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HomeMy WebLinkAboutBLD2008-00898 Final MFG Home - BLD Permit / Conditions - 5/29/2019 Inspection Line(36 0)4 27-726 2 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 lr Shelton, WA 98584 f,, RESIDENTIAL BUILDING PERMIT BLD2008-00898 OWNER: CHARLES MEIGS RECEIVED: 7/17/2008 CONTRACTOR: SOUTH SHORE CONST 1-360-275-0818 360-509-1342 LICENSE: SOUTHSCO16NL EXP-. ISSUED: 8/14/2008 SITE ADDRESS: 110 NE SANCTUARY LN TAHUYA EXPIRES: 2/14/2009 PARCEL NUMBER: 322127600010 LEGAL DESCRIPTION: TR 1 OF SURVEY 2/134 NW1/4 PROJECT DESCRIPTION: DIRECTIONS TO SITE: New MFH Tahuya River Rd Sanctuery Ln to driveway on the right. General Information Construction&Occupancy Information Square Footage Information No.of Bedrooms: 3 Type of Constr.: Type of Use: MH Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building: Valuation: Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Length: 60 Ft. Front: S 280.0 Ft. Shoreline: Ft. Water Body: None Make:KARSTEN Len g SEPA?: No ModeI:KMCK6086� Width: 27 Ft. Rear: N 100.0 Ft. Slope: Ft.Side 1: E 370.0 Ft. Shoreline Desig.: Not Applicable Year:2008 Serial No.: Side 2: W 90.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Mobile Home Submittal Fee GMM 7/17/2008 $247.00 B12008000 Planning Review Fee GMM 7/17/2008 $190.00 612008000 EH Plan Review GMM 7/17/2008 $40.00 B12008000 Water Adequacy Plan Review GMM 7/17/2008 $40.00 612008000 Address Fee GMM 7/17/2008 $162.00 612008000 Building State Fee ARC 7/22/2008 $4.50 S22008000 Mobile Home Issuance Fee ARC 7/22/2008 $247.00 S22008000 EH Plan Review CEW 8/14/2008 $60.00 S22008000 Total $990.50 BLD2008-00898 Please referto the following pages for conditions of this permit. 1 of 6 CASE NOTES FOR BLD2008-00898 CONDITIONS FOR BLD2008-00898 1) Appr imensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X ov r 2) 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 1-800-64�7- The,person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X�� 3) 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 Departmen r to y fu er inspections being performed or approvals granted. X 4) Owner/A tl onsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 5) 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 o�,a,2ove d cuments will result in failure of required building inspections. X �jC'' 6) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 7) 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 Depen rior to any further inspections being performed or approvals granted. X BLD2008-00898 Please referto the following pages for conditions of this permit. 2 of 6 8) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified installer responsible for each major part of the installation. RCW43-63B.090 An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each installer performed or in certi cation number and signature of the certified installer responsible for each major part of the installation. WAC365-210 X 9) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you can contact the Offfice of Manufacturing Housing (360) 725-2800. A ,p G� 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 BASICMSPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. 11) Per IRC - SECTION R905- REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordan��with applicable provisions of this section and the manufacturer's installation instructions. X �J 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 owner/agent/contractor is cn wled ing at all components of the stormwater management system have been installed as approved on the stormwater site plan. X v 13) 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 revoca X 14) Lake Cushman area is designated with a 551b snow load rating. The owner/agent of this permit acknowledges that if the unit permitted under this permit does not t e reco mended snow load rating, there is a potential for failure due to weight accumulation beyond that of the design criteria. X BLD2008-00898 Please referto the following pages for conditions of this permit. 