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HomeMy WebLinkAboutBLD2008-00595 Cancelled Garage - BLD Permit / Conditions - 7/14/2008 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 IP14 Shelton,WA 98584 PLUMBING PERMIT BLD2008-00595 OWNER: JOSEPHINE, ENEBRAD RECEIVED: 5/19/2008 CONTRACTOR: LICENSE: EXP: ISSUED: 6/26/2008 SITE ADDRESS: 910 NE TAHUYA RIVER RD TAHUYA EXPIRES: 4/16/2009 PARCEL NUMBER: 322127600060 LEGAL DESCRIPTION: TR 6 OF SURVEY 2/134 NW1/4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: 4 CAR GARAGE-07-14-2008 permit revised to rough-in bathroom. FROM BELFAIR GOING TO TAHUYA ON NORTH SHORE MAKE RIGHT AT KATIES CORNER, GO ABOUT ILES LEFT SIDE 901 TAHUYA RIVER RD FRESH DRIVEW General Information Plumbing Fixtures FEES Type of Use: Insp.Area: Type Qty. yp By Date Amount Receipt Type of Work: Fire Dist.: Lavatories PI k F K.q r,/1a/?nnA QdRA cad C1,nnAr Showers 1 nnin iew Fee KS 5/1q/9nnR R1cm nn gignnRr Water Closets (Toile 1 PI Review Tw r,nAnnnA �dn nn R1�nnAr uilding State Fee MAI Rn/?nnA �d sn R19nnRr Water Heaters Building Permit Fee MAI annnnA R711 75 R19nnRr Plumbing Fee KKK 7/1d/7nnA viz An C7gnnRr Plumbing Base Fee KKK 7/1d/?nnR v?,i 1n g77nnRr Total $1,467.69 BLD2008-00595 Please referto the following pages for conditions of this permit. 1 of 5 • 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 BLD2008-00595 OWNER: JOSEPHINE ENEBRAD RECEIVED: 5/19/2008 CONTRACTOR: LICENSE: EXP: ISSUED: 6/26/2008 SITE ADDRESS: 910 NE TAHUYA RIVER RD TAHUYA EXPIRES: 12/26/2008 PARCEL NUMBER: 322127600060 LEGAL DESCRIPTION: TR 6 OF SURVEY 2/134 NW1/4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: 4 CAR GARAGE FROM BELFAIR GOING TO TAHUYA ON NORTH SHORE MAKE RIGHT AT KATIES CORNER, GO ABOUT 3 MILES LEFT SIDE 901 TAHUYA RIVER RD FRESH DRIVEWAY. General Information Construction & Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: VB Type of Use: Insp.Area: No. of Bathrooms: Occ. Group: U Lot Size: Deck: Type of Work: Fire Dist.: No. of Stories: 1 Occ. Load: Building: Garage-Attached 2,160 Valuation: Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft. Front: S 100.0 Ft. Shoreline: Ft. Water Body: NONE Rear: N 100.0 Ft. Slope: Ft. SEPA?: Unkn Model: Width: Ft. Side 1: E 100.0 Ft. Shoreline Desig.: bWtlApplicable Year: Serial No.: Side 2: W 100.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee KS 5/19/2008 $463.94 S12008000 Planning Review Fee KS 5/19/2008 $190.00 S12008000 EH Plan Review TW 5/23/2008 $40.00 612008000 Building State Fee MAL 6/2/2008 $4.50 B12008000 Building Permit Fee MAL 6/2/2008 $713.75 6120080o0 Total $1,412.19 BLD2008-00595 Please refer to the following pages for conditions of this permit. 1 of 5 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 BLD2008-00595 OWNER: JOSEPHINE ENEBRAD RECEIVED: 5/19/2008 CONTRACTOR: LICENSE: EXP: SITE ADDRESS: 910 NE TAHUYA RIVER RD TAHUYA ISSUED: PARCEL NUMBER: 322127600060 EXPIRES: LEGAL DESCRIPTION: TR 6 OF SURVEY 2/134 NW1/4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: 4 CAR GARAGE FROM BELFAIR GOING TO TAHUYA ON NORTH SHORE MAKE RIGHT AT KATIES CORNER, GO ABOUT 3 MILES LEFT SIDE 901 TAHUYA RIVER RD FRESH DRIVEWAY. General Information Construction&Occupancy Information Square Footage Information No.of Bedrooms: Type of Constr.: Type of Use: Insp.Area: No. of Bathrooms: Occ. Group: Lot Size: Deck: Type of Work: Fire Dist.: No.of Stories: Occ. Load: Building: Valuation: Building Height: Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 100.0 Ft. Shoreline: Ft. Water Body: NONE Rear: N 100.0 Ft. Slope: Ft. SEPA?: Unkn Model: Width: Ft. Side 1: E 100.0 Ft. Shoreline Desig.: hWtiApplicable Year: Serial No.: Side 2: W 100.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee KS 5/19/2008 $463.94 S12008000 Planning Review Fee KS 5/19/2008 $190.00 S12008000 Total $653.94 BLD2008-00595 Please refer to the following pages for conditions of this permit. 1 of 2 CASE NOTES FOR BLD2008-00595 CONDITIONS FOR BLD2008-00595 1) 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 roa connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 2) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X 3) 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 1-800-647-09iThe person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 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 granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building Department pri r'to any further inspections being performed or approvals granted. X 5) Owner/Agent responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X The Ian review check list and corrections are art of the approved plans and must remain thereto. It is the responsibility of the applicant to make the 6 e p pp P P PP P Y 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 ved documents will result in failure of required building inspections. X �J 7) This structur is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use permit shallb applied for, reviewed and approved prior to the change. X 8) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X_� BLD2008-00595 Please referto the following pages for conditions of this permit. 