMIT BLD2008-00135 OWNER: TERRY HEISER RECEIVED: 2/1/2008 CONTRACTOR: LICENSE: EXP: ISSUED: 2/28/2008 SITE ADDRESS: 580 NE NEWKIRK RD BELFAIR EXPIRES: 8/28/2008 PARCEL NUMBER: 123213190022 LEGAL DESCRIPTION: LOT 2 OF SP 3007 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Replace M.H. Old Belfair Hwy to right on Newkirk when road turns to gravel 3 driveways on right. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: V-B Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Make:Fleetwood Length: 66 Ft. Front: S 40.0 Ft. Shoreline: Ft. Water Body: None SEPA?: No Rear: E 15.0 Ft. Slope: Ft. Shoreline Desi Model:Waverly Width: 28 Ft. Side 1: W 9.0 Ft. g.: Not Applicable licable Year:1994 Serial No.: Side 2: N 10.0 Ft. Comp. Plan Desig.: Urban Growth Area Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee KKK 2/1/2008 $247.00 S22008000 Planning Review Fee KKK 2/1/2008 $190.00 S22008000 Mobile Home Issuance Fee RTB 2/6/2008 $247.00 612008000 EH Plan Review TW 2/21/2008 $10o.00 612008000 Water Adequacy Plan Review TW 2/21/2008 $40.00 612008000 Total $824.00 BLD2008-00135 Please referto the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2008-00135 I CONDITIONS FOR BLD2008-00135 1) Approved �e dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. 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 1-800-647-0_". The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 3) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads c ect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X — 4) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. `NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of the building permit the owner/agent/contractor is ackngyd�edging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X i� 5) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are require r this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X 6) 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 potenti I risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-L47-0982he person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X i �. BLD2008-00135 Please referto the following pages for conditions of this permit. 2 of 6 7) 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. I addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building Departure p o any further inspections being performed or approvals granted. X ,'Jv 8) Owner/�geftt j2sponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X �� II 9) 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 ed documents will result in failure of required building inspections. X r 10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 11) The "approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and shall be collected by the Building De P.19Ament prior to any further inspections being performed or approvals granted. X 12) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State . Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or inst Iled.�l rtification number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X ,- 4� 13) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. 14) 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 15) 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 revoca X _. r- BLD2008-00135 Please refer to the following pages for conditions of this permit. 3 of 6 16) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as tii allows. Until resolution of any/all problems no occupancy (Final Inspection) will be granted for the residence. / OWNER/CONTRACTOR(indicate which) Signature X Z 17) This permit is for the place ent and installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X —�-- 18) 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 5' 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 19) All changes to"approv d" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance r regula�i n, must be reviewed and approved by Mason County prior to construction. X 20) 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 smell t 4ade prior to requesting additional inspections. X __7 21) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. 22) All property lines shall be clearly identified at the time of foundation inspection. X 23) 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 i pection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County r inances and building regulations. X BLD2008-00135 Please refer to the following pages for conditions of this permit. 4 of 6 24) 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 pr v nted action from being taken. No more than one•extension may be granted. X _,T 25) Pressure treated yvood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, aqd�ashing. Install metal connectors approved for contact with the new types of pressure treated material. X 'T / 26) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structure7eet the setback conditions listed. X 27) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv to ensure these structures are shown and meet the setback conditions listed. X 28) Water quality is,qot to be degraded to the detriment of the aquatic environment as a result of this project. X r �_ 29) Prior to final approval, all upland areas disturbed or newly creat by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 7`�d 30) All construction and demolition debris must be removed from the beach after project completion. Proper disgol of construction debris must be on land in such a manner that debris cannot enter or cause water quality degredation of State waters. X / > J 31) 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. �jAI 32) Older Manufactured Home must be removed from site.X �--( BLD2008-00135 Please referto the following pages for conditions of this permit. 