HomeMy WebLinkAboutBLD2006-00239 Final Remove Mobile Replace with SFR DDR2006-00108 - BLD Permit / Conditions - 11/9/2006 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
too
RESIDENTIAL BUILDING PERMIT BLD2006-00239
OWNER: FAYANNE WILLIAMS RECEIVED: 2/23/2006
CONTRACTOR: HILINE HOMES OF GRAYS HARBOR 360-482-7750 LICENSE: HILINH'981 BT EXP:2/10/2C ISSUED: 3/30/2006
SITE ADDRESS: 451 E OLDE LYME RD SHELTON EXPIRES: 9/30/2006
PARCEL NUMBER: 321275300215
LEGAL DESCRIPTION: LAKE LIMERICK 4 TRACT 215
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
REMOVING MOBILE HOME AND REPLACING WITH SFR Lake Limerick
stock#2003-0006
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: 3 Occ. Group: R-3U Lot Size: Deck:
Type of Work: NEW Fire Dist.: No. of Stories: 2 Occ. Load: Building:1,768 Garage-Attached 528
Valuation: Building Height: 22 Occ. Status: Primary Basement: COVPORCH 198
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: S 73.0 Ft. Shoreline: Ft.
Water Body:
Rear: N 42.0 Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: W 8.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: E 8.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Planning Review Fee KKK 2/23/2006 $155.00 S22006000
Hosebibs 3 Furnace<100K 1 Plan Check Fee KKK 2/23/2006 $236.83 S22006000
Kitchen Sink 1 Ventilation Fan 4 Building State Fee ARC 3/9/2006 $4.50 Si2o0600b
Lavatories 3 Heat Pump 1 Building Permit Fee ARC 3/9/2006 $1,184.15 S12006000
Water Closets (Toilets) 3 Dryer Vent 1 Mechanical Fee ARC 3/9/2006 $72.35 S12bb6bbo
Water Heaters 1 Mechanical Base Fee ARC 3/9/2006 $23.50 S12006000
Bath Tubs 2 Plumbing Fee ARC 3/9/2006 $89.00 S12o06000
Clothes Washer 1 Plumbing Base Fee ARC 3/9/2006 $20.00 S12006000
EH Plan Review TW 3/17/2006 $75.00 S12006000
Total $1,860.33
, BLD2006-00239 Please referto the following pages for conditions of this permit. 1 of 4
CASE NOTES FOR
BLD2006-00239
CONDITIONS FOR
BLD2006-00239
1) Xppfo��d per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
2) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-$ 0-,47-0982. 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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3) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved
access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where
such rgads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
4) 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
DepartTent prior to any further inspections being performed or approvals granted.
5) 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
inspect ons.
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6) 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
removal H�of approved documents will result in failure of required building inspections.
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7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X, W
BLD2006-00239 Please referto the following pages for conditions of this permit. 2 of 4
8) 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
Building\Department prior to any further inspections being performed or approvals granted.
9) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, Compliance Method: IV, Window(Max U-Factor):0.40, Skylight(Max U-Factor):0.58,
Doors Type/Max U-Factor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10.
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10) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
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11) 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
charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
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12) 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
X�rrievocation.
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13) 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 pro gct.\
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14) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
o ange or regulation, must be reviewed and approved by Mason County prior to construction.
15) 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
Ins to shall be made prior to requesting additional inspections.
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BLD2006-00239 Please refer to the following pages for conditions of this pen-nit. 3 of 4
16) All property lines shall be clearly identified at the time of foundation inspection. X�-TW
17) 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
X won County ordinances and building regulations.
18) 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
o�r ave prevented action from being taken. No more than one extension may be granted.
19) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
X�egtors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
20) Stock Plan Identification number: 2003-0006
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
I spec or at each required inspection.
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 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 property and structure for review and inspection.
OWNER OR AGENT:' _ DATE:
BLD2006-00239 Please referto the following pages for conditions of this permit. 4 of 4
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N CONCR MECHANICAL y MANUFACTURED HOME
Date Q l�o� ByCi
0 Footings Setbac Gas Piping Ribbons t
o Intenor Dat By Interior-Date By Date By
w Exterior Date By Exterior-Date B Set-up y
INSULATION
Point Load!Isolated Footings Date By D
BG!SLAB INSULATION - _<
Date By Data By FIRE DEPARTMENT y
Foundation Walls Floors Date By Z
Date By Date Q fig'6_6 By L I(31L DECKS m
FRAMING Walls r Date By
Date q Z U6 By 1,13L- Data '+" By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork
atao
� Type:
Date By Date By Date By
D.W.v DRYWALL Type:
Date166 ByLDX Int Brace Wall Date By W
Date By FINAL INSPEC ON
v Water Line l t Fin Separation CD
Date By �J Date By (� Date i tq 1)1j By O
m M
Pass or Request Inspect. c
Type of insp. Fail Date Date Done By Comments w
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Request To Revise An Approved Plan
Permit Number: BLD200(_-_ CCQB':1 Name
Parcel Number Z')I_�)_7 - _ Phone Numb daytime Q�)'` �-{4:
Project Address Mailing Address �Yl�
Please provide a complete,detailed description of the proposed revisions to the approved plans: .
