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BLD2006-00850 Final SFR DDR2006-00234 - BLD Permit / Conditions - 3/16/2007
Inspection Line(360)127-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Irflo Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2006-00850 OWNER: DIANNE NELSON RECEIVED: 5/22/2006 CONTRACTOR: M J BUILDERS LLC 360-528-0369 LICENSE: MJBUIBL946J1 EXP:4/21/2008 ISSUED: 6/27/2006 SITE ADDRESS: 240 E BALBRIGGAN RD SHELTON EXPIRES: 12/27/2006 PARCEL NUMBER: 321275300161 LEGAL DESCRIPTION: LAKE LIMERICK 4 TRACT 161 PROJECT DESCRIPTION: DIRECTIONS TO SITE: SFR, SET UP STOCK PLAN #2003-0127 Mason Lk. Rd. to right on Dartmoor to right on Ballbriggen to lot on corner of Angus Ct. and Balligger. 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: 3 Occ. Group: R-3, U Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 2 Occ. Load: Building:1,414 Garage-Attached 360 Valuation: Building Height: 25 Occ. Status: Primary Basement: COV. PORCH 60 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 25.0 Ft. Shoreline: Ft. Water Body: NONE Rear: N 32.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: W 64-0 Ft. Shoreline Desi g.: Not Applicable Year: Serial No.: Side 2: E 32.0 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 5/22/2006 $656.86 S12006000 Hosebibs 2 Ventilation Fan 4 Planning Review Fee KS 5/22/2006 $155.00 S12006000 Kitchen Sink 1 Woodstove 1 Address Fee GMM 5/31/2006 $140.00 Si2006000 Lavatories 4 Dryer Vent 1 EH Plan Review TW 6/5/2006 $75.00 S12006000 Showers 1 Building State Fee JRN 6/9/2006 $4.50 S12006000 Water Closets (Toilets) 3 Building Permit Fee JRN 6/9/2006 $1,016.15 S12006000 Water Heaters 1 Plumbing Base Fee JRN 6/9/2006 $20.00 Si2006000 Bath Tubs 2 Plumbing Fee JRN 6/9/2006 $103.00 S12006000 Clothes Washer 1 Mechanical Base Fee JRN 6/9/2006 $23.50 S12006000 Mechanical Fee JRN 6/9/2006 $99.20 S12006000 ADJUST--Plan Check Fee JRN 6/9/2006 $3.64 S12006000 Total $2,296.85 1850 Please referto the followingpages for conditions p g d ons of this permit. 1 of 5 CASE NOTES FOR BLD2006-W850 CONDITIONS FOR BLD2006.00850 1) gern Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at , ext. 450. The building permit will not be"finaled" until the permit holder can show proof that the access permit from Public Works has nd approved. 2) code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved ads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where ect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. 3) laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. l risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 82. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. 4) imensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. 5) approval, all upland areas disturbed wly to by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). 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 gra n addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Depart t ' r,to any 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. Wcti uilding Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted n and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting BLD2006-00850 Please referto the following pages for conditions of this permit. 2 of 5 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 correc s i dicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building VOUNDATION 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 proved documents will result in failure of required building inspections. 9) SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOI 10) The "appr ', 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 apprPIbe granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the B inment prior to any further inspections being performed or approvals granted. 1 1) shingto Energy Code Compliance has been approved using the following: Heat Ty is or other fuels, Compliance Method: IV, Window (Max U-Factor):0.40, Skylight (Max U-Factor):0.58, Door pe/ 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 12) Pe IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimu f ads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASI PEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X 13) Pe 3 - CTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in ac rd ce e applicable provisions of this section and the manufacturer's installation instructions. 