3 of 6 15) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason County Building Dept., and will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems no occupancy (Final Inspection)will be granted for the residence. OWNER/CONTRACTOR(indicate which) Signature X 16) This permit is for the pla nt a d installation of the manufactured home only and does not imply approval or review for any other items indidcated on the plot plan. X 17) Permanent Address must be posted and visible from the road Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails must be in good condition and meet code for year built or current code if replaced. Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit Gutters and downspouts must be installed with splash blocks provided All exterior penetrations must be sealed HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24"above grade. The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4 panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection. All conditions on the original or issued permit must be met If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available It shall be the responsibility of the person requesting the inspection to provide the manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection. Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an inspection is requested and required items are not completed prior to the inspection being performed ENFORCEMENT PROVISION: Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action and subsequent violation d penalties pursuant to the Mason County Code. X BLD2008-00898 Please refer to the following pages for oonditions of this permit. 4 of 6 18) 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 locat d 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. X e�� 19) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance oo latiop, must be reviewed and approved by Mason County prior to construction. X 1'- 4 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 international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector 7 1 mor to requesting additional inspections. X 21) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including installation instructions, shall be available in this location OR pl ed in the location specified by WAC 296-150M-655. Support configuration shall be clearly marked in the installation instructions. 22) All property lines shall be clearly identified at the time of foundation inspection. X 4' 23) 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 fi�nall�inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with X Mason Coi nan�es_and building regulations. 24) 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 ha revented action from being taken. No more than one extension may be granted. X 25) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectop,and fl shi g. Install metal connectors approved for contact with the new types of pressure treated material. X 26) Retaining walls needed to support a surcharge c s s ructures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X BLD2008-00898 Please referto the following pages for conditions of this permit. 5 Of 6 27) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "ApproveV an"to sure these structures are shown and meet the setback conditions listed. X 28) Water qu y is not to be degraded to the detriment of the aquatic environment as a result of this project. X 29) Prior to final approval, all upland areas disturbed or new reated by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 30) Temporary erosion control measures must be implemented to prevent water qualit egradatio of adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X 31) All other necessary permits from Mason County, Washington State and/or Federal Agencies that arg.riee ired r t . proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. XJ 32) 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 anytime 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 he inform tion provided is accurate and grants employees of Mason County access to the above described prope d struct or revie d inspection. OWNER OR AGE DATE: BLD2008-00898 Please referto the following pages for conditions of this permit. 