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HomeMy WebLinkAboutBLD93-00459 Final SFR - BLD Permit / Conditions - 6/20/1994 1 i MASON COUNTY ' Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 ;I ;;: 11-11 JE 11. iL.11 II.. il''.d! tl,.::i II ' i::!: 11"i!. Willi IL: 11 F O R INSPECTION" C A I I 4 2 7—9 6 7 0 8i-_TWFEN 5pm AND Ham 427-7262 BLD93-0459 PARCEL : 32134139OO10 PLAT ; 01V : BLK : I. Oi. Ir)H ADORESS : E 449 MIKELSON RD SHELTON OWNER : EDWARD SMITH 352-4439 CONTRACTOR : E&S CONSTRUCTION 352-4439 L E G A L : TR 1 OF SN NE NOU TR 1 OF SP 1182 SEE SURVEY 8132 FS 19129:1 RK 116A CLASS OF WORK . . : NEW BEDR : 4 . BATH : 3 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT TYPE OF USE . . . . : SF STORIES . . . . . . . . OCCUP . GROUP . . < : o B L D 6 . HEIGHT . . : O . Oft �PRMT S 393.00 KS 05/13(93 32696 STFE $ 4e50 KS 05J13/93 32696 TYPE OF CONST . . : ? FIREPLACES . . . . : 0 RADN t 8.00 KS 05t13/93 3 26 96 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 P L C K t 196.50 KS 05/13/93 32696 DWELL . UNITS . . . . : 0 PARKING SPACES : 0 IPLM 63.00 KS 05113193 32696 INSPECTION AREA : 2 SHORELINE ?. . . . : N M C H 75.00 KS 04/1093 32696 TOTAL: 740.00 VALULATION: 79026 SETBACKS--------------- TOILETS . . . . . . . . . . : 3 FUEL TYPES-------------- BOILERS /COMP-- -- MOBILE HOME— FRONT . . . S 25 . Oft BATH BASINS . . . . . . : 4 : /OTH/ / / : 0-3 HP . : 0 RFAR . . _ . N 75 . 0ft BATH TUBS . . . . . . . . : 2 3-15 HP .. ° 0 M0DEL : e' SIOE ( 1 ) . E 2O0 . Oft SHOWERS . . . . . . . . . . : 2 FURN < 1O0K BTU : 0 15-30 HP . : 0 —MAKE------ SIDE ( 2 ) .W 200 . 0ft WATER HEATERS . . . . : 1 FURN ;>=100K BTU : 0 30-50 HP 0 ? SHRLINE . ? O . Oft CLOTHES WASHERS . . : 1 FURN FLOOR . . . : 0 5O-r HP . : 0 —YEAR------ AREA -------- -------- KITCHEN SINKS . . . . : 1 HEAT PUMP . . . . . . : 0 LOT SIZE . . : ? FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 1 EVAP COOLERS : 0 LENGTH : 0 BUILDING . . . : 1717sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 1 HOOD'S _ . __- 0 WIDTH . : 0 BASEMENT . . . : Osf, LAUNDRY TRAYS . . . . : 0 DOMES . I.NCIN : O —SERIAL#---- DECKS . . . . . . . Osf OTSHWASHERS . . . . . . : 1 AIR HANDLING UNITS-- COMMI_ .. INC:IN : O ? GAR /CARP : G 5 7 6 s f GARB DISPOSALS . . . : 1 (= 10000 cfm. : 0 RELOC /REPAI.R : 0 AT/DT . : A URINALS . . . . . . . . . . : 0 ) 10000 ctm, . 0 OTHER UN1: TS . : 0 MISC PLM FIXTURES : 0 GAS OUTLETS . : 3 PROJECT DESCRIPTION:New Residence PR0JgECTL0CATION:HwTTy 3 to Mason Lake ggRoaddK -ppppriiCgghtTToopnnp MTTiIIkkpeep I sspoopnHH-poppleeZffEttD aaIttS ssNigjjn.poMMMMEE EE IITTNNIINN 11gg ppppyygg pppp CC99ppSS ggllp IIoo pppp ppgggg IIss uSppEN E fpB g pp RIp �PO�EDAF� EIl6A� RB CPI �MMENCESNSEVIDEACE OFTCONTINOATIONOOFCWORKN�SDAWPR06RES50IA5PECTIUNIWITHIRTTH�TIB� UAYWPERI00.SfINAIDIRSPECTI0NEA05� BE OWNER OR AGENT: _ DATE:'—���"—t-- '131191 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 f A 4 .0 1 A 4.0 1 1-4 3� 1 ,54 - 13--9 0 01? 1 HIJ)"113-0459 Iftil if,DIWI 449 IN t K t I �.Oft 14 10 SHIA I ON I j I'M 1, k U OWA R D 1,l M 1-1 H is 4 4:5 9 4)tjl :,Jfff lilt, t- &'t CONSf ROC, I ION %4);J., -44 i9i 1 1, 1110 It I of 1134 it fog IR I "I SR 111112 sit SOMY 4101 11t $11f, 11A It 11106111 01 1.1 If k t, r4l III lit HP "I I 16 1 if fil"t di 11411 'pio MA ! h!J OW el't t w'f Ill, lit I (Ill I 1pgml I as J-4, 1 If . - I"I I i ) 4 �0 1 . 0'�jliili i,htoii Yq� I. o V lJil iji)I I 11, 1 OV; I P 1.A-'t5 1'4f, 1.0 0 fl�.i l",'Al DI It I I . II Ni I I it 140141 14 It t If!"N I ool, I I f-:14 1 1 1 if o 0 lit' 49 i IiA I f 1, lit it I t I� H 1, 1 N1 TA Of Ill it 4 h k N t I lilt!