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Are two sets of the revised plans or addendum indicating the changes included? 0-_Y ❑ No
Are the approved site plans included? Les ❑ No
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Are the revisions clearly and accurately identified on the plans or addendum? C/�s ❑ No
Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑`' Yes *r
If Yes,Has the engineer or architect approved this revision? ❑ Yes ❑ No
Is a stamped and signed approval included with this request? ❑ Yes ❑ No
(Note:No structural chances to a"desicned"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? !:jq, s ❑ No
If Yes, Is a revised site plan,.with all new setback dimensions included with this request?
VYes ❑ No
Additional Information:
Applicant's signatur Date: `
Office Use Only Received by
Date Sent Assigned To Approved By Date.
B Original Valuation: $
Additional Valuation: $
.� Sq.Ft. x$ $
.� ?/ d ^]/uM Olt tt)(0 Sq.Ft. x$ $
H 4 'U �� j Total New Valuation $
P W 1 J�1 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. $ °o
Other $
Total Amount Due: $
Amount To Be Paid Up-Front$
Tab d"
Revised SRG W2212003
HiL ICE - Building Permit Information Form - 1768 Plan
This form contains the information you'll need to complete your building permit packet. We've included information for all counties,
some of it may not apply to yours. If you have any questions, please give us a call at 360-807-1849
Applicant/Owner/Contact Information: Your name, address. phone number
Contractor Information: Name: HiLine Homes of Elma
Address: 50 Enterprise Ln Ste 215
Elma WA 98541
Phone: (360)482-1750
License# HILINH*981BT
Expiration: 01/30/06
Tax Parcel#/Assessor's Acct.#: This will be with your property information.
Job Site Address: Your new home address(example: xxx Filmore St.)
Legal Description: This will be with your property information. (example:Lot xx Large Lot Sub Division xxx in Lewis County etc.)
This will be a New Single Family Residence
Describe work/Type of Job: New Home construction
Home Information: Floor Area: (sq.footage)
Main/1st: 884 #of stories: 2 Carports: 0
Second: 884 Bedrooms: 3 Decks: 0
Basement: 0 Bathrooms: 2 Porches: 201
Total: 1768
Garage: 528 (Attached)
Construction Method: Wood frame
Heating System:
Be sure to choose the information below that correlates with the heat system you have ordered.
HVAC/Mechanical Contractor is the company installing your heat system.
Cadet/Wall Mount/Zone Heaters: Standard heats stem
Installer: North Pacific Electric Contact: Bernie/Kim
License#: NORTHPE994JB Phone: 360-943-6020
Expiration: 06/27/04 Location: Olvmpia
Manuf: Marley Brand:
Module M KW: 7
WHF: AMPS: 20
On permits,for the#of wall heaters,put 1,or you'll be charged extra for every one.
Heat Pump w/furnace w/HWH:
Installer: Chehalis Sheet Metal Contact: Dave Pyles
License#: CHEHASM252MH Phone: 360-748-9921
Expiration: 07/02/04 Location: Chehalis
Manuf: Trane Module: 2TWBO03OA1000A KW: 10
Tonnage: 21/2 HSPF: 7.75 Seer: 10
LRA: 71 Efficiency: 100%
Natural Gas or Propane furnace w/HWH
Installer: Chehalis Sheet Metal Contact: Dave Pyles
License#: CHEHASM252MH Phone: 360-748-9921
Expiration: 07/02/04 Location: Chehalis
Manuf: Trane Module: TDE060A936 Watts: 977
BTU: 60,000 Efficiency: 80%
Spot Vent Fan: 1 Kitchen Exhaust Fan:_I Dryer Vent: 1 Wood/Gas/Pellet Stoves:_ Gas Outlets: 0
Plumbing System: Installer: Allied Plumbing Contact: Roger
License#: ALLIEP*986KC Phone: 360-289-4114
Expiration: 05/31/06 Location: Rochester
Toilets:_2 Bathroom Sinks: 2 Bath Tubs:_ Showers: 1 Kitchen Sinks:_ Water Heater:_1_
Clothes Washer: 1 Dishwasher:_1— Hose Bibs:�1 (first 4 enter quantity of 1,every home has 2)
Energy Compliance Information:
Compliance Method/Path: Always#3 (Per Washington State Energy Code)
Total sq.ft of glazing(glass): Standard home: 228 _ w/sliding glass door option: 245 divided by
total sq.ft.of heated area: 1768 equals a glazing percentage of 13% standard or 14% w/sliding glass door option.
