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HomeMy WebLinkAboutBLD2007-01679 Addition - BLD Permit / Conditions - 11/14/2007 ? Inspection Line(360)427-7262 MASON COUNTY DEPT-�JF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 lip Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT ' OWNER: RUTH HARRISON BLD2007-01679 CONTRACTOR: LICENSE: EXP: RECEIVED: 9/19/2007 SITE ADDRESS: 1610 E SPENCER LAKE RD SHELTON ISSUED: 11/14/2007 PARCEL NUMBER: 221323390090 EXPIRES: 5/14/2008 LEGAL DESCRIPTION: TR 9 OF GOUT LOT 6 TR 2 OF SP#1227 PROJECT DESCRIPTION: DIRECTIONS TO SITE: CHANGING EXISTING GARAGE TO LIVING SPACE AND ADDING ON ONE MILE FORM PIONEER SCHOOL ON SPENCER LAKE ROAD OLD ADDITION GREY HOUSE ON LAKE General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 1 Type of Co—nstr.: V-B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: 100 Type of Work: ADD Fire Dist.: 13 No. of Stories: 2 Occ. Load: Building:1,536 Valuation: Building Height: 24 Occ. Status: Primary Basement: addition 338 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: W 200.0 Ft. Shoreline: Ft. Water Body: SPENCER LAKE Rear: E Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: N Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: S 45.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 9/19/2007 $636.84 S12007000 Kitchen Sink 1 Gas Outlets 2 Planning Review Fee KS 9/19/2007 $170.00 S12007000 Lavatories 1 Propane Tank 1 Building State Fee RTB 10/4/2007 $4.50 s2266i000 Showers 1 Ventilation Fan 3 Building Permit Fee RTB 10/4/2007 $979.75 S22007000 Water Closets(Toilets) 2 Woodstove 1 Mechanical Fee RTB 10/4/2007 $179.95 S22007000 Water Heaters 1 Dryer Vent 1 Mechanical Base Fee RTB 10/4/2007 $25.30 S22007000 Bath Tubs 1 Boller 1 Plumbing Fee RTB 10/4/2007 $69.30 S22007000 Clothes Washer 1 Plumbing Base Fee RTB 10/4/2007 $22.00 S22007000 EH Plan Review CMH 10/29/200 $75.00 S22007000 Total $2,162.64 BLD2007-01679 Please referto the following pages for conditions of this permit. 1 of 4 ' CASE NOTES FOR BLD2007-01679 CONDITIONS,FOR BLD2007-01679 1) This��cel_i�ar located in a smoke management zone. Please contact a fire warden at(360)427-9670 ext. 459 for further information. X '�L T 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 X80Q-6,47 982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. 3) 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 X c�aVnnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. 4) Prior to final approval, all upland areas disturbed or rAwly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 5) 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 located 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 proj�est. x� 1 a 6) All other necessary permits from Mason County, Washington State and/or Federal Agencies that,,.i�re required for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X�C 7) 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 De, rtme�r t1prior to any further inspections being performed or approvals granted. x� 8) O r/A nt is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X BLD2007-01679 Please referto the following pages for conditions of this permit. 2 of 4 t 9), 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 ' rr(emovvall o_fapproved documents will result in failure of required building inspections. 10) All exterior wall cav�'tie/s exposed during construction or remodeling work shall be insulated to the full depth of the wall cavity and inspected prior to covering. X Ra' N" 11) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X QG 12) 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 BuTl�in� 1 artment prior to any further inspections being performed or approvals granted. X ��'' t 13) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the undEff the roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X 14) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). XR c< :L 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 documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be X aCgecarhall be collected by the Building Department prior to any further inspections being performed or approvals granted. 