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HomeMy WebLinkAboutBLD2003-00926 Final SFR - BLD Permit / Conditions - 1/14/2004 Inspection Line(360)127-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 so Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 lo RESIDENTIAL BUILDING PERMIT BLD2003-00926 OWNER: CHRIS COX CONTRACTOR: ADAIR HOMES INC LICENSE: ADAIRH*262RZ EXP: 1/9/2005 RECEIVED: 7/9/2003 SITE ADDRESS: 1051 NE BELFAIR MANOR DR BELFAIR ISSUED: 8/19/2003EXPIRES: 2/19/2004 PARCEL NUMBER: 123307590264 LEGAL DESCRIPTION: TR 26 OF SURVEY 2/149 PROJECT DESCRIPTION: DIRECTIONS TO SITE: RESIDENCE 101 TOWARDS SHETON EXIT OFF OF 1 ST SHELTON EXIT TURN RIGHT ON HWY 3 23MILES TURN LEFT ON 300 TURN RIGHT ON SANDHILL RD LEFT ON BELFAIR MANOR DRIVE General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: 3 Type of Constr.: V-N Type of Use: SF 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:1,702 Valuation: Building Height: 14 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline & Planning Information Make: Length: Ft. Front: S 50.0 Ft. Shoreline: Ft. Water Body: wetland? Rear: N 40.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: W 60.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: E 190.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee NJP 7/9/2003 $56.80 S22003 Hosebibs 2 Ventilation Fan 3 Building State Fee NJP 7/9/2003 $4.50 S22003 Kitchen Sink 1 Dryer Vent 1 Building State Fee NJP 7/9/2003 $4.50 S22003 Lavatories 2 Planning Review Fee NJP 7/9/2003 $150.00 S22003 Showers 1 Building Permit Fee MRG 7/22/2003$1,060.95 S22003 Water Closets (Toilets) 2 Mechanical Fee MRG 7/22/2003 $39.65 S22003 Water Heaters 1 Mechanical Base Fee MRG 7/22/2003 $23.50 S22003 Bath Tubs 2 Plumbing Fee MRG 7/22/2003 $77.00 S22003 Clothes Washer 1 Plumbing Base Fee MRG 7/22/2003 $20.00 S22003 EH Plan Review ADR 7/24/2003 $75.00 S22003 EH Permit Revision CEW 8/8/2003 $35.00 S22003 Total $1,546.90 BLD2003-00926 Please referto the following pages for conditions of this permit. 1 of 4 CASE NOTES FOR BLD2003-00926 CONDITIONS FOR BLD2003-00926 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 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X _YS 2) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located in such a position as to be plainly visible and legible from the street or road fronting the property. 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 Uniform Building Code will be assessed if the owner and/or contractol fail to post the address on site prior to requesting inspections. X Tt— ' 3) The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X 4) Any f use development or vegetation removal in the SE corner will require additional review and may require wetland categorization and delineation. _ X � 5) All upland areas disturbed or newt created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X Ms 6) Approved per dimensions and setbacks on submitted site plan. X 7�5 7) Proposeucture(s) must maintain a minimum setback from all property lines, easements and 25'from all County and State Road right of ways. X 8) 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 Departmior to any further inspections being performed or approvals granted. X 9) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located in such a position as to be plainly visible and legible from the street or road fronting the property. 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 Uniform Building Code will be assessed if the owner and/or contractor faiL to post the address on site prior to requesting inspections. X BLD2003-00926 Please referto the following pages for conditions of this permit. 