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HomeMy WebLinkAboutBLD95-0228 Cancelled SFR - BLD Permit / Conditions - 10/14/1995 i MASON COUNTY PERMIT Mason County Bldg. III 426 W. Cedar NULL A VOID BY E RATION P.O. Box 186 Shelton, Washington 98584 DATE BY _. F�% U I t- CJ I N 01 PERM I -T FOR INSPECTIONS CALL 427--9670 BETWEEN 5pm AND Sam 427-7262 PLAT : DIV : BLK : LOT : UNIONduo AVUKtNz5 RD RELFAIR OWNER , DAVE PALMER CONTRACTOR : ROF CONSTRUCTION 624-3134 LEGAL : TN 3C OF SURV 11145 TR C OF SP 11746 FS 653t405-3- a-r`=srrs:• CLASS REDR : 2 .BATH : 2TYPE ANBUNI RY PATE RE6EIP1 ;yP7 KNONpT E1 DATE NECEIPI TOR I ES . . . . . . . .f _ OCCUP . GROUP . . . :7 BLDG . HEIGHT . . : 0 .Oft JADDR 1 5.00 KS 141171t5 38898 PIN 1 48.11 KS 114117195 3s808 TYPE OF CONST . _ :7 F I REPt.ACES . . . . : 0 f RLC 1 42.01 KS 04117145 38808 NCR 1 51.10 KS 840719S 38808 OCCUP . LOAD . . . . : 0 WOODCTOVES . . . . : 0 PROI 1 348.00 KS O4117195 38908 WOCI $ 25.00 KS 0411?195 38819 DWELL .UNITS . . . . : 0 PARKING SPACES : 0 RAOp 1 8.69 KS 04117195 38808 Addit iossl fees sot Rim tere. .. ... INSPECTION AREA : 1 SHOREL I NE7 . . . . :N PICK 1 174.00 KS 04117195 30808 14TA1: 715.51 VAI ULA114N: 7972? SETBACKS---------- ---- TOILETS . . . . . . . . . . 2 FUEL TYPES- --------- BOILFRS/COMP---- MOBILE HOME-- FRONT . . .W 5 .Oft BATH BASINS . . . . . . : 0 : /tIP I / / s 0-3 HF . : 0 REAR . . . .F.. 5 .0f t BATH TUBS . . .. . . . . . : 2 3-- 15 HP . : 0 MODEL : SIDE ( 1 ) .N 5 .Oft SHOWERS 2 FURN - 100K BTU : 0 15-30 HP . : 0 -MAKE---- --- • S 1 DE (2 ) .S 5 .Oft WATER HEATERS . . . . 1 FURN >-100K BTU : 0 30-50 HP, : 0 SHRLiNE , 0 .Oft CLOTHES WASHERS . . : i FURN - FIOOR . . . : 0 50-1- HP . : 0 -YFAR AREA --------------- KITCHEN SINKS . . . . . 3 HEAT PUMP . . . . . . : 1 . LOT SIZ_E _ % FLOOR DRAINS . . . .. . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : N LENGTH : 0 BUIL.DING . . . : 1378sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . . 0 HOODS . . . . . . . : 0 WIDTH . r 0 BASEMENT _ !. , 0s r LAUNDRY TRAYS . . . . : 1 DOMES . I NC I N :S?1 SER t AL 11-- -- DECKS Osf DISHWASHERS . . . . . . : 1 AIR HANDLING IJNITS - COMML . iNCIN :0 GAR/CARP :G 5^9sf GARB DISPOSALS . . . : 0 10000 (It'm . : 0 REI.00/REPAIR : 0 AT/DT . :A URINALS . . . . . . . . . . : 0 > t0000 c,fm . : 0 OTHER UNITS . : 0 MICC PI_M FIXTURES : 0 GAS OUTLETS . : 0 Z�'a�.'aaRf�e'�917iwL�[atR�a6r.Csia��:�L�:SeAa�C�cc-r�'.r.�C.rm-:Z'.' '^.'LCs+�s�:is Cxz'�'azer��'�.a.>••�••••••.'-,;:Csrar xs<o-r.�r:3s�tc.�r:.as^�fwr::'Last`�.mc�s.:x�*^�:cr.1T41'x�aeacaaat:S-roc�za..±^'S PROJECT DESCRIPTION:RESIDENCE PROJECT IOCAT140:lIOAIN SHORE ND TO UNION RIVER RD 10 FIRST HOUSE 00 LEFT PROPfATY IS FIRST LOT TO 114RIN OF NOUSf THIS PEINII BECONES NULL ANO OID if NORM OA CONSTRUCTION AUTNOIIZII IS NOT CONIEFNCE6 WITHIN 191 DAYS. OR IF CONSIOUCTION OR WORK IS SWSPENAEP FOR A PERIOD OF 189 DAYS AT A�TINE AFT. IK S C01VENCED. EVIDENCE OF CONIINUA110N OF WORK IS A PROGRESS INSPECTION 1ITNIN IMF 186 T PERIOD. FINAL INSPfCTT4N MUST E€ APP80YE8 BEFOIE 111 ING CAN B CC PIED. OWN€R OR AGEN1:_--. -,-. ''- _ DATE:. _._ _L /-7 1t 1 PINT. rev. COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED CONCRETE Ek MECHANICAL MOBILE HOME Footings-Setback cJ h/-z I_5 date -Z(C - p-!