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HomeMy WebLinkAboutBLD2008-01274 Final SFR DDR2008-00196 - BLD Permit / Conditions - 9/30/2009 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 104 RESIDENTIAL BUILDING PERMIT BLD2008-01274 OWNER: PETER MOORE RECEIVED: 10/13/2008 CONTRACTOR: HILINE HOMES LICENSE: HILINH'981 BT EXP: 2/10/2010 ISSUED: 5/8/2009 SITE ADDRESS: 71 E CROMARTY CT SHELTON EXPIRES: 11/8/2009 PARCEL NUMBER: 321275400128 LEGAL DESCRIPTION: LAKE LIMERICK 5 TR 128 PROJECT DESCRIPTION: DIRECTIONS TO SITE: SFR Lake Limerick set up Stock Plan 2006-0052 General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 1 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:897 Valuation: Building Height: Occ. Status: Primary Basement: COVPORCH 65 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: E 25.0 Ft. Shoreline: Ft. Water Body: 24 SEPA?: Model: Width: Ft. Rear: W 1 .0 Ft. Slope: Ft. Side 1: N 24.0 Ft. Shoreline Desig.: Year: Serial No.: Side 2: S 9.0 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 10/13/200 $509.44 S22008000 Hosebibs 3 Ventilation Fan 2 EH Plan Review KKK 10/13/200 $40.00 S22008000 Lavatories 1 Dryer Vent 1 Water Adequacy Plan Review KKK 10/13/200 $40.00 S22008000 Kitchen Sink, w/disposal 1 EH Waiver Review KKK 10/13/200 $110.00 S22o08000 Water Closets (Toilets) 1 Building State Fee ARC 11/4/2008 $4.50 S22o09000 Water Heaters 1 Building Permit Fee ARC 11/4/2008 $783.75 S22o0900o Bath Tubs 1 Mechanical Fee ARC 11/4/2008 $37.55 S22009000 Clothes Washer 1 Mechanical Base Fee ARC 11/4/2008 $26.60 S22o09000 Plumbing Fee ARC 11/4/2008 $63.31 S22o09000 Plumbing Base Fee ARC 11/4/2008 $23.10 S22009000 EH Plan Review CEW 5/7/2009 $60.00 S22009000 Total $1,698.25 BLD2008-01274 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2008-01274 CONDITIONS FOR BLD2008-01274 1) Planning Note: All setbacks are measured from the furthest '6inprojection. All portions of the proposed replacement manufactured home must be a minimum of 5 feet from the south property line. X 2) Prior to final approval, all upland areas disturbed or newly a by c struction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 3) The internatil de requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access Roa s are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roa c ne with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 4) Contractor regis laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are al ris and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647 0 2. The p rson signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 5) Approv e dimensions and setbacks on submitted site plan. Setbacks are measured hdatio e furthest projection of the structure. X 6) Temporary erosion control measures must be implemented to prevent water quali egrof adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X 7) All approved a 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 g ed In ad ition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building Department r to ny further inspections being performed or approvals granted. X 8) Owner/_ nt*s esponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 9) The plan review c ck list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicat d on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The p�rmi h er is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removal appr doc ments will result in failure of required building inspections. X BLD2008-01274 Please refer to the following pages for conditions of this permit. 2 of 5 10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 11) The"approved" ite 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 approva ranted. In addition, a re-inspection fee(refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Depart ent rior to any further inspections being performed or approvals granted. X 12) 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- 0. Exce ti 00 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 theoof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X 13) Per 2003 IRC SECTION 1609-WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum win I s prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC r�rIWE D (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X 14) Per IRC -SEC ION R905- REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accorda 4 the a licable provisions of this section and the manufacturer's installation instructions. X 15) 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 documen .entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on th application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting Mason County Division f 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 tq consult with the septic design professional involved with the project. By calling for a final inspection of the building permit the owner/agent/co astQr is Ito ledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 16) Concrete used for b sement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete wok exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X BLD2008-01274 Please referto the following pages for conditions of this permit. 3 Of 5 17) Stock Plan Identification number: SET UP 2006-0052 This project prov d subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department, original building p ins an II attachments approved by the Mason County Building Department shall be available for the Mason County Building Inspector at each re fired inspection. X i 18) Any changes in propose c struction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building l Department prior to con uc on. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If doc ent r re oved, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and sf e co ted by the Building Department prior to any further inspections being performed or approvals granted. X 19) All constructi;i -P,— Xmust eet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Wasn. cupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revoca 20) 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 ord1 ance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason Q ty Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be loca d 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. X 21) All changes to"ap uilding plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or r ulatio , m st be reviewed and approved by Mason County prior to construction. X 22) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of a permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the internaf odes as amended and adopted by Mason County. Any corrections changes or alterations required by a Mason County Building Inspecto a ad prior to requesting additional inspections. X 23) All property lines shall be clearly identified at the time of foundation inspection. X 24) All building perm' s shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a fina inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason Co ty o inances and building regulations. X BLD2008-01274 Please refer to the following pages for conditions of this permit. 4 of 5 25) All permits expir 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action f keno no ceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder ave ed a tion from being taken. No more than one extension may be granted. X 26) Pressure tre ed wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, conneeto"nshing. Install metal conne tors approved for contact with the new types of pressure treated material. X 27) Retaining walls needed to support a-sw arge such a structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 28) Landings d s rs st meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv d e Ian"tc�ensure these structures are shown and meet the setback conditions listed. X This permit becomes null and void if w rkbr 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 continuatior 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 inspec ion.The owner ora the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described props rid stru ture f r review a d inspection. U OWNER OR AGENT: DATE:— ` BLD2008-01274 Please refer to the following pages for conditions of this permit. 5 of 5 o CONCRETE MECHANICAL cy MANUFACTURED HOME o Date 7—L r ( BY --- C) Footings/Setbacks Gas Piping Ribbons o Interior Date i By'7L inferior-Date BY bate By m Exterior Date By Exterior-Date By Set-up 10 m Point Load!Isolated Footings INSULATION Date By I BG!SLAB INSULATION Date By Data By FIRE DEPARTMENT X Foundation Walls Floors Date By Date By Data By DECKS FRAMING Wails Date By Date '7 IZ-3I,D j ay Data 7, 1 BY PROPANE TANKS PLUMBING Vault Data ey Date BY OTHER Groundwork Attic Date By Type: Date By bate By D.W.V DRYWALL Type- Int.Brace Wall Date �'Z3 e+j BY Date Llo G"1 BY �'� Date By W FINAL INSPECTION v Water Line / Fire Seperation � Date 1�3/07Vy Date By Date Q�( By Q Pass or Request Inspect. Type of insp. Fail Date Date done By Comments 3 0 i r a . N 1�CN 2Lh In , a 7-2 r 7- �=i1 a ZY s ��►� ��i vm6y 9 m n w3i 0 J ANNIN�� Parce,( �A;orm_441,nn . .S�CaI� =3� �wller' -� � _ALL C KS ARE L.ASUREO r/ rR�Ji!�, ''HE i-f ,-Ht_,,, 71 �5�" tad wl ar c uwi- O�G�Ka,�s ' �/(o� i�G� -4- L t M _>r' ROJ EC 1101 . , a � '� HE `� I�CII��G Cro6lcs /Z D, ��►e tin� � � ��s �� r�ox 5170 PLANS PLOT REVISrw 3Z 27s�jvo� 8' RECEIVED..— DATELANNING ..,. ? ,6 'tot map C""To Meet s HiUne Homes S 1 0 Specifications ' v Any Revisions To Be Made f A P P R OV E D By The Hone t3vvner ��' j �,' iVIASflN CO ' ;�TY' DCD PLANNING n f ! SITE PLAN EQUI:ZED TO $E ON SITE CHANGEY SUBJECT TV APPROVAL � �x�s�� �} ' i BY --.,`"Date -` -"5 D PLANNING _D TO BE ON SITE SITE PLAIti ICE i' 1A Cf-iArOIrS E; APPROVAL of t By ( s b Dri JGwa 101 PLANNING• -, � 2 ALL SETBACKS ARE MEASURED w s ' c M >FROM THE FURTHEST , PROJECTION OF THE BUILDING c c a • S,s f l oo 'Q 9 95 ♦s Name Zr MQpe-b Parcel# JZg 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 2. '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. 2Common 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 Impervious Surfaces Please Complete This Table Ar Surface Type Length X Width = ea " All dimensions in feet Buildings X = 9 v-A 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 above table X = Patios/Walks 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 = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) �-� l8 If the Total Impervious Surfa Area is LESS THAN 2000 Square Feet,plea d,acknowledge and sign below. Based Upon th information you have provided a Stormwater Site:'anNOT requireDentae elopment activity. Owner/Builder/ ent Acknowle s that submission of inaccurate infory result in a stor permit revocation. Acknowledgeme t of such is a below. I declare that 1 am the ner's legal repthe contractor. I further acknowle ge that a inform tion p is accurate and emploason County ass to the above- described prope for re iew and in pection as may e X Owner/Agent/Contractor(circle one) Date: IL' - 1 3- G '�_ If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 f r Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Storntwater 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%ommissioners/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) 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/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to 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 be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor. I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Con tractor(circle one)Date: Page 2 of 2 rD MASON COUNTY PERMIT NO. © ` BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467• Elma (360) 482-5269 ?,Q I`Y�, On the web www.co.mason.wa.us APPLICANT INFORM ION CONTRACTOR IN RMATIO Owner Ems' OaIQZE Company Name H I ! E Mailin dress Maili Address � e City St e • Zip Cod City t3 ll U State Zip Code Phone Z Other Ph.253 319 103a Phone 2 �{a- Other Ph. Lien/Title Holder Contractor Reg. # �- Exp. E mail addres . E Mail Address Drivers Lic.