6 of 6 o� CONCRETE MECHANICAL MANUFACTURED HOME M N m o -" — Date By C) Footings J Setbacks Gas Piping R bimM N o Intenor Date By Interior-Date By Date / p� By co Fxtersor Date By Exterior-Date°D INSULATION Sot,+�p � _ f3 2 ._a_�w_-_______ -ITPoint Load J isolated Footings -- Date �� �� By 56 BG I SLAB INSULATION r— Date By Data By FIRE DEPARTMENT N Foundation Walls Floors Date By Date By Data ,^ By DECKS FRAMING Walls Date By Date Ry, Data By PROPANE TANKS PLUMBING Vault Date _By Date By OTHER Groundwork Attic Date By Type- Uat4 ay Date By D W.V DRYWALL Type- Date Brace Wall Date By W Date By Date By FINAL INSPECTION-- () v Water Line Fire Seperation N �O Date B Date By C Date By Y 2 Q CD 000 m Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments o _ ��" °° PL� � CD rilf v 0 IZ / s .p in z ,V�r Orz 2• V1 (D 0 I t � 110 '•h Services OVED 356 S •t. �i2a.. c!atc C�J � M (4) 3, x 5 ' �>.!p -- -- LA N N t N G. . as CKS ARE MEASURED W i-�rh r�e�wew-� V r ;EOM THE FURTHEST ION OF THL BUILDING �- PLANNING t APPROVED c �S SO 7S goo MASON COUNTY DCD PLA J..:; SITE PLAN REQUIRED TO BE ON Zir / Cam- ��0.vt i CH G S -JECT TO APPRU� q / g By Date A 32-2-( ram- 000 l Q IeAPR 1 8 2008 RECEIVED rJUL 17 2008 BELFAIR Oi0CE P�eAse-� O� � 2 Wl,Xs� C I -� V -c-fie-5 (�j 7-Lo �Co I os cp A�A-ll I VENT ` --�S�� I cress AT 1 Sq Ft Per 150 q _t rjESE PLANS MUST BE �/ � ?N T HE JOS SI rF —C�P��S ` p. r_ �+ 1 UBMiT CHANLES E:-R APPP',!VAt. FOR INSFa.CTIOa� PRIOR TO PERFORMING WORK e., GQ MUST MEET ALL CUR ZENT WASHINGTON STATE CODES 1001-P �O ��gg p`Pife eg fs �aa �a4 a 3 z z l z. - �� D O O/D - FILE fag;°e�P�;��v c chap f0 a e,x �lzk c J4)e 9 ar s COPY N r 0/paa°es THESE PLANS MUST BE ON THE JOB SITE FOR INSPECTION. CHANGESOVAL SUBMIT CHANGES FOR AP PRIOR TO PERFORMING WORK MUST MEET ALL CURRENT WASHINGTON STATE CODES I VENT � Sq Ft Per 150 Sci Ft AT 1 " '"HESE PLANS MUSS` BE CHANGES ON THE jGItm SUBMIT CHANGES FOR APPR,;;VAI. PRIOR TO PERFORMING ORH FOR INSF EC ION ` prm MASON BUILDING INSPECTOR CHANGES/S'�UBJECT TO APPROVAL ff I�I1TG _O� 07/15/2008 11:25 3604791050 BUYRITE HOMES PAGE 01/01 Wof d' ¢a E R.2 a" F— 1, i � uJ , c Y `a TCn E � � rn C C V a �n z v� r ------- _ , — mT— ———- O i I • I I m N 0 � _ w r ^r m ryl O O f N i o Q I w m Wr---------^ -- --�- m m s Lu t m I I x v I lu oc i I �� ~ PLANS MU T BE o L - ' ON THE JOB 5 E v, H Jexlw6'° i ?:OR IhSPECTI N m $ '(q°'?'°M 4 O I ¢ I ----oa--- 1d0 ¢ I 11oM 1d0!// I p ' J I U I o r IUST MEET ALL CURRENT V I N E=------o•m- ASHINGT©N ST TE COCt!'c 1 \ I 00 \\ v I sj I r7 ueul� N I v' I .. i I p ow m I did CHANGESI ( � !WIT CHANGES FOR APPRU�A _�^_—_---- --_--- -_-- ?IOR TO PERFORMING WORF�"'--- s6 �— N Q 1161 �o ,6?, o-Z21 7ir 600 0 r ' `Name Parcel#3aaJ;2 - `11V-/Donl o BLD#:BIJ aoyf� Xffl6 1 Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) 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: http//www.co.mason.wa—us/code/commissioners/index.httn 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" XM Ii4f ML BELOW TO INDICATE THE SfiO 1GIANAGEMENT PLAN F()R THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public Phone: (360)-427-9670 EXT. 450 TO BE KEpT ilko t. Mail: P 0 Box 1850, Shelton WA 98584 ^�� C �E Physical: 415 N 6th St, Shelton WA 98584 PAR r If this development has,or will have,a septic/drainfield system you may need to n act 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 furt r acknowledge that the information rovided is accurate and employees of Mason County are granted access to the above- cribed 4forre 'ew and ins on as may be required. (� Xegl /Ag ntracto ircle one) at age 2 of 2 III Olh&Ali- YYl I Name �2I��j Parcel#3a2l;2-~]Lo - 00010 BLD# ;LCOE - C E89� Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development, or redevelopment',with more than 2,000 square feet of impervious surface'. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. '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. ,.;..::. rxs rrr ac+as Pie s...fZ4� fete �hft..f bi '>:'>:::<;>:><< Surface Type Length X Width - Area All dimensions in feet Buildings U6 X 7 _ loan X = Measurements for buildings are taken at the _ perimeter of the farthest projections(example: X - eaves/gutters) X = Driveways lao X 1 oZ = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition X - above table Patios/Walks X = X = Any paved, gravel or packed area per definition X - above table Others X = X = e tv#almpervrvtts area of€he pfv}aysed leuel rti?rttrarit1Clt ': iiars?fefia< Srr ►i I� rtQly ter Sits PIri::i :Eet3iei Total)rnperwaus Str#ace Ares(sum 4f alEreas :>:: If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT 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 Mason County Planning Intake Checklist Owners Name: 0,ka_rLr_ Date: h-Z 1-08 Project: nFJJ M Reviewed By: Commercial Develcpment: YES Comments: PLANNER: GBM TSC PBC RDH REC aig�:) Site Plan: ,,w-' North Arrow Property Dimensions: XErr flcuL,611 14 Streets and Driveways Shown. Road name: fir' sting u s ow i backs ❑ Well Location, Se tic and Drain-field hown with setbacks ,per' ti su c onds, shoreline, wetlands, natural or historic drainage, defined drainage ditches) Topography (slopes)? Proposed Structure Setbacks (Direction/Setback): F: R: r'1 / 'moo S1: S2: Iz Utility and Drainage Easements: Yes No (if yes enter condition #5022) .Z Other Easements Accessory Appurtenances: Propane / Heatpump 5VA ,,u-' Does site plan show landings II exits? ❑ Variance applied for: Yes / No parking spaces allotted? (es / No ❑ County Access Permit Need (add condition #0010) Pr.U�z��o�CE ❑ State Access Permit Needed (add condition #0020) Standard Conditions to be added to all Building per its that planning reviews: #5019 and #0700 Site Access: Are there any impediments (dogs/gates) that my restrict access to your site? TA Is the site clearly marked? How? ❑ Address�� �. ❑ Name Critical Areas: ❑ Other: Shoreline Designation: Comprehensive Plan: Rural Zonin UGA Zonina: XNot Applicable El Agricultural ,0"RR 2.5 5 10 20 ❑ VR ❑ CM ❑ Urban ❑ In-holding ❑ RMF ❑ R-1P ❑ LTA ❑ Rural ❑ LTCFL ❑ RC 1 2 3 ❑ R-1R ❑ FR ❑ Conservancy 0 Rural ❑ RI ❑ R-2 ❑ MU ❑ Natural ❑ RAC ❑ RNR ❑ R-3 ❑ GC ❑ Unkown ❑ RCC-Hamlet ❑ RT ❑ R-5 ❑ BI ❑ Allyn Urban Growth Area ❑ MPR ❑ R-10 ❑ VC ❑ Belfair Urban Growth Area ❑ Unknown ❑ HC ❑ T ❑ Shelton Urban Growth Area Water B O ate Body (type of w unnamed): SEPA: Yes/ No Unknown Flood Plain: YES/N Unknown Map# Aquifer Recharge: YES/N Unknown Map# Tags/Cases: RLC/SPI Case: 1 o"Z 069 • C01445 6-Year Dev. Moratorium: YES N� Eagle Nest Tag: YES O Other YES• Revised: 02-05-2008 I:\PLANNING\PAC\PLANNING INTAKE 7. MASON COUNTY PERMIT NO.EiA W)O- 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 �-`j On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name c Mailin Addre s Mailin ddr City Statea,_-1&ip Code City State Zip Code Phone Other Ph. Phone 3G027�S' s"/� Other ,, Sm Lien/Title Holder Contractor Reg. # uf-A CZ 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 j Well_ _ 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) 'C tic Ve&I D ec ons to site Will timber be cut and sold in parcel preparation?Yes f Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck— Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make N Model Years Length C&O Wo th -02 7 Bedroom Serial No. No. of s og No. o athrooms — Type of Heat Purch e Price$ J���� Replacement Unit? Y s Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 18Q,,days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OGR INSPEC I VITY OF THIS PERMITAPPLICATION OF 180 AYS WIL INVALIDATE THE APPLICATION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW AP OVED DENIED NOTES Building Department Planning Department 1` 1� Environmental Health Department a I '- AIAJEC&1126 Fire Marshal FEES Building Permit Fee 2 q Tv Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee D LJF' Pre-Paid at Submittal Valuation $ 2 BO 0 . 44L- TOTAL FEES