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 pePtavncation. X 17) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County X dirtar�e-�r�regulation, must be reviewed and approved by Mason County prior to construction. BLD2007-01679 Please referto the following pages for conditions of this permit. 3 of 4 18) 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 Ins for shall be made prior to requesting additional inspections. X n 19) All property lines shall be clearly identified at the time of foundation inspection. X��� T 20) 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 Maftqn Cou ordinances and building regulations. X 21) 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 hool r av revented action from being taken. No more than one extension may be granted. 22) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, c c or ,Land flashing. Install metal connectors approved for contact with the new types of pressure treated material. 23) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures meet the setback conditions listed. 24) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "A pr ved Site Plan"to ensure these structures are shown and meet the setback conditions listed. XJ C( 25) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X 2�j-7d This permit becomes null and void if work orconstruction 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 pr9perty and structure for review and inspection. OWNER OR AGENT:(LT/ 0, - q VV_ DATE: C) 7 BLD2007-01679 Please referto the following pages for conditions of this permit. 4 of 4 r I N� CONCRETE MECHANICAL MANUFACTURED HOME D o Date `7-L-&%Q By 12 ._ .. _ FDotinas l SetbaZk/ I t� Ribbons Gas Piping o By interior-Date By Date By A Exterior Date���'U7 By Exterior- Date C BL Set- _ - , INSULATION Point Load/isolated Footings Date By BG 1 SLAB INSULATION - -- C Date By Data By FIRE DEPARTMENT = Foundation Walls Floors Date By Date /�'cr,- By gate y--2-l3 By T DECKS FRAMING Wails Date By Date .t_e>� By [7ato _. �_ By PROPANETANKS PLUMBING vault Daw BY Dater By OTHER. Groundwork Attic Type F ��� DateBy Date By yU o.W.V DRYWALL Ty pe. LS`� By D Brace wall By Date By W Date _U FINAL INSPECTION m Water Lane ri Fire S®peration O v �! Date By Date By Date �Z By O �l Pass or Request Inspect. CD Type of Insp. Fail Datq Date Hone By Comments rn s -- v 0 � 9 �°' ��✓ G=�I' ,� ass _07 .w..-.... ,.e... CD -c a 3- Ali 1✓gcc.-rr.��/i v vci j /.rlv it '✓ �l/ W 44,4L- -1�✓'¢� -55 0 co o. CONCRETE MECHANICAL MANUFACTURED HOME > C) Date By C) Footings/Setbacks Ribbons Gas Piping o Interior Date By Interior-Date By Date By 0) 0 Exterior Date///,?.,,/ B Y~I/ Exterior-Date By Set-up Point Load!isolated Footings INSULATION Date By BG I SLAB INSULATION C Date By Id Date By FIRE DEPARTMENT Foundation Walls Floors Date By Date By Date By DECKS FRAMING Walls Date By Dato By Date BY PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Type Jf Date By Date By Date By D.W.V DRYWALL Type. Int Brace Wall Date co Date By Date By ------ 17- FINAL INSPECTION (D Water Line Fire Separation 0) CD �9 Date By Dal® By Dat© By CD (D -4 6 CD 7 Pass or Request Inspect. _L 0 Type of Insp- Fail Date Date Done By Comments a) Ei - -4 (D TV O 0 Cn 'D (D 0 h Request To Revise An Approved Plan P fr nl�f lumber: BLD2001_- f) ( �'1 Name C_ --T 4 Pelf If' Parcel Number 1 Z , fAA fA Phone Number daytime ( ) Project Address I (r(0 yy Mailing Address Please pro v'de a complete, detailed description of the proposed revisions to the approved plans: Are two sets of the revised plans or addendum indicating the changes included? Yes ❑ No Are the approved site plans included? $ Yes 0,No Are the revisions clearly and accurately identified on the plans or addendum? Ix Yes 14�No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes 'Zl No If Yes, Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note: No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record Does the proposed revision modify the footprint or location of the structure? ` Yes ❑ No If Yes, Is a revised site plan, with all new setback dimensions included with this request? Yes ❑ No Additional Information: Applicant's signatur Date: Office Use Only Received by: Date Sent Assigned To Approved By Date �b B �p M 11 Original Valuation: $ -7 1 Additional Valuation: $ Sq. Ft. L —x$_L9 $ o P. tt7M to �j Sq. Ft. x$ $ g�o�. _ E.H. 11 . - _ Total New Valuation $ 107 S6$7 v i ❑ P.W. Additional Fees: Additional Planning Dept. $ &C.Ct' �e p Additional Plan Review $ o_ Additional Conditions /Comments: ,OULVEq�'tS Additional Building Permit $— Additional Plumbing $ Additional Mechanical $ 5� Additional E.H. Dept. Other $ TO O Total Amount Due: Amount To Be Paid Up-Front$ ■■■■■■■■■n � ■■■■■ ■■■In■■■■ ■■■■■■ter■ �ir��!