- k"i lj I fit, A fe I it - K I it tit N 1,11, - t fit h I 110mP 1 0 fAr N �,t N I t N(, I 11 Ni, 1)P I NI' 1 N 0 V N N." Miff I i HA&Mt N I I N D Wir rcn f, f4t j (1 It I tk I iI lv)!., t N II P I 1 0 Hi'l I I lit 1 114 0 1 6 A R A k 1­' 1 4 H D I t 1 0 0 0 0 1 k i - lit tit( I NAI 1 00klo I In Irl I PI Of I I I I H 1 fill to, 111tion take Rodd right. no Ill-pi-4c,11 - 14tt at sign v ill I I . Aff 4 U . ME# 6P A_61illl! 0 A I t COVCRETE � MECHANICAL MOBILE HOME Footings-Setb Gk date C�� _ `- �l'f�y k Ribbons cl.ite_. C 7/r3 by �/1 G-4K Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date - bV date by FRAMING Walls ;.� FIRE DEPT. date ' �C 4 $�` �� date by date by PLUM G Attic OTHER Groundwork date by date b D.W.V. WALLBOARD NAILIN date �, , date �' �!' by Water . FINAL INSPECTION date by date date by e_ 4 7 ZVAW .ram I� — 1 GLAZING Plan Reviewer- Fill out this glazing section or attach a window schedule to this checklist. Inspector- Verify window information during field inspections. Include skylights, glass doors and all other glazing on this form. Use rough opening area for calculations. Date Size QuantityArea S . Ft. U-Vale Manufacturer Rev. Ins . o xo 1 20 Ar- 6 I 3 4er 1 o 0 20 �D �s Total glazing area: f'R�� •� Total conditioned area: Z 21 7 Percentage glazing: - , Verified: DOORS Plan Reviewer-List opaque doors by type (solid core,insulated,etc.)quantity, U-value,and manufacturer. Impgftor- Verify door information during field inspection. Date Type/Quantity U-Value Manufacturer Rev. Insp. Co A T l � Signature of Building Inspector: Date of Final Inspection: r MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (206) 427-9670 CORRECTION NOTICL Job Location 11t) y h �E-t SAW rL�6 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: / Items listed below must be corrected to gain code compliance oc G C) You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection Department � 1� ate - ' Inspector 0 00 4 No OT rk Mo OV THf TA ,o Date Checklist Prepared 7 c! MASON COUNTY BUILDING DEPARTMENT PLAN REVIEWER AND INSPECTOR CHECKLIST 1991 WSEC AND V&IAQ CODE COMPLIANCE Permit Number 53 Address 4_12 2 M,I�e(s�.� �o4 c( Sq. Ft. Name on Permit S('1 i H ward Contractor[Phone # yy39 Compliance Method: Prescriptive _(Option) ( ) Component ( ) Systems Analysis Date FOUNDATION Insp. Rev. ( ) ( ) Slab: R- (Ext.foundation down to frostline/slab bottom;or interior 24"top of slab&horizontal. Radiant under entire.) ( ) ( ) Below grade exterior wall insulation: R- ( ) ( �Crawlspace ventilation: 61 = J,3 ! (I sq.ft.jf.A/150 sq.ft.floor area-cross vented) �sU / FRANIING ( ) (-J ( -Ylt—andard ( ) Igtermediate ( ) Advanced ( ) ( ) Woodstoves and/or fireplaces: (6 sq.inches combustion air supply duct with damper direct to firebox.) ( ) ( ;rlstandard air seal: (Bottom plate/subfloor,rimjoist/mudsill,window/door frames,penetrations condition to non-condition.) ( ) ( Attic ventilation (I sq.ft.NFA/150 sq.ft.ceiling area) ( ) ( spot exhaust fans: (4"exhaust-bathnaundry 50 cfm®.25 WG;kitchen 100 cfm®.25 WG. Vented out with dampers.) ( ) (Fresh air ventilation: Available to all habitable rooms. Installed and operational. (Integrated forced air,windows,wall ports.) Whole house exhaust fan: cfm Intermilteni�sy m m6nual&wlo cohtroia/cone less than or=to 1.5 at.1 WG) INSULATION ( Attic baffles installed to deflect incoming air(Rigid material resistant to wind-driven moisture,extend 12"above loose rill or 6' above but insulation) Mechanical ventilation ducts RA(Exhaust in unconditioned space&supply in conditioned space.) ( ) ( -) Wall insulation (above grade) R- _(Salt,face stapled) ( ) 1 insulation (below grade- interior) R- (Batu face stapled) ( ) ( Vapor retarders on walls (Faced ball,or 4 mil poly or perm paint.