14) Stock n Identification number:2003-0127 This pro' proved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department, r' or g ans, and all attachments approved by the Mason County Building Department shall be available for the Mason County Building t required inspection. 15) Co Crete used f sement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical co k exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 16) Any Zanges 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 charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X D=-D2006-00850 Please referto the following pages for conditions of this permit. 3 of 5 17) All struc ion must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the Vvisionsofor ngton. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in on. 18) 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 - 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 p J ct. 19) All chan proved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordina or u)ation, must be reviewed and approved by Mason County prior to construction. X 20) CO CTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The con tion of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance woctor r tional codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building In I be made prior to requesting additional inspections. X21) Ay lines shall be clearly identified at the time of foundation inspection. X 22) All buildi er�nits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure �Ma re I inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with o o t ordinances and building regulations. 23) A rmits e 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action r d not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit hol av p ented action from being taken. No more than one extension may be granted. X 24) Press tr ood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, conn c r lashing. Install metal connectors approved for contact with the new types of pressure treated material. X 25) Thi c I located in a smoke management zone. Please contact a fire warden at (360) 427-9670 ext. 459 for further information. X./ BLD2006-00850 Please referto the following pages for conditions of this permit. 4 of 5 26) , Lan ' d stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your oved ' e Plan"to ensure these structures are shown and meet the setback conditions listed. 27) , propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure theses es meet the setback conditions listed. X This permit becomes null and void if work or constr ion 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 ti of wor a ogress 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 ress ' tion. a neror the agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above describe property ruct e f eview and inspection. OWN ER OR A ENT: DATE:-4 D BLD2006-00850 Please referto the following pages for conditions of this permit. 5 of 5 i 00 o ONCRETE 01< <�1 MECHANICAL MANUFACTURED HOME m 0 Date ����4/p�, t3yl,pC. r- Footin ! tbac 11�p� Gas Piping Ribbons 4^ o to By Interior-Date By Date By Z ODCn tenor D 7I�n/O(o _ Exterior-Date By Sat-up Point Load!Isolated Footings INSULATION pate BY D BG i SLAB INSULATION — Z Date By Data By FIRE DEPARTMENT m Foundation Wal s Floors •d- IW ice• It Date By Date --)( ?z 1) Data By DECKS FRAMI G W ��,j2 B Date By Date l By (j Data t © y PROPANE TANKS PLUMBING Vault Data By Date By .�..w.__�. OTHER Groundwork Attic Data g Date By Type_ Y Data By D.W.v DRYWALL Type: By LOU Int.Brace Wall Orate By Date W Date I, 7 0#a y FINAL INSPECTION Water Line Fire Seperation IV Date By Date d(, By AIL Date�`l�j'G� BY O m � Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments coo CD A KD(� 4o fove ; F uv �. e- CD 0 ct1�l�s �►�rn � it 0 6 `� �Z�Ub 8 _ a 0 N64 sn t, PL- 1 AeA ItS l' OK- S kr KA� 0L_ tz, it IZ L A1,5,106 1��1 urG ib/b2/2006 01: 51 3604260726 THOMPSON E/N�GI�NEERING PAGE 01 THOMPSON ENO INS R A r NO Cwrtm B - R r. 3�o-aae-eQaa Rwx:3eo-aas-o�e� s®1'I�wC. paw ! of � •— jol Post-it'Fax Note 7671 Datel a o T From pages PARCEL FILE `S ��Isi sF`! � To r ��A�,� co./Dept. Co. �wp� Phone# �R [7, d..M Phone 1� IRES 6-29-© 5 Fax# Fax u (2) I&d's • ((o • O-r,, (2),3d`s IA JOIST CHANGES SUBMIT CHANGES FOR APPROVA; FLOOR JOISTS PRIOR TO PERFORMING WORK. SEE PLAN ��IAl1.R�rs PLATE I LW)jL + AB a • (2 (2;W6 CONT_ lW 24" LAPS LA.W•N• aN C�-AoJ O' ■ o� ,�r 1 sir,"-1�✓A�■ •I.�s" 1}�"oG,J�!wG NATIVE LNPl5TL#R6ED SOIL T. S TYR FLOOR FOi� TION S.ECTIO ��,� APPROVED N.