HomeMy WebLinkAboutBLD92-1531 SFR MIS92-0160 - BLD Permit / Conditions - 3/15/1993 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
NI g N,.J 1:: 1.... 1:1 :F 014 (:1 F:. 1:::::: Fri: m ::I:: "'1 FOR INSPECTIONS CALL 427-9670
BETWEEN 5pm AND 8am 427-7262
BLD92-1531 PARC 321362190032 PLAT : DIV: ? BLK : ? tQT : ;
JOB ADDRESS : E CRANBERRY CREEK RD SHELTON
OWNER : ROBERT MCKIBBEN 427-7189
CONTRACTOR : ARRANT 426-6207
LEGAL : TN1OFS112NENE19 TN2OfSP2113
CLASS OF WORK . . : NEW B E D R : 3 BATH : 2 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT
TYPE OF USE . . . . : SF STORIES . . . . . . . : 1
OCCUP . GROUP . . . : ? BLDG . HEIGHT . . : 0 . Ott IPRMT $ 283.11 PIB 13/15/93 32256
TYPE OF CONST . . : ? FIREPLACES . . . . : 0 P L C K $ 25.1i PIB 43/15/93 32256
OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 PLM 27.10 PIB 13/15/93 32256
DWELL . UNITS . . . . : 0 PARKING SPACES : 0 NCH `; 22.01 PIB 13/15/93 32256
INSPECTION AREA : 1 SHORELINE ?. . . . : ? S T F E `: 4.51 PIB 03/15/93 32256 TOTAL: 361.50 VALULATION: 49436
SETBACKS-------------- TOILETS . . . . . . . . . . : 2 FULI TYPES---------- BOILERS /COMP---- MOBILE HOME--
FRONT . . . ? 0 . 0ft BATH BASINS . . . . . . : 2 0-3 HP . : 0
REAR . . . . ? @ . Ott BATH TUBS . . . . . . . . : 2 3-15 HP . : 0 MODEL : ?
SIDE ( 1 ) . ? 0 . 0ft SHOWERS . . . . . . . . . . : 0 FURN < 10OK BTU : 0 15-30 HP . : 0 —MAKE------
SIDE (2 ) . ? 0 . Oft WATER HEATERS . . . . : 1 FURN )=100K BTU : 0 30-50 HP . : 0 ?
SHRLINE . ? 0 . Oft CLOTHES WASHERS . . : 1 FURN — FLOOR . . . : 0 50+ HP . : 0 —YEAR------
AREA ---------------- KITCHEN SINKS . . . . : 1 HEAT PUMP . . . . . . : 0 ?
LOT SIZE . . : ? FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 4 EVAP COOLERS : 0 LENGTH : 0
BUILDING . . . : 1454sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0
BASEMENT . . . : Osf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN : O —SERIAL#----
DECKS . . . . . . : Osf DISHWASHERS . . . . . . : 1 AIR HANDLING UNITS-- COMML . INCIN : O ?
GAR/CARP : ? Osf GARB DISPOSALS . . . : 0 <= 10000 cfm. : 0 RELOC /REPAIR : 0
AT/DT . : ? URINALS . . . . . . . . . . : 0 ) 10000 cfm. : 0 OTHER UNITS . : 0
MISC PLM FIXTURES : 0 GAS OUTLETS . : 0
PROJECT DESCRIPTION:RESIDENCE
PROJECT L0CATI0N:HWY 3 PAST DEER CREEK STORE LEFT ON CRANBERRY CREEK 3 R 0 LOT ON LEFT AFTER CORNER
THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 181 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD
OF 181 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 181 DAY PERIOD. FINAL INSPECTION MUST BE
APPROVED BEFORE BUILDING CAN BE OCCUPIED.
