HomeMy WebLinkAboutBLD2006-01468 Cancelled Addition DDR2006-00283 Cancelled - BLD Permit / Conditions - 4/15/2008 Inspection Line(360kt27-7262
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
RESIDENTIAL BUILDING PERMIT BLD2006-01468
OWNER: TROY ERICKSON
CONTRACTOR: LICENSE: EXP:
RECEIVED: 8/17/2006
SITE ADDRESS: 11 NE JOLLY ROGER LN BELFAIR ISSUED: 10/5/2006
PARCEL NUMBER: 123305400031 EXPIRES: 4/5/2007
LEGAL DESCRIPTION: BEARDS COVE DIV 7 LOT: 31 & N1/2 OF 30 PCL 3 OF BLA#00-33
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
ADDITION TO SFR NORTH SHORE RIGHT AT SAND HILL LEFT ON LARSON BLVD. LEFT ON
LARSON ALKE LEFT ON JOLLY ROGERS FIRST HOUSE ON LEFT.
General Information Construction &Occ ancy Information Square Footage Information
No. of Bedrooms: 1 f Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 1 cc. Group: R-3 Lot Size: Deck:
Type of Work: ADD Fire Dist.: 2 No. of Stories: 1 `�Occ. Load: Building:
Valuation: Building Height: 7" JOcc. Status: Basement: addition 968
Manufactured Home Information Setba I ormation Shoreline & Planning Information
Make: Length: Ft. Front: E 70.0 Shoreline: Ft. Water Body:. Side 1: N 5. SEPA?: No
Rear: W 42.� Slope: Ft. Shoreline Desi
Model: Width: Ft 9.: Not Applicable
Year: Serial No.: Side 2: S 35.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Hosebibs 1 Ventilation Fan 2 Plan Check Fee CMH 8/17/2006 $486.69 B12006000
Lavatories 2 Propane Stove 1 Planning Review Fee CMH 8/17/2006 $155.00 612006000
Showers 1 Building State Fee RTB 9/5/2006 $4.50 612006000
Water Closets (Toilets) 1 Building Permit Fee RTB 9/5/2006 $748.75 612006000
Bath Tubs 1 Mechanical Fee RTB 9/5/2006 $66.80 612006000
Mechanical Base Fee RTB 9/5/2006 $23.50 612006000
Plumbing Fee RTB 9/5/2006 $40.00 612006000
Plumbing Base Fee RTB 9/5/2006 $20.00 B12006000
EH Plan Review ADR 9/11/2006 $35.00 612006000
Total $1,580.24
BLD2006-01468 Please referto the following pages for conditions of this permit. 1 of 4
CASE NOTES FOR
BLD2006-01468
CONDITIONS FOR
BLD2006-01468
1) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
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
Departmgn`t^prior to any further inspections being performed or approvals granted.
X
3) 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
4) 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.
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5) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
6) 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 D partment prior to any further inspections being performed or approvals granted.
X
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7) 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 (T e/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 3, �_
BLD2006-01468 Please refer to the following pages for conditions of this permit. 2 of 4
"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 �� .
9) 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.
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10) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinaa&e or regulation, must be reviewed and approved by Mason County prior to construction.
X
11) 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 shill be made prior to requesting additional inspections.
X :
12) All property lines shall be clearly identified at the time of foundation inspection. X '� J
13) 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 y ordinances and building regulations.
X
14) 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.
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15) 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.
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16) 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.
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BLD2006-01468 Please referto the following pages for conditions of this permit. 3 of 4
17) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Approve I Plan"to ensure these structures are shown and meet the setback conditions listed.
X , .
18) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at
(360) 427-9670, ext. 450. The building permit will not be "finaled" until the permit holder can show proof that the access permit from Public Works has
been "finaled"an approved.
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19) Water quality i not to be degraded to the detriment of the aquatic environment as a result of this project.
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20) Prior to final approval, all upland areas disturbed or newreated by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
21) Approved per di ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
x
22) This parcely�J'orted in a smoke management zone. Please contact a fire warden at(360)427-9670 ext. 459 for further information.
