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HomeMy WebLinkAboutBLD2007-00320 Final SFR - BLD Permit / Conditions - 1/31/2008 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2007-00320 OWNER: RICHARD DICKINSON CONTRACTOR: HILINE HOMES 360-379-8600 LICENSE: HILINH*981BT EXP: 2/10/2008 RECEIVED: 2/27/2007 SITE ADDRESS: 1682 E MASON LAKE RD SHELTON ISSUED: 3/28/2007 PARCEL NUMBER: 321331090013 EXPIRES: 9/28/2007 LEGAL DESCRIPTION: LOT: 3 OF SP#2269 PTN TR 1 OF NE PROJECT DESCRIPTION: DIRECTIONS TO SITE: New SFR EAST ON MCEWAN PRAIRIE TO MASON LK DR LEFT FOR .3 MILE SITE ON Stock Plan #2003-0005 RT SIDE OF ROAD. SHARED EASEMENT SEE SP#2269 General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: VB Type of Use: SF Insp.Area: No.of Bathrooms: 2 Occ. Group: R-3U Lot Size: Deck: Type of Work: NEW Fire Dist.: No. of Stories: 1 Occ. Load: Building:2,112 Garage-Attached 528 Valuation: Building Height: 15 Occ. Status: Primary Basement: COVPORCH 96 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: W 127.0 Ft. Shoreline: Ft. Water Body: Rear: E 20.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Shoreline Desig.: Not Applicable Side 1: N 20.0 Ft. pp� able Year: Serial No.: Side 2: S 148.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 2/27/2007 $261.47 S22007000 Hosebibs 3 Ventilation Fan 3 Planning Review Fee KKK 2/27/2007 $170.00 S22007000 Kitchen Sink 1 Dryer Vent 1 Address Fee BLJ 2/28/2007 $154.00 Si2007000 Lavatories 3 Building State Fee ARC 3/1/2007 $4.50 S12007000 Showers 1 Building Permit Fee ARC 3/1/2007 $1,385.75 S12007000 Water Closets (Toilets) 2 Mechanical Fee ARC 3/1/2007 $43.75 S12007000 Water Heaters 1 Mechanical Base Fee ARC 3/1/2007 $25.30 512007000 Bath Tubs 2 Plumbing Fee ARC 3/1/2007 $97.90 S12007000 Clothes Washer 1 Plumbing Base Fee ARC 3/1/2007 $22.00 S12007000 EH Plan Review TW 3/14/2007 $75.00 S12007000 Total $2,239.67 BLD2007-00320 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR r BLD2007-00320 CONDITIONS FOR BLD2007-00320 1) 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 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X � _�> 2) 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�onnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X G =—/ 3) Approvefd_ er dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X Y 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 ranted. In addition a re-inspection pection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building De artm nt prior t p p\ o any further inspections being performed or approvals granted. X ila�-`.: 1 D 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 inspections. _ —7) X %z:.. 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 of a ,oved documents will result in failure of required building inspections. X_il �� 7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. BLD2007-00320 Please referto the following pages for conditions of this permit. 2 of 5 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 Departm 4aQt 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. X 10) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIND SPEED (3-SECOND GUST)the wind speed for Mason County is 85 MPH. X � 11) Per 2003 IRC - SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance Wilh the applicable provisions of this section and the manufacturer's installation instructions. X ' 12) Stock Plan Identification number: 2003-0005 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 Inspector at ea required inspection. X 13) 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). 14) 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. X- , J r—t 15) 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 permit revocation. X ���, BLD2007-00320 Please refer to the following pages for conditions of this permit. 