OWNER OR AGEN/13131
�`l� DATE:
BLO—PRAT, rev91 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED
MASON� � � ����� COUNTY
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K� County ||| ��/� \�/ Cedar
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�] �� � l A/\ Shelton, Washington
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Case No . : DLD92-1531
For ; R0DERT MCKIBBEN
Page ; 1
1 ) THIS PROJECT WILL MEET THE LUNG TERM SUPER GOOD CENTS REQUIREMENTS AS AGREED UPON WITH
THE ELECTRIC U THE PROPERTY . INSPECTIONS FOR ENERGY CODE COMPLIANCE
( ) L BE PERFORMED BY A UTILITY REPRESENTATIVE '
;r4 C,
2 ) TEMPORA Y OCCUPANCY WILL NOT BE GRANTED UNTIL COLLINS WATER SYSTEM HAS BEEN
APPROVED
X
1 I MASON COUNTY G-77scC,
Mason County Bldg. III 426 W, Cedar
P.O, Box 186 Shelton, Washington 98584
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setb c date S/r ,E, by ,�.vL Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date S/i by _ date by
PLUMBING date '�� '��� OTHER
Attic
Groundw�//�/�j date by
date by �'D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date / ' -by U� `1ti��date Ji byj��� �
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O, Box 186 Shelton, Washington 98584
L,-is ip No HI-D I IS .1 1
F o u KOM- RI MCC IBBI. N
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Al�'PkuVl 11 1 /1'
c
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
IbY •• _ S 87 J9'42-E 26JJ.7J SECT ION 36'
N.
SEC. J6 A _
s Y— SEC.. J61
I.P. — --- Cuic. WN.
W/CAP LS 1I355 '(CAR RO '� Y HARTLEY)
I ATH-SO'l TH
164.54 \ 164.:0 \ 164.54 164.55 CEKTLRL IN[
,�,.,���
•, I i SEC TIOY J6�V l-
rt
r _ r ■ � � � w�M
■ r ■ ■ ■ ■ a ■ r )
NE
LOT 4 LOT 3 LOT 2 L N SEC. 36, TN?J.
1.24 AC �_ W o.`JI\S AC 1.24 AC,—�L ,/ 24 AC W^'261}aEYfT7�
(206)426-0002
`-WEST_RLY MARGIN PARCEL/.
o / •� '\� DC_R CREEK COUNTY
o r �' ROAD PER USAGE.
D !D 1=1
J I I ISEE ON-Sl TE SEWAGE SYSTEM
I I w I$i TE EVALUATION AND DISPOS,
'PEP.NIT, RECEIPT N0. 4206,
PAGES I TIQU s AT MASON
.49 g COUNTY DEPARTMENT OF HEALTI
\ \ / S 89' 22 E 657.94 ,, / SERVICES.
NORTHEERLY 1(ARC,N D TY ROA
DEER CREEK COUNTY
(JAMES A. A ROAD PER USAGE •"CARE IS VOUN IN PIACDOTT SC LE: 1 100'
HELEN F. OKONEK) C T�BplIC SYSTEM. TlOr!O< WEL S AND (00' ,
The information contained herein has,Kb.gan—abtai.ned- .,f-rom. the. selAer or
"'�7ceem reliable, however, we do not
guarantee its accuracy. If property corners or lines have been
��d--t-h,&]r have been done so with the information available at the
time. We encourage purchasers to verify this information as we are
` not licensed surveyors.