X ��
This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described property and structure for review and inspection. /
OWN ER OR AGENT: DATE:
BLD2006-01468 Please refer to the following pages for conditions of this permit. 4 of 4
o� -%ONCRETE MECHANICAL MANUFACTURED HOME M
o Date /yamCD By/1//�u n
rn Footings I Setbacks Ribbons
Gas Piping
Interior Date y �e � By PC interior-Date By Date By OExterior Date ` By Exterior-Date By
fit. Z
INSULATION up
Point Load I Isolated Footings Date By --I
Date By BG I SLAB INSULATION —. X
Data By FIRE DEPARTMENT O
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMINP Walla Date By
Date 10 2, v7 By ,-�A Data /D ;Z -7 By'�� PROPANETANKS
PLUMBING vault i Date By
Date By 4f OTHER
Groundwork Attic
Date By Date By
Type:
Dale By
D.W. DRYWALL T'ypw
Date 0-7 B Int.Brace Wall Date By W
Date f yr'-02 a FINAL INSPECTION p
w Water Line Fire Sepe ration N
Date By Date By Date By O
m tJ�
Pass or Request Inspect. c
Type of insp. Fail Date Date Done By Comments
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Building Permit #ff MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items Listed below must be corrected to gain code compliance
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You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
❑ Call for re-inspection when corrections are made before continuing
—Make corrections, items will be checked on next inspection
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❑ This is not a complete inspection Department zs/z'
Date �� ��� Inspector
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Mason County Dept. of Community Development
Mason County Bldg. 3
426 W. Cedar
Itrylo P.O. Box 186 (360) 427-9670 Local (360) 482-5269 Elma
Shelton, WA 98584 (360) 275-4467 Belfair
Notice to Obtain Final Inspection
October 24, 2008
TROY ERICKSON
11 JOLLY ROGER LANE
BELFAIR WA 98528
Case No.: BLD2006-01468
Parcel No.: 123305400031
Proiect Description: ADDITION TO SFR
The Mason County Department of Community Development is currently reviewing all
permits that are expired and have not been approved for occupancy and use.
Pursuant to Mason County Code, Title 14 Building and Construction, a permit and
final inspection for this type of activity is required under the 2006 International
Building Code or the code your permit was issued and your property is currently in
violation status of occupancy and use.
Please contact our office to make the necessary arrangements 21 days from
the date of this letter. Failure to contact our office to make the necessary scheduled
inspections will result in enforcement actions.
To bring your site into compliance, you must schedule an inspection. One (1) $68.00
site investigation fee will need to be paid prior to inspection along with any
outstanding fees currently due on your building permit. For every inspection required
after that, you will be charged $68.00 again, per inspection until final inspection and
conditions are met.
To schedule an inspection, please call (360) 427-9670 ext. 262.
If you should have any questions regarding this notification, please contact me at
(360) 427-9670 ext 595.
Sincerely,
Rich Todd Balderston
Mason County Department of Community Development
Cc: Property File
October 24, 2008 BLD2006-01468
MASON COUNTY RESIDENTIAL PLANS .SUBMITTAL CHECKLIST
Owner's Name: F J'(.k jq Date: Reviewed By:
Documents:
(/Building Permit Application Completed
V Planning Intake Checklist Completed,
_j,L-Site plan includes:Allowable building area,roof ov ngs, decks, etc. R
—Fire Apparatus Access Road info required? Yes o ��t ysa_ 1
N
L.
_J�__Tnergy Code Application Form-*Electric wall heater O Electric central furnace O LPG a
O Heat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type• ZOOS
O Other: Specify: .,
_14�Mechanical/Plumbing A ation-WATER HEATER FUEL TYPE
__Fngin4eP:44g? Yes No Snow load used: Seismic Design Category: DI or D2
Geotal report or assessment? Yes No
Construction Plans: COMPLETE lz�lans Legible recognized Scale "Elevation Views
__Vross Section V-Voundation Plan _,C.�ofFraming Plan
4-1-Moor Plan- Use of Rooms Noted
v�Floor Framing Plan-all floor levels represented? Loft,crawlspace, etc.
4)eck1ranung Plan, including covered porch roof framingplan
Plan Details: ��
Roof framing details, truss lay-out may be needed
_L,-4'all Framing -Does bearing-wall height exceed 10'?(Engineering may be requiredJ�'_y �Q
_Floor framing: Floor joists: Floor beams:
_k'Window headers. Typical header:
✓roundation: footing size,reinforcement
_/�nesete-Walls-Does Concrete Wall Height Exceed 9'? gineering may be required)
22/Landings at all exit levels? <30"above grade? Y N
�cc-Location of Furnace
ireplacelStovenformation Shown-Fuel Type?
jz'Window Sizes Marked on Plans
age? (Engineering may be required)R602.10.1, 1"story of a two story: D 1 —45%,D2—55%
Braced wall panels(shear walls)marked on plans or lateral engineering? (Plans may not be approved if not provided)
COMMENTS:
U
IRREGULAR BUILDINGS (Unusual Shape)601.2.2.2.2
Irregular portions of structures shall be designed do accordance with accepted engineering practice. A portion of a building shall be
considered to be irregular when one or more of the following conditions occur:
1)Exterior braced wall line or BWP cantilevered or offset by more than 4'
2)Roof or floor is not laterally supported on all edges
2A)Portion of roof or floor extend more than 6 ft. beyond the braced wall line.