2 of 4 10) The plan review check list and corrections, along with the Energy Compliance Worksheet(when applicable)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 sib for the duration of the project. Failure to comply and/or removal of approved documents will result in failure of required building inspections. X 11) The"approved" plot plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" plot 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 Buildin De artment prior to an further in i� p p yinspections being performed or approvals granted. X _ TS 12) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels Compliance Method: IV Window(Max U-Factor):0.40 Skylight (Max U-Factor):0.58 Doors (Type/Max U-Factor):0.40 or less, Wall insulation R-21 , Floor insulation R-30 , Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10 X -112S 13) In buildings of unusually tight construction, fuel-burning appliances (excluding cooking appliances and domestic clothes dryers) shall obtain combustion air from outside in accordance with the Uniform Mechanical Code. X 14) All construction must meet or exceed all local ordinances and the 1997 Uniform Building Code 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 15) All changes to"approved" building plans that effect compliance with the Uniform Codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. X 16) The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the Uniform Codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector be made prior to requesting additional inspections. 17) All property lines shall be clearly identified at the time of foundation inspection. X 18) 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 County ordinances and building regulations. X 19) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have prevented action from being taken. No more than one extension may be granted. X 7 BLD2003-00926 Please referto the following pages for conditions of this permit. 3 of 4 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 tinuation of work is as plrogr s i pection within the 180 day period. Final inspection must be approved before building can be occupied. OWN ER OR AGE C DATE: C IJQZ2�5 BLD2003-00926 Please referto the following pages for conditions of this permit. 4 of 4 o 'CONCRETE MECHANICAL MANUFACTURED HOME' 0 Footings / Setbacks Date B y Ribbons Date � By Gas Piping Date B y N Foundation Walls Date B y Set-up rn Date `V By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date � NCO By Date // - 2. -cO By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.U. Date Date % By FINAL INSPECTION Water Line_ Date �'�`f�% By Date By .;. ,. 2 ,"_ Date By 0 L �� 12 kzi Z —Sv fSS ti� s a �/_i�_�s .- i�/ 2 -•�� ��� �,yl�t•�s.�� ,�s;r �/cif Cn CD x 0 . � N 0 J I Gc) 40 wA�E Z paw . ID �uFF�� �w 48' +Iv -- 1"=40 {3" w � N b LINE 1� APPROVED MASON COUNTY CO PLA NING SITE PLAN REQUIRE TO BE 0 SITE C NGES SUBJEt� TO ANNR` AL By _ Date t t 30' VT , DR1VE Fu{ INGf1:SS -�GR�3 �U r�tTtES Iv).10 � RECEIVED ��0� C3�Aty �rotz CF-\R1S TT—=RESA COX hL 2 8 2003 N E (c� ► 0�, t4ow OAn t3q , 426 W. CEDAR ST.- 2:1 5 — LA U 1 Tire information on this plot plan has been provided and reviewed by the property owner who,by signing below: 1.) 5i j E acknowledges and accepts full responsibility for its accuracy Intl completeness: 2.) Is responsible to ensure that the S N E i3ELFAtR tV1L�,tJ�JR improvements to the site take place in conformance with tills plan:3.)Will establish all the corner irons,lot lines and code- '25 VA R I WN r 0 Q,5 2'3 required setbacks required of this property.Any change(s) to tills plan must be pre-approved by the governmental rj (o\.A agencies with jurisdiction,the mortgage lender Ind the �1 W contractor Ind documented. 