920 Railroad Avenue, P.O. Box 729, Shelton, Washington 98584 (206)426-2646
WA..1....r`;t_JN 5.:=3 LONG ..1..ERM SUPER GOOD CENTS/199:1 MC„> COMPLIANCE REPORT 12/21/
FILE: A:NEWI=I LE HOUSE I D: LT
Skylights @:1%:*"C:LA`S 50 ;SKYLIGHT U-0.500 8.0 3.8.'K
Ceiling fi49 blown Attic S T D baffled U--0.027 li l40 22 .7
7
E•`i49 blown Scissor 5:12 STD baffled t_J-0.0 2 610 19.81
Infiltration Standard Air Sealing ACH-0.350 11988ft3 ;,
----------------------------
S truc: Mass s Light Frame, Shec::y•tr,o ck:: walls M_ 3.000 1456 4 361,*,
--------------------------------------------------------------------------------
HEA'T I NG/COOL..I NG/VENT I L..A.L.I NCB SYSTEMS
PROPOSED
Heating System Type:: Electric: Zoned
System Efficiency: 1.00 %
Modified Efficiency: ..L.t-0
Design AC H: 0.60
Heating L..o ad( at 53F ,::It ): 1.761.1 B tu.,l.'r
`,:system Size: 5.2 kW
Maximum Size @ 1..50 : 7.7 kW
Average Annual Heat: 5595 kWh
Annual Costs
Ventilation System: Non-Heat Recovery: OTHER
Cooling System: NONE
SEER: 0.0 ( Unducted)
Cooling Lt:yF:d( a't; 5F dt ): 15209 9 Btu/hr
Recommended Size @125%: 1.8 tans
Annual cool requirement: :x::t K kWh/yr
Solar Access: Partially Shaded
------------------------------------------------------------------------------------------------------
GLAZ I i4G ORIENTATION
PROPOSED PROPOSED
South : .fir.. r,.. :' 2 North.h i : 35.5.f`'t2
Southeast . Northwest .
East 3503 West •act.
Northeast : Southwest, :
------------------------------------------------------------------------------------
Economic c:tlic;;1 e:'•1"Ie'i''I"f;;)y consumption estimates a'C'e designed for comparative
purposes only. Actual cost for heating will vary depending on weather
Page 2
WAT TSUN 5.;3 LONG 'TERM SUPER R GOOD i C:E•N TS/1991.. MCS COMPLIANCE REPORT 12/21/'
FILE: A:NEWF I LE HOUSE I D: LT
....:Y.......».__...._........_L.........._..Y...................._.............._..._...1._....-...._..........._...._._...._.J1..'i.J.._.....ELM:C.:_^:::.':::::�::L�.:C:'::::::::::'�.'::1::::�'::t.::e..........T_..:_...5 ..._ _..... .......... ... .. .... 1 .
Site: CRANBERRY RD Analyst: KELLY BUECHEL
SHE.i__TON Jurisdiction: MASON COUNTY
Utility: MASON COUNTY PUCE #3
Homeowner: JOL IN ARRANT T House Type: Single Family
Floor or Area: 1456 .L t2
Builder: .J OI-NYS CUSTOM CABINETS Weather Data: Olympia, WA
Climate Zone: 1.
The PROPOSED design QUALIFIES for SGC( 91 MCS ) Tier 1.
1
REFERENCE PROPOSED
COMPONENT PERFORMANCE* 27::c! 277 Btt.a/hr.....P::'
ENERGY BUDGET 2. 38 2.65 k:Wh/-ft2-yr
REFERENCE DESIGN
Reference
Component Description Value X Area :::: t_!A
-------------------------------------------------------------------------------
P- .1 ocfr h30 vented joist t.l.._t,i.i i29 1456 42.2
Glazing @15% 0.35 U-value U-0.:350 218.4 76.4
Doors Metal R5 base case i.1-0..1`0 42.0 8.0
AG Wall R`�°1+R 5 ACV i_!-��,.041 1.095 44-9
Ceiling, Attic Fl49 blown Attic ADV U..0.C7„'0 1466 29.3
Infiltration taa dard air sealing ACH-0.,35Ci 119 8 f t;3 76.8
-------------------------------
Reference UA
------------------------------------------------------------------------------------
PROP='OSE D DESIGN COMPONENT
Component Description Value X Area UA_
--------------------------------------------------------------------------------------------
F I oor R 30 vented Joist :T..k.oc t t-•f_1.0 `_7 1456 42.2
Glazing (rA10% ::r.:"AL.-P:I:NP.i:: VINYL... L...OWE'::/AR U_...Ci. 31:i'.ti 101.0 31.3:*:
:*::':ALPINE PATIO LOWS/AR U-0.400 41.0 16.i a:$-
Doors ;r.:si:P-'E AC:i•' TREE AVAN T I A:30 ) U_-0.090 42.0
i
AG Wall R21 ACV T1•-11 t!-t i.05:3 1121 59.4
::n:::a R42SKYLIGHT/BUFFER/RIM U-..0.0 33 50 1. 6
------------------------------------------------------------------------------
Items in parentheses not included in COMPONENT PERFORMANCE totals.