2 of 5 'Q) 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 Dtrtment prior to any further inspections being performed or approvals granted. X 7 10) Per 2003 IRC - SECTION 1609 -WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wi loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC W)V SPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X 11) Per IRC - S TION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordancj;h the applicable provisions of this section and the manufacturer's installation instructions. X ' 12) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. "NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of the building permit the own er/agent/contracto &cknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X�(�/' a 13) The use, handling and storage of haz materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X Ts 14) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the internationa c es and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. X 15) 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 uments are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged n all be collected by the Building Department prior to any further inspections being performed or approvals granted. X 16) 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 rev . X BLD2008-00595 Please referto the following pages for conditions of this permit. 3 of 5 17 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 locate0within 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. X 18) Placement of Xf re must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X 19) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or(, tion, must be reviewed and approved by Mason County prior to construction. X 20) 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 interna W nal codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shal made prior to requesting additional inspections. X 21) All property lines shall be clearly identified at the time of foundation inspection. X 22) 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 i spection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County i ances and building regulations. X 23) 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 no exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have preven ction from being taken. No more than one extension may be granted. X 24) Pressure treated d manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and ping. Install metal connectors approved for contact with the new types of pressure treated material. X 25) Water quality is to be degraded to the detriment of the aquatic environment as a result of this project. X 26) Prior to final approval, all upland areas disturbed or newly e ed by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X BLD2008-00595 Please refer to the following pages for conditions of this permit. 4 of 5 . 27) ' Temporary erosion control measures must be implemented to prevent water quality der tion of adjacent waters or wetlands. Silt fencing must be ' installed and maintained until upland vegetation has become established. X 28) Approve p dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 29) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are reed for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X 30) All Best Management Practices must be strictly adhered to throughout the proposed development. X 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 any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or 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 d structure for review an nspection. Z,--2,1 OWNER OR AGENT: _ '/ - DATE: BLD2008-00595 Please referto the following pages for conditions of this permit. 5 of 5 o CONCRETE MECHANICAL MANUFACTURED HOME MZ o __._. _ Date lay M C) Footings!Setbacks Gab Piping Ribbons � o Interior Date By interior-Date By Date By cri Exterior Date /d_/G�$ BY'� Exterior-Date By 0 01 INSULATION Set-up Point Load!Isolated Footings -- — Date By 0 BG/SLAB INSULATION __.__..._._. to Date By Data gy FIRE DEPARTMENT M Foundation Walls Floors Datc By Date By Data By DECKS Z _RAM ING Walls Date By m Date /z__5--cv7 ByTAData By PROPANE TANKS PLUMBING Vault Date t3v Date By OTHER Groundwork Attic Type: Date By Date By Date By DRYWALL a.W.V Type_ Int.Brace Wall Date gy 100 Date. By Gate By FINAL INSPECTION zz� a`Di Water Line 1 Fire Separation No Date By VI// Date By Date By O 90 Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Done By Comments CA ?'o ,o f-, X, 7Tipv �' - �- /v t� W v 7,�- s i 7 s /=h9/c_ zc-off rl"`' 3- /p e- 7 M // - h�; Permit# ©oF MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location '10 5F& y,9y/9 If 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 compliance ,,.si�r9c� � cL cL .46!/q- �C! ciyG ► vies o r►, d i` . 