3)End of BWP extends more than 1 ft.over an opening more than 8 ft in width below.
4)Opening in a floor or roof exceed the lesser of 12 ft. or 50% of the least floor or roof dimension.
5)Portions of floor level are offset vertically
_ 6)Shear wall lines do not occur in two perpendicular directions.
7) When it story above grade includes masonry or concrete constniction (exc: fireplaces,chimneys, and venecr)
When this condition applies the entire story shall be designed in accordance with accepted engineering pracurc.
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MASON COUNTY DEPARTMENT OF& MUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner. ��, � S`^ �.S -7�Q Telephone 'S-t�rr� arcel#:
Type of project ( ) New Residence ( )Addition ( ) Remodel
F
Ft. 15 Floor:G6 2� floor: Heated Basement:
area:: `r
ystem Type: Electric wall heater O Electric Central Furnace O LPG Furnace
p with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type: C ,/ /ll�"�
Other: Specify
Glazing Prescri tive Option see reverse side circle one: 1 %II IV
Percentage: Compliance
Method O Component Performance , Chapter 5— Calculation worksheets required
I
Check one:: O S stems anal sis, Cha ter4
O Whole House Ventilation 41ntegrated
Whole House Ventilation using a Heat
Ventilation using exhaust fans window or wall
System vents (VIAQ 303.4.1) covery Ventilation System (VIAQ 303.4-4)
Check one
O Whole House Ventilation Whole House Ventilation using an inline
with a Forced Air System (VIAQ 303.4.2) suppl fan. VIAQ 303.4.3)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windows:
2 z ' o
C , 12 11070sr0&7c cs Z / 41
Z-=-V 6-Oel°$L f Z-0
?ATP Aeol
30Tjr ( /7.I-
Za7°S�DF 2- Z
Windows: Total Sq. ft. 1016
Doors:
O s 6
o � j
d
Doors: Total Sq. Ft Z,
Total window and door area 5-o
Total window &door area / ` /(divided by) total sq. ft of heated area = /S %of glazing
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DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)2754467 Elma (360)482-5269
FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2004 Washington State Energy Code (WSEC)
2003 Ventilation and Indoor Air Quality Code (VIAQ)
effective July 1, 2004
Code Compliance Application Form
The following information will be required for the WSEC and VIAQ plan review:
1. Complete the Washington State Energy Code/ Ventilation and Indoor Air Quality Code
(WSEC/VIAQ)application located on the reverse side.
2. Complete the window and door schedule on the reverse side. Include all windows, skylights,
sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening
dimensions of the windows and doors. Information about the U-factor of the window will also help
to expedite the energy code review. If you are complying with the WSEC by prescriptive path and
are using the area weighted average method you must include your calculations.
3. On your building plans note the location and fuel type of water heater, location of exhaust fans
(bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and
slabs,
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. Additional
WSEC and VIAQ compliance information is available on the internet at:
http://www.energy.wsu.ed u/code/
Prescriptive Requirements 0,1for GroupR Occupancy
P Y
Climate Zone 1, Table 6-1
Glazing Glazing U-factor Door Wall Wall Wall
Option Area% of U Ceiling Vaulted Above interior exterior Slab
p Fl000r vertical Overhead" Factors 2 Ceiling' Grade below 4 Below Floors on
12 grade Grade Grade
I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
IV Unlimited
Single
Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
(R-3)Only
*Reference Case/Call (360)427-9670 ext. 352 for footnote information. Log&solid timber wall with a min. avg.thickness of 3.5"are
exempt from the above grade wall insulation requirements.
te.
MASON COUNTY PERMIT N030()( � A (gibr
BUILDING PERMIT APPLICATION C
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 �RMATIOR CONTRACTOR INF ARN
Owners ' BSc iJ Teo ly Company Name `
Mailing Address It '.ro 11+ o 6 ER.. L4N a Mailing Address
City &C�FA'R State Zip Code 91s 5 Z City State Zip Code
Phone 1/.o- Z"75- 6k /y Other Ph. Phone Other Ph.