1 ►� MA`s0t\) C O . 1 11JA r x rrf (; � —Owner Date ltc �wner U i r ADAIR HOMES , INC . SINCE 1969 BEAVERTON July 2, 2003 1111 SW 170T" AVE. BEAVERTON, OR 97006-4220 SALES (503) 645-3547 Mason County Building Dept CONST (503) 645-1156 PO Box 186 FAX (503) 645-5986 Shelton WA 98584 BEND 63309 NELS ANDERSON RD. Dear Official, BEND, OR 97701-5743 SALES (541) 382-4068 Please find enclosed a building permit application for Chris &Teresa Cox. (541) 382-6924 FAX (541) 382-8989 y g a q The will be building 1702 S ft home at 1051 NE Belfair Manor Drive, FAX Belfair, WA 98528. OLYMPIA 2303 93RD AVE. SW Enclosed are three sets of blueprints, plan check fee of$ 207.00 , strip OLYMPSALES A, 60 98512-1028 ma to site, approved septic design, and lot plan. The water is still SALES (360) 352-8571 P PP P � g� P P i CONST (360) 352-7641 waiting for approval but I will send you the information once I receive it. FAX (360) 943-0701 MEDFORD If I have forgotten anything or if your requirements have changed, please notify me at (360) 352-7641. 541 BUSINESS PARK DR. SUITE A MEDFORD. OR 97504-4191 Thank you very much for your time and assistance. SALES (541) 732-1560 (541) 774-8 FAX / FAX (541) 774-8847847 �ut n�a~ CALDWELL Sarah Marshall 1904 E. CHICAGO ST. Administrative Assistant SUITE C Adair Homes Inc. f CALDWELL, ID 83605 n BUS (208) 459-8274 \\A FAX (208) 459-8289 O v To�1 BUSINESS CENTER $ J 1111 SW 170T" AVE. ` BEAVERTON, OR 97006-4220 S0 PHONE (503) 645-4730 "( A FAX (503) 645-9715 1 kP- OR CCB#593 r WA#ADAIR H#262RZ * RM FIOfIIf Builders Assodation of wt.o'i 'a Rx d F� x =� Q p► ��' LuMT3ERMgy�jS CH��S TmssA COX 10� 1-7330-7 tsmZ64 P 7-3 tJ j INS �r l04 Qy, r� , Lq $2p0 r ` MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT P.O. Box 186 ♦ 426 W Cedar Street ♦ Shelton, WA 98584 www.co.mason.wa.us Phone (360)427-9670 ext . 352 Irf • Building Belfair: (360) 275-4467 • Planning Elma: (360) 482-6968 to • Environmental Health Seattle: (206)464-6968 Fax: (360)427-7798 SITE PLAN INSTRUCTIONS A complete, accurate, and detailed site plan is important to avoid delays in the review and approval of your proj- ect. A sample site plan and topography are located on the inside of this form. An easy to use grid, which can be used to draw your site plan on, is also located inside. The following items will be required, if applicable, to complete the building permit application package. Additional information may be needed depending upon indi- vidual site conditions. For more information see submittal standards and instructions on the back of this form. Dcn = c_n = � X K X > o c) g � cno o � cnX -an -om o — oQ, my coG- m >vo 0C m m co o 0 -0 3 m B -p P 3 o- (� � _ � o c 3 T � Submittal CD o m m y 0 2 Q o � � m 3 o _ 0 oo m o � � v mo' 07 CD Requirements �' C m 3 — 0 � 00 • a 0 v �. Ca_ ? o 0 Building Permit Application Form Site Plan 4 4 4 4 4 4 4 4 5 Septic Records Septic Permit Application 3 &Septic Design Water Adequacy Form Construction Plans 3 3 3 3 3 5 Energy Code ,, ,f V Application Form Healed Septic Pumpers Report X X X X X X Existing systems older than 3 years. Property Lines Flagged v v Geotechnical Study" 3 3 3 3 3 3 3 3 See instructions on back Plumbing/Mechanical VO ,, VO VO Application Form Engineered Calculations" 2 2 2 2 2 2 Floor Plan VO S.E.P.A. VO The number in the table indicates the number of copies required if applicable. Required for submittal of a complete application. X A pumpers report may be required when a