5 of 6 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 inspection.The owneent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and struct a for reviewlVaddiction.OWNER OR AGENT: LG✓s __ DATE: Z Lam' BLD2008-00135 Please referto the following pages for conditions of this permit. 6 of 6 i o CONCRETE MECHANICAL MANUFACTURED HOME _ rn CD Date (n Footings!Setbacks Gas Piping By Ribbons rn o Interior Date By Interior-Date By Date 3 Z By Exterior Date By Exterior-Date By Cn Set-up m Point Load I Isolated Footings INSULATION Date / ��_ By > BG/SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Walls Floors Date By Date By Data By DECKS FRAMING Walls Date _ By Date By Data By PROPANE TANKS PLUMBING vault Data By Date By OTHER Groundwork Attic Date By Type. Date By Date By D.w.v DRYWALL _ Type: Int.Brace Wall pate By Date By pat. By FINAL INSPECTION n i Water Line Fire Seperation �� N CD Date By Dale By Dale /�.©� By p m 4io Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments w CD CA CD vp 0 o. o' 0 zh CD m I 0 1914933 MASON CO WA 02/20/2008 03:20 PM CERT TERRY HEISEIIR{{#167MM32 RIeI+c FeII1e1II++ $42..00 Pages. 1 e. I IUIII III�II I'I II'I�illll'I�IIII IIII HII IIII IIIIIII I�I INI■(IIII IIII�1'I i� N\ Return to: TERRY HEISER 15514 FISHERMANS LANE NW _POULSBO WA 98376 CERTIFICATE OF RESIDENTIAL USE. LIMITATION ON NUMBER OF BEDROOMS I(We)the undersigned,hereby place this notice on record that the following described real estate situated in Mason County,State of Washington;to wit:(Division and Lot Number or Range/Township/Section Number. Note:Range,township,section numbers are the 1"5 digits of the parcel number) OR _01 W_ —23 _21_ Subdivision Division Lot Range Township Section and having the Tax Parcel Number of 12321-31-90022 is subject to the following understandings and conditions: 1. The use of this parcel will be restricted to no more than _2_bedrooms. 2. The on-site sewage system was designed for and the building permit was issued on the basis of no more than —2 bedrooms,and a maximum residential occupancy of no more than —4 persons. 3. Use of the other rooms as bedrooms,in excess of the number identified herein,could result in hydraulic overload and premature failure of the on-site sewage system,and could result in Mason County taking steps to cause vacation of the premise. 4. In the event of any future residential remodeling,expansion,or replacement that results in additional bedrooms to the number specified herein,the property owner will obtain the appropriate permits for expansion of the on-site sewage system. WITNESS hand this day 20_ Signat6re Signature State of Washington ) County of Mason ) 1,the undersign a Notary Public in and for the above named County and State,do hereby certify that on this ay of 20 ,_ V personally appeared before me, who is known to be signer o e above instrument,and Icknowledged that he(she)(they)signed it. GIVEN under my hand and official seal the day and year last a . en. �F,L ; O N tary Public in and fo•the State of Washington, .4p11µ•ESA�F� residing at Q: �pTAiq� :N My commission expires: 1 I) Name Parcel# 10�30� ) -3 I - �ex�aa 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 surface2. 'Redevelopment means,on an already developed site, the creation or addition of impervious surfaces, structural development including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity, and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving,gravel roads, packed earthen materials,and oiled, macadam or other surfaces which similarly impede the natural infiltration of stormwater. Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. .......:.::.:..:.:::. ......:::::::.:..::................... .............................................. Ctrs. ' ft ::::<:;::::::>::. :::::::::. I Ph ......................................................:..:...:::.:::::.:::::::::::::::::. Surface Type Length X Width = Area * All dimensions in feet Buildings X = X = Measurements for buildings are taken at the perimeter of the farthest projections (example: X = eaves/gutters) X Driveways X = IN kt Y- Length of drive begins at the right of way Parking Areas X = X = Any paved, gravel or packed area per definition above table PatiosMlalks = X = Any paved, gravel or packed area per definition X _ above table >: Others X X l fate:atal1 .i ::> pe::.; <trs .r.. a x€t>te:.p#apest ><< _ tip::::'::::'.'.`::::::> .:;.: ..