Lien/Title Holder a Wa ere- Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# e 2 c TU 3 t?3 DOB ? ? r 3 Drivers Lic.# DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. 12- 5y n o Fire District
Legal Description
Site Address (Plea a include street name, street number and city) &-FR
Directions to ite °'�� a)¢
L A Le l K a f rrz-
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluff�5%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add-K Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑
Use of Building =` r Describe Work ' �3 "- A A 0 rT i o~
No. of Bedrooms A I No. of Bathrooms I_Square Footage- 1st Floors 9(0B 2nd Floor'
3rd Floor Basement Deck 90W Covered Deck Other Sq. ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/ No
Installer Name Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all
the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work
proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or
agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County acGew to the above
described property and structure for review and inspection. This permit/application becomes null & void if work or authorized-'construction is
not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS-4Y
MEANS OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE T(A ((��00 PPLICATION.�
X s^ �i Date: �i �S'-. �fl�� , ��II 2006
Owner/'Owners Representative/'Contractor (indicate which one) Bid
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date �/CE
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department 9IA
Planning Department
Environmental Health Department
Fire Marshal
FEES
Building Permit Fee - J' Site Inspection
Plan Review Fee EH Review Fee i
Plumbing & Base Fee Or GAD Planninq Review Fee
Mechanical & Base fee 3, PG Other
Wood /Gas/ Pellet Stove Fee S`Z . 3A State Fee rises
Violation Fee — 4 6 Pre-Paid at Submittal
Valuation $ TOTAL FEES
y
MASON COUNTY PERMIT NO.
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W. Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670- Belfair(360)275-4467- Elma(360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORi]I(IATION,
Owner ��` IAA} -rTo Lt Company Name
Mailing.Addt�ess /� (U <<J6F� Mailing Address
City -r c` A t>Z Mate u"R Zip Code S Z$ City Mate Zip Code
Phone ,:Vao -7-79` G614( Other Ph. Phone Other Ph.
Lien/Title Holder �� Nor`- Contractor Reg.4 Exp.
E mail address E Mail Address
Drivers Lic.# ` « k Ty?74D DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Z n S / Fire Districe- f A
Legal Description
Site Address Please i-clud street name, stree number and it Etz
Directions to site I`t PA w)( N' ` " y)
Sr" h kv
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units - 1 st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS ,/
Type of Fixture No. of Fixtures Fees Fuel Type:ElectriG_ LPQ Natural Gas— Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink 4farr Furnace
Bath Tubs 7 Heatpumps Z
N ()&"ns
Showers Spot Vent Fan ' 7 1 -F 4-r 7
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove / 7 2s 14
Dishwasher Kitchen Exhaust Hood 11
;
Hosebibs f Dryer Vent '�
Other Other Base Fee ' ° t
0 Base Fee ;2.3- 5 o
TOTAL PLUMBING TOTAL MECHANICAL -30?
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 F blder 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 O..FF CONTINUATIO OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X ,D'tA icf Date:.�t k� trJL
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
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
MASON COUNTY '
DEPARTMENT OF COMMUNITY DEVELOPMENT
411 No. Fifth Street//P.O. Box 186, Shelton WA. 98584
360.427.9670 ext. 352
Re
quest for �A 1
Administrative reduction in the Required Setbacks ($90.00� 7��6
For administrative review, the minimum variance on a yard setback request is 5 feet
from the side lot lines and 10 feet front and rear lot lines or right of way. Request for�°3Fl;/CE
further reduction requires standard variance. Setbacks are measured from the furthest
projection of the structure.
Applicant/Owners: D �( c C LSD
Mailing Address: .E �br �G Gyli�
City: v '9- Acmil/ State: Zip:
Site Address: QVi4'-,
Telephone No.: C3&0a (Q(p
Parcel Number(s): Zoning
Requested Variance: Front / Rear • CE3
(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 area, 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;
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; O
b) soils that restrict building or septic development; A
c) lot width at the front yard line of no more than 50 feet; Q7 W
d) lot size of no more than one-fourth acre; "e) existing improvements of buildings, septic systems, and well areas. 0
R1
m .a
Side yard requirements: r -4
1) Existing lots of record as of March 5, 2002; -n Z
You must meet one of the following. (Please circle all that apply) �,.;. --i
2) One of the following exists on the lot: _
a) steep slopes, wetlands, or streams present; m M
b) soils that restrict building or septic development;
c) lot width at the front yard line of no more than 50 feet;
lot size of no more than one-half acre;
e) existing improvements of buildings, septic systems, and well areas
NAadministativevariance.doc (tw) February 05
Explain how these circumstances preclude a reasonable development proposal from
meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
bU-e- rtO `f 4—
Owner/Agent (please indicate)
Signature and date
Official Use Onl y
Approved Date
Denied V Date
Reason for denial:
UAadministativevariance.doc (tw) February 05