2 You are hereby notified that the above corrections shall be _ BEFORE PROCEEDING WITH ANY FURTHER WOR I T Call for re-inspection when corrections are made before continuing ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOTa Date 7 Department CORRECTION NOTICE. Inspector/, A Dn NOT R, MnVE THIO TAG i s oo i lt/nO2iddd 01 1O3f8nS S HO ' 311S NO 38 01 03?,In038 NV Id 311S r� ONINNVId QOa AlNn0O NOSY N a3A0ddd F1 S f i 0 � i O T �,Qy 040 e p D a z -Hz D z or � z m Z Z ( cmD tG) ga� Cf� c�� Named Parcel# (J BC Mason County Department of Community DevelopmeJ/�� //V Small Parcel Stormwater Management Application/Workshee't�(page 2.of Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC) regulates compliance requirements for Stormwater Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website: b!W//www.co.mason.wa-us/code/commissioners/index.htm Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A)4—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/drainfreld 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- des 'bed property for revie and inspection as may be required. ONN-ner/Agent/Contractor(circle one)Date: e.5- i-O e) Page 2 of 2 Nam .mh r rl c— Parcel# :34 2-7[D_MO(OO BLD# r)�brnCL 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 surface2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces, structural development including constriction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. .: .. To,Ca/cuCate It ..<'..` '::eatri ; �, Gc� late:: " '7" bt� Surface Type Length X Width = Area ' All dimensions in feet Buildings X = X = Measurements for buildings are taken at the X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a 7811 Parcel Stormwater Site.Plan is;Required `i!`t3 im Prviou.s Surface Area sum of all area P :::> ............... If the Total Impervious Surface A a is LESS THAN 2000 Square Feet, plea read, acknowledge and sign below. Based Upon the information you have prov T required for this development activity. 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/Contractor(circle one)Date: 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 RECEIVED MASON COUNTY PERMIT NO--'� o ",DO � [� MAY 1 9 2008 BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 i/y�/Il , MASON (�BWfmhT(f60) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 I Y AL On the web www.co.mason.wa.us APPLICANT INFORM ION CONTRACTOR INFORMATION Owner i �= Company Name Mailin Address vifailing Address City State Zip C de City State Zip Code Phon `' �P Phone Other Ph. Lien/Title Holder - Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic. # / DOB Drivers Lic.# _ DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well ✓ Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No 1 Fire District — Legal Description Site Address (Please include street name, street number and city) 2zz, Directions to site Will timber be cut and sold in parcel preparation? Yes/No Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement action?Yes/No TYPE OF JOB - I_ew_ Add Alt Repair Other_ PRIMARY,RESIDENCE . SEASONALIf ❑ Use of Building_1`'� �' � Describe Work _ c G No. of Bedrooms No�of Bathrooms Square Foota - 1 st Floor 2nd Floor 3 r Basement D Cnvered Deck Other Sq. ft. Garage Attached Detached IOQ)Carport Attached Detached ANUFA UREDPQME IN MATION - M M Year U L n - Widt Ser&I N S ' No. f Bedroo s No. of t oms T p f H at — irchas Price Re lacem nt Unit? es/ In alle ame Ce ion 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. PR OF CONTINUATION OF W RK IS BY MEANS OF A PROGRESS INSPECTION. X � '�-�rGC'� Date Ow er/Owners Re re entative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date •1 1-p DEPARTMENTAL REVIEW APPROWD DENIED NOTES Building Department10 w4t, to Planning Department Ln, i cr -0 (p 3 Environmental Health Department -i Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee l Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES `,.;nr-,--n.^'�^+�^'F�M'^'^."-...^.t,+*^--o ,'q'=_^iR;s'„'cT'�'"T7'F ... ,.. ,;^^7...7'r"'p-i7'—'...grT..=F-.•^-r.,+ar-,af.-a �) �i� 'R PERMIT NO. MASON COUNTY 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 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailinq Address ✓ Mailing Address City = State �✓t�Zip Code City State Zip Code Phoned �0' �-7S•L'y ther Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.#___— Exp. E mail address E Mail Address Drivers Lic.# != f (= !`°" h' 'iLDOB 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 Site Address (Please include street name, street number and city) Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff 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. 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 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 parry 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. PROD CONTINUATIOI UOF WO fs IS BY MEANS OF A PROGRESS INSPECTION.. Date: X '� f wner/ wners Representative/Contractor (indicate which one) r FOR OFFICIAL USE BEYOND THIS POINT Accepted by: f lanning 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