-circle one) ( ) ( -)____Rim joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.) 6 ( ) ( ) Vaulted ceiling insulation R- (vapor retarder&I"air space) FINAL Q contact over Zdrotr- ►�s�. Floor insulation R- I I (Substantial coota w/surface,supports less than or=to 24"OC,not blocking vents.) t�tjJVe ( ) ( Ventilation system is operational (spot,whole house,fresh air to all habitable roorru. integrated syste certification by installer is re uireoi) 1 ) ( HVAC ducts in unconditioned areas R-8 (joints sealed;mechanically fastened with a minimum of 3 fasteners.) ( ) --)----Pipe insulation R-3 (Hot and cold lines in unconditioned areas-service or recire.see Table 5-12). ( 7 SHW heaters: (NAECA label,separate power or gas shut-off,on R-10 pad if electric in unconditioned or on concrete.) eating system type: _C f h a P l ) ( don monitor on site with instructions.No. - supplied by MCBD Thermostat: (ileal range 55-75;AC 70-85;both 55-85. Backup heat controls(lockout)prevent simultaneous operation of primary system) ( ��Giround lid fuel appls.: (Glass/metal light-fitting doors;dir.comb.air source,a 4"dies.dampered,indir.source fox existing coast.) cover: (6 mil black polyethylene or approved equal lapped 12"at joints,extending to foundation wall) ( 'FP trations(All exterior wall and ceiling penetrations sealed to drywall-plumbing,exposed beams,will receptacles,fans,recessed lights.) ( Ceiling Insulation R-,�o(Insulate&weatherstrip access,baffle to prevent spillover-no cardboard) ( ) Vapor retarder paint if a vapor retarder was not installed when insulation was installed. R GLAZING Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. Igpector- Verify window information during field inspections. Include skylights,glass doors and all other glazing on this form. Use rough opening area for calculations. Size Date M44 uandt Area S . Ft. U-Value Manufacturer Rev. Ins . 3 0 X ! /c9, S - S .i a xo l 20 0 X O X0 IS Total glazing area: Total conditioned area: ��7 Percentage glazing: _ /D Verified: DOORS Plan Reviewer-List opaque doors by type (solid core,insulated,etc.)quantity,U-value,and manufacturer. Impector- Verify door information during field inspection. Type/Quantity Date U-Value Manufacturer Rev. Insp. 410 vu 0/ .Signature of Building Inspector: Date of Final Inspection: U W NLK J NAMLI: G- WINDOW & DOOR SCHEDULE WINDOWS INCLUDE ALL WINDOWS, SKYLIGHTS, SLIDING GLASS DOORS, FRENCH DOORS AND STORE DOORS. ANY WINDOWS IN DOORS (LESS THAN 50% OF AREA) MUST BE TAKEN OUT OF THE DOOR AREA AND PUT INTO THE WINDOW AREA ON THE SCHEDULE. BRAND MODEL U-VALUE QUANTITY SIZE TOTAL SQ. FT. c� v TOTAL WINDOW AREA Sol - DOORS BRAND MODEL U-VALUE LOCATION SIZE TOTAL SQ. FT. © leg �.Qg ';�%n(sp �, z al, x[� TOTAL DOOR AREA S�T2' r 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE PRESCRIPTIVE PATHS OTHER FUELS (GAS, OIL, HEAT PUMP) HVAC* Glazing wan Wall lnt4 Wall ext4 Slab* Equip. %Floor Glazing Doors Vaulted Above Below Below on Option Effic. Area U-Value U-Value Ceiling" Coiling" Grade Grade Grade Floor Grade Mod. 10% 0.70 0.40 R-30 R-30 R-15 R-15 R-10 R-19 R-10 Mod. 12% 0.65 0.40 R-30 R-30 R_15 P,15 A-10 R-19 R-10 III High 21% 0.75 0.40 R-30 R-30 R-19 R-19 R-10 R-19 R-10 XX Q x X.. LOW V. Reference case 21% 0.60 0,40 R-30 R-30 F349 R-19 R-10 R-19 R-10 V1.7 Med. 25% 0.50 0.40 R-38 R-30 R-19 R_19 R-10 R-25 R-10 V11.11 Mod. 30% 0.45 0.40 R-30 R-30 R-19 R-19 R-10 R-25 R-10 I Mwwffwm retwernerift for each option Wed. For example,it a proposed design has 5 Flom over crawl spaces or on)oed toen*--d air conditions. 