- •SON COUNTYDC PLANNING � �0 I Si rE PLAN RE RED TO E ON SITE APPROVED CHANG UBJECTTOA ROVAL MASON COUNTY DCD PLANNING , By Date _ SITE PLAN REQUIRED TO BE ON SITE PLAN N G: CHUG S SUBJECT TO APPROVAL ALL SETBACKS AR MEASURED \ Date —L � SOX FROM THE FU THEST PROJECTION OF THF BUILDING TPLAN PLOT REVISION RECEIVED 12, ' p. � � DATE—a _ A, TcSr F+oLV'y � 43 o '- a3'• s •/ l �3" Mc rr� _.. L o T PL A-N s " rl rrc 3�)/2 7 oom,-/ 20 APPROVED MASON COUNTY DCD PLANNING , \ SITE PLAN REQUIRED TO BE ON SITE \ G S SUBJECT�TO�APPROVAL � By So X N 1 •vv J.D�t^ y C h 'v tA 11) o •3 � t � jl V to -:. A Tt Sr f+oLL s C _ 1" hotti ii 43 0 A3 s MG7L .� 5 /`?O rrt WIUi=k ' L71ArirJL <\f,=L5eiK, _P Q Rtt=L It 3�)/2 7 59 ooi ,-/ Request To Revise An Approved Plan Permit Number: BLD200 Name Parcel Number_3_'� ( ate -�_ phone Number daytime(_J Project Address Mailing Address (, anm Sb Please provide a to detailed description fefr?,osed revis, PS to theapproved plans: . Ll) Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes t7'No Are the approved site plans included? 'a-Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? p"Yes ❑ �o Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes Ur "o If Yes,Has the engineer or architect approved this revision? ❑ Yes 7No Is a stamped and signed approval included with this request? ❑ Yes (Note:No structural changes to a"desiened"plan will be approved without the written consent of the en(:Leer and/or arciutect of nor i,� Does the proposed revision modify the footprint or location of the structure? 114es ❑ No If Yes, Is a revised site plan,-with all new setback dimensions included with this request? ❑ Yes ❑ No Additional Informatign' — . Applicant's sign a Date.—Y Office Use only Reoetvea bar Date Sent Assigned To Approved By pate B Original Valuation: $ Additional Valuation: $ Sq.Ft. x$ $ Sq.Ft. x$ $ E.H. Total New Valuation $ p.W Additional Fees: Additional Planning Dept. $ Additional Plan Review $ New Setbacks: Front / Rear / Additional Building Permit $ Sidel. / Side2 / Additional Plumbing $ Additional Conditions/Comments: Additional Mechanical $ Additional E.H.Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ Y ReVW sac casizaW MASON COUNTY DEPARTMENT OF_60_�MUNITY DEVELOPMENT WSEC/VIAQ Compliance Application Owner: i�lTl Tel _ _ O(c Parcel#:_ Type of project ( ) New Residence ( )Addition ( ) Remodel Total Sq. Ft. 1 s Floor :07& 2 nd floor:736 Heated Basement: of heated area:: Heating System Type: O 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: I I I V Percentage: Compliance Method a Component Performance , Chapter 5— Calculation worksheets required 1a ago 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 Recovery Ventilation System (VIAQ 303.4.4) System vents (VIAQ 303.4.1) Check one O Whole House Ventilation Integrated O Whole House Ventilation using an inline with a Forced Air System (VIAQ 303.4.2) supply fan. VIAQ 303.4.3) Window & Door Schedule (If needed, attach an additional sheet) Total Manufacturer Roomllocation U-Factor Size Quantity —Square Feet Windows: Windows: Total Sq. ft. �3 Doors: Doors: Total Sq. Ft Total window and door area Total window & door area A61' /(divided by)total sq. ft of heated area %of glazing MASUN UUUNI Y 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 (WSECNIAQ)application located on the reverse side. 2. Complete the window and door schedule on the reverse side. Include all windows, skylights, sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening dimensions of the windows and doors. Information about the U-factor of the window will also help to expedite the energy code review. If you are complying with the WSEC by prescriptive path and are using the area weighted average method you must include your calculations. 3. On your building plans note the location and fuel type of water heater, location of exhaust fans (bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and slabs, 4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. Additional WSEC and VIAQ compliance information is available on the internet at: http.//www.energy.wsu.edu/code/ Prescriptive Requirements 0,1for Group R Occupancy Climate Zone 1, Table 6-1 Glazing Glazing LI-factor Door Wall Wall Wall Area % of _ Ceiling Vaulted Above interior exterior Slab' Option Floor „ U s 2 Ceiling3 Grade below 4 Below Floors on ip Vertical Overhead Factor 12 grade Grade Grade I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10 II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 IV Unlimited Single Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 (R-3)Only *Reference Case/Call (360)427-9670 ext. 352 for footnote information. Log &solid timber wall with a min. avg.thickness of 3.5"are exempt from the above grade wall insulation requirements. x:.