3 of 5 16) 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.) 17) 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. X / - 18) 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 sh be rn prior to requesting additional inspections. X 19) All property lines shall be clearly identified at the time of foundation inspection. X 20) 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 Cograty ordinances and building regulations. X 21) 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 pre nted action from being taken. No more than one extension may be granted. X 6i 22) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X , 23) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed. X r T 24) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 25) This parcel is located i¢a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information. BLD2007-00320 Please refer to the following pages for conditions of this permit. 4 of 5 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 beforebuilding 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 inspction. OWN ER OR AGENT: ,��� a DATE: ���` BLD2007-00320 Please referto the following pages for conditions of this permit. 5 of 5 o CONCRETE MECHANICAL MANUFACTURED HOME n o Date ' C�-7 ByAwa C Foc.tings Ribbons /Setbacks Gas Piping Rions o interior y Date By Date By Interior-Date B (n o Exterior Date,J�' '�/" Bye Exterior-Date B __ t-� Z �r _u Paint Load/Isolated Footings INSULATION . m.....__.,_. pate 8y � BG P SLAB INSULATION Date By Data By FIRE DEPARTMENT = Foundation Walls 2W Floors Date By y Date By Data By DECKS X 5.22 0 0 FRAMING Walls Date By Dale _ By Data 91407 L'y �` �' PROPANE TANKS PLUMBING Vault pate By Date By , OTHER Groundwork Attic Type_ Date. gy Date By Date Ly 0,W.V DRYWALL Type: Date By Int Brace Wall Date By 03 tl _— 2 Z ` e ev�A FINAL INSPECTIOiN v CD Water Line Fire Sa ration Date iL By ( / Date By Date. By p m 11 Pass or Request Intsped. c Type of InsP. Fail Date Date Done By Comments CD _ — N �✓st/� - JT Z2o yra�� G .a2 r- 2-107 a u� 8 -? a 0 C 70 .� ` jf5,r�,e 0 R,tC��rc�4 � ��i�� DtC���hS4� �3�� N�yl�n ��'• SI.J wA S11e��o'�i �J� 9SS��f T-P- 4 1331010013 Plot Map Drawn To Meet "=4 p` i iiLine Homes Specifications. sG L E Any Revisions To Be Made Cy The Horne Owner. LtAh c6dln r,FbO 05',*,- � rA� re ...�;�.�. �µ.o c�t ®r, e .:...._., ;to CC '" a A._....., ._ v � � n wage d J � NavSe ` U r �3 s 0 ��► ► APPROVED ► 5s' �� MASON COUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL �r,—� By Date t==' VICINITY MAP NORTH NAME: ,,cN Z-A �) ` o" SITE ADDRESS: pji L(x.k eRci, CITY: ZIP: Q S MAILING ADDRESS: b3 dt I N ey(on D�-_ Il c? CITY: a ZIP: PARCEL NUMBER: 3 310 9 CXD I-3�5'1 PHONE NUMBERS H: 36p ,`Z© -y ;L W W: 360-1-09 - 7 17 3 C: MILES FROM HILINE SALES OFFICE: M 1 V\ , 5 ►�� ��5 RPR71,2-20060JED) 13: 06 Ma, County Title Insurance (FR' `604260716 P. 006/006 IZZ2 SHORT FLA r ARARm�AlES A 5Y/RIEY BR/Y, JOHN A. & F raPv�v ✓E*AN $rSHOP, PAUZ E: & &YTHZ- E. R 70 Aft C 7A ar 1W NE•114 Or SEC770Af 33, M MVSHIP 21 WORN, 21) 2P 612 2 ,2 RANGE T AST, W.AI, 33 34 XUD J'�173AP WA Y FouND CONC M. RRE,i.IJ:VVIV. WA. 98.372 MONUMENT PER IPAR=AK1 T2j=-jD-G0WV VOL SUEE 14 ACE 17D La d 1_ Q C] N k d � `y dd ..•••� s o / r ea'aD'41' W POSSIOLZ 'P 11 I ,I kc� %LL • o w I 1 of), R hrory� JO' U I ,43 Ames c A-733 ���o•-� Z7.7D' �� 1.44 A ES x . �4G'�>• Apo. UNA as,20•41 E Cf o� cd _ FDUN6 9NPr,CN 1�1'K 1 3�7 RG'De• l q �1v[RCo.+Ol ONlIG17 PER 1DSIJUE 114 PAGE'•173 0» j' &77' OF"sum" �O• P�7Z3f4 ' '1 5 01' '771 W �� �t"" `+zPD35t�.LE •.