HomeMy WebLinkAboutBLD2016-01015 Final Demo - BLD Permit / Conditions - 7/20/2018 Inspection Line (360)427-7262
��6aN nor, MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County
615 W Alder St
Shelton, WA 98584
/Aid RESIDENTIAL BUILDING PERMIT
BLD2016-01015
OWNER: CHRIS & GARY WHITEWELL RECEIVED: 10/10/2016
CONTRACTOR: PRIME BUILDING & DEVELOPMENT 253-820-5950 LICENSE: PRIMEBD84303 EXP: 9/23/2( ISSUED: 2/15/2017
SITE ADDRESS: 2721 E MASON LAKE DR EAST GRAPEVIEW EXPIRES: 8/15/2017
PARCEL NUMBER: 222335200062
LEGAL DESCRIPTION: MADINGS SUNNY SHORE ADD#6 TR 62
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
DEMO EXISTING SFR AND REPLACE WITH A NEW 2470 SQ FT SFR MASON BENSON RD E RIGHT MASON LAKE DR E
General Information Construction&Occupancy Information Square Footage Information
No. of Bedrooms: 3 Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3 Lot Size: Deck: 537
Type of Work: NEW Fire Dist.: 3 No. of Stories: 2 Occ. Load: Building:1,510
Valuation: $ 287,782.24 Building Height: Occ. Status: Primary Basement:960
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: Ft. Shoreline: Ft. water Body: Mason Lake
No II
Rear. Ft. Slope. Ft.
SEPA?:
Model. Width. Ft. Side 1: NE 6.0 Ft. 9
Shoreline Desi .: Urban
Year: Serial No.: Side 2:NW 6.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 3 Ventilation Fan 3 Plan Check Fee JBN 10/10/201 $ 1,330.26 S2201600000001
Lavatories 3 Exhaust Hood 1 Building Permit Fee JBN 10/10/201 $2,046.55 S2201600000001
Bath Tubs 2 Dryer Vent 1 Planning Review Fee JBN 10/10/201 $205.00 S2201600000001
Showers 1 Heat Pump 1 Building State Fee JBN 10/10/201 $4.50 S2201700000001
Water Heaters 1 Mechanical Permit Fee JBN 10/11/201, $67.40 S2201600000001
Clothes Washer 1 Mechanical Base Fee JBN 10/11/2011 $28.50 S2201600000001
Kitchen Sink 1 Plumbing Base Fee JBN 10/11/201( $24.70 S2201600000001
Dishwasher 1 Plumbing Permit Fee JBN 10/11/201i $ 119.30 S2201600000001
Hosebibs 4 EH Plan Review JBN 10/11/201, $ 178.29 S2201600000001
EH Plan Review JBN 101111201, $26.71 S2201700000001
Total $4,031.21
BLD2016-01015 Please refer to the following pages for conditions of this permit. Page 1 of 6
CASE NOTES FOR
BLD2016-01015
CONDITIONS FOR
BLD2016-01015
1) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD WAY.z
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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
1-800-647 Z. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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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
Department prior o any further inspections being performed or approvals granted.
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4) Owner/Age is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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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 of ved documents will result in failure of required building inspections.
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6) THE FOUN�QT,F�N SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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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 ZY
ent prior to any further inspections being performed or approvals granted.
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BLD2016-01015 Please refer to the following pages for conditions of this permit. Page 2 of 6
8) 2012 IECC/Washington State Energy Code Compliance has been approved as follows:
Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C, Window(Max U-Factor):0.30, Skylight(Max
U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation min. R-49, Vault Insulation R-38,
and Slab Insulation R-10.
In addition the following credits from R406.2 shall be completed as follows:
3d- Ductless Heat Pump
5a- Efficient Water Heating
5c- Efficient Water Heating
2a-Air Leaka Control
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9) A permanent certificate, completed by the owner, builder or registered design professional, shall be posted within three feet of the electrical distribution
panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall
and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there
is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of
heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 105.4, and air leakage
results if a blower door test was conducted.
Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 5 air changes per hour when tested
with a blower door in accordanve with IECC/.WSEC Section R402.4.