septic system is existing and has been installed for three or more years. The pumpers report, dated within the last three years, shall include the size and condition of the tank and the condition of the baffles. • Additional information and permits may be required by the Planning Dept. call extension 281 for information. * If applicable, needed when site conditions require the additional information. Rev: 3/1/02 SITE PLAN REQUIREMENTS: A complete, accurate and detailed site plan is important to avoid delays in the review and approval of your project. Use the checklist below as a tool to help you complete the site plan. ❑ 1. Scale: A scale of 1"=20', is typical but other scales such as 1"=10' or 1"-40' are also acceptable. Do not exceed 1"=60. ❑ 2. North arrow ❑ 3. Property line location and dimensions. ❑ 4. Label abutting streets ❑ 5. Shoreline/Surface water: Indicate creeks, streams, lakes, ponds, wetlands and other bodies of water within 300 ft of the proposed project. ❑ 6. Wetlands and Seasonal Drainage: Show setback distances from wetlands or seasonal drainage. ❑ 7. Easements: Indicate location and size of road, utility, and private easements. ❑ 8. Show All Existing Development: Identify existing and proposed structures. Include porches, decks, roof overhangs, cantilevers, and structures that will be demolished. ❑ 9. Proposed Building Footprint: Use scale to show distances to property lines, existing structures, septic tank and drainfield. Stake or flag footprint of proposed structure. ❑ 10. Sewage Disposal System: Identify septic tank location and drainfield. ❑ 11. Existing and proposed Buffers: Include open space, fences, sidewalks and parking areas. ❑ 12. Retaining walls: Proposed and existing. ❑ 13. Slopes/Site contours (Topography): Identify any slopes greater than 15%, fills or cuts greater than 4ft. that are located within 300ft. of the proposed project. Use Contour lines or arrows to show the direction of the slope. ❑ 14. Wells: Show existing and proposed, need to include all wells located within 100 ft of property. ❑ 15. Waterfront projects: Show all structures on adjacent property. ❑ 16. Driveway/ Site Access ❑ 17. Stormwater Run-off Path: Identify stormwater run-off path and direction of flow. ❑ 18. Land modification/Grading permits: Site applications for land modification permits must show topography before and after the proposed work. o . ake sore�lem es. te PI, Sample Site Plan and Topography i all C o Be dentirted r�U�e�eekljst rare 04Y0 inlb to Scale: 1"=40' stes rr`denf. urs�tep a4.t'oo _.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.,_.._.._.._.._.._. s sir es Main. Street se `��� rief4re f° ro a _.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._ ._.._.._.._.._.._.._.._1 a Pr �k4� e�tsf` e 1 PO ay tru�tu reed 1 shore th ere ams,re 10�a -4110 WableB10a eet wo ld�o f Reserve Drainfield agA�eah�e 1 1 p � 104' Io ' Draii afield c:C Stormwater in 1 -- —I ---------I 225, run-off path 1 - - P ---I-- 6' 56' 40' 1 ', .CD 114' Existing iCD 1 r Garage ! Wetland 1 ` I i Buffer Zone 11 D 171' 1 m 125' ............ ............. 