HomeMy WebLinkAboutBLD2009-00086 Final SFR DDR2009-00013 - BLD Permit / Conditions - 11/23/2009 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
P10
RESIDENTIAL BUILDING PERMIT
BLD2009-00086
OWNER: BRETT& MEAGAN KILMER RECEIVED: 2/10/2009
CONTRACTOR: HILINE HOMES LICENSE: HILINH"981 BT EXP: 2/10/2010 ISSUED: 2/24/2009
SITE ADDRESS: 173 E SLEAFORD RD SHELTON EXPIRES: 8/24/2009
PARCEL NUMBER: 321275400025
LEGAL DESCRIPTION: LAKE LIMERICK 5 TR 25 S 31/111
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
New SFR Lake Limerick
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 2 Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U-1 Lot Size: Deck:
Type of Work: NEW Fire Dist.: No. of Stories: 1 Occ. Load: Building:1,664 Garage-Attached 484
Valuation: Building Height: Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W 25.0 Ft. Shoreline: Ft. Water Body:
Rear: E 43.0 Ft. Slope: Ft. SEPA?:
Model: Width: Ft. Shoreline Desig.:
Side 1: IN 5.0 Ft.
Year: Serial No.: f Side 2: S 5.0 Ft. Comp. Plan Desig.:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 2/10/2009 $288.35 S22009000
Hosebibs 2 Ventilation Fan 3 EH Plan Review KKK 2/10/2009 $41.00 S22009000
Kitchen Sink 1 Dryer Vent 1 Water Adequacy Plan Review KKK 2/10/2009 $41.00 S22009000
Lavatories 2 Planning Review Fee KKK 2/10/2009 $205.00 S22009000
Water Closets (Toilets) 2 ADJUST--Plan Check Fee RTB 2/13/2009 $648.79 S22009000
Water Heaters 1 Building State Fee RTB 2/13/2009 $4.50 S22009000
Bath Tubs 2 Building Permit Fee RTB 2/13/2009 $1,441.75 S22009000
Clothes Washer 1 Mechanical Permit Fee RTB 2/13/2009 $49.20 S22009000
Mechanical Base Fee RTB 2/13/2009 $28.50 S22009000
Plumbing Base Fee RTB 2/13/2009 $24.70 S22009000
Plumbing Permit Fee RTB 2/13/2009 $94.44 S22009000
EH Plan Review ADR 2/20/2009 $62.00 S22009000
Total $2,929.23
BLD2009-00086 Please referto the following pages for conditions ofthis permit. 1 of 5
CASE NOTES FOR
BLD2009-00086
CONDITIONS FOR
BLD2009-00086
1) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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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
1-800- 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 roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road.
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4) All other necessary permits from Mason County, Washington State and/or Federal Agencies that� required for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
5) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
Department prior to any further inspections being performed or approvals granted.
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6) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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7) 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
rr(emoval of approved documents will result in failure of required building inspections.
8) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
BLD2009-00086 Please referto the following pages for conditions of this permit. 2 of 5
9) 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.
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10) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors
(Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab
Insulation R-10.
Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the
underside of the roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation.
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11) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. "NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system
of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contractor is acknowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X 4=01�l
12) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
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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
charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
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14) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
perm it;.rp,v`o�cation.
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BLD2009-00086 Please referto the following pages for conditions of this permit. 3 of 5
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 project. IL X
16) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
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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
Inspector slie made prior to requesting additional inspections.
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18) All property lines shall be clearly identified at the time of foundation inspection. X
19) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason Coun ordinances and building regulations.
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20) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have ppr�evented action from being taken. No more than one extension may be granted.
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21) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connecto,c and flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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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.
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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
�ApprM
Site Plan"to ensure these structures are shown and meet the setback conditions listed.
BLD2009-00086 Please referto the following pages for conditions of this permit. 4 of 5
24) Wateriquality is not to be degraded to the detriment of the aquatic environment as a result of this project.
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25) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X U
26) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established. X 31L
27) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/ Reserve requires a 1 Oft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. N foundation drains within 30ft, down gradient of drainfield/reserve area.
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This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at 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 property and structure for review and inspection.
OWNER OR AGENT: DATE: c4cK `1 t
BLD2009-00086 Please refer to the following pages for conditions of this permit. 5 of 5
a CONCRETE MECHANICAL MANUFACTURED HOME X
o Date S'rZT 01 By LQ1-- —.
