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BLD2006-00288 Final SFR - BLD Permit / Conditions - 10/26/2006
Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext. 352 4 Mason County Bldg. III 426 W. Cedar P.O. Box 186 lip Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2006-00288 OWNER: KEVIN SHEARER CONTRACTOR: ALLEN SHEARER TRUCKING (360)275-3465 LICENSE. ALLENST074PA EXP: 2/6/2007 RECEIVED: 3/2/2006 SITE ADDRESS: 53 NE MAST RD BELFAIR ISSUED: 4/20/2006 PARCEL NUMBER: 123307690051 EXPIRES: 10/20/2006 LEGAL DESCRIPTION: TR 5 OF SURVEY 4/79 LOT: A OF SP 1379 PROJECT DESCRIPTION: DIRECTIONS TO SITE: New SFR Sandhill 2nd left on Larson, right on Mast, 1st left throught arch way to end. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: V-B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:2,132 Garage-Attached 832 Valuation: Building Height: Occ. Status: Primary Basement: Cov. Porch 224 Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft. Front: W 25.0 Ft. Shoreline: Ft. Water Body: SEPA?: No Model: Width: Ft. Rear: E 20.0 Ft. Slope: Ft. Side 1: N 20.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: S 20.0 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 KKK 3/2/2006 $871.62 B12006000 Hosebibs 4 Ventilation Fan 3 Planning Review Fee KKK 3/2/2006 $155.00 B12006000 Kitchen Sink 1 Woodstove 1 Address Fee GMM 3/9/2006 $140.00 612006000 Laundry Tray 1 Dryer Vent 1 Building Permit Fee JRN 3/20/2006 $1,363.35 612006000 Lavatories 2 Building State Fee JRN 3/20/2006 $4.50 612006000 Showers 1 Plumbing Base Fee JRN 3/20/2006 $20.00 612006000 Water Closets (Toilets) 2 Plumbing Fee JRN 3/20/2006 $89.00 612006000 Water Heaters 1 Mechanical Base Fee JRN 3/20/2006 $23.50 612006000 Bath Tubs 2 Mechanical Fee JRN 3/20/2006 $91.95 612006000 Clothes Washer 1 ADJUST--Plan Check Fee JRN 3/20/2006 $14.56 612006000 EH Plan Review TW 4/17/2006 $75.00 61200600o Total $2,848.48 BLD2006-00288 Please referto the following pages for conditions of this permit 1 of 4 CASE NOTES FOR ++ BLD2006-00288 CONDITIONS FOR BLD2006-00288 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� 2. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such r ad r�nect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 3) Approved a in�ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 4) Water qualit t to be degraded to the detriment of the aquatic environment as a result of this project. X 5) Prior to final approval, all upland areas disturbed or new y cr ed by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 6) 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 o further inspections being performed or approvals granted. X 7) 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 jurisdic nn and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting inspectionsl� X BLD2006-00288 Please referto the following pages for conditions of this permit. 2 of 4 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 coy rections 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 o�documents will result in failure of required building inspections. X 9) All slabs within the heated space shall be insul e o r nimum 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 10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X C<4 11) Washington State Energy Code Compliance has been approved using the following.- Heat Type: EI ctric or other fuels, Compliance Method: IV, Window (Max U-Factor):0.40, Skylight (Max U-Factor):0.58, Doors (Type al actor):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 12) 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). [nc te X - V 13) 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 W s;igp�o�� tOccupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit rev X 14) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. , { X —t) 15) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation u b reviewed and approved by Mason County prior to construction. X— ��L 16) 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 be ma requesting additional inspections. X �� BLD2006-00288 Please referto the following pages for conditions of this permit. 