Denotes s non-standard values - check calculation of thermal value.
Denotes adjusted UA to reflect 7-1/2 mph wind speed.
Permit NO.BLD
MASON COIIN'I'Y
BUILDING PERMIT APPLICATION
PLWE PRINT
d, t-0 4 0- 15 31
#1 Owner �P; /�< < / /� Phone#
Site Address Jai +i C�Q 6a Ln Z
City r c :ems St-- Zip
Directions to Job Site
- .r il/Dt i Ij TD �/1i1�t1�PL0?l77A
Owner Mailing Address .,4-
City ,J St GL,4 Zip
Lien/Title Holder 9( - r
Address f&r 7fy
City r,l,r St- 'WA zip
#2 Contractor Name _l�i�hc� ���Ati� Contractor Reg#lk-�AA Cc.d 807--
Address 810 5 . Expiration date < < /Z 6/ 13
City S�161 +OVN Stwa Zip a 8 56 Phone zo(-- H Zo - 6 z o-1_
#3 If septic is located on project site, include records. (�OOA41u(44
Connect to Septic? Y, Public Water Supply_ Well Y,
(If residential, proof of potable water may be required)
#4 Parcel' NO.Ar T, J:� - oll(�-3
Legal Description/i/z
#5 Building Square Footage: (existing/proposed)
1st Fl Ns 6 / 2IId FI �— - 3rd Fl / Loft /
Basement' / ' Deck 32 / #bedrooms�_ #bathrooms _
Garage - / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use of building 2QS� c e. Describe work C p {---
#7 Type of Job: New r Add Alt Repair Demolition
Wovdstove__ Re-Roof Bulkhead Other
#8 MOH ME_H9ME INF RM= N
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
No. 2 Toilets Vent Systems X 3 . 00 >
3 Bath Basins _ Vent Fans X 3 . 00
Bath Tubs No . Boilers/Compressors ISCO
'I Showers 0 -3 HP 6 . 00
I Hot Water Htr —2� 3 -15 HP 6 . 00
I Laundry Washer
15-30 HP 6 . 00
Sinks z_ 30-50 HP
6 . 00
Floor Drains 50 + HP 6 . 00
Laundry Basins No. Air Handling Unit
I Dishwasher _�� 10000 cfm. 7 . 50
Disposal > 10000 cfm. 7 . 50 I
Urinals Other
Other Evan Coolers
Hoods
Permit Basic Fee Fire Suppression
TOTAL PLUMBING $ � Domes . Incin.
Comml . Incin.
Reloc/Repair 6 . 00
Mechanical Fixtures Gas Outlets X 2 .00
No. Fuel Types Wcodstove separate
Furn < 100K BTU 6 . 00 Other
Furn >a 100K BTU 6 . 00
Furn - Floor 6 . 00 Permit Basic Fee 10 . 00
Heat Pullets 6 . 00 TOTAL MECHANICAL $ 1 `_-
I
i
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION-
A=ORIZED 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 CONTRA=RS AFFIDAVIT
I CERTIFY THAT I AN EXEMPT FROM THE REQUIREMENTS OF THE .I CERTIFY THAT I AM A CURRENTLY REGISTERED CONTRACTOR
CONTRACTORS REGISTRATION LAW RCW 18.27 AND AN AWIRE IN THE STATE OF WISHINGTON AND I AN AZURE 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 IN THE PERMIT IS ISSUED AND ALL WORK GONE 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 APPROVAL FROM THE BUILDING
DEPARTMENT. OEPARTMENT.
