HomeMy WebLinkAboutBLD2008-01185 Final Detached Garage with Loft DDR2008-00180 - BLD Permit / Conditions - 9/17/2010 Inspection Line(360)427-7262
IrPMASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
14 Shelton, WA 98584 fa LS ; 0y)
RESIDENTIAL BUILDING PERMIT BLD2008-01185
OWNER: KENNETH KROHN RECEIVED: 9/18/2008
CONTRACTOR: LICENSE: EXP: ISSUED: 10/9/2008
SITE ADDRESS: 550 NE LAKE RIDGE DR BELFAIR EXPIRES: 5/3/2009
PARCEL NUMBER: 223047690010
LEGAL DESCRIPTION: TR 1-A OF SURV 12/68 TR A OF SP#1629
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Detached garage with workshop and loft area. ST RT 3, L ON ST RT 300,OLD BELFAIR HWY,L ON BEARCREEK
DEWATTO RD, L ON TAHUYA BLACKSMITH RD, R ON LAKE RIDGE DR TO
SITE ADDRESS ON THE RIGHT SIDE
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 1 Occ. Group: U-1 Lot Size: Deck:
Type of Work: ACC Fire Dist.: 2 No. of Stories: 2 Occ.Load: Building: Garage-Detached 1,641
Valuation: Building Height: Occ. tatus: Basement:
Manufactured Home Information Setback I formatio nk Shoreline& Planning Information
Water Body: Erickson Lake
Make: Length: Ft. /0�/t: W 138.0 Ft. Sh line: Ft. SEPA?:
Rear: E 400.0 Ft. lope: Ft. Shoreline Desig.: Rural
Model: Width: Ft. Side 1: S 24.0 Ft.
Year: Serial No.: Side 2: N 34.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixt FEES
Type Qty. Qty. Type By Date Amount Receipt
Hosebibs 2 Exha_u ood 1 Plan Check Fee GMM 9/18/2008 $495.79 B12008000
Lavatories 1 Ventilation Fan 1 Planning Review Fee GMM 9/18/2008 $19o.00 B12008000
Showers 1 EH Plan Review GMM 9/18/2008 $40.00 B12008000
Water Closets (Toilets) 1 Building State Fee RTB 9/23/2008 $4.50 612008000
Water Heaters 1 Building Permit Fee RTB 9/23/2008 $818.75 612008000
Floor Sink 1 Mechanical Fee RTB 9/23/2008 $20.75 612008000
Mechanical Base Fee RTB 9/23/2008 $26.60 612008000
Plumbing Fee RTB 9/23/2008 $47.11 612008000
Plumbing Base Fee RTB 9/23/2008 $23.10 612008000
ADJUST--Plan Check Fee RTB 9/23/2008 $36.40 612008000
Total $1,703.00
BLD2008-01185 Please referto the following pages for conditions of this permit. 1 of 5
Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Ir Shelton, WA 98584
flo
RESIDENTIAL BUILDING PERMIT
BLD2008-01185
OWNER: KENNETH KROHN RECEIVED: 9/18/2008
CONTRACTOR: LICENSE: EXP: ISSUED: 10/9/2008
SITE ADDRESS: 550 NE LAKE RIDGE DR BELFAIR EXPIRES: 4/9/2009
PARCEL NUMBER: 223047690010
LEGAL DESCRIPTION: TR 1-A OF SURV 12/68 TR A OF SP#1629
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Detached garage with workshop and loft area. ST RT 3, L ON ST RT 300,OLD BELFAIR HWY,L ON BEARCREEK
DEWATTO RD, L ON TAHUYA BLACKSMITH RD, R ON LAKE RIDGE DR TO
SITE ADDRESS ON THE RIGHT SIDE
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: V-B
Type of Use: SF Insp.Area: No. of Bathrooms: 1 Occ. Group: U-1 Lot Size: Deck:
Type of Work: ACC Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building: Garage-Detached 1,641
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline&Planning Information
Make: Length: Ft. Front: W 138.0 Ft. Shoreline: Ft. Water Body: Erickson Lake
SEPA?:
Model: Width: Ft.