0 9"ratio to the conditioned Vbor area of I M it"I comply with all at the requirviments of Ilia 21%gisring option(or hightw). Proposed designs which cannot 6 Required stab perimetag ineulgilion shall be a water resistant mats6al,manufactured nwM the speof6crequ"mwftotalwod option above,may ealcu6i000f, kance for is intended use,and insWed a000rding to manufacturer's specilications. see by Chapters 4 or 6 of this "ifitin 602.4. 2 Fteou'r0maints' APPIr"to Off ceilings except single rafter or joist vaulted ceilings. 7 Those options shall be applicable to buildings loss than throe stones. 'AdV dernotes,Advanced Framed Coding, 8 This well insulation requirwnwif denotes,R-19 wail cavity insulation plus R.5 foam 3 Requirement applicable only to single rafter or Pat vaulted ceilings. sheathing. 4 Below grade waft SW be inoulaled ether on the exterior to a minimum loved no M 9 Minimum HVAC Equipment efficiency requirement 'LOW denotes&nAFLIr=of0.74. 10.or on dis,intencir to die same level am wails above grade. EASCIM insulation 'Mod donotissi an AFLIE of 0.76. 'High'denotes an AFLIE of 0.98. irm"lled an below Veda waft"I be a water montant met",manufactured for Is intended use,WW instadled acoording to the manufacturers specifications. Sea Sechoin 6012 ELECTRIC RESISTANCE HEAT GlaZkV W41 Well lnt4 Wall ext' Slab$ %Floor Glazing Doors Vaulted Above Below Below on Option Area LI-Value U-Value Ceiling' Ceiling' Grade Grade Grade Floor Grade I. 10% 0.46 0.40 R-38 R-30 FI-21 R-21 R-10 A-30 R-10 12% 0.43 0.20 R-38 R-30 R-19 R-19 R-10 A-30 FI-10 12% 0.40 0.40 R-38 R-30 R-21 R-21 8-10 R-30 R-10 :X 0. V. Reference case .......... X X 18% 0.39 20 R-M R-30 R-21 A-21 R-10 FI-30 111-10 V1. 21% 0.36 0.20 A-38 A-30 R-21 R-21 R-10 FI-30 R-10 V11.7 25% 0.35 020 R-38 R-30 R-11941-51 R-21 R-10 A-30 R-10 Vill.? 30% 0.32 0.20 R-38 R-30 A-19+R-51 R-21 R-10 R-30 A-10 I Minimum requewrinents for each option listed. For*xanvA*,it a proposed design has 5 Floors over arawl spaose of onmood to&mbiwif sit conditions. a glazing ratio to Ow oondft"nod ftor area of I M 4"1 oornrily with all of the requ"meeft or the 21%glazing option(or hightwy proposed designs which cannot 8 Required slob pwinwer inoutation soapbe a war resistant material,manufactured""Of the SPeoffiC norttwomerths of a hood option above,"my calculate compkanoo, for its i'dw use,"instaw a000rding to manufacturers speciricaliont. see by ChWeni 4 or 6 of the code. section 6024, 2 ReQu"iments applies to an owlings except single raftw of joist vaulted ceilings. 7 These options shelf be applicable to buildings loss than throe stories. 'Add denotes Advanced FriLmodCeding. A This well Mutation reQuorement denotes R-19 wall cavity insulation pierA-S foam 3 Requirement eP0icaW4`only to single rafter of joist vaulted owlingre. sheathing. 4 Below grade waft shall be insulated eshw on the exterior to a rninimurn level or R_ 10.Oro"the n1sinor to the*xrrio love!as wells above grade ExIeriormoulatron instaJisid on below grade wish WWI be a waver resistant material,m"irlactured for is intended use,and installed acooming to the manutacturses specifications. see "dion 6022 MASON COUNTY BUILDING DEPARTMENT 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE OWNER �'70tV0APD 'Z7 TELEPHONE 85-;2- 44 3Y OWNERS MAILINGADDRESS �,q '�. �� ,�,��� OL W a COMPLIANCE INFORMATION TYPE OF PROJECT: M/NEW RESIDENCE()ADDITION()REMODEL()OTHER AREA(SQ.FT.) 1ST FLOOR 79a 2ND FLOOR HEATED BASEMENT Note: Heated basements