The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is
not required for additions less than 750 square feet. Reference IECC/WSEC R401.3 & R101.4.3
Compliance certificates are available online at the WSU Energy program website titled, " WSEC 2012 Certificate"and are available in %or'/z sheets. The
Mason County Permit Center will also have some available.
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10) A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section
R404.1.
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11) 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 A 'spection of
the building permit the owner/agent/contrac or i§acknowledging that ail components of the stormwater management syste 1 stalled as
approved on the stormwater site plan. X
BLD2016-01015 Please refer to the following pages for conditions of this permit. Page 3 of 6
12) A concrete encased grounding electrode must be installed and used at each new building or structure that is built upon a permanent concrete foundation.
In Mason County the electrical code is regulated by Washington State Department of Labor& Industries (L&I).
For more information contact L&I for additional information. In Olympia call (360)902-6350 and in Bremerton call (360)415-4000.
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13) To perform an inspection the Mason County Building Inspector will need to access the interior of the structure. An electrical permit completed and
approved by Washington State Labor& Industries must be available on-site during the inspection.
The Mason County Building Inspector will inspect the following: Verify that the system is installed in accordance with manufacturer specifications-The
inspector will check to make sure that the exterior unit is permanently installed and supported, the exterior unit complies with required setbacks to
property lines, fuel tanks are located at least 10-ft from the system, a source of ignition,all exterior penetrations are properly sealed,condensate lines are
installed and are properly supported, including proper material, slope, and that the condensate line terminates to a proper location outside of the
foundation, copper refrigerant lines are insulated with '/2" thick continuous closed-cell foam insulation or better, indoor units are located at least 3-ft from
smoke and carbon monoxide alarms,and that modifications made to the structure, to install the unit, does not affect existing structural members.
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14) A separate inspection in addition to the inspections required in the IBC, Section 110 shall be required in accordance with the 2015 IBC, Section 1705.12.2
and Section 1707.1. The additional inspection is required when shear wall fastener spacing is required to be 4 inches or less. The shear wall schedule
shown on sheet 3 designate wall(s)type 2 & 3 with fastener spacing 4 inches or less.
The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified to inspect lateral connections,
the Engineer of record (EOR), or an authorized representative of the (EOR). The special inspectors duties and responsibilities shall be as specified in
Chapter 17. When a third party inspector is used to perform the inspection, special inspection reports shall be submitted to the Mason County Building
Department, 615 W Alder St, Shelton, WA 98584 and also available on site for review by the Building Official. Inspection reports shall be completed and
submit t he Mason County Building Department in a timely manner and shall be submitted prior to the framing inspection of said project. X
15) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer specifications and in accordance with IRC
Section R315.
Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level of the dwelling.
EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances),
repairs, or additi requiring a permit occur, or when one or more sleeping rooms are added or created.
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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 re oc n.
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BLD201 6-01 01 5 Please refer to the following pages for conditions of this permit. Page 4 of 6
17) Installation of heating equipment in a single-family residence shall meet the requirements of the current IECC/WSEC R403, applicable sections of the
IRC, and IMC.
Heating equipment shall be sized in accordance to ICC/WSEC, Section R403.6. Heating and design load calculations for the purpose of sizing HVAC
systems are required and shall be calculated in accordance with accepted practice, including infiltration and ventilation. Design calculations shall be
available for inspection during inspection.
Referencing IRC M1601.4, all ducts, air handlers, filter boxes, and building cavities shall be sealed. All joints of duct systems and seams shall be made
substantially air tight by means of tapes, mastics, liquid sealants, gasketing or other approved closure systems. Closure systems used with rigid fibrous
glass ducts shall comply with UL181A and shall be marked 181A-P for pressure-sensitive tape, 181A-M for mastic or 181 A-H for heat-sensitive tape.
Closure systems used with flexible air ducts and flexible air connectors shall comply with UL181 B and shall be marked 181 B-FX for pressure-sensitive
tape or 181 B-M for mastic. Duct connections to flanges of air distribution system equipment or sheet metal fittings shall be mechanically fastened.
Mechanical fasteners for use with flexible nonmetallic air ducts shall comply with UL 181 B and shall be marked 181 B-C. Crimp joints for round metal ducts
shall have a contact lap of at least 1-1/2 inches (38 mm) and shall be mechanically fastened by means of at least three sheet-metal screws or rivets
equally spaced around the joint. Closure systems used to seal metal ductwork shall be installed in accordance with the manufacturer's installation
instructions.