3 of 4 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 Cgm�) ances 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,h�vee pr�,vented action from being taken. No more than one extension may be granted. X �� �Z 20) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectgFflashing. Install metal connectors approved for contact with the new types of pressure treated material. X 21) ***FIRE MARSHAL REVIEW: THIS PARCEL IS LOCATED WITHIN A SMOKE MANAGEMENT ZONE. PLEASE CONTACT THE FIRE WARDEN AT 427-9670, EXTN. 459 FOR FURTHER INFORMATION. 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.T org the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above describe�propertyan c fo a an0 ndinspec OMERORAGEN DATE: BLD2006-00288 Please refer to the following pages for conditions of this permit. 4 of 4 ,ON,t;RETE MECHANICAL MANUFACTURED HOME to Date I I�J�rs By L144 _ `Footings J Setbacks Gas Piping Ribbons D o Interior Date l"'`f 'a By 7T Interior-Date By Data By rn 00 I[,.,Exterior Date By Exterior-Date B Set-up - co Point Load r Isolated Footings INSULATION Date By m BG I SLAB INSULATION � Date By Data Ste- ®G ayT/1 FIRE DEPARTMENT Z Foundation Wails Floors Date By Date _ By Data By DECKS FRAMI G Walls Date By Date 10 2D 0,(o g 5 Data Zp ©(o By R� PROPANE TANKS PLUMBING vault Date By - Date a OTHER Ground,aork Ater (3 y 0 Date By Type: Data By D.W.v DRYWALL Type_ Date _711q bb By t4k, Int.Brew Well Date By co Date By FINAL INSPECTION 0 Water Line // CC Fire Soperation tV CD Date Z` �(o By l� Date By Date By Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Done By Comments N 00 CD rl��rE J - S 772 8 a � f CD I 2(= v � � ? c v Aw 91-_U1R&x)EDLc-5 L01 20 0 (�lAl Baa r �/}� $ z ab 8 ? SE ITT•- �t�tAL F��� 1o�161CYo i'ol ,l� R SEi� AFAe F2.Annl= ADEQUA-k By II May 02 06 07:17a SHEARER EXCAVATION 3602753397 p.2 Apr 11 06 09: 57a Bob 6 Patty Payssa 360-427--2353 P. 1 PIONEER DIGGING. INC. PARCEL#: 1 2330-76-90051 SOIL LOGS: lb,360-426-1603 CUSTOMER: KEVIN SHEARER sL1-0-24"GSL. S12-024"G5L SI3-0-23"GsL 24"+G.T. 24"+G.T. 231,+CIT. ® PJob!?ay3x Coe�ljrnr.) DRAWING: PLOT PLAN ROOTS TO 24" RaoTsTo 2-4" ROOTS TO 23" rtlu Poyox C�,or�u: SCALE: 1"=40' 7. tp :;A y ,0 2 / 1 10 7 CD 0 i Ni It N \ i 1 O O' 40' 80, May 02 06 07:17a SHEARER EXCAVATION 3602753397 p.1 Shearer Excavation P.O. Box 1802 Belfair, WA 98528 360-340-3118 ATT: Cherell FROM: Kevin Shearer 53 ne Mast rd This in the new site plan with the flopped house the only thing that is off is the 100ft circle around the well that is not right and I couldn't figer that out on my computer. If there is any problems call me please ASAP and ill fix it because I am having a inspection on Wed may 3 2006. -7 Kevin Shearer 360-340-3118 1�ZD d,Ga G -- 00&"t Roof Beamf 2003 International Residential Code(01 NDS)1 Ver:7.01.01 By: rich balderston , mason county dcd on:08-15-2006 : 11:02:04 AM Project: Shearer SFR-Location:6x12 in kitchen Summary: 5.5 IN x 11.5 IN x 13.0 FT /#1 -Douglas-Fir-Larch-Dry Use -Ow*on Adegua*A*444% Controlling Factor: Section Modulus/Depth Required 10.9 In Deflections: Dead Load: DLD= 0.12 IN Live Load: LLD= 0.26 IN= U602 Total Load: TLD= 0.38 IN = U407 Reactions (Each End): Live Load: LL-Rxn= 2925 LB Dead Load: DL-Rxn= 1397 LB Total Load: TL-Rxn= 4322 LB Bearing Length Required (Beam only,support capacity not checked): BL= 1.26 IN Beam Data: Span: L= 13.0 FT Maximum Unbraced Span: Lu= 2.0 FT Pitch Of Roof: RP= 6 : 12 Live Load Deflect.Criteria: U 360 Total Load Deflect. Criteria: U 240 Roof Loading: Roof Live Load-Side One: LL1= 25.0 PSF Roof Dead Load-Side One: DL1= 10.0 PSF Tributary Width-Side One: TW1= 0.0 FT Roof Live Load-Side Two: LL2= 25.0 PSF Roof Dead Load-Side Two: DL2= 10.0 PSF Tributary Width-Side Two: TW2= 18.0 FT Roof Duration Factor: Cd= 1.15 Beam Self Weight: BSW= 14 PLF Slope/Pitch Adjusted Lengths and Loads: Adjusted Beam Length: Ladi= 13.0 FT Beam Uniform Live Load: wL= 450 PLF Beam Uniform Dead Load: wD_adj= 215 PLF Total Uniform Load: wT= 665 PLF Properties For:#1-Douglas-Fir-Larch Bending Stress: Fb= 1350 PSI Shear Stress: Fv= 170 PSI Modulus of Elasticity: E= 1600000 PSI Stress Perpendicular to Grain: Fc_perp= 625 PSI Adjusted Properties Fb'(Tension): Fb'= 1549 PSI Adjustment Factors: Cd=1.15 CI=1.00 CF=1.00 Fv': Fv'= 196 PSI Adjustment Factors:Cd=1.15 Design