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BLD2016-00074 Final SFR DDR2016-00017 - BLD Permit / Conditions - 11/15/2016
Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County 615 W Alder St Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT ` BLD2016-00074 OWNER: RJ PEABODY RECEIVED: 2/4/2016 CONTRACTOR: LICENSE: EXP: ISSUED: 3/21/2016 SITE ADDRESS: 101 NE ANCHOR WY BELFAIR EXPIRES: 9/21/2016 PARCEL NUMBER: 123305000065 LEGAL DESCRIPTION: BEARDS COVE DIV 3 TR 65 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR -STOCK PLAN2012-0007 ON ANCHOR WAY IN BELFAIR General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3 Lot Size: Deck: 80 Type of Work: NEW Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:1,410 Carport-Attached 400 Valuation: $ 178,155.86 Building Height: 25 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: N 10.0 Ft. Shoreline: Ft. Water Body: Rear: S 25.0 Ft. Slope: Ft. SEPA?: Unkn Model: Width: Ft. Side 1: E 15.0 Ft. Shoreline Desig.: bWtiApplicable Year: Serial No.: Side 2: W 10.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 3 Furnace>100K 1 Plan Check Fee JBN 2/4/2016 $287.23 S2201600000001 Lavatories 2 Ventilation Fan 1 Planning Review Fee JBN 2/4/2016 $205.00 S2201600000001 Bath Tubs 1 Exhaust Hood 1 EH Plan Review JBN 2/4/2016 $205.00 S2201600000001 Showers 1 Dryer Vent 1 Address Fee JBN 2/4/2016 $ 173.50 S2201600000001 Water Heaters 1 Building State Fee JTL 2/17/2016 $4.50 S1201600000001 Clothes Washer 1 Building Permit Fee JTL 2/17/2016 $ 1,436.15 S1201600000001 Kitchen Sink 1 Mechanical Permit Fee JTL 2/17/2016 $64.70 S1201600000001 Dishwasher 1 Mechanical Base Fee JTL 2/17/2016 $28.50 S120160000000i Hosebibs 1 Plumbing Permit Fee JTL 2/17/2016 $ 101.90 S1201600000001 Plumbing Base Fee JTL 2/17/2016 $24.70 S1201600000001 Total $2,531.18 BLD2016-00074 Please refer to the following pages for conditions of this permit. Page 1 of 6 CASE NOTES FOR BLD2016-00074 CONDITIONS FOR BLD2016-00074 1) 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-O The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X (�'� 2) 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 pr rtoany further inspections being performed or approvals granted. X 3) Appro d er dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 4) All construction and demolition debris must be removed from the site after project completion. Prop is osal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X 5) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent er�or properties. Silt fencing, straw, or surface matting must be installed and maintained until upland vegetation has become established. X I 6) ConcrpN leachate and wash water must be contained during construction pouring, such that water quality degradation of adjacent waters does not occur. X 7) 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 8) 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 aI roved documents will result in failure of required building inspections. X 9) All slabs within the heated space shall be insulate to a minimum R-10 for at least 24". Monolithic slabs shall be insulated around the perimeter from the top of the slab to the bottom of the footing X�^ BLD2016-00074 Please refer to the following pages for conditions of this permit. Page 2 of 6 10) 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 Dgtpartment prior to any further inspections being performed or approvals granted. X 11) 2012 IECC/Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C, Window(Max U-Factor):0.30, Skylight (Max U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation min. R-49, Vault Insulation R-38, and Slab Insulation R-10. In addition the following credits from R406.2 shall be completed as follows: 5a-Water heater must have minimum EF 0.93 or better X 12) A permanent certificate, completed by the owner, builder or registered design professional, shall be posted within three feet of the electrical distribution panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 105.4, and air leakage results if a blower door test was conducted. Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 5 air changes per hour when tested with a blower door in accordanve with IECC/.WSEC Section R402.4. The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is not required for additions less than 750 square feet. Reference IECC/WSEC R401.3 & R101.4.3 Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2012 Certificate"and are available in %or'h sheets. The Mason County Permit Center will also have some available. X 13) A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section R404.1. X 14) WIND LOADS- Roof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic wind speed for Mason County is 85 MPH. X BLD2016-00074 Please refer to the following pages for conditions of this permit. Page 3 of 6 15) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer's installation instructions. A drip edge shall be provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5) X QJ� 16) 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 i"cknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 17) A concrete encased grounding electrode must be installed and used at each new building or structure that is built upon a permanent concrete foundation. In Mason County the electrical code is regulated by Washington State Department of Labor& Industries (L&I). For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-4000. X 18) Stock Plan Identification number: This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department, original building plans, and all attachments approved by the Mason County Building Department shall be available for the Mason County Building Inspector at �chh required inspection. X 1m 19) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer specifications and in accordance with IRC Section R315. Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level of the dwelling. EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances), repairs, or addi tions requiring a permit occur, or when one or more sleeping rooms are added or created. X 20) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical con ete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X BLD2016-00074 Please refer to the following pages for conditions of this permit. Page 4 of 6 21) 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 22) 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 X arged andM ollected by the Building Department prior to any further inspections being performed or approvals granted. 23) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or r ul ation, must be reviewed and approved by Mason County prior to construction. X 24) 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 ade prior to requesting additional inspections. X 25) All property lines shall be clearly identified at the time of foundation inspection. X 26) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason Cou inances and building regulations. X 27) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have preverftd action from being taken. No more than one extension may be granted. X 28) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and4lashing. Install metal connectors approved for contact with the new types of pressure treated material. X 29) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures eet the setback conditions listed. X BLD2016-00074 Please refer to the following pages for conditions of this permit. Page 5 of 6 30) 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 Plan"to ensure these structures are shown and meet the setback conditions listed. X 31) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/ Reserve requires a 1 Oft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. No"!�7 drains within 30ft, down gradient of drainfield/reserve area. X On-site septic system final installation approval required prior to temporary/final occupancy. SWG2016-00040 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)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 OF INSPECTION. INACTIVITY OF THIS PERMIT APPLI TION OF 180 DAYS WILL INVALIDATE THE APPLICATION. ,- Signature Date go_lw� :Ift (5V1� G� OWNER - iF£EPRESENTATIVE - CONTRACTOR Print Name (Circle onesa+ ' e) BLD2016-00074 Please refer to the following pages for conditions of this permit. Page 6 of 6 BUILDING NameRl ��qbzJv Parcel# (!Y0 G S BLD# 2 )6 Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment', with more than 2,000 square feet of impervious surface'. '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. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings 6 X 3 = l X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example.- eaves/gutters) X = Driveways to X 10 = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = 3 6 X = Any paved, gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area(sum of all areas) S Z If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/ gen ontractor(circle one)Date: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. DECEIVED Page 1 of 2 MCCD - Name Parcel 9 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: hft//www.co.mason.wa—us/code/commissioners/*mdex.htn Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT. 450 Mail: P 0 Box 1850,Shelton WA 98584 Physical: 415 N 6th St, Shelton WA 98584 If this development has,or will have,a septic/d rain field system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT. 352 Mail: P 0 Box 1666, Shelton WA 98584 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner, owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 Amp °O°�'r MASON COUNTY COMMUNITY SERVICES Permit No: , PERMIT ASSISTANCE CENTER: Recv'd: �-� "' • BUILDING•PLANNING•FIRE MARSHAL R-! CEFVE+D 615 W. Alder St- Shelton, WA 98584 Phone Shelton: (360)427-9670 ext. 352 Fax:(360)427-7798 FEB 0 4 2016 Phone Belfair. (360)275-4467 Phone Elma:(360)482-5269 lasa http:l/www.co.mason.wa.us/community dev BUIDING BUILDING PERMIT APPLICATION I\4 C C D - PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: A I- p4q6ej NAME: MAILING ADDRESS: 51 .5 MAILING ADDRESS: CITY: ct STATE: 1v , ZIP: CITY: STATE: ZIP: PHONE#1: PHONE: CELL: PHONE#2; EMAIL : EMAIL: Ir — Q V%^5y,\ ,C�y _ L&I REG# EXP._/_/_ CONTACT PERSON : OWNER ❑ CONTRACTOR ❑ OTHER/BELOW NAME: G MAILING ADDRESS:XW4 R1, 1V. CITY: o STATE: tj Q- ZIP: 3 y PHONE 3b0-37L EMAIL: PARCEL INFORMATION: p PARCEL NUMBER(12 DIGIT NUMBER) ►a.3 3 0 5 m o d o 5 ZONING LEGAL DESCRIPTION(ABBREVIATED) FIRE DISTRICT SITE ADDRESS CITY DIRECTIONS TO SITE ADDRESS or - o e IS PROPERTY WITHIN 200 FT: (Checkalt rharapply): SALTWATER❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14% YES❑ NOR TYPE OF WORK: NEW [g. ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) Q g , IS USE: PRI MARY J�k SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg) a YES(Part[s]of Bldg) ❑ NO ❑ DESCRIBE WORK R��. N,�c-Aj C.�2h,S"� —'r —�!�3�Ir I�PLAM 019- 000 SQUARE FOOTAGE: 1ST FLOOR o sq. ft. 2ND FLOOR 8'70 sq. ft. 3RD FLOOR sq. ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq. ft. STORAGE sq.ft. OTHER sq.ft. GARAGE ©o sq. ft. ATTACHED X DETACHED ❑ CARPORT sq. ft. ATTACHED ❑ DETACHED ❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED KE YEAR WIDT BEDROOMS BATHS SERIAL NUMBER OWNER 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 or owner's legal representative. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or legal representative, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s) 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 OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) X a, Signature of OWNER Date ter— DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT Z-t�-f PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS Intake y� Approved&Ready for Pick-Up: �PQON coU MASON COUNTY COMMUNITY SERVICES Permit No: PERMIT ASSISTANCE CENTER: Recv'd: RECEIVED •BUILDING•PLANNING• FIRE MARSHAL 615 W. Alder St- Shelton, WA 98584 Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798 Phone Belfair:(360)275-4467 Phone Elma:(360)482-5269 FEB 0 4 2016 18.54 htto://www.co.mason.wa.us/community dev/ B U I LD I N &LUMBING & MECHANICAL PERMIT APPLICATION N' C C D- OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: R 7Y Refiboj NAME: MAILING ADDRESS: MAILING ADDRESS: CITY: 6 U'r 0 - I STATE:W , ZIP: CITY: STATE: ZIP: I" PHONE: PHONE: CELL: 2°d PHONE: MAIL : EMAIL: r Q L&I REG # EXP._/_/_ PARCEL INFORMATION: �C PARCEL NUMBER(12 Digit Number): 13 3 p S6®O© �,�, Zoning: J LEGAL DESCRIPTION(Abbreviated): SITE ADDRESS: h C, CITY: DIRECTIONS TO SITE ADDRESS: o u o 1rCA TYPE OF JOB NEW I,-- ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS— IT FLOOR 2NDFLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric_t,,�LPG Natural Gas Ductless_ Toilets 3 Type of Unit No. o f� Fees Bathroom Sink 2 Furnace Bath Tubs Heat Pump Showers � Spot Vent Fan 1 Water Heater Propane Tank Clothes Washer 1 Gas Outlets Kitchen Sinks 1 Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hose bibs Dryer Vent 1 Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)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 OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X '�L- - Signature of Applicant Date X ��� 0)Yn !�( � Owner/Owners Representative/Contractor Print Name (indicate which one) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL MASON COUNTY Mason County Permit Center Use: DEPARTMENT OF COMMUNITY DEVELOPMENT DDR 20/6 - 00o/ 7 411 N.Fifth Street/P.O.Box 279, Shelton WA 98584 360.427.9670 ext.352 Date Rcvd Request for Administrative Variance for Reduction in the Required Setbacks ($115.00) 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 and gutters. nn Applicant/Owners: R [� pa4 6 [�( uz Mailing Address: P.d 1 B,-,:3 S City: J�j u r State: �� , Zip: qj Telephone: Email: k 1 r�C�I-2 If this reduction is tied to a building permit, please give permit case number. BLD 20140 - 00D_-7 Parcel Number(s): I 33 B 5 80I)0 6 5 Zoning Site Address: AV�An r � n' Requested setback variance: to ft. 0,Front ❑ Rear ❑ Side 4 ) a ft ❑ Front ❑ Rear Q Side W 2 5+ 5 ft. ❑ Front ❑ Rear LA Side ST nt Front Setbacks-From access easements and road right of ways. Minimum 10 feet. Rear Setbacks—From the rear property line. Minimum 10 feet. Side Setbacks—From the side property line. Minimum S feet except for certain shoreline designations. 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. I:\Community DevelopmentTAC-Permit Assistance Center\VARIANCES\Admin Variance.doc Edited on 7/16/10 II i r FRONT AND OR REAR YARD REDUCTION REQUESTS: For existing lots of record as of March 5,2002; You must meet one of the following: 1) One of the following exists on the lot(check all that apply): ❑ 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; ❑ e) existing improvements of buildings, septic systems, and well areas. SIDE YARD REDUCTION REQUESTS: For existing lots of record as of March 5,2002; You must meet one of the following: 2) One of the following exists on the lot(check all that apply): ❑ a) steep slopes, wetlands, or streams present; A b) soils that restrict building or septic development; ❑ c) lot width at the front yard line of no more than 50 feet; (k 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. l O W C-t V'-a 'Q S r,Q sMX Cfi owl C aan Owner Agen (please indicate) Signature Date Official Use Only Approved by: Date Denied by: Date Reason for denial• L\Community Development\PAC-Permit Assistance Center\VARIANCES\Admin Variance.doc Edited on 7/16/10 0007 206 -00 U) 7L 5 c Q\-Q- r = 2 0 PLANNING .DECEIVED FEB 0 4 2016 MCCD - fb cCck --� ) Z 3 30 SD 000L,S F-5 Peaboo�- Zby)eo� 29 1 4r5 ir 70 N �5 3r� ~0 o oCY so 'o lot 4 , �C c� ALL SETBACKS ARE rAEASURED I FROM THE FUf=�T HEST PROJECTION OF THE BUILDING 0 ZU1 0001 • ti r Z7. 7'•f Fefr�- �rZ �o � � ••.�-�..� tx� fit+. � ,� � � MC PUBLIC HEALTH MAR 0 7 2016 i Z 0 U G� ' gyp` Z-C�rnr-$ 2iec ALP tApt, <-.c j j —%.X 'rGC t wA�y••�'�f PAULA JAY JOHNSON to s p ro zo 30 0 ` ,p� 2o� 5