X OWNER /K 6`� % BY
DATE ^ ?-- DATE 12-Z,- 9 v
Return permit to: Department of General Services
426 W. Cedar/P.O. Box 186, Shelton, PIA 98584 427-9670/1-800-562-5628
FOR OFFICIAL USE ONLY: Accepted by: Date:
Show following on the site plan
Lot Dimensions 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 BELO
316 .9z-
v
00
T
V
PLICANT TO DRAW TOPOGRAPHY PROFILE BELO
C
L1L11 :y1r11Ylij,jr ILJ l�L V 11 iVV
FOR OFFICE USE aNLy
Approved Cond Hoid
Approval
Planning:
Environmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshall:
Other:
FEES
llSpecial Conditions: II Ilsite Inspection I II
II II I, A
II IlBuilding Permit I . It:D
II - -7 G II I
_ I
II II Violation Fee I II
it II H ;f
II Violation Investigation Fee f II
II II I I i
II II IIPlan Check
II II II Plumbing Fee
II II I I II
II 'I
II II Mechanical Fee I II
II II H II
II II IlWoodstove Fee I it
II 11 I Ilbding state.Fee'
.I i I
IlBuilding Valuation: `P 11 11 TOTALI 2 I
1
L ' 56 5 Permit No.BLD
MASON COUNTY
BUILDING PERMIT APPLICATION
PLEASE PRINT
n
#1 Owner ( 'Oaaa Phone# 4 27 -1 (�q
Site Address F !e-f r-ra't he�rV�
City .k^Q.\ Foy. State ,,.�a . Zip
Directions to Job Site L.j masf- o ayr CreQ. sferQ L
C lax L., to o.r-n, C r (ill `�rdl L off-
Owner Mailing Address , 3-701 E(ar.(S{ ,�.a �(, Kd mo
City S(,&Q +- t" ot., - State 9YSP41 Zips ,
Lien/Title Holder�,__a c L nr u
Address
City_ State i., a . Zip
#2 Contractor Name�c,.a b Contractor Reg #�Q 1J C C. d 80Z�
Address A/D Expiration Date
City Sinn «-ou State C• Zip R8 SFZ( Phone ?nG- 41-G - �Ze7
#3 If septic is located on project site, include records. W¢'(l
Connect to Septic? X Public water Supply Y Well
(If residential, proof of potable water may be required. )
#4 Parcel No. Lr n+ 2 S- k0 _ Z r S- 3 36 a 1 g
Legal Description&hF- ( o-AALr td-W !at av4-r
#5 Building Square Footage: (existing/proposed)
1st Fl 2nd Fl / 3rd Fl / Loft /
Basement / Deck / #Bedrooms 3 / #Bathrooms Z /
Garage X� / Carport / (Circle: Attached or Detached?)
Other sq ft /
#6 Use /of building _ Ia-Sc C-V- Describe work ou, ��o ` •
#7 Type of Job: New _ Add Alt Repair Demolition
Woodstove 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
S
how foTlowinQ on the A Tan
ensions Plood Zones
g Structures Peaces
ure Setbacks
Lines Driveways
ge Plan Shorelines
System TaP�raPhy
wells
d Improvements Easements Flanking Street Fronting Street Scale:
Date:
APPLICANT TO DRAW SITE PLAN BELOW .
cc � � �� � p h � p �q Ssz
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
-� Plumbing Fixtures ($2. 00 each) Fee:
No. Boilers/Compressor Fees:
No. Toilets
Bath Basins
0-3 HP ____E�_00
Bath Tubs 3-15 HP 6.00
Showers
15-30 HP 6.00
Hot Water Htr 30-50 HP 6.00
Laundry Washer 50 + HP 6.00
��nks No. Air Handling Unit
Floo"r,,Drains
Laundry Basins
<� 10, 000 cfm. 7. 00
Dishwasher
> 10, 000 cfm. 7.50
Disposal
Other
Urinals
Other EvaP Coolers
Hoods
Permit Basic Fee Fire Suppression
TOTAL PLUMBING
• 0 Domes. Incin.