C) Footings!Setbacks Gas Piping Ribbons fn
o Interior Date By Interior-Date By Date By PO
rn Exterior Date 3 t7 l BY C.IOC Exterior-Date By
Set-up
INSULATION
Point Load I Isolated Footings Date By M
BG/SLAB INSULATION ------------- - —I
Date By Data By FIRE DEPARTMENT
Foundation Walls Floors Date By 90
Date By Data -7 a', By�f DECKS D
FRAMING Walls Date By
Date (o Jv Qr1 By L�i� Data b OR BY PROPANE TANKS Z
PLUMBING vault Data ey
Date By OTHER
Groundwork Attic cy
Date O B Type-
Qate By y Date By
D.w.v DRYWALL Type.
Date a?�c1"I By Z,,,oc Int.Brace Wall Date By W
Date By FINAL INSPECTION 0
Water Line Fire Seperation N
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TOPOGRAPHY PROFILE:
PLANNINGFcB 10 0009
MASON COUNTY
Direction: Scale: Approval: for office use
Building Permit number:' ` �1,� Building:
Owner/Applicant: ,� xtk G�Cl� JAAC-S``� �''s Planning:
Date of
Parcel Number
j �� �� application: Env. Health:
Case Activity Listing 1/5/2018
11:56:SIAM
Case#: BLD2009-00086
11914
Parcel #: 321275400025
Description: New SFR
Assigned Done
Activity Description Date 1 Date 2 Date 3 hold Disp To By Updated Updated By
BLDA510 Reprint Building Permit 2/26/2009 None DONE GMM 2/26/2009 G M M
BLDA990 Plot Plan Revision Received 2/26/2009 None DONE GMM 2/26/2009 GMM
Applicant wanted to flip the house,which would be moving the garage to the other side. Signed of new sit plan. Meets all setbacks.
BLDA977 Enforcement Actions Pending 3/2/2009 None DONE DLC 3/4/2009 DLC
Concerned person reported 6-ft-8-ft cuts next to property line. Inspection schedulded 3.3.2009 to verify. Also LMOR to notify owner of potential danger.
Inspection performed on 3.3.2009: Inspector found cut is max.5-11 and closest to strung property line is 3-11. This falls within grading ordinance guidelines. Complaint is invalid at this time. LDK 3.3.2009.
The inspector found that the soil removed from the site was placed at a vacant lot located across from 100 E Sleaford mailbox. Photos are attached and will be forwarded to planner for review. do 3.4.2009
BLDC100 Inspection 3/3/2009 None DONE LDK 3/4/2009 CMRC
Inspection performed on 3.3.2009: Inspector found cut is max.5-ft and closest to strung property line is 3-ft. This falls within grading ordinance guidelines. Complaint is invalid at this time. LDK 3.3.2009.
The inspector found that the soil removed from the site was placed at a vacant lot located across from 100 E Sleaford mailbox. Photos are attached and will be forwarded to planner for review. do 3.4.2009
BLDC110 Footing Inspection 3/13/2009 3/16/2009 None PASS LDK 3/17/2009 KKK
Footings/Setbacks Passed.
BLDA977 Enforcement Actions Pending 3/4/2009 None DONE CMRC 3/18/2009 DLC
Contractor or owner needs to contact Planning at x577 concerning the removal of dirt onto neighboring property. Area has slope greater than 15%and requires MEP&georeview.
The ENF 2009 case has been closed.
BLDC 125 Framing Inspection 5/26/2009 5/27/2009 None FAIL LDK LDK 5/29/2009 KS
1.INSTALL SOLID BLOCKING BETWEEN TRUSS.SEE PG 53 AT HOUSE/GARAGE WALL
2.HEADER AT GARAGE DOOR CALLS OUT FOR 3 1/8X 3 1/2.ONLY 4X12 INSTALLED.PROVIDE BEAM CALCS.
3.PROVIDE FULL BEARING AT OVER FRAMING RAFTER AT SEAT CUTS AT BEARING ONTO LOWER ROOF
4.WILL NEED TO PROVIDE FRESH AIR TO MASTER BEDROOM.NO WINDOW POSTS ON SLIDER
5.DRY-OUT AND REMOVE ALL STANDING WATER IN CRAWL
MAKE CORRECTIONS,ITEMS WILL BE CHECKED ON NEXT INSPECTION.OK TO INSULATE WALLS ONLY.
BLDC130 Plumbing Inspection 5/26/2009 5/27/2009 None PASS LDK LDK 5/29/2009 KS
Page 2 of 3 CaseActivity-rpt
Case Activity Listing 1/5/2018
11:56:S1AM
Case #: BLD2009-00086
1PIO
Parcel#: 321275400025
Description: New SFR
Assigned Done
Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By
BLDC135 Mechanical Inspection 5/26/2009 5/27/2009 None PASS LDK LDK 5/29/2009 KS
BLDC125 Framing Inspection 6/9/2009 6/10/2009 None PASS LKK 6/15/2009 PIB
Items#4&5 need to be checked at final.