Rear: E 400.0 Ft. Slope: Ft. Shoreline Desi g.: Rural
Side 1: S 35.0 Ft.
Year: Serial No.: Side 2: N 10.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Hosebibs 2 Exhaust Hood 1 Plan Check Fee GMM 9/18/2008 $495.79 B12008000
Lavatories 1 Ventilation Fan 1 Planning Review Fee GMM 9/18/2008 $190.00 B12008000
Showers 1 EH Plan Review GMM 9/18/2008 $40.00 612008000
Water Closets (Toilets) 1 Building State Fee RTB 9/23/2008 $4.50 612008000
Water Heaters 1 Building Permit Fee RTB 9/23/2008 $818.75 B12008000
Floor Sink 1 Mechanical Fee RTB 9/23/2008 $20.75 B12008000
Mechanical Base Fee RTB 9/23/2008 $26.60 612008000
Plumbing Fee RTB 9/23/2008 $47.11 B12008000
Plumbing Base Fee RTB 9/23/2008 $23.10 612008000
ADJUST--Plan Check Fee RTB 9/23/2008 $36.40 612008000
Total $1,703.00
BLD2008-01185 Please referto the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
BLD2008-01185
CONDITIONS FOR
BLD2008-01185
1) Loft ar h been reviewed as and is not approved as sleeping area. Owner verifies loft will not be used as sleeping room.
X
2) All other necessary permits from Mason County, Washington State and/or Federal Agencies that e r ui �orproposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
3) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There re ote.nti I risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-80 - 4 he person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
1-80r
X
4) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be gr ed., ICI addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and must be collected by the Building
D m�pr any further inspections being performed or approvals granted.
X
5) Ow /P> it i�onsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
X ((// ��
6) 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
Offic'a hppFed
t holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
rem al documents will result in failure of required building inspections.
X
7) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
8) 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
appr val ill not be g anted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the
Buil i D rtm prior to any further inspections being performed or approvals granted.
X
BLD2008-01185 Please referto the following pages for conditions of this permit. 2 of 5
9) 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.
Exce ti n: -30 ins lation 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
and a the f sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation.
X
10) 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 wi h c sul-w the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contract s a d ing that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
11) Concrete u d for basergent walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other
vertical c cr a wo a osed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2).
X
12) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Departme t prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
theret d um is re removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be
char an I collected by the Building Department prior to any further inspections being performed or approvals granted.
X
13) All cons uction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of hingt O cupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
per i ev tion.
X
14) 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 Ma on County R ad, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which
is proposed to b to to ithi 2 ' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may
affect your proje
X
BLD2008-01185 Please refer to the following pages for conditions of this permit. 3 of 5
15) All Chan es o"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordi ce e � n, must be reviewed and approved by Mason County prior to construction.
X
16) 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 nt rnational odes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building prio
In a or II ade r to requesting additional inspections.
X
17) All property lines shall be clearly identified at the time of foundation inspection. X�KA
18) All buildi g permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to re u t final ' s ection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mas Co ances and building regulations.
X
19) 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
actio fo a Wrionpt exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
hold r avd action from being taken. No more than one extension may be granted.
X
20) Pre s ur rea ed woo anufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
con n ors, fl ing. Install metal connectors approved for contact with the new types of pressure treated material.
X
21) By definjtion, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure
the e u res meet ttPe setback conditions listed.
177
22) Land n a stairs mu t meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"Ap ve e Pl7�=
ure these structures are shown and meet the setback conditions listed.
X
23) Water ali i n t be degraded to the detriment of the aquatic environment as a result of this project.
X
24) Prior to final approval, all upland areas disturbed or n y d by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
25) Temporary erosion control measures must be implemented to prevent water queityd n of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established. X
BLD2008-01185 Please referto the following pages for conditions of this permit. 4 of 5
7
26) A ov er i nsions and setbacks on submitted site plan. Setbacks are measured from the furthest pr jection of the structure.