•. a e� KU ' IL �• 1 w � 107R R■733.1;4• ' x L-<w,ar Lola' 1 x O 1. • �Kpa50'41' w N 4=1'I0' 17 J I eaaa• •� , . � � LEGE�(,� • FOUND COANEXC Ar,140TO ^`c`�4,ts� r o �r a/a•J{LDAJI w MERIDIAN o tJ] A KAU=w BASED ON MASON LAKE ROAD FOUND coNCRCTE ® � ° COUNTY ROAD PROJECT XONUUMr PER o � o val.iufr 14 NUMBER loos 1? OF R ; ' ' ' ; y FOREST LAND SURVEYS i �'S'.s"'u u +� RICHARD B. NORRIS P.LS_ 1 HO MESiL ICE Window Schedule for H PLAN 2112 Manufacturer: Mil9 and Windows Inc. Type: Vinyl Model: Style Line Series U-Value= 0.35 Window SIZE GLAZING TOTAL LOCATION Quantit widthxhei ht AREA SQUARE FT. 1 5'Ox5'0 25 25 Bedroom #2 1 5'Ox5'0 25 25 Bedroom #3 '1 6'Ox4'0 24 24 Master Bedroom 1 3'Ox3'0 9 9 Master Bath 1 2'Ox5'0 10 10 Entry 1 4'Ox3'6 14 14 Kitchen 1 6'Ox4'0 24 24 Den 1 4'Ox5'0 20 20 Great Room 1 8'Ox5'0 40 40 Great Room 1 6'OX6'10"SGD 41 41 Dinina Room Total Window Area = ' 232 SQ. FT. [Total Glazing Area =232 SQ.FT. (232 / 2112) 0.11 x 100 = 11% (Glazing Area / Conditioned Floor Area) x 100 = Glazing Percentage If a sliding glass door option was chosen, switch the appropriate window with he slidinq lass door and use the calculation below. 1 'Ox6'10 SGD 41 41 [ppropriate Room (249 / 2112) 0.12 x 100 = 12% (Glazing Area / Conditioned Floor Area x 100 = Glazing Percentage All other doors,windows and skylights do not need to be calculated because they meet all minimum requirements Updated 5/5/05 HiL - Building Permit Information Form - 2112 Pla 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 Address: 1213 Long Rd Centralia WA 98531 Phone: (360) 807-1849 License# I I 1 YJT Expiration: 2 — Tax Parcel#/Assessor's Acct.# : This will be with your property information. Job Site Address: Your new home address(example: )xx Filmore St.) Legal Description: This will be with your property information. (example:Lot xx Large Lot Sub Division root in Levels 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: 2112 #of stories: 1 Carports: 0 Second: 0 Bedrooms: 3 Decks: 0 Basement: 0 Bathrooms: 2 Porches: 96 Total: 2112 Garage: $28 (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 In stalier: North Pacific Electric Contact: Bernie/Kim cense#: NORTHPE994JB Phone: 360-943-6020 piration: 04/01/04 Location: Olympia anuf: Marley Brand: odule#: KW: 10.5 HF: AMPS: 20 permits,for the#of wall heaters,put 1,or you'll be charged extra for every one. Heat Pump w/furnace w/HWH: Ii staller: Chehalis Sheet Metal Contact. Dave Pyles cense#: CHEHASM252MH Phone: 360-748-9921 xpiration: 07/02/03 Location: Chehalis anuf: Trane Module: 2TWR1030A1000A KW: 10 onnage: 21/2 HSPF: 7.75 Seer: 10 RA: 73 Efficiency: 100% Ii u l a o ro ne f acstaller: Chehalis Sheet Metal Contact. Dave Pyles cense#: CHEHASM252MH Phone: 360-748-9921 xpiration: 07/02/04 Location: Chehalis anuf: Trane Module: TDE06OA936 Wks: 977 TU: 60,000 Efficiency: 80% Spot Vent Fan: 1 Kitchen Exhaust Fan: 1 Dryer Vent: 1 Wood/Gas/Pellet Stoves: 0 Gas Outlets: 0 Plumbing System: Installer: Dee Dubs Plumbing Contact: Darren License#: DEEDUPL1990KQ Phone: 360456-7469 Expiration: 05/31/04 Location: Olympia Toilets: 2 Bathroom Sinks: 3 Bath Tubs: 1 Showers: 2 Kitchen Sinks: 1 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: 232. w/sliding glass door option: 249 divided by total sq. ft. of heated area: 2112 equals a glazing percentage of 11% standard or 12% 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. Vemtilation 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#: 162 CFM:70 Copyright 2003 HiLine Homes of Centralia JUN-29-06 09:56AM FROM-Hiline Financial 2537702226 T-TTO P.002/002 F-011 DEPARTMENT OP.I.A80R AND INDUSTRIES REGISTERED AS- PROVIDED BY LAW AS* �} CONST CONT. (3ENE$AL I' ' .r;���l1 y,,��Z�lt.