BLDC 145 Insulation Inspection 6/9/2009 6/10/2009 None PASS LDK 6/15/2009 PIB
Install insulation dam/baffles bewteen vault and flat ceiling.OK to dry wall.
BLDC 100 Inspection 6/22/2009 6/24/2009 None PASS LDK 6/25/2009 KKK
Int.BWP.
Item 4&5 still need to be checked at final.
BLDC157 Final Inspection-Failed 8/6/2009 8/7/2o09 None FAIL LDK 8/13/2009 PIB
1.) Seal all exterior penetrations of siding(cables wires etc.)
2.) Complete all final grading min 6"slope away form 10'-if 10'cannot be obtained create swales to diver water around structure.
3.) Seal off other 1/2 of foundation vent at dry vent termination.
4.) Al foundation vents within 1"of grade will require vent well. Remove all dirt from foundation vents.
5.) Seal hole in garage separation at garage door support bracket.
6.) Rise from garage floor to threshold is 9"-this will require a step. Rise of stopes must be equal or min within 3/8". Must be as wide as door and tread depth min 10". Temp Occupance for 180 days.
Make corrections.items will be checked on next inspection.
BLDC155 Final Inspection-Passed 11/19/2009 11/23/2009 None PASS LDK 11/25/2009 PIB
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Page 3 of 3 CaseActivity..rpt
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173 Sleaford Rd 91 Sleaford Rd
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Name R(rA Parcel# 3211215yv0025 BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development, or redevelopment', with more than 2,000 square feet of impervious surface'.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment.
'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads, packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater. Open, uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate It»petylous S itfaces Please Gomplete`This"Tab le`
Surface Type Length X Width = Area " All dimensions in feet
Buildings X =
X �� = *, Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X =
X = Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved, gravel or packed area per definition
X _ above table
Patios/Vllalks X =
X = Any paved, gravel or packed area per definition
X _ above table
Others X =
X = If the total.impervious area of the proposed, site
X = develapm nt is"greater than 2600 square feet a
Small Parrel,Sturrnwater Site'l'lan is Required
Total Impervious Surface Area (sure of all areas ' al 44E
If the Total Impervious Surface Area is LESS THAN 200)Square Feet, please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwate Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that submission of inaccurate nformation may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I a the owner,owner's legal representative,or the contractor. I
further acknowledge that the information provided is accurate and a ployees of Mason County are granted access to the above-
dZA"
view and inspection as may be required.
Owner/Age t/Contractor(circle one)Date:
If the Total Impervious Surface Area is GREATER THAN 0 0 Square Feet, please read, acknowledge and sign
the information provided on page 2 of 2.
Pagel of 2 , r
Name �6 ��t�MC( Parcel# `�75`�()GG25 131- �Ja06q. CaOC��(�
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
http//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14, Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan". This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A)�The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) �L— An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT. 450
Mail: P 0 Box 1850, Shelton WA 98584
Physical: 415 N 6th St, Shelton WA 98584
If this development has,or will have, a septic/d rain field system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other, parcel. You may also wish to consult with the septic design professional involved with the project.Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will he added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor. I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
describe roperty for review and inspection as may be required.
X zz
wne /Agent/Contractor(circle one)Date:
Page 2 of 2
ASON COUNTY PERRMIT NO. 00
r aBUILDING PERMIT APPLICATION rAc ¢-,
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
(360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-52691 }�
0!4_�Shelton
Y) On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Vokcc 140 Company Name 141 WIC h rc,
Mailing Address Iu C UMe i I L Mailing Address 1r.
City State�_Zip Code City .. VI 01% State Zip Code (AkAlA
Phone V " 1424 -hot er Ph. .�4G• olaq" 1191q Phone 1(b - 6"1- 17a� Other Ph. - 0.1 3
Lien/Title Holder a�<W rL t.*�<< Contractor Reg. # HILIIUN gftll Exp.
E mail address lh-rvl MCM606 k(►4 mA,1 E Mail Address
Drivers Lic. # Drivers Lic. # DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Sewer System Name of SewJi5yst
PARCEL INFORMATION - 12 Digit Parcel No. ` Fire District
Legal Description cv.c r 1 c ht_ 4
Site Address (Please include street name, street number and cite)
Directions to site 49I tin
S&G
Will timber be cut and sold in parcel preparation?Yes/ No
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building vita ----Describe Work Ace-
No. of Bedrooms 2No. of Bathrooms -) Square Footage- 1 st Floor 1 LI 2nd Floor
3rd Floor Basement Deck— Covered Deck Other Sq. ft.