� by W�'`- Ribbons date bf Gas Piping date b Foundation Walls date by Set Up date r-/-Z d - 5 by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING O/ Walls Q FIRE DEPT. date =2tQ-PSG �y �—2C��9� by wc..� date by PLUMBING date OTHER Groundwork Attic date by date by D.W.V. WALLBO RD NAILING 1 C date y date by C � Water Li FINAL INSPECTION date by date by date by �,� ss•.3 . -, re4%r an L . -HQ CGSn, Lcjc e— a� e, / n n e b z t�ir _ pm It- .: IM"Will US=NO U&M.T.�AA pjtijimc NM.a Ww--,-,�4 A_, MEP IM, all-F,1-1,=m ji�� Icy WAPOPJ�l, I ..r i�r� - - Cam. �• ► I .ai� �L�i allo �i��i� � � :1�:. � / ►J�_I�... c �_��I� Oil!tljill ��p ri RM-M-APME HISM.. . . I MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O, Box 186 Shelton, Washington 98584 I I� PERM I T C" ND 1 T" 1 (3N -3 Case No . r BLD95-0228 Fort DAVE PALMER Page : i r 1 ) Su ec% to conditions of Resource Lands, and Critical Areas (RL_C ) Checklist notification I t � . 2.) Tf#e_ handling and storage of hazardoijs materials or T i ajmmab I e and oombust l b 1 e li ui In excess of 10 gallons is not allowed without the approval of the Mason County C F1 _ rshal . X All approved plans are required to be on--site for Inspection purposes . It Inspection Is called for and plans are not on site , Approval WILL NOT be granted . in addition , a Re-- I " ect i on fee in the amo+ant of $30 , 00 per hour (minimum 1 hour ) will be charged and mrj.: collected by this department prior to any further- inspections being performed or aap I o al granted . X 4 ) NT TO 1991 UNIFORM BUILDING CODE , SECTION 305(C ) AND SECTION 513 ALL SITES MUST H - APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO Bt PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMEy'r REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SiTE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE Ay IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INONS . X 5 ?RUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC RFNTS • X G ) en of structure must comply with standards setforth per UBC sec . 2907 rg descending and/or ascending slopes . X__—..._..•__...__ _ 7 ) S uc r e most be setback 5 ' from all rat. I i I ty and drainage ea -emerrts , a -total of 10 ' f o ;h property line, or a vaar ! ance must be obtained from the Building Department X ------ -------------------------- —� —��.__ MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 8 ) P o d structure or any portion thereof greater than 30" in height from grade line, m t intaln a minimum of 5 ' setback from all property lines , easements and right: of wa s X 9) ' r"F� ed structure or o 1 ns thereof with an prc►jection over 30" in height from grade must maintain a a aration distance between adjacent structures and that furthest projection . X 10) CONSTRUCTION PROCESS TO IEI_.D CORREC AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE . x 2 limas the nei;r? of 51ructure Top of _ = C� 1�, MaX.