�s .:. kk+:l"�;�.r y-�..n��' '::'••-.,�:-'4' ri•::ri�r•" "'f i ^i t�'•*' lrL'y'. r����. `.Y'J"A '7�..D .f 'EF F'E'C'��' T3ATk,'�`"�'r'`�� I•���0�0 Z�' ' . HILINE• HOMES 113.06 62ND AVE'E ' ' PUYALLUP WA 98373 - Detach Ar1d Usplay Ccrrifictat REGISTERED AS PROVIDED BY LAW I CONST- CONT GENERAL AS REGIST. # EXP. DATE please Remove CC01' HILINH*981BT .02/10/2008 And Sign EFFECTIVE DATE 01/30/2002 Identification HILINE H O - _ '.. Card Before 11306 62ND AVEA E• Placing In PUYALLUP •WA '.'98373 - Billfold J•bwcd 1) OF_'N_PTMENT UJ'LABOR AIVt)1NDUSTRu:S J 1'62;_u52.au,,pan, a 0®r MASON COUNTY PERMIT NO. UQ�- 06 0S 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 C On the web www.co.mason.wa.us APPLICANT�INFORMATION CONTRACTOR INFORMATION Owner /r 4/,,!/�c.L', t i nJ Company Name Mailing Address A leg L; > Mailing Address /� fl�'i� City to j�,!Zip Code City State A _ Zip Code 9 Phone ?ro d /w: _Other P . I �/5a4 8 Phone Other Ph. Lien/Title Holderl�:' -- ✓ Contractor Reg. # Ali fil#'K9YIT Exp. E mail address r> E Mail Address Drivers Lic.# c/�rk; }Sn rear, DOB �.� 5'4f Drivers Lic.#--- DOB____ _ SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water S ystem Name of Water System PARCEL INFORMATION - 12 Digit Parc�,Flo -' CJ Fire District Legal Description_Z: Or !+. 9 zt Site Address(Please inn ude st eet name, street number and cit Directions to sited e-i-i` " '1k � Will timber be cut and sold in parcel preparation?Yes/N_6` Pond / tw r / Is property within 200' of Saltwater Lake aA' River Creek AM Aq 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 - N�;w --- Add_Alt Repair Other_ PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building ;,ems;?,( n c e- Describe Work No. of Bedrooms_. —No. of Bathrooms % Square Footage- 1 st Floor ,-,'//.2 2nd Floor 3rd Floor------ loor Basement Deck Covered Deck Other Sq. ft. Garage �,�ttached iel"' 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 Ackr owledges 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 easem(;nt holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to a,oply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and(:rants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUAT'ON OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X %4�w� G o u_,��.---� — Date; caner/ wners,Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by:__ DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department &j C-7 �— Public Works Department Fire Marshal FEES Building Permit Fee i Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fens Uo Planning Review Fee Mechanical & Base fi::e (D < O S Other Wood/Gas/Pellet cstove Fee State Fee ' S Violation Fee Alo EAU Pre-Paid at Submittal Valuation $ C 3 Z TOTAL FEES ill /76 i 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 "—'11c On the web www.co.mason.wa.us APPLICANT R4FORI1JIATdRN j . CONTRACTOR INFQfWATION Owner A-Ac'xiov6dAj Company Nam E'er r7- Mailinq Address ZAK Mailirruta Address V -59�,&,-I-e Y ek1d ?, City Zip Code -6/c. ribY lkiy- 7i� -Qfofa—W0Q Zip Code— 7?1 Phone )thprP" 7S Phone 7XII(ither Ph. 4&,4lAf#4' r Lien/Title Holder i�,OAJ r A-fK Contractor Reg. Exp. E mail address/^'c""I"' Ic come-ct-5 f-Ape"" E Mail Address Drivers Lic.# Z)f6jk1,&S5CVWC- DOB &Wc "K' — , 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. Fire District Legal Description 1-14''7 Site Address W" (Pleas include str9et name street number and cit Directions to Site vJ.,2 r�'6�4 9& , c,.,- e'-' :;e ;26 &'V A yo,Or.,/ ,4 1"j. Is property within 200'of Saltwater Lake River/Creek Pond Wetland SeasonalRunoff—Stream—Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair—Other Use of Building Location of Fixtures/Units - 1 st Floor 2nd Floor�-- Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. ol Fixtures Fees Fuel Type.Electric— LPQ— Natural Gas— Heat Pump— Toilets ----&, Type of UnitNo. 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 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. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. 17 4 4&T ..' Date: 4r1;;E.zg 7 Owner/Owners 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 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