Duct tape is NOT permitted as a sealant on any ducts. When ducts are located in unheated spaces the ducts hall be insulated to R-8
DUCT TIGHTNESS TESTING shall be conducted by person(s) trained to perform such testing. A signed affidavit documenting test results in accordance
to IECC/WSEC Section R403.2.2 shall be provided to the Mason County Building Department prior to the final occupancy inspection. Affidavit forms are
available on at the WSU-Energy Program website titles, "Duct Leakage Affidavit" or"Duct Leakage Testing Results (Existing Construction)." Duct
tightness test'in .s not required if the air handler and all ducts are located within the heated space.
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18) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulaWmust be reviewed and approved by Mason County prior to construction.
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19) 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 shal a ade prior to requesting additional inspections.
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20) All property lines shall be clearly identified at the time of foundation inspection. X
21) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason C my ordinances and building regulations.
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BLD2016-01015 Please refer to the following pages for conditions of this permit. Page 5 of 6
22) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder have Fc ted action from being taken. No more than one extension may be granted.
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23) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
connectors_�@nd flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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24) Epoxy Hole inspection is required. See detail S1 on sheet S1 for locations and callouts
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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 contractor. I further declare that I am entitled to receive this permit and to do the
work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The
owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s) for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if
construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT,APFF4.ICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
E/I- !:�//
Si re Date 11
--::s-a »c-al 0 (2 �^ `� ^` �-� OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2016-01015 Please refer to the following pages for conditions of this permit. Page 6 of 6
Mas� �a fe
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PLANNING �
-75' �.. OCT 10 2016
~ 15 K Alder Street
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TOPOGRAPHY PROFILE:
:yON Ct�UN;rY DCD PLANNING
PLAN TO BE ON
IANGES SUUEWETDTO APPROVAL,SITE
- Approvak for offce use
Building Permit number: y ' Building:
�Owner/Applicant: M ; s F a Date of Planning:
VW 1-6 application: Env. Health:
Parcel Number: 2:2:_z33--62-ty-_,)0(o2_
BUILDING
Name Parcel#—:2 9 233—5�? —6�&2— BLD# C?0)6 —V/0) S
w�- S 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 surfacez.
'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.
2Common 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 Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings X = OLF—
— fVW0401,�Z)114k JGi,*
X = Measurements for buildins are tak at the
perimeter of the farthest projections(example:
X = 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
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area(sum of all areas)
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 ac ledge that the information provided is accurate and employees of Mason County are granted access to the above-
describe pro erty for review and inspection as may be required.
X Il Owner/Agent/Contractor(circle one)Date: V to I -�V/
f 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 RECEIVED
OCT 4 p 2016
615 W. Alder Street
Name Parcel# BLD#
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.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) 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
100 W.Public Works Dr
Shelton.WA 98584
If this development has,or will have,a septic/drainfield 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 400
415 N. 6th St— Bldg#8 lower level
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-
described property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
RECEIVED
Planner. Grace Rebecca IVED
MASON COUNTY PLANNING INTAKE CHECKLIST OCT 1 0 2015
Owners Name: �'14 we 11 1 Date: 615 W. Alder Street
Project: Commercial ?: yes
Site Plan: ���� � ,� �►
YNorth Arrow P� N
N G
�Property Dimensions: x � .7 Irregular Shape ? yes no
sr Streets and Driveways shown
*s Road Frontage Name: E MG.Sar-, JAA!"t= ,prL
,e—All Existing Structures Shown with setbacks and use.
,a'Identified Surface water(streams,ponds, shoreline,wetlands,natural/historic drainage, defined drainage)
.ey opography (slopes)
-M imum Structure Setbacks (direction/setback):
F:_�_/ R:��/ S 1 / S2 /
❑ Utility and Drainage Easements: yes no (if yes enter condition#5022)
❑ Other Easements
' (,Accessory Appurtenances: propane tank Hea�pu4np_
❑ Does site plan show landings at all exits ?
