HomeMy WebLinkAboutBLD2013-00385 DDR2013-00040 SFR - BLD Permit / Conditions - 6/19/2013 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 279
Shelton, WA 98584
` NP14
RESIDENTIAL BUILDING PERMIT BLD2013-00385
OWNER: RJ PEABODY RECEIVED: 5/24/2013
CONTRACTOR: LICENSE: EXP: ISSUED: 6/19/2013
SITE ADDRESS: 31 NE CUTLASS WY BELFAIR EXPIRES: 12/19/2013
PARCEL NUMBER: 123315100115
LEGAL DESCRIPTION: BEARDS COVE DIV 8 LOT: 115
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR ST RT 3 TO BELFAIR, L ON ST RT 300/ NORTH SHORE RD, R ON LARSON
LAKE RD, L ON CUTLASS WAY TO LOT ON THE LEFT SIDE
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: 2 Occ. Group: R3U Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,440 Garage-Attached 480
Valuation: $ 172,961.92 Building Height: Occ. Status: Primary Basement: cov porch 64
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: N 25.0 Ft. Shoreline: Ft. Water Body:
Rear: S 60.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: E 8.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: W 5.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 2 Furnace<100K 1 Plan Check Fee GMM 5/24/2013 $911.66 S1201300000001
Lavatories 3 Ventilation Fan 3 Planning Review Fee GMM 5/24/2013 $205.00 S1201300000001
Bath Tubs 1 Exhaust Hood 1 EH Plan Review KKK 5/24/2013 $ 103.00 S6201300000001
Showers 1 Dryer Vent 1 Water Adequacy Plan Revi KKK 5/24/2013 $ 103.00 S6201300000001
Water Heaters 1 Address Fee GMM 6/3/2013 $ 173.50 S1201300000001
Clothes Washer 1 Building State Fee DLC 6/19/2013 $4.50 S1201300000001
Kitchen Sink 1 Building Permit Fee DLC 6/19/2013 $ 1,402.55 S1201300000001
Dishwasher 1 Plumbing Permit Fee DLC 6/19/2013 $ 110.60 S1201300000001
Hosebibs 2 Plumbing Base Fee DLC 6/19/2013 $24.70 S1201300000001
Laundry Tray 1 Mechanical Permit Fee DLC 6/19/2013 $67.50 S1201300000001
Mechanical Base Fee DLC 6/19/2013 $28.50 S1201300000001
Total $3,134.51
BLD2013-00385 Please refer to the following pages for conditions of this permit. Page 1 of 5
CASE NOTES FOR
BLD2013-00385
CONDITIONS FOR
BLD2013-00385
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- 7,� -p982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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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
Depart en prior to any further inspections being performed or approvals granted.
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3) Owner M'�7
sponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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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
rem=1f proved documents will result in failure of required building inspections.
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5) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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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
Build' Department prior to any further inspections being performed or approvals granted.
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7) Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric forced air furnace, Compliance Method: Prescriptive option III, Window(Max U-Factor):0.30, Skylight(Max U-Factor):0.50, Doors
(Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38 advanced or R-49 standard, Vault Insulation R-38,
and Slab Insulation R-10.
In addition the following credit from Table 9-1 shall be completed: Option 6, dwelling < 1500 sq. ft
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BLD2013-00385 Please refer to the following pages for conditions of this permit. Page 2 of 5
8) A permanent certificate, completed by the 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 503.10.2, 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 0.00030 Specific Leakage Area (SLA)
when tested with a blower door at a press of 50 Pascals (0.2 inch w.g.). Testing shall occur at any time after rough in and after installation of penetrations
of the building envelope, including penetrations for utilities, plumbing, electrical, ventilation, and combustion appliances and sealing thereof. 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 WSEC 105.4 Certificate and 502.4.5 Building Air Leakage Testing.
Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2009 Certificate" and are available in '/4 or'/z sheets. The
Mason County Permit Center will also have some available.
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9) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC
Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall
be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or
installed in or around swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps(but not T-10 or T-12 lamps).
Ref WSEC 505.
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10) 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.
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11) 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.
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12) 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/contract o i acknowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
BLD2013-00385 Please refer to the following pages for conditions of this permit. Page 3 of 5
13) 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
su o ds connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
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14) 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
per tion.
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15) Installation of heating equipment in a single-family residence shall meet the requirements of the current Washington State Energy Code, applicable
sections of the IRC and IMC.