must be insulated and finished to meet minimum energy code requirements. TOTAL SQUARE FOOTAGE OF CONDITIONED (HEATED) AREA 17/? COMPLIANCE METHOD: () PRESCRIPTIVE PATH -- circle option -- II iglazing IV V VI VII VIII Glazing percentage area divided by total conditioned area) O COMPONENT PERFORMANCE -- Chapter 5 -- attach documentation and worksheets ( ) SYSTEMS ANALYSIS -- WATTSUN 5.2 -- attach documentation and worksheets HEATING SYSTEM: , ELECTRIC RESISTANCE ' () Electric Central Furnace ( ) Electric Wall Heaters ( ) Baseboard Units a/G� ( ) Radiant Panels Other OTHER FUEL ( ) Heat Pump ( G Furnace ( ) Oil Furnace () Other () Boiler Syst dicate type) Make Model Size AFUE HSPF VENTILATION SYSTEM: M/sIp"ot and Whole House (V/Central Ducted System V,/Integ rated with Furnace Y (�l () Heat Recovery System (air to air heat exchanger -- heat recovery heat pump) GENERAL NOTES: Your building plans should indicate certain compliance measures: framing to be used (standard, intermediate, advanced); type of vapor barriers being used; location of furnaces, hot water tanks and other equipment; location of solid fuel burning appliances, fireplaces and their combustion air duct runs; and termination points of exhaust ventilation fans. MASON COUNTY BUILDING DEPARTMENT -� 1991 WASIIINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE RESIDENTIAL REQUIREMENTS (NEW CONSTRUCTION, ADDITIONS, &REMODELS) THE PROCESSING OF YOUR APPLICATION CAN BE EXPEDITED IF YOU PROVIDE COMPLETE AND DETAILED INFORMATION. YOU ARE ENCOURAGED TO COMPLY TO THE 1991 WSEC BY UTILIZING THE APPROPRIATE PRESCRIPTIVE PATH FOR YOUR PROJECT. THIS WILL ALSO HELP EXPEDITE MATTERS. THE FOLLOWING INFORMATION MUST BE PROVIDED: 1) A complete window schedule must be submitted with your WSEC compliance information, even if a window schedule is included on your building plans. Note that sliding glass doors (patio), french doors, and any door with 50% or more glass in it is considered a window with the area (sq.ft.) being the entire units rough opening dimensions. Any windows in doors (less than 50% of area) must be taken out of the door area and put into the window area on the schedule. This window schedule must minimally show the dimensions of the rough openings of each window, the model (casement, horizontal slider, single hung, awning, picture, etc...), and the units tested U-value. 2) If you are complying to the WSEC by prescriptive path and are using the area weighted averaging method you must include your calculations (worksheet). 3) Indicate type of hot water heater, location of exhaust fans (bathrooms, laundry, kitchen), the location of your whole house fan, and all insulation levels (walls, floors, ceilings, and slab) on your building plans. 4) Indicate how you will comply with the requirement for introducing fresh air to each habitable room on your building plans (window frame vents, through the wall ports, or an integrated system with your furnace). 5) If your home is 2,000 square feet or less, and using electric resistance heating (excluding heat pumps) a $900.00 "Payment to Owner at Time of Construction" will be issued from your service utility after the final County inspection has passed. Using electric heating or a heat pump in your home???? You may want to talk to your service utility regarding Long Term Super Good Cents incentives. Call PUD#3 at 426-0777 or PUD#1 at 877-5249. If you need assistance in showing compliance to the WSEC please ask for the brochure "What You Need to Know to Meet the Energy Code"; call the state energy office at 1-800-235-8248;or call and make an appointment with Dan Fitchitt or Debbera Coker of the Mason County Building Department at 427-9670. Permit No. • MASON COUNTY BUILDING PEI.MIT APPLICATION PLEASE PRINT � O #1 Owner gF U � Z z/W/7-,41-- Phone# - Site Address G ely9 /y11-if Sov ?,b Fire District # City S t k.