>:...;::.;.,;..;:.: ,.:.: <X ......: , <:: :;;.::::::,.;:;:;::,,><<<» X _ vec3prrtett gatMthart 2I3tJt3 lyqua fe2 a :.;:.:;.;:.; ;;:.;:.::. :. . IE.l'ar l.. trst iwati t 5it�F"l rt.,s..t a VIM- .... r`V`16"1 surf cre 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 sign e below. I declare that I am the owner, owner's legal representative, or the contractor. I further acknowledge that the informa4on provided is accurate and employees of Mason County are granted access to the above- describe�rty for revie ancl,Gispection as may be required. X J C� Owner/Agent/Contractor(circle one)Date:2 — / — If the Tot mpervious 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 Manic Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website: hLtp/twww.co.mason.wa—us/code/commissioners/index.htm Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no-part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT. 450 Mail: P 0 Box 1850, Shelton WA 98584 Physical: 415 N 6th_StsShelton 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 985.84 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor. I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 WJ4 to - AP Ou - J � �. MASON WL11,14,l I D LANNING x� � SITE "' A:V RE.7 r rr s tr-C I'v .i3JEC1" 1 r-,-R VAL y, bat�. _ S v F � ao 4' 260 >/- � r i ►Z, .� �t1 PLAN G , PLANNING: a ALL SETBACKS ARE MEASURED I FROM THE FURTHEST PROJECTION OF THE BUILDING �✓q r vTOPOGRAPHY PROFILE: 0 I to Va 6p j 0 Direction: Scale: Approval:for once use Building Permit nuummber. 0 Building: Owner/Applicant: 1 e rr 7 C 1 Se� Date of Planning: Parcel Number. �C n 31_ ' g O 0 z � application: Env. Health: � I i � �/ . t z 6h � h)7 l 114 _ 4W Od s 7 Wl }I?iOM JN0-1 bOtildaool V016 7�, ti3 tt/AO�iddV 2301 S=1JNdH0 1lviens T laSo1� Q W O )gad C4-0�>;� gas 11 Z2 'sue..: S3aOJ 31VIF NOIDNIHSVM IM3 Ian:) lld 133W Lsnw / (✓ NOI1 31.IS SOfi 3H1- NO f f a,,r PP 38 1Sf1W cNV-ld 3S3H-L C Cop ge-aj-r THESE PLANS MUST BE ON THE i0b SITE FOR INSPECTION roved plans: MIDST MEET A,-; 'I-UR�ENT Documents att hem app/ 0 VVASHIN�TO�1 ,.i A�E CODES _ ages Plan revie check I Engineering: Y N Lateral Ve- Num er of pge CHANGES OVAL SUBMIT CHANGES FOR AP PRIOR TO PERFORMING WORK VENT AT 1 Sq Et Per 150 Sq Ft APPROVED MASON BUILDING INSPECTOR CH ES SUBJECT�AF �V�p- -DATE 0 ON.STAJ& MASON COUNTY o PCV n o N DEPARTMENT OF COMMUNITY DEVELOPMENT Y s U Planning Division o Y �? P 0 Box 279, Shelton,WA 98584 0 �0 (360)427-9670 1864 NOTIFICATION OF INCOMPLETE APPLICATION February 20, 2008 TERRY HEISER 15514 FISHERMANS LN NW POULSBO WA 98376 Parcel No.: 123213190022 Project Description: Replace M.H. Dear Applicant: You have submitted a permit application (case no. BLD2008-00135) 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. Sincere y, James Sch z Land Use Plann r Mason County Pla ing Department Comments: According to tidemark (BLDA900) applicant stated in phone call that he was changing size of proposed decks on replacement mobile home. Applicant will need to resubmit revised site plan when actual size of proposed decks is determined. Cannot approve site plan as is. Also applicant needs to be aware of setbacks (RR-5 and RR-3) for both rear yard(10ft) and sideyard (10) or a DDR (variance) will be required. 2/20/2008 1 of 1 BLD2008-00135 MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 0 Cl 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 APPLIC4NT INFORMAT N CONTRACTOR INFORMATION Owner _s(f r Company Name Maili Addres S/ L Mailing Address City State W Zip Code q-j:F -7 14- City State Zip Code Phone - Other Ph. - Phone Other Ph. Lien/Title Holder k "7`\C4 C/P UPI /t)_ Contractor Reg. # Exp. E mail address e ISCr(V E Mail Address Drivers Lie.# I DOB -Z - Drivers Lie. 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 M G U S PARCEL INFORMATION - 12 Digit Parcel No, j 13 O U Z2. Fire District Legal Description Site Address (Please includ stre�t name, street pumber a�d7city) O IV E e � `r � - Directio s to site '� � f �C Cy -1 o I AS � t C �1 J G o Will timber be cut and sold in parcel preparation? Yes/ Is property,within 200'of Saltwater d1 0 Lake O River/Creek tot O Pond Wetland I- O Seasonal Runoff j Stream /1 Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?YeR7Nq TYPE OF JOB New Add Alt Repair Other PRI ARY RESIDOICE SEASONAL ❑ Use of Building&W 2f�C( Describe Work 2 C C' m No. of Bedrooms �—No. of Bathrooms Z Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Wa Uer /'[1 T_Year_�_q_ Length (9 Width Serial No /9 f L(3 I/1 6 j Z Z 37--(No. of Bedrooms �- o. of Bathrooms_ Type of Heat c !^ �Pua��a�e�r�iceleplaceenUnitInstaller Name Mi QS Certification No. - Z OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CON UATION OF O IS BY MEANS OF A PROGRESS INSPECT17N. �j X Date; ( � _0' o<'t Owner/Ow ers R r entative/C ntractor indicate which one FOR OFFICI L USE BEYOND THIS POINT Accepted by: e I- DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department nb 5 Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Q Site Inspection Plan Review Fee QG EH Review Fee Plumbin & Base Fee ..Planning Review Fee Mechanical & Base fee "---- Other Wood/Gas/Pellet Stove Fee - State Fee Violation Fee Q Pre Paid at Submittal Valuation $ TOTAL FEES