Requirements: Controlling Moment: M= 14047 FT-LB 6.5 ft from left support Critical moment created by combining all dead and live loads. Controlling Shear: V= 3717 LB At a distance d from support. Critical shear created by combining all dead and live loads. Comparisons With Required Sections: Section Modulus(Moment): Sreq= 108.81 IN3 S= 121.23 IN3 Area (Shear): Areq= 28.52 IN2 A= 63.25 1N12 Moment of Inertia(Deflection): Ireq= 417.02 IN4 1= 697.07 IN4 r - . THLS IS TO CERTIFY THAT THIS rfOME CONSTRUCTED BY N N 0 o ' g .ale 0 r cn contractor.services a MASCO Company HAS BEEN INSULATED WITH MATERIALS LISTED HERIN MEETING`STANDARDS OF STATE, FEDERAL AND MANUFACTURER SPECIFICATIONS. GALE CONTRACTOR SERVICES GUARANTEES THE INSTALLATION AND WORKMANSHIP OF THESE INSULATION PRODUCTS FOR TN EE (3) YEARS...THE..THERMAL.AN.D ACOUSTICAL PERFORMANCE OF THE PRODUCTS ARE WARRANTE'ED BY THE MANUFACTURER: CEILINGS R-Value/Inches FLOORS' ' .'' R-Value/ Inches WALLS R-Value / Inches r Kraft I— Kraft'! r" Kraft Unfaced r Unfaced f/ Unfaced S'�""- r Encapsulated r Encapsulated P r Encapsulated r Foil r Foil r Foil r FS-25 r FS-25 r FS-25 Loose Fill r Loose.FilI r- Loose Fill Street Address City State 0 Gale Contractor Services o e'itified by ate Company 0 0 r Request To Revise An Approved Plan Permit Number: BLD200� (20 AT Name Parcel Number 3 U _ 7 b _ 005/ Phone Number daytime 3(/U ) 3 0 — l Project Address Mailing Address 0 U Please provide a complete, detailed description of the proposed revisions to the approved plans: . 7S7&5� Are two sets of the revised plans or addendum indicating the changes included? 01 .Yes ❑ No Are the approved site plans included? ./0 Yes ❑ No Are the.revisions clearly and accurately identified on the plans or addendum? �A-Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ly-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 chanees 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? P Yes ❑ No If Yes, Is a revised site plan,.with all new setback dimensions included with this request? - �L.Yes ❑ No Additional Information: Applicant's signature V A Date: Office Use Only Received by- Date Sent Assigned To Approved By Date rE.H. Original Valuation: $ Additional Valuation: $ Sq.Ft. x$ $ Sq.Ft. x$ $ 2 I 0 Total New Valuation $ P.W. Additional Fees: Additional Planning Dept. $ Additional Plan Review $ New Setbacks: Front / Rear / Additional Building Permit $ Sidel. / S1de2 / Additional Plumbing $ Additional Conditions/Comments: Additional Mechanical $ Additional E.H.Dept. $- 5. O Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ . Tah oi�il RevbW SRG W22tM 1732D �CIO G - as�_A`t Roof Beam[2003 International Residential Code (01 NDS))Ver: 7.01.01 By: rich balderston , mason county dcd on:08-15-2006 : 11:02:04 AM Project: Shearer SFR- Location: 6x12 in kitchen Summary: 5.5 IN x 11.5 IN x 13.0 FT /#1 - Douglas-Fir-Larch- Dry Use Section Adequate By: 11.4% Controlling Factor: Section Modulus/Depth Required 10.9 In Deflections: Dead Load: DLD= 0.12 IN Live Load: LLD= 0.26 IN = U602 Total Load: TLD= 0.38 IN = L/407 Reactions(Each End): Live Load: LL-Rxn= 2925 LB Dead Load: DL-Rxn= 1397 LB Total Load: TL-Rxn= 4322 LB Bearing Length Required (Beam only, support capacity not checked): BL= 1.26 IN Beam Data: Span: L= 13.0 FT Maximum Unbraced Span: Lu= 2.0 F7 Pitch Of Roof: RP= 6 : 12 Live Load Deflect. Criteria: L/ 360 Total Load Deflect. Criteria: L/ 240 Roof Loading: Roof Live Load-Side One: LL1= 25.0 PSF Roof Dead Load-Side One: DL1= 10.0 PSF Tributary Width-Side One: TW1= 0.0 FT Roof Live Load-Side Two: LL2= 25.0 PSF Roof Dead Load-Side Two: DL2= 10.0 P3F Tributary Width-Side Two: TW2= 18.0 F-' Roof Duration Factor: Cd= 1.15 Beam Self Weiqht: BSW= 14 PI_F Slope/Pitch Adjusted Lenqths and Loads: Adjusted Beam Length: Ladj= 13.0 F" Beam Uniform Live Load: wL= 450 PLF Beam Uniform Dead Load: wD_adj= 215 PLF Total Uniform Load: wT= 665 PLF Properties For:#1- Douglas-Fir-Larch Bendinq Stress: Fb= 1350 PSI Shear Stress: Fv= 170 PSI Modulus of Elasticity: E= 1600000 PSI Stress Perpendicular to Grain: Fc_perp= 625 PSI Adjusted Properties Fb'(Tension): Fb'= 1549 PSI Adjustment Factors: Cd=1.15 CI=1.00 CF=1.00 Fv': Fv'= 196 PSI Adjustment Factors: Cd=1.15 