� Sk4t to of a Faotirq Face of r Toe of Nat to c=xed 40'*- Slructure Slap* 3iu' r= TYPICAL STRUCTURAL SETSAC?( BUILDING OFFICIAL MAY APPROV ALTERNATE SETBACXS a CLEA.RALy(=-S Sccie I" = 20' Sample Site Plan 153' 14' a0 32 20' _ a PROPOSED n -� RESIDENCE rain Q EDGc OF BANK Septic 7anR./ m 6B* a 2a• T J do. O o LaPE N STop - - - - - - -- - - -- -n 5 n � N'ti 3'selbau W4II fit*121 238' I TYPICAL U • - SITE PLAN (" = 20 J. OOE 1406 MQjan U. Or. N age No. 2 CASE HISTORY FOR CASE NO.: BLD95-0228 DAVE PALMER NE241 UNION RIVER RD BELFAIR 06/28/95 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- BLDC155 Final inspection 06/16/95 06/19/95 06/16/95 1. POST THE ADDRESS. FAIL LW 06/19/95 LAW 2. THE METAL DOOR INTO THE GARAGE FROM THE HOUSE MUST BE A 20 MIN. RATED FIRE DOOR. 3. PROVIDE BACK FLOW PREVENTERS ON HOSE BIBS. 4. SEAL PENETRATIONS IN THE FIRE WALL WITH MUD. 5. INSULATE THE DUCT IN THE GARAGE AND UNDER THE CANTILEVERED FLOOR IN THE SAME AREA AND IN THE CRAWL SPACE TO R-8. 6. INSULATE THE CANTILEVERED FLOOR IN THE GARAGE, HEATED AREA ONLY. 7. SHEETROCK TO THE FLOOR WITH 5/8 TYPE X AT THE GARAGE SIDE EDGE OF THE CANTILEVERED JOISTS, OPEN UNDER JOIST TO HOUSE. 8. PROVIDE BAFFLES BETWEEN THE HOUSE AND THE GARAGE AT THE EDGE OF THE BLOWN IN INSULATION. 9. PROVIDE BAFFLES AT THE FOUNDATION VENTS IN THE RIM JOIST. 10. THE FLOOR INSULATION NEEDS TO BE IN CONTACT WITH THE FLOOR SHEETING, 12 INCH DEEP SCI'S AND R-19 INSULATION, THERE IS A 6 INCH GAP ABOVE THE INSULATION. BLDC155 Final inspection( 06/22/95 06/23/95 06/23/95 NOT ALL OF THE CORRECTIONS WERE DONE FAIL LW 06/28/95 LAW FROM THE LAST LIST, CORRECTIONS 1,2 AND 3 STILL NEED TO BE COMPLETED. CORRECTION REQUIRED A 20 MIN. RATED METAL FIRE DOOR BETWEEN THE HOUSE AND THE GARAGE, THE CONTACTOR PROVIDE ME WITH INFORMATION FROM THE MANUFACTURE ON A 20 MIN. RATED DOOR THAT THEY MAKE BUT I NEED TO FIND OUT IF THIS REPORT IS FOR THIS DOOR, NO LABLING OR MARKING ON THE DOOR. 6/28/95 LW: I CALLED THE PHONE NUMBER OF THE INFORMATION SHEET PROVIDE BY THE CONTRACTOR, I GOT A RECORDING SAYING THIS NUMBER HAS BEEN DISCONNECTED. D Gaff�n Pi 6011 ,17 REELFR - I - AUDITOR MASON COUNTY &uAv, �'W� 9? CERTIFICATE OF RESIDENTIAL USE ALLAi . BROfCHE 95 AIR 17 AM 11= 55 REQUEST OF: `tit 1'c�L►1 E D cv h v1 o r I, Q�iK,rU�l� hereby acknowledge that the residence located on Mason County Assessor's Parcel Number Z3�� �3Z has no more than 2- bedrooms. I understand that my on-site sewage disposal system was designed and my building permit was issued on the basis of this number of bedrooms, and use of additional rooms in the residence as bedrooms could result in overload and premature failure of my on-site sewage disposal system. Furthermore, I understand that usage of additional rooms in the residence as bedrooms could result in Mason County taking steps to cause the vacation of said premises. Prior to remodeling or replacement of said residence, I agree to obtain the appropriate permits for expanding my on-site sewage disposal system. DATED this 1- 1 day of (}�'� ;Lecgr:a Owner of Property On this day personally