>WSH, Z ip Directions to Job Site v-o /.,- APo . 4471S. Owner Mailing Address AIK 44) City Q , , ,o,.st St_ ZipS��_ Lien/Title Holder ";__ Address City St Zip #2 Contractor Name L--5 >�,�, Contractor Reg# 'r' ,�/S Jl Address /tea ��� � .v< r�,� Expiration date /L/ 2 / City. SdZip Phone #3 If septic is located on project site, include records . Connect to Septic? Public Water Supply ✓ Well (If residential, proof of potable water is required) #4 Parcel No. S11:34 • - 13 - CIPPM Legal Description 467 o-9 S.S. -/ — #5 Building Square Footage: 1st F1 7q2-- 2nd Fl 3rd F1 Loft Basement Deck #bedrooms #bathrooms Garage _ Carport Garage/Carport : ttached or Detached Other #6 Use of building � � x�� Describe work #7 Type of Job: New V Add Alt Repair Demolition Re-Roof Bulkhead Other #8 MOBILE HOME INFORMATION Model Year Make Model Length Width Serial No. #Bedrooms #Bathrooms Type of Heat #9 Any water on or adjacent to property: saltwater lake river pond wetland seasonal runoff other y� Show following on the site plan Lot r�mensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Name of Flanking Street Scale: Name of Fronting Street Date: APPLICANT TO DRAW SITE PLAN BELOW oZ 7 5>LI 0\ X 100 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW ,.Lu=:Lng Fixtures Fee Mechanical Fixtures Toilets Primary Heat Source (circte type) ►� Bath Basins I, Elect/heatpump/other C'g5 ti Bath Tubs (v j Showers No . FEE Hot Water Htr _ __LFurn 1 Laundry Washer Heat Pumps Sinks 3 ✓ Vent Sys (Central) (D Floor Drains —Vent Fans (Spot/Whole) U Laundry Basins Boilers/Compressors 1 Dishwasher Hp IDisposal �_ Air Handling Unit Urinals cfm. Other Fire Protection Systems Permit Basic Fee TOTAL PLUMBING $ Other -- - Gas Outlets.Hookups I1 Wood/Pellet/Gas Stove Other Permit Basic Fee 15 TOTAL MECHANICAL NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER WORK IS COMMENCED OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT 1 AM EXEMPT FROM THE REQUIREMENTS OF THE I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR CONTRACTORS REGISTRATION LAW RCN 18.27 , AND AM AWARE IN THE STATE OF WASHINGTON AND I AM AWARE OF THE OF THE MASON COUNTY ORDINANCE REQUIREMENTS FOR WHICH ORDINANCE REQUIREMENTS REGULATING THE WORK FOR WHICH THIS PERMIT IS ISSUED AND THAT ALL WORK DONE WILL BE 1N THE PERMIT IS ISSUED AND ALL WORK DONE WILL BE IN CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE CONFORMANCE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT FIRST OBTAINING APPROVAL FROM THE BUILDING WITHOUT FIRST OBTAINING APPR L FROM THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Return permit to: Department of General Services 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 FOR OFFICIAL USE ONLY* Acce ted b }` ; Date: y p . DEPARTMENTAL REVIEW FOR OFFICE USE CMY Approved coed Hold Approval Planning: Environmental Health: Building Plan Review: Occupancy Group: Fire Marshal: Other: FEES Ilspecial Conditions: II Ilsite Inspection I I1 II II I I II II IlBuilding Permit 13c3 II II II I I II 11 11violation Fee I II II 11 I I II 11 11violation Investigation Fee I II II II 1 I II 11 IlPlan Check I Sb 11 II 11 I it 11 ll Plumbing Fee I II II II I' II 11 IlMechanical Fee I II II 11 1' I II 11 11Woodstove Fee I II II II I � � I II II IIBuildin�s�ta�tb�Fee i IlBuilding Valuation: 11 11 TOTAL I rQ)II