27) All Best Management Practices must be strictly adhered to thrououghout proposed development. X
28) This structure has NOT been reviewed or approved as an Accessory Dwelling Unit (ADU): c d I unit detached from an existing single-family
dwelling for use as a completely independent or semi-independent unit with provisions for oki g, sanitation and sleeping. ADUs are required to
meet the requirements under Mason County Development Regulations 17.03.029. X
29) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfie d/ Reserve requires a 1 Oft setback from all footing/foundations.
B. S ptic n (s) r q W es 5ft setback from all footing/foundations.
C. N un on ins within 30ft, down gradient of drainfield/reserve area.
X
This permit becomes null and vo'd if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of n uation of work is a progress inspec'on within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means oAprand
inspection.The owner r the gent n t ners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above describe structur revie a d in pec' n.OWN ER OR AGE DATE:�(y` `5=��'y C
BLD2008-01185 Please referto the following pages for conditions of this permit. 5 of 5
a ONCRETE MECHANICAL MANUFACTURED HOME
X
o Date
w Footings 1 Setbacks Gas Piping� By Ribbons _
Interior Date By Interior-Date By Date By Z
w Exterior Date By Exterior-Date B A
Point Load!Isolated Footings INSULATION Date By z
BG 1 SLAB INSULATION Z
Date By Data By FIRE DEPARTMENT M
Foundation Walls Floors Date By =
Date . ._O f By Data By DECKS
FRAMING walls Date By
Date // —�-o By Data Z,3 BY PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic
Date By Date By
Type-
DRYWALLOat® J'�•-d� By/?7�
D.W.)/ Type:
Int.Brace Wall
Date By
-13 Date _ _(' BY Date By FINAL INSPECTION
Water Line Fire Seperation N
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Date Q -v7 By Date By Date _ B O
m O
Pass or Request Inspect. o
Type of Insp. Fail Date Date Done By Comments
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BEGINN114G at the Northwest corner of the North ons-half of the Northwest qusrTur oT C:N4WN(
;h.- NOr-;heast quar"t,::r of the Southwest quarter of said Section 1r; ilionce, South 22 of the
3; 4�1' 53" West along the—Wesfi I Ina of sold subdivision 110.18 feet; thence South 89' 20 44'
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under ,
- -- PARCEL. IA
PARCEL
---I TOGETHER W 1 TH a 60 foot wide access And ut l I t I eseasement to Erickson L.ako Road as
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��- E / II,,► ( ; MASON COL
SITE PLAN R!
W I 1 I { I +
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i
Request To Revise An Approved Plan
Permit Number: BLD200 - Name �) 0
Parcel Number,96'�)�/ -7GO 0010 Phone Number
Project Address Mailing Address
GL
Please provide a co lete, detailed description of the proposed revisions to the a proved plans:
.
ouv'I Cs 1 OY
Are the site building Jans, approved y Mason County,
included with this application? ❑ Yes ❑ No
Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No
Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes ❑ No
Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ 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 an engineered plan will be approved without the written consent of the engineer or architect of record.)
Does the proposed revision modify the footprint or location of the structure? ❑ Yes E. No
If Yes, Is a revised site plan, drawn to scale, included with this request? ❑ Yes No
Additional Information:
Applicant's signat 4 Date:
Received by: Date:
)ff'ice t Ise Only
Forward to departments indicated below: Approval/Date Original Valuation:
0 Building Additional Valuation:
Sq Ft x
PIanArt l M
Sq Ft x
C Environmental Health Total New Valuation:
Additional Fees:
r Public Works Additional Plan Review
Additional Conditions/Conunents: Additional Building Permit
Additional Plumbing
Additional Mechanical
Outer
Total Amount Due: S
Nam hn Parcel# -'300 jd BLD#'t--�0,2WB-7�-D 1_
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.