1 ' i 1 c i 100 l 11 ', Allowable Building �i� { Area % € I 1 l 80' � I Well i �* 300' O < _.._.._..,.._.._.._.._.._.._.._.._. ..............._.._.._.._.._.._ ._.._.._.._.._.._.._.._.. North +45' +51 0' 68' 55' 1 40' 25' 1 36' 36' 35' IIL 11 TOPOGRAPHY PROFILE: Direction: Scale: Approval: for office use Building Permit number: Building: Owner/Applicant: Date of Planning: application: Env. Health: Parcel Number: JUL-23-2003 12: 16 ADAIR HOMES-OLYMPIA 360 943 0701 P.01i02 ' HOMES3 INCm ADAIF� 1 BEAVERTON TO: AMANDA REYNOLDS 1111 SW 170711 AVE. BEAVERTON, OR 970064220 SALES (503) 645-3547 FROM: SARAH MARSHALL CONST (503) 645-1156 ADAIR HOMES, INC FAX (503) 645-5986 BEND DATE: 7/23/03 63309 NELS ANDERSON RD. BEND, OR 97701-5743 RF: CHRIS &TERESA COX SALES (541) 382-4068 CONST (541) 382-6924 FAX (541) 382.8989 OLYMPIA PARCEL: 123307500260 2303 93A" AVE. SW TOWNSHIP: 23 N OLYMPIA, WA 98512.1028 LOT: D SALES (360) 352-8571 RANGE: I CONST (360) 352-7641 FAX (350) 943-0701 SECTION: 30 ADDRESS: 1051 NE BELFAI R MANOR DR MEDFORD BELFAIR, WA 98528 541 BUSINESS PARK DR. SUITE A D. OR 97504-a191 I HAVE INCLUDED THE CHANGES FOR CI-iRIS & TERESA MEDFOSALES (541) 732-1560 COX'S PLOT MAP. THE SEPTIC TANK AND DRATNIELD CONST (541) 774-8996 SHOULD BE ACCURATE ON THE MAP. IF YOU HAVE ANY FAX (541) 774.8847 QUESTIONS OR,CHANGES TfIAT ARE NEEDED, PLEASE CALDWELL CONTACT ME AT (360) 352-7641. 1904 E. CHICAGO ST. SUITE C THANK YOU, CALDWELL, ID 83605 BUS (208) 459-8274 I FAX (208) 459.8289 1 � BUSINESS CENTER J'�r Jill SW 1707u AVE. BEAVERTON, OR 97006-4220 SARAH MARSHALL PHONE (503) 645-4730 FAX (503) 645-9715 OR CCB#i 593 WA#ADAIR H#262RZ MonkemlWmAz bo" W MVW rR F"I" Z0'd 101O1 01ulc1 Aaum a7t'(1 -tatttitp tom►=S�-_e' 'c ii AIM ' C_77 NoSVW Cti 1 pa)uatu�t�np pate.IO1Ju.11Uof i t r4 %z dS.L ( O CL 7-m L `j Dill(71tn_wpual a8uR1-loco arO�Iro11J1pS1.1rt{ 1p1A�631�na7115 ; \ -)Z(DO SL QED I luJu0 I11IJ3A(AI Dill Xrl p3A6A(l(lu-3.t(I ail lsutu uuld still 01(s)aauuga duV •,cpartaid still j0 pa-.tnba-1 s)lauglas pa..lnbaj -Dp03 Put:631211 101•su0.11.lgu.loa WII IN 41511qulsa 111M ft:uuld `� X X s1g1 gUA]aauuta.lojlt0a ul aauld 01181 ails aq1 01 sluatuaA0.t(hnl Qa dcl"V" gill)Ulf)a.1115113 o)0lg1slsndsa.1 sl (•z :ssaualaldtuoa puu dau.lnaau s)I.14)3 Allllglsuodsa.t 1111.1 s7d03au pills sa2palmot.l2ls (•I :nAolag aulu9ls Xq'0tlAA.taitma A)aada.ul alp;cq paA+DlAai puu pa111Aa.td ttaaq slsy uuld 101d still 110 110111Ftt1.10lul aq1. LC►b1-- Sol 1 t1I J-r% SS92S�J3^SS3� 1 �)o! 3n�Z10 1 n� 'AQU 0w ) 1 N N m z w '-0Ll—£ 6` H S r o 1-1 cr O- 1+ (Yt0 r p� -r•� Z0/Z0'd TOLD 2b6 092 HIdWJl1O—S9WOH aIHQH LT:ZT 2O0Z-ZZ-1nr Listings as of 03/18/03 at 1:50o Vacant Land Agent Detail Report m LN:23037658 1-0 Lot NE Belfair Manor Or Belfair 98528 Maso ST:Active LP:24,950 'T LT: D ELK: COM: Belfair PRJ: Short Plat 2104 AR: 171 TAX- 12330-75-00260 OPLS: 24,950 MAP:9 GIRD: C-3 NIA: Yes FIN: SPS: t' DO: From Belfair,North Shore Rd to rt on Sandhill Rd to left on Belfair Manor OMD: Dr.to last driveway on rt to 1st lot on left. LD: 03/18/03 XD: 09/30/03 ^ SLDT:00/00/00 LO: Reid Real Estate(ID:4013)Phone:360-275-2868 SOC: 4.0 LAG: Roy E Boad(ID:735)Phone:360-275-2868 CLO: GZC: Residential CLA: PTO:No F17: Not Provided OTVP: OCC: OWN:JESFIELD OPH: (360)275-7462 OAD:Belfair,WA PHO: POS: Closing TXY: TX: SNR: ATF: E TRM: C 20%dwn 3 yr term 8.5% STY: 41-Res-1 Acre+ J �o0P '—'-' `RR,Mobiles Not OK SKS:N CTR: SEC:30 23 01 ZNR: WRJ: t�' ACR: 1.200 LSF: 52272 LSZ: 169x329 WFG: DOC: Road Agreement,Well Agreement WFT. LDE: Dead End Street VEW: RD: RDI: Gravel,Privately Maintained,Recorded Maint.Agrm IMP: FTR: Partially Cleared TPO: Level, Rolling SLP: LVL: WTR: On Property,Community Well SFA: ESM: GAS: Not Available STD: 00/00/00 SUR: ELE: On Property SEP: SDA: SST: SWR: Not Available SAP: SOD: 00/00/00 SDX: 00/00/00 SD: North Mason#403 EL: Sand Hill JH: Hawkins SH: North Mason Legal Description:Lot D Short Plat 2104 Marketing Remarks: 1 1/4 acre only 3 miles from Belfair has frontage on Dept. of Natural Resources forest land.Power,water&phone to property with ideal soil for septic,building and garden.No manufactured housing. Presented By:Roy E Boad/Reid Real Estate Lot Sizes And Square Footage Are Estimates. Information From Reliable Sources, But Not Guaranteed. V� XCO 4��O http://Iocator.nwmis.com/scripts/mgrgispi.dll 3/18/03 ..