appeared before me 'WO PTVLffEe— , to me known to be the individual described in and who executed the within and foregoing instrument, and acknowledged that HCF signed the same as (� free and voluntary act and deed, for the uses and purposed therein mentioned. GIVEN under my hand and official seal this day of 199,0. Notary Public J / Expiration Date: County residing in i, MASON COUNTY BUILDING DEPARTMENT 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE MNe��� DOWNER io TELEPHONE COMPLIANCE INFORMATION TYPE OF PROJECT: �NEW RESIDENCE()ADDITION()REMODEL()OTHER AREA(SQ.FT.) 1ST FLOOR y 2ND FLOOR HEATED BASEMENT Note: Heated basements must be insulated and finished to meet minimum energy code requirements. TOTAL SQUARE FOOTAGE OF CONDITIONED (HEATED) AREA COMPLIANCE METHOD: PRESCRIPTIVE PATH — circle o 'on— I H III(V� V VI VII VIII Glazing percentage /S © (total g azing area divided by total conditioned area) () COMPONENT PERFORMANCE — Chapter 5 — attach documentation and worksheets () SYSTEMS ANALYSIS — WATTSUN 5.2 — attach documentation and worksheets WATER HEATER Electric water heater () Gas water heater HEATING SYSTEM: ELECTRIC RESISTANCE () Electric Central Furnace () Electric Wall Heaters () Baseboard Units O Radiant Panels O Other 7OHER FUELS Heat Pump with electric furnace () Heat pump with gas furnace ( ) Gas Furnace () Oil Furnace () Other () Boiler System (indicate type) Maket-h >5F Model /jKSize z AFUE HSPF L, VENTILATION SYSTEM: WSpot and Whole House ( ) Central Ducted System () Integrated with Furnace () Heat Recovery System (air to air heat exchanger — heat recovery heat pump) GENERAL NOTES: Your building plans should indicate certain compliance measures: framing to be used (standard, intermediate, advanced); type of vapor barriers being used; location of furnaces, hot water tanks and other equipment; location of solid fuel burning appliances, fireplaces and thei<combustion air duct runs; and termination points of exhaust ventilation fans. WINDOW & DOOR SCHEDULE ► WINDOWS INCLUDE ALL WINDOWS, SKYLIGHTS, SLIDING GLASS DOORS, FRENCH DOORS AND STORE DOORS. ANY WINDOWS IN DOORS (LESS THAN 50% OF AREA) MUST BE TAKEN OUT OF THE DOOR AREA AND PUT INTO THE WINDOW AREA ON THE SCHEDULE. BRAND MODEL U-VALUE QUANTITY SIZE TOTAL SQ. FT. Vt 3� � i X S c-c S 3� y 1 rr Lr .36, SAX r i h . 3s' f Lam' Xs' 3 o 31 y 31v 1 sa r cb $ y 1 �L✓ TOTAL WINDOW AREA _ F DOORS BRAND MODEL U-VALUE LOCATION SIZE TOTAL SQ. FT. o O zH r G C5 1 O d f w u4 CbcK cx e 9 r S 4L TOTAL DOOR AREA - .TUN.20. 19'+c-', 1: ROM F'GL BLDG PRODUCT'S PHONE NO. : 3608761c10 JUN-20-1995 13:3j FRUM PGL M I LLUORK T( 91,i?068761210 P.(11 Wc: hock I ters¢y Internotionul Inc. TJQX 1v7t3. /�t�tlocl�.Ctalllc.,nt� g.e�c + _ a I 44 t Z143a-7344-- Te109 33.77y7 RtR '!)LC Vtt t;iplUJFt: F !lLt;n t"DUBANVE AUL IfUGr, gTtttr.All }'�� x �' ''" UtJott llyitt: N n 3' C►^ x r' t;� �:ixi"I;I, t=i AMA;•, Tttttrnl.i.h:;� f7r,1 E;I I'i' T11NIMA ;I:ttJ 2ti0G t1t71:1'll 1tEXtiV1,t)v IM U TVL,00, Ulljo 4.11� 15 i+iAI414OCK ULttqt ;C I t(t Etzt�n'I'x()CtA1 a, I NG_ V-0. 