Comml. Incin.
Mechanical Fixtures Reloc/Repair 6.00
No. Fuel Types
Gas Outlets x 2 .00
l
Woodstove Separate
Furn < 10 BTU 6.00 Other
Furn >_ OOK BTU 6.00
Furn - Floor 6.00 Permit Basic Fee
H Pumps 6100 10.00
TOTAL ME CAL $
_ ent System x 3.00
/_Vent Fans x 3 .00
NOTICE: THIS PERMIT BECOMES NULL AND:`VOID IF WORK* OR. CONSTRUCTION
AUTHORIZED IS NOT COMMMCED:` WITHIN 180 DAYS OR N OR; FPORR;.IS
OR IF CONSTRUCTIO SUSPENDED OR ABANDONED 17op A PERIOD OF 180-DAYS AT ANY TIME AFTER y70ytE: IS
COMMENCED. .......:, ...
7permit
WNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I am exempt from the requirements of the I certify that I am a currently registered contractor in
registration law RCW 18.27 , and am
Mason County Ordinance requirements for the State of Washington and I am aware of the
ermit is issued and that all work done will ordinance requirements regulating the work for which
mance therewith. No changes shall be the permit is issued and all work done will be in
g conformance therewith. No changes shall be made
made without first obtaining approval from the Building without first obtainin a
Department. g pproval from the Building
Department.
X OWNER X BY
GATE:
DATE_
Return permit to: Department of General Services 426 W. Cedar Street/P.O. Box 186
Shelton, WA 98584 427-9670/1-800-562-5638
FOR OFFICIAL USE ONLY: Accepted by:
Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
AM-P. C .w
Planning:
Environmental Health:
Building Plan Review:
Occupancy Group:
Fire Marshall:
Other:
FEES
Special Conditions: Site Inspection
Buildin Permit
Violation Fee
Violation investigation Fee '
G',
Plan Check
19
tPlumbing Fee
Mechanical Fee
Woodstove Fee
r
ildin State Fee
Building Valuation:
'
TOTAL
EL 'IZ - 1S31
BUILDING PERMIT #
DATE I - � � - L,
Planner Area �j�Y. c 0
CHECKLIST FOR PROPOSED CONSTRUCTION
Yes No
[ ] [ ) Within 200 FT of designated shoreline, wetland, or
associated wetland
Where?
[?] [ ] Proposed construction on/over/in wetland Seef 11"p
[ l C ] Proposed construction within floodplain
[ ] [ ] Eagle nest
[ ] [ l State road access needed
[ ] [ ] Commercial Development (parking standards, sign
ordinance, public works review, other applicable
agencies)
Mobile Home or RV Park
Exempt from building permit application
Exempt from SEPA process (WAC 197-11-305 , WAC 197-11-800)
[ ] [ ] Meets all requirements (which section (s) of SMP does
proposed construction pertain to?)
S- r- )Z
[ ] [ ] Variance or Conditional Use Permit required
[ ] [ ] Exempt from Shoreline Substantial Development Permit
process (Wac 173-14-040)
[ ] [ ] Exempt from Substantial Development, but within Army
Corp. jurisdiction (WAC 173 -14-115)
[ ] [ ] Address needed
[ ] [ ] Directions needed
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WASHlNGTON. - -•�
POTLATCH AWASH.
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ment was NOTES TO THE USER
Prepared primarily by stereoscopic SYMBOLOGY EXAMPLE • wetlands which have hewn fIH 0 e