�r�rrr■■■®■ r ■■■ ISO■■■■■■ ■► �■■■e■ONE■■��■■■■■ No 0■■■■■■■■_'■■IRRIENUFAISE OMEN 7111". IMF ■�����■s■gin■■■■■■■ ANEMONES ■■■■■■■■� � N1i.Lrr�il�e 1■ice:■���■� OEM is aBuilding: Date of • • .. r. . ■ application: FORM MUST BE COMPLETED IN INK PERMIT NO. PLEASE PRESS HAND 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 INFOZOi,TION CONTRACTOR INFORMATION Owner '0AV'I D :'?10T7t--� A,IQ 1-5C" Company Name — Mailing Address—[At-1Cj...1= :5A —12— L-1-5 • 0,h Mailing Address City -SI L—!LT I'.:state\&A Zip Code qas�,a4± City State Zip Code Phone3&Q-n ,-0:93:`tOther Ph. Phone Other Ph. Lien/Title Holder_..—, Contractor Reg.4 Exp. E mail address C*12LV-A!' Cry m E Mail Address Drivers Lic.#_14[A 6JLC' &jy 13 OB-j- LIF Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer Sy;,tem PARCEL INFORI67ATION - 12 Digit Parcel No. - eJ' Fire District � �_- Legal Description-,tZel-C- 1 9„ <T"efv :a-/ 44-> *F 2- Site Address (Plew e include street name, street number and city) 16io e �t'��/ ' ���- 4 SCe- Directions to site-�Z&E"W'4-�e _R iQ y �'`- � r ry' 0-4,0 "7-0 eE_ .° r l'.r.lC /�.C��r � f) SI�E�✓C'-!�_✓� C.K /g-'o TrJ AL- Is property within 250'of Saltwater Lake r� River/Creek Pond Wetland Sea:3onal Runoff—Stream—Slopes or Bluffs > 15% TYPE OF JOB - New Add e Alt Repair Other Use of Building PL11�4 Location of Fixture 3/Units - 1 st Floors 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPC'� Natural Gas_ Heat Pump_ Toilets _. w Type of Unit No. of Units Fees Bathroom Sink —. — Furnace Bath Tubs _ Heatpumps Showers Spot Vent Fan Water Heater IR ro­pa ne Tank Clothes Washer - Gas Outlets Kithen Sinks �— Wood/Gas/Pellet Stove Dishwasher _.�- Kitchen Exhaust Hood I Hosebibs _. Dryer Vent Other —• Other Base Fee Base Fee ' _ TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER /i;knoivledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature be low.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 ease meni holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them W apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate ar d gre its employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINIJ'ATION OF WORK IS BY;OEANS OF A PROGRESS INSPECTION. X -r. .ir—': 7� t.� "r- Date: Owner/Ownrirs Ri;presentative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by '--Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTA P1. REVIEW APPROVED DENIED NOTES Building Departme:it Occ Group—Tvoe :onstr. Planning DepartmE_nt Environmental Hee.lth C,epartment FEES Plumbing & Base f a Site Ins ection Mechanical & Baso fee UFC Plan Review Fee Wood/Gas/ Pelle Stove Fee Other Vinkatinn Ppo TOTAL FEES FORM MUST BE COMPLETED IN NK MASON COUNTY PERMIT NO�OO�7�J C• 9 PLEASE PRESS HARD IUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 y 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 DAwV t(Z f`RW �i-�A.1Z��5 or.7 Company Name Mailing Address ! k n M 'Sbr- . c�ri f-►<_ RID Mailing Address City RELLT #J State W^ Zip Code R AXIS' A- City State Zip Code Phone'3G0-42_t-©334- Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address ��ferr. �G,K_ Cvm E Mail Address Drivers Lic.# DOB 1-1-7-- Drivers Lic. # DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well jf!� Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parc9l No. ;L '' --33 _ Fire District -61 Legal Descriptionr'Q,&e-.I"4T CmaV7 �-Ir � SAC 74. "TOwpj_5S6"� 'Z 1 ' LoT :, Site Address(Please include street name, street number and city) t Dire ns to site 'M `4- G4E- - z- 70 l Will timber be cut and sold in parcel preparation?Yes/or Is property within 200' of Saltwater Lake or 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 o TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE B-SEAS NAL ❑ Use of Building oDescribe Work 114 No. of Bedrooms I No. of Bathroom 3rd Floor -154 Square Footage- 1 st Floor 1 % O 2nd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached t� MANUFACTURED HOME INFORMATION - Make Model Year Length Widt Serial No. No. of Bedrooms No. of B rooms Type of Heat Purch Price $ Replacement U Yes/ N Installer Na Certification No. OWNER/BUILDER Ackno �and' curate information may result in a stop work order or permit revocation. Acknowledgement of such i cl re that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this rk as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permissiQ��9 r qp�r �ji�m any easement holder or any other party in interest regarding this application or the work �- proposed in the application, I ha�'dbtall��iid�lission from them to apply for this permit and conduct the work proposed. The owner or � agent on owners behalf, repro cents that the information provided is accurate and grants employees of Mason County access to the above described property and st.iK1 ©f e�qav� {d1� on. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if consfr�thS Vis suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS FAPROGRfSSINSPECTION.INACTIVITYOFTHISPERMITAPPLICATIONOF180DAYSWILLINVALIDATETHEAPPLICATION. f Date: 57E!>'T' jQ,--2.0o'J t Owner Owners Representative/Contractor (indicate which one) IT FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date 9- IgI-61 DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Fire Marshal Z FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbinq & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST DE COMPLETED IN NI( MASON COUNTY PERMIT NO PLEASE PLEASE PRESS HARD 9UILDING 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 INF(':IRNIATION CONTRACTOR INFORMATION Owner GAV c;l �!g { �H1 ti2Q.lSr�� Company Name " '• Mailing Address Mailing Address��i�17 r" _`�i��'i.V '.�+Q L-K.. IZ r7 9 — City_,S7"6'ZL—..State^Zip Code !qk'6 13' -4- City State Zip Code— Phone Other Ph. Phone Other Ph. Lien/Title Holder.._ Contractor Reg. Exp. E mail address^�"s 'vi� ��-box c<--,rn E Mail Address --- _Drivers Lic. # _ DOB t- C'7 Drivers Lic. # DOB__, _ : i' SEPTIC I WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic '" Connect to Water System Name of Water System Well 9,"O" Sewer ;3ystem Name of Sewer System PARCEL INFOFMATION - 12 Digit Parc9l No. G Fire District Legal Description.'L&I`se_� 'I" a 66V!T L4r'.[_' (. Sic q?-o _ bb_ A ` IIJA ,1' 2 't_..a'T 2. -_ Site Address (Please include street name, street number and city) 16, ICE c�, q!��/e�� � 1-.k. 627. S'1fELyc_--1 ' Dire ns to site_ 1:30 rl0 ACa.A'T'C CiA0 (, CA&4-'i` o A!C-A'r2 lqt A=b Will timber be cut and :3old in parcel preparation?Yes/ff Is property within 200' of Saltwater Lake River/Creek Pond Wetland _Seesonal Runoff Stream Slopes or Bluffs 15% Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement action?Yes o TYPE OF JOB - New Add 7 Alt Repair Other_ PRIMARY RESIDENCE ['SEASONAL ❑ Use of Building (Z�� Describe Work A-DA No. of Bedrooms-! No. of Bathrooms 4 Square Footage - 1st FlooL11-2nd Floor -1 5H 3rd Floor _Basement Deck L0 Covered Deck Other Sq. ft. - Garage — Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year A Length VAlidth_,s Serial No. No. of Bedrooms No. of B rooms __- Type of Heat—,Z. Purch �Price Replacement U Yes/ N Installer Na _ Certification No. OWNER/BUILDEF,. AcM:no �( �o f i ccurate information may result in a stop work order or permit revocation. Acknowledgement of such is �e cl re that I am the owner, owners legal representative, or the contractor. I further declare that I am entitled to iece6,e this permit and to do fib rk as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permissi �9 r��q r �(�gyqm any easement holder or any other party in interest regarding this application or the work proposed in the app icaticn, I has tai4�eq�iUA ission from them to apply for this permit and conduct the work proposed. The owner or agent on owners