00X 1070 hNt`f,tlCii, Cl1x.IFt>Itr11A, 9'�5U'�-�1 t17 1r'tl.L too_ : Svt.,i- •l�)3- ter, t, Jou IiLl% d9�,-tIdUO TtGrPo jUnr? 11 , 191p tarsi i1.!); �1VRC:.t:F3 'Iil>; CI. MM, tlAMi;I) IMP ' ii TO luirmt)t>ltn 7il1C;3 It{ .'G�ItI'. IT Htlt,-r ui: 1{G1'1�UltVCt:U xf. I'Ct3 p,>liJ'l.�t[.'F i. a,_ TUN. ::' '. 1995 1:53PM P =; FROM PG'_ ELDG PRODUCTS PHONE NO. 7,606761210 J04-20-1995 13:34 PROM PGL MILL-WORK Ti 91 2068761210 p 04 • *l )mock Heisey tntemationui inc . n�u�ic ��✓r Greg 13.10. Britt in Hariag-er. T. sting SUPE[CV ISSXN ; ENrlvgr-.F.R �GFESs�0 419 a CALIV►I. MaAager, E' re Laboratories Diviglion (U.S ) ( 1 7) - -- __------- TQTHL n.04 - JUN. 20. FPOM PGL BLDi1 PRODUCTS PHONE NO. : 3608761210 JUN-20-191:�5 13:3`' FROM F'GL MILL-.UW T4 91206�761210 P-iY2 Woo•nmk Mersey InternQUonnt Inc. x01TRODUC rioN On June 8, 1984, the Antioch, Californi.j mire Tenting Labdra-• tort' of War; tock Hersey lnternationaX,' inc.. conducted a$ Standard 20 MinUte f - re endurance and hose stream is est Eor Thexma Tru Ori a 3'0" x 6' 3"toam--f i7.1ed steel door hung n a 31011 x 6 '8" atee], f came. The test assembly was installed i :. a mtisonry wail. The test was Conducted in accordance with the criteria as speCifiec in AST14 $-1" 1, V.L. 101B, NFPA 252, CSFM 4 ;;. 7, UBC 41. 2 and CAN4 3- 104 for 2.1, minute rated fire resistant _oorx. This cast a 3sembly passed a 20 minute Uire endurance test in ` accordance )., irh the requirements of the si-andards. i • This test w-is conducted for Therma Tru of xoledo, Ohio, and was witnezzed b� Mr. Robert Schlingman who rel" enented the company. Ii . i� 'U'A.20. 199c 1:F :F PGL BL.DG F,R.ODUf_T,_, PHONE NO. : 3600?61210 JUN- -19y5 13=3�, FROM PGL MILLUORK Ti Q1?0667F,1?10 F r 1 Warnock ock W+c'raey in ' ternctloncal Inc. 5 t pe.t door lesc>r ibed in' this re- F»+ct Qds ed 3 20 minuttk Eire 0ndk.ratr,�Q a,:,a a hOb sir #tam test. iri Cc��c+:lanr -21 with the fire hazard ccite +'ia s Pacified in ]1S'TM 1013, idPPA 252, C ELIA 43. 7, UB::' 4.1. 2 and r'AB4 Ew104 fQrr 20 mintet _, rated firQ rE�lsrant- Aoera. Th-r dour +der in th; s report is elig ' ble for 18h e.liny and I.istfray U11dr - the Warnock ~IlerSey. InternE Lional, Inc. raCtacy All Pection and l,iatIng PrQgram. This rePort does not au',Qmgti cat i_ im 1 i� y Product certification. Productn must bear WUZ labesa n order ; to de1vvnstracr Watnc ,jt Verney certit`ica-- t,ion. { YvAlttd, CK LiLSEY 114TERVATzt UAL, INC_ - h'!'I'1t7CEi UZVT5101H il1� .. Date Checklist Prepared ' 3y 'gs MASON COUNTY BUILDING DEPARTMENT ' PLAN REVIEWER AND INSPECTOR CHECKLIST 1991 WSEC AND V&IAQ CODE COMPLIANCE Permit Number Address hE 741 l nigY') ► Aue._�- Sq. Ft. / Name on Permit t�Q� a j u� d Contractor/Phone # 313-Cps Z8 Compliance Method: Prescriptive c�(Option) ( ) Component ( ) Systems Analysis Fu.ecb �. Date FOUNDATION Insp. Rev. ( ) ( ) Slab: R- (Ext.foundation down to frostline/slab bottom;or interior 24"top of slab&horizontal. Radiant under entire.) ( ) ( ) Below grade exterior wall insulation: R- ( ) (� Crawlspace ventilation: l-1 —7 1 0 z 11.2 !o sq.ft.NFA/150 sq.ft.floor area-cross vented) FRAMING ( ) ( Standard ( ) Intermediate ( ) Advanced ( ) W WOOdstoves and/Or fireplaces: (6 sq.inches combustion air supply duct with damper direct to firebox.) ( ) ( Standard air seal: (Bottom plate/subfloor,rim joist/mudsill,window/door frames,penetrations condition to non-condition.) Attic ventilation (1 sq.ft.NFA/150 sq.ft.ceiling area) Spot exhaust fans: (4"exhaust-bath/laundry 50 cfm C.25 WG;kitchen 100 cfm C.25 WG. Vented out with dampers.) ( ) ( Fresh air ventilation: Available to all habitable rooms. Installed and operational. (Integrated forced air,windows,wall ports.) ( ) (74 --'Whole house exhaust fan: cfm (Intermittent systen)manual&auto controls/sone less than or=to 1.5 at.1 WG) JIZO -K�v-t- r1pC.4 ( INSULATION Attic baffles installed to deflect incoming air(Rigid material resistant to wind-driven moisture,extend 12"above loose fill or 6" above batt insulation) ( ) Mechanical ventilation ducts R-4(Exhaust in unconditioned space&supply in conditioned space.) ( ) ( Wall insulation(above grade) R m"' g ) R- (Batts face stapled) ( ) ( ) Wall insulation(below grade-interior) R- (Batts face stapled) Vapor retarders on walls (Faced batt,or 4 mil poly or perm.paint.-circle one) ( ) ( ) Rim joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.) ( ) ( ) Vaulted ceiling insulation R- (Vapor retarder&V airspace) FINAL ( ) (79 Floor insulation R- lot t (Substantial contact w/surface,supports less than or=to 24"OC,not blocking vents.) ( ) ( Ventilation system is operational (spot,whole house,fresh air to all habitable rooms. If integrated system,certification by installer is required.) HVAC ducts in unconditioned areas R-8 (joints sealed;mechanically fastened with a minimum of 3 fasteners.) Pipe insulation R-3 (Hot and cold lines in unconditioned areas-service or recirc.see Table 5-12). SHW heaters: (NAECA label,sdparate power as shut-off,on R-10 pad if electric in unconditioned or on concrete.) Heating system type: Z.5 V_(") ( ) ( Radon monitor on site with instructions.No. - supplied by MCBD ( ) Thermostat: (Heat range 55-75;AC 70-85;both 55-85. Backup heat controls(lockout)prevent simultaneous operation of primary system.) ( ) Solid fuel appls.: (Glass/metal tight-fitting doors;dir.comb.air source,or 4"dia.dampered,indir.source for existing const.) ( ) ( Ground cover: (6 mil black polyethylene or approved equal lapped 12"at joints,extending to foundation wall.) ( ) Penetrations(All exterior wall and ceiling penetrations sealed to drywall-plumbing,exposed beams,wall receptacles,fans,recessed lights.) tM I/\. ( ) Ceiling Insulation R-� (Insulate&weatherstrip access,baffle to prevent spillover-no cardboard) ( ) Vapor retarder paint if a vapor retarder was not installed when insulation was installed. GLAZING Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. laspec r- Verify window information during field inspections. Include skylights, glass doors and all other glazing on this form. Use rough opening area for calculations. Date Size Quantity Area S . Ft. U-Value Manufacturer Rev. Ins . K COO 3 III Lk oZo -6c4 Total glazing area: Z S Total