>(Variance applied for: yes o Parking spaces allotted: J no
ess Permit Neede a d condition#0010
c ess Permit needed (add condition #0020)
lanning conditions: #5019 and #700
❑ Are there any impediments (dogs/gates)that may restrict access to your site? yes no
❑ If yes, do we need appointment? yes no
Ys site clearly marke Ad es Name Other
ZONING
UGA'S
BELFAIR/S LTON ural LAND DESIGNATIONS.
GC PIT R-1 R-1P RC 1 RR AGRICULTURAL
POS FR R- R-1R RC 2 RR 5 LTCFL
BI GC-CI -3 RI RC 3 RR 1 IN-HOLDING
HC LTA R-5 RMF RR 20 TRIBAL
T MU R-10 RT/RTC RNR
M P BP vc RAC NR
Critical Areas: (streams, ponds, shoreline, we steep slopes)
Shoreline Designation: ❑ N/A rban ❑ Rural ❑ Conservancy ❑ Natural
Water Body: On
SEPA: yes no unknown Flood Plain: <]F!!5o unknown Map #
Aquifer Recharge: yes no uo! e Map#
Taes/Cases:
RLC/SPI: 6 year Reforestation: yes
Eagle Nest Tag: yes Other/North Bay Sewer: yes
1 !C ! Qoo
MASON COUNTY COMMUNITY SERVICES Permit No:
PERMITASSISTAMICECI`WTER: Recv'd:
•BUILDING•PLANNING•FIRE MAR5HAL
F Pho e: Alder 7- _Shelton,WA Fax:3 RECEIVE D
Phone:360-427-9670 ems.352 Fax:360-427-779&
nv htto://www.co.mason.wa.us/community dev/
BUILDING BUILDING PERMIT APPLICATION OCT 10 2016
__- 615 . Ider Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:C4Nr`iScf^d 6T,� WA .6/ old NAME: �f;wte Z J1Q"AJ �-QDticlgpru+•t�
MAILING ADDRESS: 30 SoJvn I' MAILING ADDRESS: D Moses L r-t 5E
CITY:To-rdwh STATE:w A ZIP: � I CITY: ( L0.STA ZIP: 9RSI3
PHONE#1: Z S 3 "y 7,Z —Z 2 If PHONE: CELL: 2 5'3 - 8 2 a S9S�
PHONE#2: 2 — — Z Cf I EMAIL: Ca 50, c la fir rnd i I .
S� 3 �?1 �
EMAIL: i\. ►OW'( •4rd" L&I REG# i m O EXP. / t/
CONTACT PERSON: OWNER❑ CONTRACTOR
/' OTHERBFLOW❑
NAME: �Sa✓►t e3 Pe�e[Sd. MAILING ADDRESS: U$02 -T1n1v.1D sd-1 C!N Sr,
CITY: Q /k��� STATE—/ 1�---ZIP-_g S_J�3_PHONE:-� _ _ CELL:2S'- - ZO-579 c�
EMATL: CQ50.le)6 Q ct,P LQ R ryrcc i e
PARCEL INFORMATION
PARCEL NUMBER(12 DIGIT NUMBER) 2-2Z_�3 SZ—c)®c7 62 ZONING
LEGAL DESCRIPTION�ABBREVIATED) FIRE DISTRICT
SITEADDRESS 2Z ( = Y✓luS�` L c CITY l -rooO t1sez,:
DIRECTIONS TO SITE ADDRESS 1' c,r� Bey,s� E —rt'�aso Lk !Dr
IS PROPERTY WIMN 200 : 6cAecit mV aVa+gepPv/:
SALTWATER❑ LAKEZRIVERICREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
IS THE-PROJECT WITHIN 300 FT Of SLOPE(S)GREATER THAN 14% YESP NO/
TYPE OF WORK: NEW ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) 1/�5 em GR ail
IS USE: PRIMARY
.Z SEASONAL Q NTJMBER OF BFDROOMS _ NUMBER OF BATHROOMS_��
HEATED STRUCTURE? YES(Whole Bldg)1Q YES(Pargsj,of Bldg)❑ NO❑
DESCRIBE WORK U,-A by-f fL jrF� h D 1 u —Tzi J�d d -/yew ha 0;-e ax �S4J`:, Pw
SOUARE FOOTAGE• ��yy
I ST FLOORS /6 sq.ft. 2ND FLOOR_ _sq.ft. 3RD FLOOR sq.ft. BASEMENT 760 sq,ft.