Design Requirements: Controllinq Moment: M= 14047 FT-LB 6.5 ft from left support Critical moment created by combining all dead and live loads. Controllinq Shear: V= 3717 LB At a distance d from support. Critical shear created by combining all dead and live loads. Comparisons With Required Sections: Section Modulus(Moment): Sreq= 108.81 IN3 S= 121.23 IN3 Area (Shear): Areq= 28.52 IN2 A= 63.25 IN2 Moment of Inertia(Deflection): Ireq= 417.02 IN14 1= 697.07 If\4 MASON COUNTY PERMIT NO. `�y BUILDING PERMIT APPLICATION JDa 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 ,94T INFORMATION CONTRACTOR INFORMATION .r 1 • ,r >=A r '2. Company Name all . . Ae -tC dilin Address X 2 Mailing Address O Y A State W� Zip Code city AtL State "JA Zip Code ie 3ZZ) y0 311b Other Ph. Phone 3 r1VS OtherPh.VoQNVJII�f�l i/Title Holder A1110,11 AC-Artie-Z Contractor Reg. 7 Ex- mail address E Mail Address irivers Lic.# -IIQARje_4 ,?.vl! DOB eJe-*3 Drivers Lic.# )41E:AEAttq!j VD613 3�-Z- SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Conneqt to Water System Name of Water System Well %g Sewer System Name of Sewer System PARCEL INFORMATION - 1 Digit Parcel No. Fire District Legal Description - G Site Address(Please include street name, street number arid ci D'rectiQns too, si 9a ZN� mil' 0 'M+49 i= - -,►� r.' 1 Will timber be cut and sold in parcel pre gyration?Yes/ Is property wit in 200' of Saltwater Lake River/Creek '� Pond Wetland NV Seasonal Runoff AIV Stream 00 Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New )( Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building s Describe Work _SfZRY a-H `jO)`lL No. of Bedrooms ?" No. of Bathrooms 2— Square Footage- 1st Floor 2 1`; - 2nd Floor 3rd Floor �` Basement #!, Deck Covered Decker—Other Sq. ft. Garage '� Attached X., 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 access 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 qr-if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY ffrPR!P%��S SP CTION..INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. ny�IJ�'2. Date: .-- Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department 319+ - Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee �' Site Inspection Plan Review Fee 2 EH Review Fee Plumbing & Base Fee J Planning Review Fee Mechanical & Base fee ` Other Wood /Gas/ Pellet Stove Fee State Fee S Violation Fee Pre-Paid at Submittal Valuation $ (. sue° TOTAL FEES k39, S MASON COUNTY PERMIT NO.fa'��OIDN9 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 INFORMATION Owner KEVaH'Am:!,)d �-2 Company Name AIIEN :24 A24-- 77Z-r04--ncr, Mailing Address PD 130& Mailing Address PU 54", f 002 City Ba-W44 2 State W/Zip Code �18528 City a -4-4 State W-4 Zip Code y052Z Phone 3(Da 3yv -1t115 Other Ph. Phone '4& ^ Other Ph. 1 I IaH S I+�Af2—� Contractor Re # Ex 0-1Lien/Title Holder g� p� -U-V E mail address E Mail Address Drivers Lic.# DOB 3'1 t'�0 Drivers Lic.#�lkENM`AL11 Qj D065=2�1'�fo SEPTIC INFORMATION - Connect to New Septic>< Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Djqit Parcel No. t 2_330 ' — (_0 - 90015-/ Fire District Legal Description Q6VJNo Site Address(Please include street name, str et number and city) I� Diregtionsto site�}►� W:ol uD(� 6tj �,Qr74;, aKT m4cT- 157 Wilt I 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 1�oMt_ Location of Fixtures/Units- 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric-Y_LPG—Natural Gas_Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink 3 Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater —J Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove I Dishwasher l Kitchen Exhaust Hood 1 Hosebibs — Dryer Vent I Other Other Ae'Ate'25 t-1 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 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 parry in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permiS and duct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants a loyeeg'of Maso County access to the above described property and structure for review and inspection. PROOF OF C TINUATIO K IS BY ANS OF A PROGRESS INSPECTION. Date: Owner/Owners Represen alive/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type 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