# DOB v2 4q- 5(P Drivers Lic.# DOB SEPTIC/WATER SYSTE" INFORMATION - Connect to New Septic- Existing Septic 77 Connect to Water System `' Name of Water System`' I�'!G►'CG�/ Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel b Fire District fE Legal Description Site Address (Please i lude street name,street number and city) �� S Directions to site l-fb i Q r old u4pu 1t Will timber be cut and sold in parcel pre ar ation es No ,_ A '- Is property w' hin 200' of Saltwater n - Lake River/Creek A Pond '� 0 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?Ye No TYPE OF JOB - ew Add Alt Repair Other PRIMA R SIDE E SEASONAL ❑ Use of Building ©S� Describe Work ° Jl nq 17. No. of Bedrooms_ 2 No. of Bathrooms�_Square Footage- 1 st�Eloor� nd Floor 3rd Floor Basement— Deck—Covered Decl' Other a 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 information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROP CTI UATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X 11 � � Date: 10-12�-,7-603 Owner/O ners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted bt1s Date (t)• i3.08 DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department n0 - En Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee ? Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee 86• Al Planninq Review Fee Mechanical & Base fee 40 ( Other Wood/Gas/Pellet Stove Fee I State Fee 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 APPLIC T INFORMATIO CONTRACTOR I F RMAT O Owner z�77_6PZ 0©IQ1x_ Company Name �- Mailing Address %©- O d Maili I Addr s City S ate Zip Code City State Zip Code Phone Other Ph.23 31 ,3335 Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address 211/711k 1 2% hiWit COM E Mail Address Drivers Lic.#kf&9EPK#yqM DOB - Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic 9 Connect to Sewer System Name of Sewer System PARCEL INFOR TION- 12 Digit Parcel No Fire District :11 Z- Legal Description LAKe 4- Site Address (Please include street name,street number pnd cit ) Directions to site S Y i1/1 " 11 ' 1 Is property y in 200' of Sa twater 44y take River/Creek and Wetla Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units- 1st Floor— 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG_Natural Gas_Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink % Furnace Bath Tubs �_ Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the wo s prc in the application.I declare that I have obtained the permission from all the necessary parties. If permission is required from any ea ment holder or ny other party in interest regarding this application or the work proposed in the application,I have obtained permission from t eI to apply for this rmit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accu to djqd grants emplo es of Mason County access to the above described property and structure for review and inspection. PROOF OF CO NUA711 OF WO K IS BY MEANS OF A PROGRESS INSPECTION., X Date: I Owner/ wners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted y tanning Pd Ck# Date (y 13.n S Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Grou 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 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 411 N. Fifth Street/ P.O. Box 186, Shelton WA 98584 360.427.9670 ext. 352 �? C DDR 'C,>C� Rec'd by Request for Administrative Variance for Reduction in the Required Setbacks ($105.00) For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction requires a standard variance. Setbacks are measured from the furthest projection of the structure including roof eaves. G, • Applicant/Owners: b_ Q. • Mailing Address: ?10 Telephone z JISIM'�— ����`U1����' D6 � "7t,& E3 {?- City: Y(--� i_M State: a_ Zip. q0 ��7 If this reduction is tied to a building permitpl as give permit case number. BLD -- i Parcel Number(s): 7a z Zoning:3�-5 Site Address: UP, Requested variance: Front / Rear(/=Yardplease circle all that apply) Requested setback variance:66(­4�1- 54 ft. An illustrated site plan is required. Your site plan must show the following: north arrow, abutting street or easements, set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and driveway. Show all proposed new development. The following circumstances must apply: FRONT AND OR REAR YARD REQUIREMENTS: 1) Existing lots of record as of March 5, 2002; You must meet one of the following: (Please circle all that apply) 2) One of the following exists on the Iot- 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. \\CLUSTER I_HOME_SERVER\HOME\COMMON\PLANNING\PAC\VAR•IANCES\Adminstrative.var.doc Created of 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; width at the front yard line of no more than 50 feet; size of no more than one-half acre- ex ting improvements of buildin , 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. 40 "PnA C� ' Q+' Owner/Agent (please indicate) Signature and date Official Use Only Approved �� Date 2 Denied Date Reason for denial: \\CLUSTERI_HOME_SERVER\HOME\COMMON\PLANNING\PAC\VARIANCES\Adminstrative.var.doc Created of