Swinging doors and skylights are not counted in this configuration because they meet all requirement minimums.
Window Schedule: See attached form.
Ventilation System:
Intermittently operating Whole House Ventilation System using exhaust fans&window fresh air vents. (VIAQ 303.4.1)
House Fan Specifications: Whole house fan:Qty: 1 Manuf: Solitaire Ultra Silent Module#: S110U CFM: 110
Bathroom One-Bulb Heater/Fans: Qty 2 Manuf: Solitaire Ultra Silent Model M 162 CFM: 70
Copyright 2003 HiLine Homes
VICINITY MAP NORTH
NAME: it
1j C SITE ADDRESS: LIN FER 2
CITY:
ZIP: MASON COUI" Ty
MAILING ADDRESS:
CITY:
ZIP:
PARCEL NUMBER: �3Z 12—
PHONE NUMBERS H: �1=
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MILES FROM HILINE SALES OFFICE: C76r
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MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner: �ll �Q Telephone: Parcel#: a,3
Type of project ( ew Residence ( )Addition ( ) Remodel
�r
Total Sq. Ft. 1 S Floor : 2" floor: Heate a gm ent:
of heated area:: - ) � r--
Hea ' g System Type: O Electric wall heater O Electric Central Furnace O LPG Furnace
eat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type:
O Other: S ecif
Glazing Prescri tive Option see reverse side circle one: 1 II
Percentage: Compliance
Method O Component Performance , Chapter 5— Calculation worksheets required
�3 Check one:.*
O Systems analysis, Chapter 4
O 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 Room/location U-Factor Size Quantity Square Feet
Windows:
Windows: Total Sq. ft.
Doors:
Doors: Total Sq. Ft
Total window and door area
Total window & door area I(divided by)total sq. ft of heated area = %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
(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 our building plans note the location and fuel type of water heater, location of exhaust fans
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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 U-factor Door Wall Wall Wall 4
Area%of Ceiling Vaulted Above interior4 exterior Slab
Option Floor „ U s 2 Ceiling3 Grade below 4 Below Floors on
10 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.
ACCESS & GRADE WORKSHEET
DATE: 1 (o
ADDRESS (DL_J)
INSPECTOR r LL9 `-
DRIVEWAY ACCESS
Length: �L�' Width: Surface:
Size of turn-around:
Condition of shoulders:
Verticle clearance:
GRADE
M
REMARKS
v -
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
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailing Addre Mailing Address
Cit lky% StateLdLZip Coe City State Zip Code
Phone - Other Ph Phone Other Ph.
Lien/Title Holder Contractor Reg.4 Exp.
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septi�,Y,__ Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District
Legal Description
Site Address (Please include street name, streeet number and city)
Directions to site
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff—Stream—Slopes or Bluffs J 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. f Fixtures Fees Fuel Type:Electric I-"LPQz_ Natural Gas— Heat Pump_
Toilets o Type of Unit No.of Units Fees
Bathroom Sink � Furnace
Bath Tubs Heatpumps —�—
Showers I Spot Vent Fan
Water Heater Propane Tank
Clothes Washer — Gas Outlets
Kithen Sinks I Wood/Gas/Pellet Stove
Dishwasher ___L— Kitchen Exhaust Hood
Hosebibs I 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 parry 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.
PROOF OF CONTINUATION OF RK IS BY MEANS OF A PROGRESS INSPECTION. �/
X % Date: _ 'l l)
di ner wners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group-Type Constr.-
Planning 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
FORM MUST BE COMPLETED IN INK PERMIT NO BLD�
PLEASE PRESS HARD MASON COUNTY
BUILDING PERMIT APPLICATION p
426 W.Cedar/P.O.Box 1B6,Shelton,WA 98584
Shelton (3601427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORjVIATlO
Owner \ Contractor Name ►1 11 NF dMr�
Mailing Ad ess ���\ �'�jl 1 Mailinn AridrP-,� S
Cityzjt21-ILA State Z�pTcje Cit y t -
Phone( y --tetherPh.(�)y -'f7�7 Ph(fin� �t��ther_ P,h.( Zlp de `�1Q�'t�
Lien/Title HDldel CentractorReg. #_ 141!uNN�9al A7
Address iE Expirations _p 7 /SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existin S tic X Connect to Sewer
System__Nante of Sewer System Well Water System_
Name of
Water System irYlpry J( ( _�
PARCEL INFORMATION-12 digit Tax Parcel No.