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_1 Length X Width = Area All dimensions in feet
Buildings Li X oZ0 =
�} X I a Measurements for buildings are taken at the
2,
perimeter of the farthest projections (example:
Q1l X = eaves/gutters)
rX
=
Driveways =
= 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) 'IDg
If the Total Impervious Surface rea is LESS THAN 2000 Square Feet,please r d,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Build /Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowle ement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further
act 1 ge that the information prov' ed is accurate and employees of Mason County are granted access to the above-described
prop for revi and i sp ti a ay required. n Q
X Owner/A ent/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
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:
httpHwww.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
Mail: P 0 Box 1850, Shelton WA 98584
Physical: 415 N 6th St, Shelton WA 98584
If this development has,or will have,a septic/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. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further
acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-described
property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date:
Page 2 of 2
Property line North
Nominally 14 ft undeveloped
Fence
3 5 ft
20.5 ft
West foundation
49.5 ft north to south
PLOT PLAN revised to reflect actual
location of new building.
Property width from N to S is 110.5 ft.
Aligned with west wall of new building
are several large trees so fence is curved
out about 14 ft from property line to
protect these trees.
When the house was built we marked the
line between the lots carefully and this is
defined by the water box near the road
(about 10 ft S of the big gate) and my
future drawings have used that as a
reference line.
26 ft setback from next
lot, which I also own.
Property line South (accurately located)
MASON COUNTY PERMIT NO. _BICI 9fY)P)- 0( I .�
BUILDING PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Tm
Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 _5
On the web www.co.mason.wa.us
APPLICA�/T INFORMATION / CONTRACTOR INFORMATION
Owner l�2&.kk� /f • -, Company Name
Mailing Address O E C-h-t Mailing Address
City T r e' State ) Zip Code '1 City State Zip Code
Phone ' '2-8f H Other Ph?nb-79d-M l I Phone Other Ph.
Ljen/Title Holder Contractor Reg. # Exp.
tmail address ro Gt*S E Mail Address
fivers Lic.# BM55 Drivers Lic. # DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existjng Septic—
Con nect to Water System ^ i` ame of Water System "r Ile' ���d ll p - ffi
Well Sewer Syste Name of Sewer System
PARCEL INFORMATION y12 DigA Parcel No. Fire District
Legal Description r
Site Address (Please i c de t eet name, stre num er a d city) ,S� ✓r
rectio,s to site ��
Will timber be cut and sold in p rcel preparation?Yes/No �� r fi y/�I If ItQ
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluff—T/o
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 ._ _Ot er RIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Describe Work AA
No. of Bedrooms No. of Bathroo Squar age - 2nd Floor
3r9 ILQo Basement c� overed Deck Other Sq. ft.
Garage,) Attached _. Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit? Yes/ No
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 gBers behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above
descriperty and structure for review nd inspection. This permit/application becomes null & void if work or authorized construction is
not coed within 180 days or if c ns ction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY
MEANPROGR,ESS,INSP TIO .I ACT TYOF THIS PERMIT APPLICATION O 80D YS ILL INVALIDATE THE APPLICATION.
X Date: 2-D .�
Owner-/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted bya Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
BuildingDepartment q D j
LUUv
Planning Department
I
Environmental Health Department jaELFAip. OFFICE
Fire Marshal
FEES
Building Permit Fee - 2 Site Inspection
Plan Review Fee �Z� EH Review Fee
Plumbing & Base Fee Y; // .1,3 - Planning Review Fee
Mechanical & Base fee p�D_ S' -(�Q' Other
Wood /Gas/ Pellet Stove Fee �� State Fee
Violation Fee -13� Pre-Paid at Submittal
Valuation $ TOTAL FEES
. _
r � � ��
1 �'-g
l� �" �6 .� � � ,� �Y
�( �T
FORM MUST BE COMPLETED IN INK PERMIT NO.T2I�d VDU ' DI 8�
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
APPLICA T INFORMTIO CONTRACTOR INFORMATION
Owner le LA h ", Company Name
Mailin Address- 2 ' C 4 u M« Mailing Address
City `�%� -State l�A Zip Code q S� City State Zip Code
Phone�2UL 37a-Abq` Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg..4 Exp.