Garage 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 informaticn 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
MEAN QFAPROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X r o le, e, Date: 12Z! 7f(>
Owner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW Al ROVED D NIED NOTES
Building Department
Planning Department
Environmental Health Department
Fire Marshal
FEES �j-
Building Permit Fee Site Ins ection
Plan Review Fee 'l �� EH Review Fee
Plumbing & Base Fee 7. ��y 2y ?� Planning Review Fee
Mechanical & Base fee - d Other
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee a . l 3-0 Pre-Paid at Submittal
Valuation $ TOTAL FEES
MASON COUNTY PERMIT NO.ZP-ICW09 -nnoaQ
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.Cedar• P.O. Box 186, Shelton,WA 98584
Shelton (360) 427-�670•Belfair(360)275-4467• Elma (360) 482-5269
n the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMAT n�
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Owner iiMR �roc,( Company Name T
Mailin Address F Mail* Address. yc- I-
1 Zip Code Nfs3`13
City tate W!k" Zip Code �lFS5Sr`l City State "r .,,,x..
Phone Other Ph. l ay Phone •5 o Other Ph.
Lien/Title Holder kC1� �at�1G Contractor Reg. Exp.
E mail address EcM.,,6-f'5, y. Q ko�r-\,%t p^^ E Mail Address
Drivers Lic.# < - S l 1 Q DOB 01 1 Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic& Existing Septic?— Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. CJC�O Fire District
Legal Description << t(Ag ko n
Site Address (Plegue include street name, street number and city)
Directions to site u I
`` ' L. c
Is property i hin 200'of Saltwat r Lake River/Creek Pond
Wetland /l ,A Seasonal Runoff Stream_,A� _Slopes or Bluffs > 15%
TYPE OF JOB - New X' Add Alt Repair Other Use of Building
Location of Fixtures/Units - 1 st Floor e 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric,X__ LPG_ Natural Gas Heat Pump_
Toilets Type of Unit No.of Units Fees
Bathroom Sink ��_ Furnace
Bath a Heat um s
Showers s Spot Vent Fan I
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/PelletStove
Dishwasher Kitchen Exhaust Hood 1
Hosebibs a Dryer Vent i
Other Other -te,&k 7
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 property and structure for review and inspection.
P F CONTI ATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X Date: P/l-7 f0f�_
wne /Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Datec)-I 10 09 Bld Pd Receipt No.
DEPARTMEN AL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
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DEPARTMENT OF LABOR AND INDUSTRIFS
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGI ST . # EXP. DATE �tv'
w EFFECTIVELDATE981HT 01/30/2002 1V
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11306 62ND AVE E
o PUYALLUP WA 98373
1705•Ui20011 019^1
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rREGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL Please Remove
REGIST. 4 BXP. DATE
CC01 HILINH*981BT 02/10/2010 And Sign
EFFECTIVE DATE 01/30/2002 Identification
Card Before
HI-LINE HOMES Placing In
11306 62ND AVE E Billfold
PUYALLUP WA 98373
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o Issued by DEPAR'rmE , of LAIJOR AND INDUSTRIES
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MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
411 N. Fifth Street/ P.O. Box 186, Shelton WA 98584
360.427.9670 ext. 352 DDR D`(-C'C�
Rec'd by
Request for
Administrative Variance for Reduction in the Required Se c $11Pe
For administrative review, the minimum variance on a setback request is
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: ` )6� c. meySC.n 1<1 ( fy c'C�
Mailing Address:
Telephone : 0
City: 5Lt/ &f\ State: (A Zip:
If this reduction is tied to a building permit, please i e permit
case number. BLD
Parcel Number(s): � QL ka 15-lfcsc0as Zoning -5
Site Address: 1-7�) 6 S)cz focJ
Requested variance: Front / Rea=SideYard plea circle that apply)
WW, I�0FCL.
Requested setback variance: 5
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) 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;
\\CLUSTERI HOME SERVER\HOME\COMMON\COMMUNITY DEVELOPMENT\PAC\VARIANCES\2009
Adminstrative.vandoc Updated: 12-15-2008
e) existing improvements of buildings, septic systems, and well areas.
SIDE Y RD 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.
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GGf�d_ & c.\n �\CA . C..rrr-a�lY �,. r1
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Owner/ Agent (please indicate)
Signature and date
Official Use Onl y
Approved Date��
Denied Date
Reason for denial:
\\CLUSTERI_HOME_SERVER\HOME\COMMON\COMMUNITY DEVELOPMENT\PAC\VARIANCES\2009
Adminstrative.var.doc Updated: 12-15-2008