be-ialf, 'eprr ents that the information provided is accurate and grants employees of Mason County access to the above described property E.nd st,mj�PVC r i v� �1 ! p Gt�on. This permit/application becomes null & void if work or authorized construction is not commenced within 1£i0 days o�r�ifconos�r��t1` R�rl�is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS FAPROGR�SSINSPECTION.INACTIVITYOFTHISPERMITAPPLICATIONOF180DAYSWILLINVALIDATETHEAPPLICATION. r Date `s' ej'7 c l Owner Owner::. Representative/Contractor (indicate which one) FOR OFFICIAL, USE BEYOND THIS POINT Accepted by:6 ..) Date 9 • ICI-6� DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Departmgmt PlanningDe artrr gent e_.' Uc q--0001U Lam' KI�g Environmental Health Department r - 11 Fire Marshal I _. rn2-w FEES Buildin Permit F,�e Site Inspection Plan Review Fee EH Review Fee 2 Plumbing & Base Fee Planning Review Fee Mechanical & Bac-e fe.: Other Wood/ Gas / Pellet StDve Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES FORM MUST BE COMPLETED IN INK PERMIT NO. PLEASE PRESS HARD 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 t AVI D ''�'12�1[.0 6jA.A#Q tsc3hJ Company Name Mailing Address 1.6 , Sa —A Ll' . .Q b Mailing Address City S L-re1At State\&A Zip Code%,s-R!+ City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address Ge,m E Mail Address Drivers Lic.# IQ -i bOB L 1L 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. " R r 510,076 Fire District Legal Description �' 4-C=�T oj' Czay '- %� Se_' 3 PT7-6rAJN6�{12 �• ''� �- Site Address (Please include street name, street number and city) Ebro A-1c. .Q SEiE�Z;�Y Directions to site IV1644WA 4C,g7-2= 426 7 107-6/5'r� 1424-1.¢-A •2� 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 PAIVzkz'— RCS Location of Fixtures/Units - 1 st Floors 2nd Floor j-f f Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type-.Electric— LPC✓ Natural Gas Heat Pump_ Toilets 2 Type of Unit No. of Units Fees Bathroom Sink 2-- Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater lPropane Tank Clothes Washer �— Gas Outlets Kithen Sinks �— Wood/Gas/Pellet Stove Dishwasher �— Kitchen Exhaust Hood 1 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 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. PROOF OF CONTINUATION OF WORK IS BYJMEANS OF A PROGRESS INSPECTION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYODTHIS POINT Accepted b Planning Pd Ck# Date -ICI-0:] Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. Planning Department Environmental Health Department FEES Plumbinq & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES - MASON 00UNTY PERMIT NO: , 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 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner_ y,V p Et2.15 r�n� Company Name Mailing Address 111�1_0_g; Apg nje_Cs:,a t K- R Q_ Mailing Address City SL1.gr-Tow/ State,6, ^ Zip Code!2k CL a? *4- City State Zip Code Phone3(@n-•42L•U33-4- Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. Email address r'��V�.r�-- �� . ��m E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic y Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. - Fire District Ic Legal Description Site Address (Please include stye t name, street number and city) Il�-,1Z) Q. C Pr-edc a- ,7 &-.E, 1 �1:_.S A-La Dire �ons to siteA so ? LAIAe � f � Will timber be cut and sold in parcel preparation?Yes/CJ 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 - New Add Alt Repair Other PRIMARY RESIDENCE g-SEASONAL ❑ Use of BuildinglI&a VA LX- 'IMS Describe Work No. of Bedrooms No. of Bathrooms 2. _Square Footage- 1st Floor It 1 t? 2nd Floor 1 3rd Floor Basement Deck(etD Covered Deck Other Sq. ft. Garage Attached Detached Carport . _0 Attached Detached' MANUFACTURED HOME INFORMATION - Make Model Year Length Width_ Serial No. -'f --"No. of Bedrooms y No. of Bathrooms Type of Heat Purch�is6 Price$ �-! Replacement UAx Yes/ NV 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 pqrmission 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. 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 FAPROGIjESS INSPECTION.INACTIV STY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X 0�7 -s,.,,.