9 Fire District
Legal Description
Site Address(Please include street name, street number and city)
Directions to site
Will timber be. cut and sold in parcel preparation? (Yes/No) %42�
Is your, properly within 200' of the following: Body cf Water (Name)__
Lake _ k'iver/(,reek Pond Wetland Seasonal Runoff Stream Slopes SaltorBllJf}5
PERMANENT RESIDENCE SEASO t
TYPE OF JOB New d Alt Repair Other Use of Buildi
Describe bVol k .J+j—
No. of Eediooins No. of Bathiooinsj�2_ SQUARE FOOTAGE-1st Floor 2nd Floor
31d Floor Lott Basement Deck Other
Garage Attached Detached Car oft sq If
P Attached Detached
MOBILE HOME INFORMATI�+�` 1ake Model
Length Widll / Serial No. Model Year
T e of Heat No. of Bedrooms N athrooms
yp Purchase Plice $ Replacemen I ?(Yes/No InstaCer N e )
- Certification No. /
NOTICE: THIS PERMiI'BECOMES NULL 8 VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
intorination provided is accurate and grants employees of Mason county access to the above described property and structures for review and
Inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-1 certify that I am exempt from the requhemenls of the 'CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
Contractor Registration Law RCW 1827 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done In requirements regulating the work for which this permit is Issued and all work
conformance therewith. No changes shall be made v:ithout first obtaining shall be done in confor nce therew h. No changes shall be made without
approval
first obla r
x ale
x
ale _
j FOR OFFICIAL USE BE t'O.ND THIS POINT
Ac:cel:!ed by i12J _DateQkLL.0
ubnlittal Amount Due
Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES
Building Department
Occ Grow 1 Type Constr. t
I , C a Sw
Planning Department
Environmental Health Department TOb &V Lno
1
I I
Public Vlrorks Department
i I i
Fire Marshal �----I I
i
I
Valuation $ S3 21 'p.
FEES
Building Permit Fee I I t
tS Site Inspection
Plan Review Fee ; EI Review Fee
I
Plumbing & Base Fee Ci CEO/ I Planning Review Fee
_ 1
Mechantral&Base free q S S S' Cther
Wood/Gas/Pellet Stove Fee ! State Fee
Violation Fee
_ /V 0 EN F; I Pre-Paid at Submittal t )
TOTAL FEES {
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
�\ PO 411 No. Fifth Street//P.O. Box 186, Shelton WA. 98584
_0006 360.427.9670 ext. 352
Request for
N G0 Administrative reduction in the Required Setbacks ($90.00)
Mp,SO For 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: glum
Mailing Address:
City: State: IYA Zip:_
Site Address: �(lt�_
Telephone No.:�� "1002) - Y
J
Parcel Number(s): � —Zoning
Requested Variance: Front / Rear • Side Yard (please circle all that apply)
Requested setback variance: 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;
d) lot size of no more than one-fourth acre;
e) existing improvements of buildings, septic systems, and well areas.
t� Slde yard requirements:
\_j 1) Existing lots of record as of March 5, 2002;
You must meet one of the following. (Please circle all that apply)
2) e of the following exists on the lot:
a steep slopes, wetlands, or streams present;
soils that restrict building or septic development;
c) lot width at the front yard line of no more than 50 feet;
t " of size of no more than one-half acre;
"existing improvements of buildings, septic systems, and well areas
HAadministativevariance.doe (tw) February 05
Explain how these circumstances preclude a reasonable development proposal from
meeting the setback standard for Rural Residential
n al 2.5, 5, 10, or 20 zones.
n /
Owner/Agent(please indicate)
Signature and date
Official Use Only
Approved Date
Denied Date
Reason for denial:
HAadministativevariance.doc (tw) February 05
r
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 1.05.010). 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
63. � t '
E. otok e Lyme I � -
c- SkeliQni WA co-se
34
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Pot er
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APPROVED
Rrt^,SOS! COUNTY DOD FL.A',- l'NG
SITE PLAN REQUIRED TO BE ON SITE
CHANGES SUBJLCT TO APPR(O,VAL��,
gy.� _ Date
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