Heating equipment shall be sized in accordance to IRC, Section M1401. Heating and design load calculations for the purpose of sizing HVAC systems are
required and shall be calculated in accordance with accepted practice, including infiltration and ventilation. Design calculations shall be available for
inspection during inspection.
Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made
substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous
glass ducts shall comply with UL181A and shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape.
Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive
tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened.
Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal ducts
shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or rivets
equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation
instructions.
Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8
DUCT TIGHTNESS TESTING shall be conducted by person(s)trained to perform such testing. A signed affidavit documenting test results in accordance
to WSEC Section 503.10.3 shall be provided to the Mason County Building Department prior to the final occupancy inspection. Affidavit forms are
available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit"or"Duct Leakage Testing Results (Existing Construction)." Duct
tightness testing is not required if the air handler and all ducts are located within the heated space.
All heating equipment shall meet the requirements of the National Appliance Energy Conservation Act(NAECA) and be so labeled. (WSEC503.4) or in
accordance to WSEC Section 1411.
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16) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordina�n, must be reviewed and approved by Mason County prior to construction.
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BLD2013-00385 Please refer to the following pages for conditions of this permit. Page 4 of 5
17) CONSTRUCTION PROCEIS TO BE FIELD CORRECTED AS REQUIRED PER MASON CCUNTY BUILDING DEPARTME ,i- ,,ND THE ADOPTED
BUILDING CODE.
The construction of the pe-�;itted project is subject to insoections by the Mason County Building Department. All construction ;gust be in conformance
with the international codes us amended and adopted by ,'Mason County. Any corrections, ch::^,ges or alterations required by Mason County Building
Inspectoc.5hall be made prior to requesting additional inspections.
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18) All property lines shall be clearly identified at the time of foundation inspection. X
19) 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 tV�
inances and building regulations.
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20) 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 v prevented action from being taken. No more than one extension may be granted.
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21) Retaining walls needed to support a surch a such as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X ..
22) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLYAFFECT ANYADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD WA)(.��
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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 son County cess to the above described property and structure for review and inspection.
OWNER OR AGENT: DATE: 6 —J C7 —(3
BLD2013-00385 Please refer to the following pages for conditions of this permit. Page 5 of 5
RECEIVED i
.JUN 0 3 2013 PLANNING
426'W. CEDAR ST 80.00,
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Mason County B U I L ' N 41N n 3 2013
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) �
Based Upon the information you have provided a Stormwater Site Plant 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:
http//www.co.mason.wa---us/code/commissioners/fndex htm
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)-je,"7 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 61h St,Shelton WA 98584
If this development has, or will have,a septic/drainfield 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 consuh 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.
61)
X Own e Agen Contractor(circle one)Dale t} /
Page 2 of 2
Name e Parcel# 1 23.3 I S l Cho 1 1 BLD#
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 surfacez.
'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 Iimited 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 stormwatea.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
F�- alcclate Impetviflvs Sirces_ ease Goirrpefe This Table:_
Surface Type Length X Width = Area t All dimensions in feet
Buildings 3 X =
X = Measurements for buildings are taken at the
perimeter of the farthest projections(example:
X = eaves/gutters)
X =
Driveways X =
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 �D
X = Any paved, gravel or packed area per definition
above table
X =
Others X = _
X = "ff,the total.impervious area-of the proposed-site
X = development is greater them_2000-square feet a
-Total impervious Surface Area($vm of all areas)
Small Parcel:Stormwater.Site Plan;is Required..
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/Agent/Contractor(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.
Page I of 2
�pq ` MASON COUNTY PERMIT NO. _�/-'D`R04V
SI r `ti
� � BUILDING PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 • Belfair (360) 275-4467• Elma (360) 482-5269-T�R
On the web www.co.mason.wa.us
APPLICA T INFpRM TIO CONTRACTOR INFORMATION
Owner ?+ Company Name }��1 tl FrZ�_� �x �,•�
Mailing Address ` 2, Mailing Address
City L State-f�.Zip Code / — City State Zip Code
Phone IfOther Ph. Phone <;Other Ph.
Lien/Title Holder N0 1-i 4. Contractor Reg. #
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic I Existing Septic
Connect to Water System L"2 Name of Water System 4' r ► C T.
Well Water System Name of Water System
PARCEL INFORMATION- 12 Digit Parcel No 31 71 Fire District
Legal Description _
Site Address (Please include street name, street number and city
Directions to site,v •D 1 OV�
V a c '-"', C O.r c
Will timber be cut and sold in parcel prepara on? Yes/ to nnrr
Is grope within 200'of Saltwater j��Lake/River/Creek x�Pond
Wetland o Seasonal Runoff Stream Slopes or Bluffs > 15% )Y,
Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement action?Yes�o
TYPE OF JOB - ew—f'Add Alt Repair Other PRIMARY RESIDENCE K SEASONAL ❑
Use of Building v Describe Work o Y1
No. of Bedrooms—3� No. of Bathrooms 9 Square Footage- 1st Floor 2nd Floor
3rd Floor -' Basement Deck Covered Deck T44 Other Sq.ft.
Garage Attached t Detached Carport Attached Detached
MANUFACTUR D 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.
PR OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
1
X �L, Date: Lo -26 f3
Owner/Owners R presentativ /Contractor (indicate which one)
FOR OFFICIAL USE BEY D THIS POINT Accepted by: f'1 Date I
DEPARTMENTAL REVIEW P VED DENIED NOTES
Building Department
Planning Department _0C,;:LC i3 L40
Environmental Health Depa ent 4E)
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee L711. 47 EH Review Fee
Plumbing & Base Fee Planning Review Fee ,.
Mechanical & Base fee sa + o`Z Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal / �P
Vaivation$ 1'2494, , TOTAL FEES
C�L7/ D
U I LD I N u MASON COUNTY PERMIT NO. 3IC 1 _6 i�)
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 INFQRMATION CONTRACTOR INFORMATION
Owner R S 1=11 h� 'I Company Name �\� r-n�
Mailin Addres s Mailing Address
City u - State Zip Code City State Zip Code
Phone Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address s�4l",'�&'��"'N.' a� E Mail Address
Drivers Lic.# 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, 1 2-3 3 15 1 coo i 1 S Fire District
Legal Description
Site Address (Please include street name, street number and city)
Directions to site
Is property Within 200' of Saltwater—ALi—Lake 64P River/Creek /V, Pond n/
Wetland _Seasonal Runoff_Stream Slopes or Bluffs > 15% N
TYPE OF JOB - New_L,�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
Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG_Natural Gas_Heat Pump_
Toilets ��� Type of Unit No. of Units Fees
Bathroom Sink �' i Furnace
Bath Tubs HeaSpot
Vent Ft
Showers i Spot Vent Fan
Water Heater I Propane Tank
Clothes Washer I Gas Outlets
Kithen Sinks I Wood/Gas/Pellet Stove
Dishwasher I Kitchen Exhaust Hood I
Hosebibs Dryer Vent t
Otheyr. Gy ! Other W <t 1 hs ,
fit / Base Fee (Elee-t-py' 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 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.
PROF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X `M Date:
Owner/ wners Representativ /Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted b fanning Pd Ck# Date LO ` Bid Pd Receipt No.
DEPARTM NTAL 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
PLANNING MASON COUNTY Mason County Permit Center Use:
DEPARTMENT OF COMMUNITY DEVELOPMENT DDR 2015 _ dUoy
411 N. Fifth Street/P.O. Box 186, Shelton WA 98584 L "t.)
360.427.9670 ext. 352 Date Rcvd 0-3- - i
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 'ED
including roof eaves and gutters.
[� JUN 0 3 2013T
Applicant/Owners:`l .�. i P AR $ .
i".Mailing Address: T.
6ox 515
City:-Bo r- 2,` State: (JJl4 Zip:
Telephone" c , 3235
Email:
If this reduction is tied to a building permit, please give permit case number.
BLD vLQ 13 - OCk6�5
Parcel Number(s): - - Zoning_ 'S
Site Address: 31 n t ou7H&c c �L I r&&L WA '�7&5 2-E!)
Requested setback variance: ,
ft. ❑ Front ❑ Rear ,.Side �
ft ❑ Front ❑ Rear ❑ Side
ft. ❑ Front ❑ Rear ❑ Side
ft ❑ Front ❑ Rear ❑ Side
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 5 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.
IACommunity Development\PACWARIANCES�Admin Variance.doc Edited on 7/16/10
FRONT AND OR REAR 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;
❑ 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.
LYARD REDUCTION REQUESTS:
e�xistinis 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;
❑ 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-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.
uy-t LJ ue
Owner/Agent (please indicate
ignature ellDate "
Official Use Onl
Approved by: Date
Denied by: Date
Reason for denial:
IACommunity DevelopmentTACNARIANCES\P.dmin Variance.doc Edited on 7/16/10