�(,�,, / Date: CAMpT" /Q Cowneg Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by'. ; ° Date DEPARTMENTAL REVIEW SUROVED DENIED NOTES Building Department t Planning Department Environmental Health Department I Fire Marshal _ FEES Building Permit Fee Site Inspection Plan Review Fee 3 6. EH Review Fee Plumbing & Base Fee • .30 Planning Review Fee Mechanical & Base fee Yq— �S� Other Wood /Gas/ Pellet Stove Fee 0_ 00 State Fee S� Violation Fee c- Pre-Paid at Submittal Valuation $ TOTAL FEES 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 �"-NAx.$, n #(Q%cU4 T—W4 4k.jQ se�,Ag Company Name Mailing Address] ar ag- ►g Lg e Q D-- Mailing Address City State _Zip Code4? a- City Mate Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. 9 Exp. E mail address rA a as g_-—4 � -Sc-^o E Mail Address Drivers Lic.# DOB 4 Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septitj- Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. ,fir - - !40v!?4 Fire District -4' Legal Description -It''Int 3 IL�--?r1C..lA!:ia - T 2- Site Address (Please include street name, street number and city)f19 ', ,'94&AACI i;A Directions to site 2 4 Is property within 200'of Saltwater Lake 4'"' 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 - 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS TVpe of Fixture No. of Fixtures Fees Fuel Type:Electric _ LPCi_ Natural Gas_ Heat Pump_ Toilets ;t Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs # Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer a tlets Kithen Sinks Woo as/Pellet Stove / Dishwasher en Exhaust Hood Hosebibs Dryer Vggnt_ Other Other bc, /ir 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 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. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. f X a 43- Date: �-- - Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning 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 MASON COUNTY PERMIT NO_2 �[)4. BUILDING PERMIT APPLICATION , ¢ 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 t� 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 Mailing Address Z. Mailing Address City$t;ry^F1y�_State�CA Zip Code a'��"& -4i City State Zip Code Phone:' -4?��?t .�t- Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. Email address l Qt " r%jo bcxw . ���'1 E Mail Address Drivers Lic. # JAA 12 a I noz, DOB Drivers Lic. # DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Weller Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. 2 1130- �,3—r+�o op Fire District Legal � Description:17Aw r �- � V r x,rxr & ::SG � ?.T:MI,I At P 648 '2 1-�-�-T 2 Site Address(Please include strett name, street number and city) Dire ons to site A=els Ot at. Will timber be cut and sold in parcel preparation?Yes/er Is property within 200' of Saltwater Lake .2- River/Creek„ Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 1501. Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/Nd TYPE OF JOB - New Add ?" Alt Repair Other PRIMARY RESIDENCE &J-"SEAS'ONAL ❑ Use of Building62s%eA cc: f2EM Describe Work A D9i j q:3dQ No. of Bedrooms -No. of Bathrooms SquareFootage- 1 st Flood C-2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. ' Garage Attached Detached Carport---�— Attached Detached Imo"` MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. -'No. of Bedrooms - No. of B rooms Type of Heat = Purch-�Le Price $ Replacement ,�. Ur�+it'� Yes/ N 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 regardin4 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 T described property and structure 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 OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X Date: g�cr'�"�"" wne Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES �' Building Department Planning Department '- Environmental Health Department F, , Fire Marshal FEES ` ( t Buildinq Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbinq & Base Fee Planning Review Fee Mechanical & Base fee Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee I Pre-Paid at Submittal Valuation $ TOTAL FEES NAM No omms US Min. so �� � ELM Imp MEN WE tj 0 F Date of appliGation: W W.