conditioned area: 1-7 y Percentage glazing: C-0.4 Verified: DOORS Plan Reviewer-List opaque doors by type(solid core,insulated,etc.)quantity,U-value,and manufacturer. jmpector- Verify door information during field inspection. Date Type/Quantity U-Value Manufacturer Rev. Insp. 30(-, &Ttl!4z z, y Signature of Building Inspector: Date of Final Inspection: Permit No. 1tclg5.6aa8 MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 a� PLEASE PRINT #1 ner t`�Sct U�_�: Phone# L-)o � Site dress nE 2.41 U►"1 i cm lU f/l� Occd Fire District# City } St t-kl�flt' Zip Directions to Job Site V L)O T14 O&Z-e Q-C> -t7 o sf l 4-a cc 1 A�CiTif C5r-- Owner Mailing Address _ J City fps r:A S- St Cam- Zip 1 Lien/Title Holder Address Clty St Zip #2 Contractor amJ Contractor Reg# Addr s �� Expira' tee/ /45 Cit + St L-L� Zi6-56EI � #3 If septic is located on pf oject site, include records. Connect t Septic? v Public Water Supply Well Conne to Sewer System? Name of System Y Y (If re dential, proof of potable water is required) �9,95► D #4 arcel No. 2. ZCt - '�� - 01(C32.- � 14 Legal Description's F r-lq s #5 Building Square Footage: (existing/proposed) IQ 1st FI��, / Z-(,rl 2nd FI `-7 3rd FI / Loft / ^� Basement / — Deck / #bedrooms 2— / #bathrooms / Garage Carport / (Circle:Attached or Detached?) Other sq.ft. / #6 Use of building Z` t( Tl f'rL_.- Describe workcoy\�',"Lc id6 C X-- 1z� ,r�r,5�►a o t�') (-05� #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INF ION Model a Make Model Length i Serial No. # Bedrooms #Bathroo Type of Heat Purch rice$ pe #9 I icate by circlin t appli able source if any water is on r adjacent to subject prort �i. o tr etl d k h er ea n R p�,04her Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Name of Flanking Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW N 1 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW N ; , Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No. Z Toilets = CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other LBath Tubs No. nits Fees 1 Showers )���'''" '� _ Furn BTU C Hot Water Htr �_ Heatpumps Laundry Washer 7 _ Vent Systems 3 Sinks `� { Spot Vent Fans _Floor Drains No. Boilers/Compressors Laundry Basins _ HP f Dishwasher No. Air Handling Units 0 Disposal cfm# U Urinals No. Fire Protection Systems _Other Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ N2 Other CC' Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $�' OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH.NO CHANGES SHALL BE THERE TH. NO HANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST AINI APPROVAL FROM THE BUILDING THE BUILDING D PARTMEN DEPARI T. X OWNER X BY DATE 2/ S' DX FOR OFFICIAL USE ONLY: Accepted by: �" 1i Date: 4 ,ti DEPARTMENTAL REVIEW FOR OFFICE USE-ONLY Approved Cond. Hold Approval Planning: �5 Ses��cc" Y�_ �Y( �V2'� uivlU, sxer mn2S Environmental Health: 1 Building Plan Review Occupancy Group: Type of Const:Of) Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Ll Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee �l OtherAddroxx9q., 600 Other Building Valuation: (d 'Z'L-t TOTAL FEE