DECK S 3 sq.ft. COVEILED DECK sq.ft.STORAGE sq.ft. OTHER T sq.ft.
GARAGE sq.ft. ATTACHED❑ DETACHED❑ CARPORT sq.ft. A'I"TACHED❑ DETACHED❑
MANUFACTURED HOME INFORMATION: •4 COPIES OF THE FLOOR PLAN REOUIRED
MAKE ODEL LENGTH
DT BEDROOMS IIAJUS SERIAL NUMBER
OWNER 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 or owner's legal representative.I further
declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the
necessary parties,including any easement holder or parties of interest regarding this project.The owner or Legal
representative,represents that the information provided is accurate:and grants employees of Meson.County access to
the above described property and structure(s)for review and inspection.This permit/application becomes null&void if
work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of
180 days.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT
APPLtCATIOY OF 18G DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.09.42)
X L (9t �
gnature Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTESICONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PERMIT SPECIALISTS Intake Approved&Ready for Pick-Up:
U1854
584 7Uti MASON COUNTY PERMIT NO.DEPARTMENT OF COMMUNITY DEVELOPMENT �/ /�BUILDING•PLANNING•FIRE MARSHALWWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. ill,426 West Cedar Street (360)275-4467 Belfair ext.352RECEIVED
PO Box 279,Shelton,WA 98 (WO),*2-5269 Ekm ext.352
B U I L D I NJMBING & MECHANICAL PERMIT APPLICATION OCT 10 2016
615 OWNER INFORMATION: CONTRACTOR INFORMATION: Street
I
NAME: C % a ij G ,f4 Q r, e 3 LJc f-
MAILING ADDRESS: -7 3 D( S',)-}-n {,4 MAILING ADDRESS: Y 80 T To&►e5 C L Ir 5&
CITY: Ta e mv+^, STATE: 1-U A- .ZIP: 'g V4 CJTy:UJ y MPi�k STATE: L,/ A- ZIP: 92-57- 3
PHONE: 2573 y7Z2-eW CELL: 25-3 3 8i bZ 9d' PHONE: CELL: Z 5-3- Zo—Swe
EMAIL: G w h',4-LAQ O'k a Fr►ta',� , d, , EMAIL :CgSA b Q I Ia roP (---3 9 rn a`,) . (d-4A
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER): 2 Z Z 3 3 - S Z 6 O0 6 2
LEGAL DESCRIPTION(a8BRFV/.4TEo):
SITE ADDRESS: 2 7 Z 1 F yr/ ss^ La k / CITY: 6:ra ee V,t---J
DIRECTIONS TO SITE ADDRESS:
VVtascM �io.xsa*•� �c) t 4- C- 17 IT
TYPE OF JOB
NEPN ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS— l ST FLOOR 2"D FLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Type of Fixture No.of Fixtures Fees Fuel Type:Electric,,,'*"LPG Natural Gas Heat Pump_
Toilets 3 Type of Unit No.of Units Fees
Bathroom Sink 3 Furnace
Bath Tubs 2. HEatpump
Showers I Spot Vent Fan 3
Water Heat Fk!Q— _ mpa TaU -
Clothes VWa r I
Kitchen Sinks 1 .Wppo&G&444 eiletSteve
Dishwasher I Kitchen Exhaust Hood
Hosebibs 3 Dryer Vent
Other t er
P sMe
Base Fee ase Fee
TOTAL PLUMBING TOTAL MECHANICAL
C+WNER I BUILDER acknowledges submission of inaccurate information may result in.a stop workorderor permit revocation.
Acknowledgement of such-is by signature below. I declare that I am the owner,owners legai representathm,-or contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties,including
any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is
accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This
permiUapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is
suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS
PERMIT APP (CATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. �y
X PW,rh �/ZX�
agnature of Applicant"" Da
X mot�►►P} P��t f 5�"` Owner/Owners Re resentativ C ntract
;1
Print Name (indicate which one
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NflTFS/CONDITIONS
BUILDINGS DEPARTMENT JT?
PLANNING DEPARTMENT
FIRE MARSHAL