E mail address E Mail Address
Drivers Lic.# DOB I Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System
Name of Sewer System
• PARCEL INFORMATION - 12 igit Parc I No. - -2 (C fir
District
Legal Description 1 Su Ca
Site Address (Please include t name, street number and city) n n
it ct' to site �" L
L 1 I —
Is property within 200'of Siftwater Lake River - - - IPond
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 UNffS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric L LPC Natural Gas_ Heat Pump_
Toilets ( Type of Unit No. of Units Fees
Bathroom Sink I Furnace
Bath Tubs Heatpumps
Showers Spot Vent Fan 1
Water Heater Propane Tank
Clothes Washer Gas Outlets
'('them Semk I �,14y-Sin IL Wood/Gas/PelletStove
Dishwashera� Dryer ent Exhaust Hood(-W
Hosebibs Other
ther
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 nit to o the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
require fro any easement holder or any oth r party in interest regarding this application or the work proposed in the application,I have obtained
permi io rom them to apply for this permit nd conduct the work proposed. The owner or agent on owners behalf,represents that the information
provi s accuand ran plo ees f MFJA
County access to the above described property and structure for review and inspection.
PR co;NT ION WO BYNS OF A PROGRESS INSPECT N.
-� Date: —�
Ow er/Owners R presentative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted byqu
Planning Pd Ck# Date q- l8 -08 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 Ins ection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
411 N. Fifth Street/ P.O. Box 186, Shelton WA 98584
360.427.9670 ext. 352
DDR a 00 8- 00180
Rec'd by LA__:
Request for
Administrative Variance for Reduction in the Required Se aclks ($105.00)
For administrative review, the minimum variance on a setback request is 5 feet
from the side yard lot lines and. 10 feet for front and rear lot lines or any access
easement. Request for further reduction requires a standard variance.
Setbacks are measured from the furthest projection of the structure, including
roof eaves.
Applicant/Owners: �LnnPA
Mailing Address: i c# �
r
Telephone :`31o0 -.�7� • aP)a1 aa(o- -4 D -�/.���- V►'�
City.. State: Zip:
If this reduction is tied to a building permit, please give permit
case number. BLD cZ0o8 --01 185
Parcel Number(s): r—�,2 O�?2 -7(o - qO0 I(D Zoning F -S
Site Address: O — r4 le— -
Requested variance: Front / Rear 6ide Yard please circle all that apply)
Requested setback varianm5oo l-G . 10 ft.
An illustrated site plan is required.
Your site plan must show the following: north arrow, abutting street or
easements, set backs to all property lines and existing buildings, slopes, surface
water, wetlands, critical areas, septic, well and driveway. Show all proposed new
development.
The following circumstances must apply:
FRONT AND OR REAR YARD REQUIREMENTS:
1) Existing lots of record as of March 5, 2002;
You must meet one of the following: (Please circle all that apply)
2) One of the following exists on the lot:
a) steep slopes, wetlands, or streams present;
b) soils that restrict building or septic development;
c) lot width at the front yard line of no more than 50 feet;
d) lot size of no more than one-fourth acre;
e) existing improvements of buildings, septic systems, and well areas.
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r
SIDE YARD REQUIREMENTS:
1) Existing lots of record as of March 5, 20021
You must meet one of the following. (Please circle all that apply)
2) One of the following exists on the lot:
a) steep slopes, wetlands, or streams present,
oils that restrict building or septic development;
c lot width at the front yard line of no more than 50 feet;
d lot size of no more than one-half acre;
e) xisting improvements of buildings, septic systems, and well areas.
Explain how these circumstances preclude a reasonable development proposal
from meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones.
I o+
A kkV��
Owner/Agent (please indicate)
Signature and date
Official Use
Approved Date
Denied Date
Reason for denial:
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