�.�•ytT'"iL� i'iR'17..F^., ".*�i+TY.^..i-..;.a,r�gi. _%7 fi f MASON COUNTY PERMIT NO� i f BUILDING PERMIT APPLICATION 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 k Shelton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 r On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name_4t4j! ;5�iF1.414 6 Z 4 G Mailing Address 24/Ls: 8:�� A Mailing Address;j,"jgg: ,&,-6- J1�� � City Stated—Zip Code mac% City State �4_,A, ' Zip Code Phone - - Other Ph Phone-z(���,�Fj n�.v Other Ph. 3Gr�d���3�-9 Contractor or Reg. T_T Exp. Lien/Title HoldW;b.4 r�w 4.)cls c $ E mail address E Mail Address Drivers Lic. # DOB 1, _ Drivers Lic. # DO - SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. U TST/(�� Fire District Legal Description Z-4,&cLln•4411-y "fi t' && Site Address (Please include street name, street number and city) Directions to site Will im er be cu'f and sold i arcel preparation. Yes/No Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 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 14 SEASONAL ❑ Use of Building Describe Work No. of Bedrooms 3 No. of Bathrooms__a__Square Footage- 1st Floor 6 7/a _2nd Floor :72CA � 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage--A(j Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County 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 corryrtetSc within days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY M OFF G S INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. Date: D,_ Owner t Owners Representative/Contractor (indicate which one) 11 FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department I Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee — Planninq Review Fee Mechanical & Base fee OL Other Wood /Gas/ Pellet Stove Fee State Fee L1 50 Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar-P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 -Belfair(360) 275-4467- Elma (360) 482-5269 On the web www.co.mason.wa.us APIPLick"T INFORMATION CONTRACTOR INFOR . TIO / Owner �t NE Company Name GL �✓�/I S «<- Mailin ddres Mailin ddress City tate��Zip Code City tate 1�1�_ Zip Code- Phone �" Oth r Ph- U'SaB-O�tr►9 Phone �� Other Ph. Lien/Title Holder &*%- Contractor Reg.#MTf9UZ�19y(aSl xp E mail address -e �" j E Mail Addresser{ tti� 'M Drivers Lic.# DOB - - -7 Drivers Lic.# DOB 7-1- 0 SEPTIC INFORMATION - Connect to New Septic Existing Septic: Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No. Fire District Legal Description Site Address (Please tpcl de stree name, street nu er and city) fir. Di r cti ns t to nv n Is property within 200'of Saltwater Lak& River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric,_,. LPG_ Natural Gas_ Heat Pump— TW@ of Unit No. of Units Fees Toilets Furnace Bathroom Sink loy a Heatpumps Bath Tubs Spot Vent Fan Showers Propane Tank Water Heater Gas Outlets Clothes Washer Z Wood/Gas/Pellet Stove Kithen Sinks Kitchen Exhaust Hood �.-- Dishwasher Dryer Vent .�— Hosebibs 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 byn signature below.I declare that I am the l cation.owners I declare thatrI have obtained the pemiss on contractor from all theenecessary partiesare that I am .if permtled to ission sceive this permit and to do the work as proposed in the erp required from any easement ho r or any other party in interest regarding this application or the work proposed in the application,I have obtained permission em to ap for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is acgfi a and is employees of Mason County access to the above described property and structure for review and inspection. PROOF OF G INU N OF WORK IS BY MEANS OF A PROGRESS INSPECTION Date: U-4<0 XOwner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POIBNdTPd Receipt No. Accepted by: Planning Pd Ck# Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. Plannin 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 � �EPARTMENT OF COMMUNITY DEVELOPMENT C 06 411 No. Fifth Street//P.O. Box 186, Shelton WA. 98584 360.427.9670 ext. 352 COOVA Request for A �l Administrative reduction in the Required Setbacks ($90.00) MFor administrative review, the minimum variance on a yard setback request is 5 feet from the side lot lines and 10 feet front and rear lot lines or right of way. Request for further reduction requires standard variance. Setbacks are measured from the furthest proiection of the structure. / Applicant/Owners: 1456Lt_ lJ I AV I )C-Z-s � dill- Mailing Address: J% U 13G)e City: State: W Zip: Site Address: oZyD G� i4�blLlgSrt-,ZJ �Z�i � � GU�4 f Telephone No.: '?106— Sa5-03&'j Parcel Number(s): D/d 7S?00/ o/ Zoning Requested Variance:(Fro / Rear • Side Yard (please circle all that apply) Requested setback variance: ID � FT. An illustrated site plan is required: Your site plan must show the following: north arrow,abutting street or easements,set backs to all property lines and existing buildings, slopes,surface water,wetlands,critical area, septic, well and driveway. Show all proposed new development. The following circumstances must apply. Front and or Rear Yard requirements: 1) Existing lots of record as of March 5, 2002; You must meet one of the following. (Please circle all that apply) 2) One of the following exists on the lot: a) steep slopes, wetlands, or streams present; b) soils that restrict building or septic development; c) lot width at the front yard line of no more than 50 feet; Blot size of no more than one-fourth acre; existing improvements of buildings, septic systems, and well areas. 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 HAadministativevariance.doc (tw) February05 Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones. Ft sel /3#,Ve r�� lAv4r ok Alj&ac C� Owner/Agent (please indicate) Signature and date Official Use Only Approved Date Denied Date Reason for denial: HAadn inistativevariance.doc (tw) February 05 1.05.030 Variances 1.05.031 Purpose The purpose of this Section is to provide a means of altering the requirements of this Ordinance in specific instances where the strict application of these regulations would deprive a property of privileges enjoyed by other properties which are similarly situated,due to special features or constraints unique to the property involved. 1.05.032 Use Variances Prohibited No variance shall be granted to permit the establishment of a use otherwise prohibited within the development area in which the property concerned is located,except as provided in Section 1.05.018(B). Applications for such variances shall not be accepted for processing or review. 1.05.034 Granting of Variances Authorized A. The Board of County Commissioners shall have the authority to grant a variance from the provisions of this Ordinance when, in their opinion,the conditions set forth in Section 1.05.036 have been met. The Board shall have the authority to attach conditions to any such variance when,in their opinion,such conditions are necessary to protect the public health, safety or welfare,or to assure that the spirit of this Ordinance is maintained. B. The Administrator shall have the authority to grant a variance from the provisions of this Ordinance when the granting of such variance will result in a measurable deviation of ten(10%)percent or less from the provisions set forth in this Ordinance. In issuing such variance,the Administrator shall make a positive determination that the conditions set forth in Section 1.05.035 have been met. The Administrator shall have the authority to attach conditions to any such variance when, in his(her)opinion, such conditions are necessary to protect the public health,safety or welfare,or to assure that the spirit of this Ordinance is maintained. C. The Administrator may allow a reduction in the required front yard setback by administrative variance under the following circumstances: for existing lots of record as of March 5, 2002,where physical attributes of the lot (such as steep slopes,wetlands, streams,soils; lot width at the front yard line of no more than 50 feet or lot size of no more than one-quarter acre; and existing improvements of buildings,septic systems, and well areas) preclude a proposed development from meeting the 25-foot front yard setback standard. The front yard setback shall be the minimum necessary to accommodate a reasonable development proposal,but not less than 10 feet distance from the property line or any easement boundary. The Administrator shall document in the property file the rationale for said administrative variance decision. D. The Administrator may allow a reduction in the required side yard setback by administrative variance under the following circumstances: for existing MASON COUNTY DEVELOPMENT REGULATIONS June 2003