--�--. 529702 529702 Short "a' of a portion • of Che Southeast quariCer Short pis No. Q�l� (SE}) of the NorchNest Is row d: qquarter (NWT) of Section Z- �.(30), Township (23) NQrth- Range (1) West. W.M, ctor of er+er ervices Parcel No. 12330 75 00260 Short Platfor: James Jesfield P. 0. Box 159 Belfair, WA 98528 (206) 275-6684 SOUTHEAST QUARTER OF THE NORTIIWEST QUARTER 35'SACC r.SNI SCALE'. I" S 2O0 0.voiroa'i RLC I a^ °'z��sl�• AII(OAFL bluseN A/ /1 0 J 3s'00nq¢UTiCIYJ � tTASCM��T Q 0s ` A Sid a uS%t Q SAIL < W LAF S - u- Cell C 'Mo 4 ti i i q � o Q lea D e41 3C' f AtEMEuT - "DIT011'1 Fl(o O`ASEMCAJT AS WARNING - Meson County has no 39a7:7P SNOW uIN VOL 2 responsibility to build, 8FE URVPYS- improve, maintain, or otherwise JAMw A, N're 1q9, service the private roads 7PSFIeLO contained within or providing aervice to the Property des- rTI tALSFwCz DIRECTOR cribed in the short plat. n�k I Request To Revise An Approved Plan Permit Number: BLD200 2(o Name C._4(z ks e 1 ezes-4 C Parcel Number 1aS!2,b - 7S Phone Number daytime (3(D o ) �2-7 5 -7 cf o �- Project Address DS Mailing Address NE G SII��C P (� Please provide a complete, detailed description of the proposed revisions to the approved plans: Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No Are the approved site plans included? ❑ Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ No If Yes, Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note:No structural changes to a"designed„plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes ❑ No If Yes, Is a revised site plan,with all new setback dimensions included with this request? ❑ Yes ❑ No Additional Information: 426 W: CEDAR 512 Applicant's signature Date: Office Use Only Received by: Forward to declartments indicated below: Apapw6tpate ❑ fl' ing Original Valuation: $ Additional Valuation: $ Planning w U Z Sq.Ft. x$ $ Sq.Ft. x$ $ Environmental Health 13Total New Valuation $ ❑ Public Works Additional Fees: Additional Planning Dept. $ New Setbacks: Front / Rear / Additional Plan Review $ Additional Building Permit $ Side1 / Side2 / Additional Plumbing $ Additional Mechanical $ Additional Conditions/Comments: Additional E. H.Dept. $ 3 Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ 7ah initial Revised SRO 7/2003 MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION OQU4 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 INF RMATI N Owner 5 � _T�0r_e_C;0_ N)k Contractor Name Mailin ddress IY Mailin Address City. U t%, State VA Zip Coe City I State 1�QIZip Code Phone ( ) 4Mther Ph. ( ) Phone ( Z~ 0+1 Other Ph. ( ) Lien /Title Holder '�Ll. Contractor Reg. # 1 ( wzxp�/ zj Email Address Email Add r ss SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System 7- Name of Water System PARCEL INFORM 1 digit lax Pa el No. I Z3 3C Fire District Legal Description N Site Address (Please incl de street na e, street nu er and city) X /(I tnor pr. IY' Directions to site 1 ac vc� -tm 1 k e Yi 2 3lf InAliton Q it; Man Will ti ber be cut and sold in parcel preparation? (Yes o mt7 Is property located within 200' of saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE SEASONAL RESIDENCE ❑ TYPE OF JOB - New V Add Alt Repair Other Use of Building Is this permit sub ittaI t ere t of Stop Work Notice, Correction Notice or other enforcement action? (Yes/No) Describe Work No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE - 1st Floor D 2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INF R A I Model Model Year Length Width riaa No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? (Yes/No) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. THE OWNER OR AGENT ON OWNER'S BEHALF,REPRESENTS THAT THE INFORMATION PROVIDED IS ACCURATE AND GRANTS EMPLOYEES OF Mason COUNTY ACCESS TO THE ABOVE DESCRIBED PROPERTY AND STRUCTURES FOR REVIEW AND INSPECTION OF THIS PROJECT. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT- I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT - I certify that I am currently regis- ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and of the ordinance requirements regulating the work for which this that all work will be done in conformance therewith. No changes permit is issued and all work shall be done in conformance there- shall be made without first obtaining approval. with. q changes shall be made without first obtaining approval. I X Date X at 7 .. FOR OFFICIAL US B YO.ND THIS POINT 0 Accepted by Planning Pd Ck# Date 4�J/0-7Bld Pd. `.7-i Reciept No. DEPARTMENTAL REVIEW AP OVED DENIED CON ITION CODES Building D g ment Occ Group . .Type Constr. Planning De artment Environmental Health Department Public Works Department Fire Marshal s Valuation$ w FEES 3 Building Permit Fee Site Inspection U Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES i MASON COUNTY 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 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner WC4 , L hy Contractor Name Mailin Address Mailing Address City State Zip Code City State( lr_ Zip Code- Phone y - I Other Ph.( Ph. -•t - Other Phl Lien/Title Holderlt�'�tf?�_ Contractor Reg. # A-- 2, Address Expiration _/ / SEPTIC INFORMATION-Connect to New Septic_ �Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 digit Tax Parcel No. !% l0�-�- / Fire District Legal Description Site Address (Plea a ricl de street name street number and city) Directions to site 4 } Aa, Is your property within 200'of the following: Body of Water(Name) ,(m�_ Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New V Add Alt Repair Other Use of Building Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets Type of Unit No. of Units Fees Bathroom Sink - Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater = Propane Tank Clothes Washer Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher - Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF lon FI NIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Vgy VDI rH 18 .DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS A ORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The eMton owner's beef,represents that the information provided is accurate and grants employees of Mason County access to the abo cribed property gn�® tures for review and inspection of this project. Acknowledgment of such is by signature below: O ��j OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I aPermit O as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington d h of the ordinance requirements for which this permit is issued and that all work will be.4pne in requirements regulating the r Ithi issued and all work conformance therewith. No changes shall be made without i tko t shall be done in conform No changes shall be made without approval. A- first obtaining approval. r X Date X_q h�h n0"'Or-Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. _.. .......... _ DEPARTMENTAL R1wVtEW APPROVED...........DENIED CONDITION:CQDES Building Department Occ Group Type Constr. Planning Department Other Other FEES Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical& Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES