HomeMy WebLinkAboutBLD2006-02094 Final SFR DDR2007-00196 - BLD Permit / Conditions - 4/24/2008r—
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 186
' Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2006-02094
OWNER: DARCY GADOUAS RECEIVED: 12/7/2006
CONTRACTOR: HILINE HOMES 360-807-1849 360-807-1722 LICENSE: HILINH*981BT EXP: 2/10/2008 ISSUED: 1/11/2007
SITE ADDRESS: 221 NE JOLLY ROGER LN BELFAIR EXPIRES: 5/15/2008
PARCEL NUMBER: 123315100068
LEGAL DESCRIPTION: BEARDS COVE DIV 8 LOT: 68
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR FROM NORTH SHORE RD, TAKE SAND HILL RD, WEST ON LARSON DR,
STOCK#2003-0007 ��� ` C SOUTH ON LARSON LAKE, SOUTH ON JOLLY ROGER TO SITE.
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: R-3U Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,664 Garage-Attached 484
Valuation: Building Height: 14 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: N 15.0 Ft. Shoreline: Ft. Water Body: NONE
Rear: S 25.0 Ft. Slope: 21.0 Ft.
SEPA?: Unkn
Model: Width: Ft. Side 1: E 10.0 Ft. Shoreline Desig.: bWtiApplicable
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
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 12/7/2006 $223.39 S12006000
Hosebibs 3 Ventilation Fan 3 Planning Review Fee KS 12/7/2006 $155.00 S12006000
Kitchen Sink 1 Dryer Vent 1 Building State Fee ARC 12/13/2006 $4.50 b3i bbibbb
Lavatories 2 Building Permit Fee ARC 12/8/2006 $1,116.95 B12007000
Water Closets (Toilets) 2 Mechanical Fee ARC 12/8/2006 $39.65 13izbbibbo
Water Heaters 1 Mechanical Base Fee ARC 12/8/2006 $23.50 612007000
Bath Tubs 2 Plumbing Fee ARC 12/8/2006 $75.00 B12007000
Clothes Washer 1 Plumbing Base Fee ARC 12/8/2006 $20.00 612007000
Address Fee BLJ 12/11/200 $140.00 612007000
EH Plan Review ADR 12/21/200 $75.00 612007000
Public Works Review PMC 1/3/2007 $38.50 bi2bb7000
Building Re-Inspection MRB 6/5/2007 $64.00 S22007000
EH Permit Revision CEW 7/9/2007 $35.00 612007000
Total $2,010.49
BLD2006-02094 Please referto the following pages for conditions of this permit. 1 of 5 AA
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 186
IrP4 Shelton, WA 98584 'S-Q,
RESIDENTIAL BUILDING PERMIT BLD2006-02094
OWNER: DARCY GADOUAS RECEIVED: 12/7/2006
CONTRACTOR: HILINE HOMES 360-807-1849 360-807-1722 LICENSE: HILINH'981BT EXP: 2/10/2008 ISSUED: 1/11/2007
SITE ADDRESS: 221 NE JOLLY ROGER LN BELFAIR EXPIRES: 12/4/2007
PARCEL NUMBER: 123315100068
LEGAL DESCRIPTION: BEARDS COVE DIV 8 LOT: 68
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR FROM NORTH SHORE RD, TAKE SAND HILL RD, WEST ON LARSON DR,
STOCK#2003-0007 SOUTH ON LARSON LAKE, SOUTH ON JOLLY ROGER TO SITE.
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: R-3U Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,664 Garage-Attached 484
Valuation: Building Height: 14_—------9c Status: Primary Basement:
Manufactured Home Information Setback Information' Shoreline& Planning Information
Water Body: NONE
Make: Length: Ft. Fr t: N 15.0 Ft. Shoreline: F SEPA?: Unkn
Model: Width: Ft. ear: S 12.0 Ft. Slope: 21.0 Ft. g.: DWVA Ilcable
'de 1: E .0 Ft. Shoreline Desi pp
Year: Serial No.: Si 2: W 7.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures hanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 12/7/2006 $223.39 S12006000
Hosebibs 3 Ventilation Fan 3 Planning Review Fee KS 12/7/2006 $155.00 S12006000
Kitchen Sink 1 Dryer Vent 1 Building State Fee ARC 12/8/2006 $4.50 612007000
Lavatories 2 Building Permit Fee ARC 12/8/2006 $1,116.95 612007000
Water Closets (Toilets) 2 Mechanical Fee ARC 12/8/2006 $39.65 612007000
Water Heaters 1 Mechanical Base Fee ARC 12/8/2006 $23.50 612007000
Bath Tubs 2 Plumbing Fee ARC 12/8/2006 $75.00 612007000
Clothes Washer 1 Plumbing Base Fee ARC 12/8/2006 $20.00 B12007000
Address Fee BLJ 12/11/200 $140.00 B12007000
EH Plan Review ADR 12/21/200 $75.00 612007000
Public Works Review PMC 1/3/2007 $38.50 612007000
Building Re-Inspection MRB 6/5/2007 $64.00 S22007000
Total $1,975.49
BLD2006-02094 Please referto the following pages for conditions of this permit. 1 of 5
26) Prior to final approval, all upland areas disturbed or newly creptedrby construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X v. —
27) Approved peCdi ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X
28) The approval of this project is subject to the recommendations and specifications outlined in t e attached geotechnical report or assessment. Structures
and/or land modifications (grading, cuts, fills, etc.) required in the geotechnical report t,_may require a seperate permit. The geotechincal
report/assessment shall remain attached to the approved building plans. X
29) Off street parking shall be located on the subject parcel, per the Mason County Development Regulations.
On-street parking or parking in Mason County or State of Washington Right-of-Way or access easement shall not be construed as meeting these criteria.
x
r—
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 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 owneror the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described pr erty and strucre for revie and inspection.
OWN ER OR AGENT: -'J • ' DATE: Z
BLD2006-02094 Please refer to the following pages for conditions of this permit. 5 of 5
' 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 186
Shelton, WA 98584
1�
RESIDENTIAL BUILDING PERMIT BLD2006-02094
OWNER: DARCY GADOUAS RECEIVED: 12/7/2006
CONTRACTOR: HILINE HOMES 360-807-1849 360-807-1722 LICENSE: HILINH*9816T EXP: 2/10/2008 ISSUED: 1/11/2007
SITE ADDRESS: 221 NE JOLLY ROGER LN BELFAIR EXPIRES: 7/11/2007
PARCEL NUMBER: 123315100068
LEGAL DESCRIPTION: BEARDS COVE DIV 8 LOT: 68
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW SFR FROM NORTH SHORE RD, TAKE SAND HILL RD, WEST ON LARSON DR,
STOCK#2003-0007 SOUTH ON LARSON LAKE, SOUTH ON JOLLY ROGER TO SITE.
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: R-3U Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,664 Garage-Attached 484
Valuation: Building Height: 14 Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: N 25.0 Ft. Shoreline: Ft. Water Body: NONE
g Rear: S 50.0 Ft. Slope: 21.0 Ft. SEPA?: Unkn
Model: Width: Ft. Shoreline Desig.: bWtiApplicable
Side 1: E 12.0 Ft.
Year: Serial No.: Side 2: W 7.0 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 KS 12/7/2006 $223.39 S12006000
Hosebibs 3 Ventilation Fan 3 Planning Review Fee KS 12/7/2006 $155.00 S12006000
Kitchen Sink 1 Dryer Vent 1 Building State Fee ARC 12/8/2006 $4.50 bizbbibbo
Lavatories 2 Building Permit Fee ARC 12/8/2006 $1,116.95 612007000
Water Closets (Toilets) 2 Mechanical Fee ARC 12/8/2006 $39.65 612007000
Water Heaters 1 Mechanical Base Fee ARC 12/8/2006 $23.50 B12007000
Bath Tubs 2 Plumbing Fee ARC 12/8/2006 $75.00 612007000
Clothes Washer 1 Plumbing Base Fee ARC 12/8/2006 $20.00 B12007000
Address Fee BLJ 12/11/200 $140.00 B12007000
EH Plan Review ADR 12/21/200 $75.00 812007000
Public Works Review PMC 1/3/2007 $38.50 612007000
Total $1,911.49
BLD2006-02094 Please refer to the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
�. BLD2006-02094
CONDITIONS FOR
BLD2006-02094
1) This parcel i loc d in a smoke management zone. Please contact a fire warden at (360) 427-9670 ext. 459 for further information.
X ,
2) 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
1-80g he person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X 'LJ ka, i
3) 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
Depnt kriotAp any further inspections being performed or approvals granted.
X
4) 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
inspectior�s.
X !J
5) 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. Th 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
remov I of pr d documents will result in failure of required building inspections.
X
6) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
7) 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
to current fee schedule minimum 1 hour will be
approval will not be granted. In addition, a re inspection fee (refer ) charged and shall be collected by the
Buildin_g-pe n prior to any further inspections being performed or approvals granted.
X ��„�
BLD2006-02094 Please referto the following pages for conditions of this permit. 2 of 5
�) 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,
boors (Ty eflox 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
9) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the
minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609
BAST IN S EED (3-SECOND GUST) the wind speed for Mason County is 85 MPH.
X
10) Per 2003 IRC - SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in
acco,� a wi h t applicable provisions of this section and the manufacturer's installation instructions.
X
11) Stock Plan Identification number: 2003-0007
This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department,
original building plans, and all attachments approved by the Mason County Building Department shall be available for the Mason County Building
In
sper as required inspection.
12) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical con rete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X
13) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
cha� n sha be collected by the Building Department prior to any further inspections being performed or approvals granted.
X
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
permi vo ti h.
X
15) 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 proje,.
X
BLD2006-02094 Please referto the following pages for conditions of this permit. 3 of 5
6), All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other
r Mason County
ordina ce o reg ation, must be reviewed and approved by Mason County prior to construction.
X
17) 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
Inspect r.shall �de r to requesting additional inspections.
X \
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 Cou y or�ftances and building regulations.
X
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
holde ave revented action from being taken. No more than one extension may be granted.
X
er
hich
21) Pressure treated wood manufactured
after January 1,
2004 may
for contact with
Xht concentrations of he new types of pressure treat d material.quickly corrode metal fasteners,
conners, nd ashing�N�QQ -
22) 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.
C�
X
23) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Apprq�d ite Ian" t nsure these structures are shown and meet the setback conditions listed.
X
24) 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. yads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such ct with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
X
25) Water quali i not to be degraded to the detriment of the aquatic environment as a result of this project.
X I ��
BLD2006-02094
Please referto the following pages for conditions of this permit. 4 of 5
�6) Prior to final approval, all upland areas disturbed or n vv cr ated by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
27) Appr ved per imensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X i
28) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. Structures
and/or land modifications (grading, cuts, fills, etc.) required in the geotechnical report/ ses ent, ma r -re a seperate permit. The geotechincal
report/assessment shall remain attached to the approved building plans. 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 pr ress 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 o e 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 struct a for review and i ection.
OWNER OR AGENT: _ 4 ATE: tG�
BLD2006-02094 Please referto the following pages for conditions of this permit. 5 of 5
CONCRETE MECH,f1NICAL MANUFACTURED HOME D
o Date a;1 Z�;U? By I l --� O
rn Footings i Setbacks IZ 07 ' - Gas Pt ing Ribbons 0
o Interior Date By Interior-Date By Date By C
Exterior Date By I Exterior-Date BX Sot-up
N
A -
Point Load I Isolated Footings INSULATION Date By
BG I SLAB INSULATION --- — D
Date By Data By FIRE DEPARTMENT n
Foundation Is Floors Date By <
Date •j p-7 By�j Data - O B /: / DECKS
FRAMI G Walls Data By
Date v; 1 ey�`� Data f� v7 By� PROPANE TANKS
PLUMbIN6 vault Date By
Date By OTHER
Groundwork Attic
Date —pO BY Type-
By TypDate By
D.w.v DRYWALL Type-
Date `1 _S p By
Int Brava Wall Date By
Oatie - `D? B'� ' FINAL INSP TION T p
Water Line I Fire Saperatlon cf jy-+�g /,�� IN)
Date By Date By Date B p
m a)
Pass or Request Inspect.
Type of insp. Fail Date Date Done By Comments o
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ACCESS & GRADE WORKSHEET DATE:
ADDRESS LDT. v ��p(f�t
c 1.
INSPECTOR
DRIVEWAY ACCESS
Length: �' Width: �� Surface:
k
Size of turn-around:
Condition of shoulders:
Vertical clearance: I
need post at end of driveway wi rk�;f tive address numbers
GRADE,OF DRIVEWAY % OF ROAD %
ROAD ACCESS
Length: Width: Surface:
Condition:
Vertical clearance:
( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE.
.1
(_ ) LOT INSIDE SMZ, 4X4 FIRES ONLY.
( ) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED.
LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES.
REMARKS
continue remarks on back)
Request To Revise An Approved PIan
Permit Number: BLD200,6
Parcel Number 2 Name GV,` S CQ
Project Address�2 `�o l ��-=U— -- Phone Numberda tme
L� F Maili,ng Address a i 7o kl -6 Lu% }_
Please rovide a complete,detailed desc rition of the proposed revisions to the roved l
U 2_ t � � � approved pans: .
-----------------
Are two sets of the revised plans or addendum indicating the changes included?Are the approved site plans included? Yes ❑ No
Are the.revisions clearly and accurately identified on the plans or addendum? WYes ❑ No
. Does the Plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ja 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
Mote-No shvcxu l�� es to a"dcsi ed" lan "ll be No
ved without the written tonscat of c neu and/or 'ect of retard.
Does the proposed revision modify the footprint or location of the structure?tore?
Yes Is a ❑ Yes
revised site plan,:vv�th all new setback dimensions included with this request? No
Additional Information: ❑ Yes ❑ No
Applicant's signature
Office Use Only Date: 6 t 3 6-7
Reoatved by.
Date Sent Assigned To Approved By Date
13, Original valuation: $
Additional valuation: S P. � Sq.Ft.
-2( -______--x $
---------------
Sq.Ft
E.H. x
Total New Valuation S S
S
P.W. -�/� U Additional Fees:
6 Additional Planning Dept. $
ew Setbacks: Front / Rear Additional Plan Review $
/Side' Additional Building Permit $
_____,_/ Side2 / Additional Plumbing Additional Conditi Additional Mechanical $
Additional E.H.Dept. S
Other $
Total Amount Due: $
Amount To Be Paid Up-Front S
T.a QW—
rtertsed SwG wuRow
`• Request To Revise An Approved n
Permit Number: BLD200�_- Name ,,. '�C Q jov4 " _
Parcel Number 1233 I loop _- Phone Number aavtime (3(,0 ) [,G;t. 7 31r2
Project Address 221 �011 x�„ L� to E Mailiing Address `81ZD � g L,,, _ N,w, WR
\ t , \fie, ctf?5'XS6 St IvestA&\x 1�_S� e-as63
Please provide a complete, detailed description of the proposed revisions to the approved plans:
[:ti�1—�a��`t_��c-�-c►r.�ta�. �., cry `+-ate,
Are two sets of the revised plans or addendum indicating the changes included? ( Yes ❑ No
Are the approved site plans included? W Yes ❑ No
Are the revisions clearly and accurately identified on the plans or addendum? 9 Yes ❑ No
Does the plan contain an engineer's or architect's lateral or vertical analysis? oi�Yes O No
If Yes, Has the engineer or architect approved this revision? 91 Yes ❑ No
Is a stamped and signed approval included with this request? ❑ Yes K 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 jai No
if Yes, Is a revised site plan, with all new setback dimensions included with this request?
❑ Yes ❑ No
Additional Information:
Applicant's signature Date: t U S o 1
Office Use Only Received by:
Date Sent Assigned To Approved By Date
❑ B - )Original Valuation: $
N�d onal Valuation: $
❑ P. WI Sq.Ft. y o x$ 7S—$
Sq. Ft. x$ $
❑ E.H. ` � � �� Total New Valuation $�/
Additional Fees:
P Additional Planning Dept. $
Additional Plan Review
Additional Conditions/Comments: Additional Building Permit $ 133 - 6 D
Additional Plumbing $
Additional Mechanical $$
Additional E.H. Dept.
Other $
Total Amount Due: $
Amount To Be Paid Up-Front$
For office use only)
Stock plan number 2003- 6 oO 7
Stock Plan fee: (Subsequent reviews 20%permit fee) $
Mason County Community Development
Request for Stock Plan Approval
Applicant:
Mailing Address:
elephone: Fax: a lular/Pager/Other: E-Mail Address:
Describe Project:
G�� y8y �aaxaa�
No. of Bedrooms No. of Bathrooms: Height of Structure: Number of Floors:
Max.proposed.) �,J a
If Engineer or Architect prepared, do you have Snow Load: Manufactured truss
'ter authorizing multiple use? Yes 3 Engineering included?Jvv
Square Footage of Structure:
Include options/maximum square footage (see Stock Plan Policy for allowable options)
Main Floor: Second Floor Third Floor Basement:
/ (o (o4/ -- —
arport: Garage: Decks: Covered Porch:
S/8"5Z
Storage: Other (Describe):
Heat type: 0P71 od WSEC Compliance: Prescriptive Option: .7Y IAQ Compliance:
or Component Performance:
Plumbing Fixtures: Mechanical Units:
Toilets: a Furnace: i
Bathroom Sink: a Heat Pump: 6P>iowr�
Bathtubs: Q Spot Ventilation Fans: J
Showers: 6 Propane Tanks:
Water Heaters: Gas Outlets: �7,39.(D5
I Clothes Washer: v0 Fireplace/Stove:
Kitchen Sinks: u Fuel Source?
Dishwashers: / -�'�0 Kitchen Ex. Hoods: /
Hose bibs: Dryer Vent:
Other: — Other:
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner:-Do rc S ,C o oup s Telephone:36&,6k2-t34 Parcel#: 1a-33151 ooO �$
Type of project New Residence ( )Addition ( ) Remodel
Total Sq. Ft. 1s Floor: 2" floor: Heated Basement:
of heated area:: I bb'4 — —
Heating System Type: Electric wall heater O Electric Central Furnace O LPG Furnace
O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type:
O Other: Specify
Glazing Prescriptive Option see reverse side circle one: 1 II IV
Percentage: Compliance
1 Method O Component Performance , Chapter 5— Calculation worksheets required
Check one:: O Systems analysis, Chapter 4
Whole House Ventilation system O Whole House Ventilation using a Heat
Ventilation using exhaust fans&window or wall fresh air
System
vents (VIAQ 303.4.1) Recovery Ventilation System (VIAQ 303.4.4)
Check one
O Whole House Ventilation Integrated O Whole House Ventilation using an inline
with a Forced Air System (VIAQ 303.4.2) su I fan. VIAQ 303.4.3)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windo s: `310 $'O 10 1 40
Li\A qrn •3 6 4lo X h 10 l Z U
�-cVot o rd ;v"v` <r— .3 6 b'o X ni'o I 3 0
cj
M�1 a'� 3'0 4
113cA roovv. z .36 4'o k 5`o i 2, 0
Windows: Total Sq. ft. 1 4q
Doors:
�A o"A ID,v, .36 b'oxb'10� 1 41
i tAa -n Vo X V10''S
Doors: Total Sq. Ft $2
Total window and door area 3
Total window &door area �� i /(divided by)total sq. ft of heated area 6 6 4 _ (3� %of glazing
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)275-4467 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 energycode review. If You are complyingwith the WSEC b r Y y 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.edu/code/
Prescriptive Requirements °,'for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing U-factor Door Wall Wall Wall
Area%of U- Vaulted Above interior exterior Slab
Option Floor vertical Overhead" Factor9 Ceiling Ceiling3 Grade below °Below Floors on
it
12 grade Grade Grade
1 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
11 * 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.
i
A A
Uniformly Loaded Floor Beam[2003 International Residential Code(01 NDS)1 Ver: 7.01.10
BY: rich balderston , mason county dcd on: 12-17-2007: 3:59:12 PM
Proiect: qadouas deck-Location:floor beam
Summary:
3.5 IN x 5.5 IN x 5.0 FT /#2-Hem-Fir-Dry Use
Section Adequate By: 28.6% Controlling Factor: Section Modulus/Depth Required 4.85 In
Deflections:
Dead Load: DLD= 0.02 IN
Live Load: LLD= 0.07 IN = U841
Total Load: TLD= 0.09 IN = U667
Reactions(Each End):
Live Load: LL-Rxn= 800 LB
Dead Load: DL-Rxn= 209 LB
Total Load: TL-Rxn= 1009 LB
Bearing Length Required (Beam only, support capacity not checked): BL= 0.71 IN
Beam Data:
Span: L= 5.0 FT
Unbraced Length-Top of Beam: Lu= 1.33 FT
Live Load Deflect. Criteria: L/ 360
Total Load Deflect. Criteria: L/ 240
Floor Loadinq:
Floor Live Load-Side One: LL1= 40.0 PSF
Floor Dead Load-Side One: DL1= 10.0 PSF
Tributary Width-Side One: TW1= 4.0 FT
Floor Live Load-Side Two: LL2= 40.0 PSF
Floor Dead Load-Side Two: DL2= 10.0 PSF
Tributary Width-Side Two: TW2= 4.0 FT
Live Load Duration Factor: Cd= 1.00
Wall Load: WALL= 0 PLF
Beam Loadinq: �AN� MUST BE
Beam Total Live Load: THESE P 13 SITE wL= 320 PLF
Beam Self Weiqht: ON THE BSW= 4 PLF
Beam Total Dead Load. EGT10N wD= 84 PLF
�[v �'
Total Maximum Load: FOR wT= 404 PLF
Properties For:#2- Hem-Fir
Bendinq Stress: Fb= 850 PSI
Shear Stress: Fv= 150 PSI
Modulus of Elasticitv: E= 1300000 PSI
Stress Perpendicular to Grain: Fc_perp= 405 PSI
Adjusted Properties
Fb'(Tension): Fb'= 1103 PSI
Adjustment Factors: Cd=1.00 CI=1.00 CF=1.30
Fv': Fv'= 150 PSI
Adiustment Factors: Cd=1.00
Design Requirements:
Controllinq Moment: M= 1261 FT-LB
2.5 ft from left support
Critical moment created by combining all dead and live loads.
Controllinq Shear: V= 827 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= 13.72 IN3
S= 17.65 IN3
Area (Shear): Areq= 8.27 IN2
A= 19.25 IN2
Moment of Inertia(Deflection): Ireq= 20.77 IN4
1= 48.53 IN4
d
Floor Joistr 2003 International Residential Code(01 NDS)1 Ver: 7.01.10
i y� Bv: rich[balderston , mason county dcd on: 12-17-2007 :4:02:06 PM
Summary:
VY24'0:C:1#2 `Herb'-Fir-'DN Use
1 v!#t3ttldnadequate 8y `31l.D% Controlling Factor: Moment of Inertia/Depth Required 7.93 In
Center Span Deflections:
Dead Load: DLD-Center= 0.01 IN
Live Load: LLD-Center- 0.12 IN=U806
Total Load: TLD-Center= 0.13 IN = U733
Right Cantilever Deflections:
Dead Load: DLD-Riqht= 0.02 IN
Live Load: FAILED LLD-Riqht= 0.26 IN=2U367
Total Load: FAILED TLD-Right= 0.28 IN=2U343
Center Span Left End Reactions(Support A):
Live Load: LL-Rxn-A= 320 LB
Dead Load: DL-Rxn-A= 60 LB
Total Load: TL-Rxn-A= 380 LB
Design For Uplift Loads (Includes Uplift Factor of Safetv) Rxn-A-min= -40 LB
Bearinq Lenqth Required(Beam only, support capacity not checked): BL-A= 0.63 IN
Center Span Riqht End Reactions(Support B):
Live Load: LL-Rxn-B= 720 LB
Dead Load: DL-Rxn-B= 180 LB
Total Load: TL-Rxn-B= 900 LB
Bearinq Lenqth Required (Beam only, support capacity not checked): BL-B= 1.48 IN
Dead Load Uplift F.S.: FS= 1.5
Joist Data:
Center Span Lenqth: L2= 8.0 FT
Right Cantilever Lenqth: L3= 4.0 FT
Floor sheathinq applied to top of joists-top of joists fully braced.
Live Load Duration Factor: Cd= 1.00
Live Load Deflect. Criteria: U 480
Total Load Deflect. Criteria: U 360
Center Span Loadinq:
Uniform Floor Loading:
Live Load: LL-2= 40.0 PSF
Dead Load: DL-2= 10.0 PSF
Total Load: TL-2= 50.0 PSF
Total Load Adiusted for Joist Spacing: wT-2= 100 PLF
Riqht Cantilever Loading: THESE I�LAN.3 MUST BE
Uniform Floor Loading: SITE
Live Load: ON THE JOB
Dead Load: FOR INSPECTION DL-3= 10.0 PSF
Total Load: TL-3= 50.0 PSF
Total Load Adiusted for Joist Spacing: wT-3= 100 PLF
Properties For:#2- Hem-Fir
Bendinq Stress: Fb= 850 PSI
Shear Stress: Fv= 150 PSI
Modulus of Elasticitv: E= 1300000 PSI
Stress Perpendicular to Grain: Fc-perp= 405 PSI
Adjusted Properties
Fb' (Compression Face in Tension): Fb'= 868 PSI
Adjustment Factors: Cd=1.00 CI=0.74 CF=1.20 Cr=1.15
Fv': Fv'= 150 PSI
Adiustment Factors: Cd=1.00
Design Requirements:
Controllinq Moment: M= -800 FT-LB
Over riqht support of span 2(Center Span)
Critical moment created by combining all dead loads and live loads on span(s)2, 3
Controllinq Shear: V= 444 LB
At a distance d from riqht support of span 2(Center Span)
Critical shear created by combining all dead loads and live loads on span(s)2,3
Comparisons With Required Sections:
Section Modulus(Moment): Sreq= 11.06 IN3
S= 13.14 IN3
Area (Shear): Areq= 4.44 IN2
A= 10.88 IN2
Moment of Inertia(Deflection): Ireq= 62.39 IN4
FAILED 1= 47.63 IN4
Floor Joistf 2003 International Residential Code(01 NDS)1 Ver:7.01.10
BY: rich balderston , mason county dcd on: 12-17-2007:4:02:17 PM
Project: qadouas deck-Location:floor joist
Summary:
1.5INx7.25INx12.0FT(8+4)(51) 16O.C./#2- Hem-Fir-Dry Use
Section Adequate By: 14.5% Controlling Factor: Moment of Inertia/Depth Required 6.93 In
Center Span Deflections:
Dead Load: DLD-Center- 0.01 IN
Live Load: LLD-Center- 0.08 IN = U1210
Total Load: TLD-Center- 0.09 IN= U1099
Right Cantilever Deflections:
Dead Load: DLD-Riqht= 0.01 IN
Live Load: LLD-Riqht= 0.17 IN =2U550
Total Load: TLD-Right= 0.19 IN=2U515
Center Span Left End Reactions(Support A):
Live Load: LL-Rxn-A= 213 LB
Dead Load: DL-Rxn-A= 40 LB
Total Load: TL-Rxn-A= 253 LB
Design For Uplift Loads (Includes Uplift Factor of Safety) Rxn-A-min= -27 LB
Bearinq Lenqth Required (Beam only, support capacity not checked): BL-A= 0.42 IN
Center Span Riqht End Reactions(Support B):
Live Load: LL-Rxn-B= 480 LB
Dead Load: DL-Rxn-B= 120 LB
Total Load: TL-Rxn-B= 600 LB
Bearinq Lenqth Required(Beam only, support capacity not checked): BL-B= 0.99 IN
Dead Load Uplift F.S.: FS= 1.5
Joist Data:
Center Span Lenqth: L2= 8.0 FT
Right Cantilever Lenqth: L3= 4.0 FT
Floor sheathinq applied to top of joists-top of joists fully braced.
Live Load Duration Factor: Cd= 1.00
Live Load Deflect. Criteria: U 480
Total Load Deflect. Criteria: U 360
Center Span Loadinq:
Uniform Floor Loading:
Live Load: LL-2= 40.0 PSF
Dead Load: DL-2= 10.0 PSF
Total Load: TL-2= 50.0 PSF
Total Load Adjusted for Joist Spacing:
Riqht Cantilever Loading:
Uniform Floor Loading: THESE PLAN. MUST �� w -2= 67 PLF
Live Load: ON THE JOB SITE LL-3= 40.0 PSF
Dead,Load:
Total Load: FOR INSPECTION! DL-3= 10.0 PSF
TL-3= 50.0 PSF
Total Load Adjusted for Joist Spacing: wT-3= 67 PLF
Properties For:#2-Hem-Fir
Bendinq Stress: Fb= 850 PSI
Shear Stress: Fv= 150 PSI
Modulus of Elasticity: E= 1300000 PSI
Stress Perpendicular to Grain: Fc-perp= 405 PSI
Adjusted Properties
Fb' (Compression Face in Tension): Fb'= 868 PSI
Adjustment Factors: Cd=1.00 CI=0.74 CF=1.20 Cr=1.15
Fv': Fv'= 150 PSI
Adjustment Factors: Cd=1.00
Design Requirements:
Controllinq Moment: M= -533 FT-LB
Over riqht support of span 2 (Center Span)
Critical moment created by combining all dead loads and live loads on span(s)2, 3
Controllinq Shear: V= 296 LB
At a distance d from riqht support of span 2 (Center Span)
Critical shear created by combining all dead loads and live loads on span(s)2, 3
Comparisons With Required Sections:
Section Modulus(Moment): Sreq= 7.37 IN3
S= 13.14 IN3
Area(Shear): Areq= 2.96 IN2
A= 10.88 IN2
Moment of Inertia (Deflection): Ireq= 41.59 IN4
1= 47.63 IN4
12/10/2007�Trish Woolett yFIle0001'.PDF w __ Pave 1 ,
of APPROVED
` MASON COUNTY DCD PLANNING
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ON THE JOB SITE PRIOR TO PERFORMING WORK
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Number of pages MUST M TON S?ATE CODES
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MASON BUILDING INSPECTOR
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JECT TO APPROVAL ,
DATE
�rA VICINITY MAP NORTH
NAME: 5TEUC 4 4+,2l7�O 45�MOUAs
SITE ADDRESS: ZZ! `Jottc4 C-C16 t1d ti(-
CITY: k5i L Ft5YZ f (mil
ZIP: 1I652e
MAILING ADDRESS: 61-10 0,ju E LN AjE
CITY: SILVER(F
ZIP: qe 3Ig3 7
3
PARCEL NUMBER: f 233 Is-1 occ(oFU
PHONE NUMBERS H: 300- 09Z-`73y2—
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PLANNING:
ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
PR0JECTf0N-0E-THE-BWL 75
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MASON COUNTY PERMIT NO,—�k oQ
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
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailin Address 1 Mailing Address
City X1 ev&Ne State\361C3, Zip Code 39:5 City CF_`J \"a. State Jto. Zip Code !2gr3 t
Phon 42-:13 4z Other Ph.3(,0 71 -cr 246 Phone '5li n_ sio 7. i%4! Other Ph.
Lien/Title Holder Contractor Reg. # d t L I M H IR T Exp. Z
E mail address 40. vv r%'j WPtZ&o. C.oyv% E Mail Address
Drivers Lic.# p5ti DOB . � O Drivers Lic.# DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New eptic_ Y Existing Septic
Connect to Water System _Name of Water System 1'ieo rek z Cnye k %gg r DI S2
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. 115 1 cloo 6 A Fire District
Legal Description
Site Address (Please includ street n me, street number and city) L c Q
Directions to site
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200'of Saltwater IJ0—Lake M 0 River/Creek No Pond N
Wetland Ito Seasonal Runoff_Lk)_Stream N° Slopes or Bluffs trS
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o
TYPE OF JOB - New�__Add Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑
Use of Building 1ZC'S i Describe Work Mew �khi&&c C —S-+d`Ve 'A` Ian
No. of Bedrooms _'5 No. of Bathrooms'—Square Footage- 1st FlooL J 6b 2nd Floor. n
3rd Flo Basement O Deck S 20 Covered Deck Other Sq. ft. —
Garage 415 Attached x Detached Carport Attached Detached
MANUFACTURED HgfflEANFORMATION - M key'` Mod Year
Length Wi Serial No. No. of B�edr s No. of Bathrooms
Typeof Heat Purch rice$ Re ment Unit? Yes/ No
Installer me - 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 permitlapplication becomes null & void if work or authorized construction is
not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY
NS OFAPROGR S INSPECTI CTIVITY OF THIS PERMIT APPLICATION OF 180 DA S WI)L INVALIDATE THE APPLICATION.
XME4
Date: Z
wne ners Re en tive Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by:::j_hk Date
DEPARTMENTAL REVIEW APPAR2V D DENIED NOTES
Building Department e ' 4
Planning Department
Environmental Health Department I �_)
Fire Marshal V `
FEES
Building Permit Fee / Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee S ` Planninq Review Fee
Mechanical & Base fee I Other
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee h/o eAlA Pre-Paid at Submittal
Valuation $ TOTAL FEES
PERMIT NO.
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
On the web www.co.mason.wa.us
APPLICANT INFORMAT N CONTRACTOR It FQR�MATIO Ill t
Owner -Ddtre� ' . �O.�Ov.o.S Company Name FFlk - e 1�lOw�
Mailing Addre$ I�O h� ,W Mail g A dyes t2i3 O�" 1 c
City J��V a e t te\)n Zip C e 3��' City�F� 'ro ` Gta Zip Code
Phone -*°) 642- `UNZ- Other Ph 3� 2-1 1- ` Phone 3W-`an-l �R er Ph.
Lien/Title Holder Contractor Reg.4 1l. I � Exp. ' °'O
E mail address �� �` Z e'r� • LO~^ E Mail Address
Drivers Lic.#G%1)0&►.DS /MFI'DOB `7`7 Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic. Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit arcel No. O a0 Fire District
Legal Description to 1 bt O rc Cove v%%AN-- 1orr
Site Address (Please in lu street arse, s reet number i 4
Dire tipns to site or n d pV% � R ooV^ orSo� vD r
L XT o r ar v. o v% `3 o t✓ 10 'Pro v%^ Litf1v
Is property within 200'of Saltwater 0 Lake River/Creek PO tPond IV 0
Wetland- Seasonal Runoff '' Stream %jn Slopes or Bluffs > 15%
TYPE OF JOB - New 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 _ LPC Natural Gas_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink �— Furnace
Bath O Heat um s
Showers bs p
—�- Spot Vent Fan
Water Heater _T— Propane Tank
Clothes Washer — T— Gas Outlets
Kithen Sinks �— Wood/Gas4eelle_tStove
Dishwasher �— Kitchen Exhaust Hood
Hosebibs �— Dryer Vent
Other — Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or 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 prope and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X v- Date: 1 �- ('0 2 DDE
er)3wners Re esen five/Contractor (indicate which one)
FOR OFFICIAL USE BEYONDTHIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group-TvP2 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 PERMIT NO-- �
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 �.
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailin ddress 1 Mailing Address 12►A
City State-4Ic�L Zip Code 9 2-A :5 City CNb,`E,ne%X.a State �•s 0i Zip Code !2.9431
Phone' d.':13 42:Other Ph.:3 tin-2-71 -5 246 Phone ',(%cN- 801- 1%44 Other Ph.
Lien/Title Holder Contractor Reg. # N 1 L I AI H 981 B T Exp. Ae9ft Z
E mail address 40. %mn2. WPtZ.ero. Lo1�n E Mail Address
Drivers Lic.# g3apMOSti DOB - �,"p Drivers Lic. # DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New eptic—�_ Existing Se tic
Connect to Water System '_Name of Water System Reek reA 5 Cove I I99 t ?S'T
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. 211 15 1 (100 (erg Fire District
Legal Description
Site Address(Please includV street n me, street number and city c OS I A e
Directions to site II
Will timber be cut and sold in parcel preparation?Yes/ o
Is property within 200'of Saltwater Mo Lake <J o River/Creek No Pond tV o
Wetland A10 Seasonal Runoff _Stream N� Slopes or Bluffs 15% WAS
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye 0
TYPE OF JOB - New Alt Repair Other PRIMARY RESIDENCE ® SEASONAL ❑
Use of Building 1 eSi once Describe Work ►.leul 1k^M^e Lnv.s:t41 V
No. of Bedrooms. No. of Bathrooms Square Footage- 1st Floor 1 /�b� 2nd Floor
3rd Floor O Basement r) Deck S 2e Covered Deck Other Sq. ft.
Garage— Attached X Detached Carport Attached Detached
MANUFACTURED HqUE INFORMATION - M Mod Year
Length Wi Serial No. No. of Bedr s No. of Bathrooms
Type of Heat Purch rice$ Re cement Unit? Yes/ No
Installer me — 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 or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY
NS OFA PROGR S INSPECTI CTIVITY OF THIS PERMIT APPLICATION OF 180 DA S WI INVALIDATE THE APPLICATION.
X Date: Z
wne "A001'
ners Re en tive I Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW AP PAR2vgD DENIED NOTES
Building Department
v
Planning Department
Environmental Health Department }
Fire Marshal
FEES
Building Permit Fee / Site Ins ection
Plan Review Fee EH Review Fee
d Planning Review Fee
Plumbin & Base Fee S
Mechanical & Base fee I Other
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee )V0 eNA Pre-Paid at Submittal
Valuation $ 1 Z 1 R9 g. Z� TOTAL FEES
i
2i-9s y Q,
MASON COUNTY ��
DEPARTMENT OF COMMUNITY DEVELOPMENT T'o
411 N. Fifth Street/ P.O. Box 186, Shelton WA 98584 0 O�
360.427.9670 ext. 352
DD C) -
Rec'd by
Request for
Administrative Variance for Reduction in the Required Setbacks ($100.00)
For administrative review, the minimum variance on a setback request is 5 feet
from the side yard lot lines and 10 feet for front and rear lot lines or any access
easement. Request for further reduction requires a standard variance.
Setbacks are measured from the furthest projection of the structure, including
roof eaves.
Applicant/Owners: ,ram S . C-Xk Cc 5
Mailing Address: 81`'10 Kv���c� L\r%
Telephone : 3 6o ' (,ei 2 - i1 42
City: 5,A Vc'vrj AQ State:VM,& Zip:
If this reduction is tied to a building permit, please give permit
case number. BLD hoc)6 - p-1, o c14 \\
Parcel Number(s): 17-33 1 5 (300 Zoning" eZ'5 Ad\\4 Uk
Site Address: 100 " ev- .(- _ �- MC"'V Ui ) c1c
Requested varianc : Fron Rear/ Side Yard (please circle all that apply)
Requested setback variance: f 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 areas, 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) e,following exists on the lot:
steep slopeetlands, or streams present;
b) soi s t at restrict building or septic development;
c idth at the front yard line of no more than 50 feet;
d) to ze of no more than one-fourth acre;
e existing improvements of buildings, septic systems, and well areas.
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I
SIDE 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;
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.
.o
O ease indicate)
Signature and date
Official Use Only
Approved Date a ' -0q-
Denied Date
Reason for denial:
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