HomeMy WebLinkAboutBLD2002-01389 Cancelled SFR - BLD Permit / Conditions - 7/17/2006 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
11plo Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2002-01389
OWNER: KEVIN MOHUNDRO RECEIVED: 10/15/2002
CONTRACTOR: LICENSE: EXP: ISSUED: 4/6/2006
SITE ADDRESS: 7081 NE TAHUYA BLACKSMITH RD BELFAIR EXPIRES: 10/6/2006
PARCEL NUMBER: 223047790101
LEGAL DESCRIPTION: TR 10-A OF SURV 13/40 LOT: A OF SP #1790 PERMIT
PROJECT DESCRIPTION: DIRECTIONS TO SITE: NULL & VOID BY EXPIRATION
RESIDENCE FROM BELFAIR NORTH 014.01-D BELFAIWY LEFT AT BEAR CREEK
DEWATTO RD, ELFT AT BLACKS11 D RTAHUYA RD.
-7>>-1 -C?LQ
General Information Construction &Occupancy Information Square Footage Information
No.of Bedrooms: 2 Type of Constr.:
Type of Use: SF Insp. Area: No. of Bathrooms: 2 Occ. Group: Lot Size: Deck: 876
Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,297
Valuation: Building Height: Occ. Status: Primary Basement:
Manufactured Home Information Setback Information Shoreline & Planning Information
Make: Length: Ft. Front: E 260.0 Ft. Shoreline: 65.0 Ft. Water Body: LAKE ERICKSON
g Rear: W 65.0 Ft. Slope: 5.0 Ft. SEPA?: No
Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Unknown
Year: Serial No.: Side 2: Ft. I omp. 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 KLW 10/15/200 $591.34 60908
Kitchen Sink 1 Fireplace 1 Planning Site Inspection RAM 10/18/200 $70.00 S12006000
Laundry Tray 1 Furnace<100K 1 EH Plan Review CEW 10/22/200 $75.00 S12006000
Lavatories 3 Propane Tank 1 Planning Dept. Permit TW 2/13/2003 $50.00 Si2006000
Showers 2 Ventilation Fan 4 Building State Fee SAC 4/2/2003 $4.50 S12006000
Water Closets (Toilets) 2 Dryer Vent 1 Mechanical Base Fee SAC 4/2/2003 $23.50 S12006000
Water Heaters 1 Plumbing Base Fee SAC 4/2/2003 $20.00 S12006000
Bath Tubs 2 Adjust Plan Check Fee JRN 4/3/2003 -$13.65 S12006000
Clothes Washer 1 Building Permit Fee JRN 4/3/2003 $888.75 S12006000
Total $1,709.44
` BLD2002-01389 Please referto the following pages for conditions of this permit. 1 of 5
CASE NOTES FOR
BLD2002-01389
CONDITIONS FOR
BLD2002-01389
1) This application is su t Buffer and Landscaping requirements as established under Mason County Ordinance
1.03.036.X
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; person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
X
3) The use, handling and storage of hazardous ma erials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of
the Mason County Fire Marshal. X dl�
—7
4) 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 Xproject. AIL�„ n
5) A Road Access Permit or Approval st be granted by the Mason County Department of Public Works. For more information contact Public Works, at
(360)427-9670, ext. 450. X
6) Approved per dimensions and setbacks on submitted site plan. X
7) All upland areas disturbed or newly to by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt
fencing or straw matting). X
8) Temporary erosion control measures must be implemented to prevent water quality degr d ' n of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established. X
9) The wetland (lake) buffer n set ck requirement is 65', which is comprised of a 50' undisturbed vegetative buffer starting at the lakeshore + a 15'
building setback. X
BLD2002-01389 Please referto the following pages for conditions of this permit. 2 of 5
10) 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 ri Ito y further inspections being performed or approvals granted.
X
11) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located in such a position as to be plainly visible and
legible from the street or road fronting the property. Mason County Building Department requires that this be completed prior to calling for any site
inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or
contractor a to p the address on site prior to requesting inspections.
X
12) The plan review check list and corrections, along with the Energy Compliance Worksheet(when applicable)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 f t duration of the project. Failure to comply and/or removal of approved documents will result in failure of required building inspections.
X
13) ALL FURNACE INSTALLATIONS SHALL MEET THE MINIMUM EFFICIENCIES SET FORTH IN THE 1994 WASHINGTON STATE ENERGY CODE
(WSEC). ANY PORTION OF THE MECHANICAL SYSTEM THAT IS ALTERED REP CED SHALL MEET THE MINIMUM STANDARDS SET
FORTH IN THE 1994 WSEC AND 1997 UNIFORM MECHANICAL CODE. X
14) The"approved" plot plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" plot 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 Dep r en rior to any further inspections being performed or approvals granted.
X
15) Washington State Energy Code Compliance has been approved using the following:
Heat Type: Electric or other fuels Compliance Method: IV Window(Max U-Factor):0.40 Skylight (Max U-Factor):0.58
Doors (Ty Mai -Factor):0.40 or less, Wall insulation R-21 , Floor insulation R-30 , Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10
X
16) In buildings of Lually tight construction, fuel-burning appliances (excluding cooking appliances and domestic clothes dryers) shall obtain combustion
air from outside 'n acc rdance with the Uniform Mechanical Code.
X
17) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X
18) 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
charged a e collected by the Building Department prior to any further inspections being performed or approvals granted.
X
BLD2002-01389 Please refer to the following pages for conditions of this permit. 3 of 5
19) All construction must meet or exceed all local ordinances and the 1997 Uniform Building Code requirements as adopted and amended by Mason County
and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would
result in permit rev of
X
20) Installation of heating equipment in single family residences shall meet the requirement of the current WSEC. The furnace to be installed shall not exceed
200% of the heating design load or prescriptive requirements of Chapter 9. Furnace efficiency shall be .78 AFUE or higher or rated 80% combustion
efficiency. All ducts shall be securely fastened and sealed with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric systems or tapes
installed in accordance with rgailufaLturers installation instructions. Duct tape is NOT permitted as a sealant on any ducts. Ducts in unheated spaces shall
be insulated to R-8. X
21) Proposed str c ar must maintain a minimum of a 5' setback from all property lines, easements and 25'from all County and State Road right of ways.
X
22) All changes to"approved" building plans that effect compliance with the Uniform Codes as amended and adopted, or any other Mason County ordinance
or regulatio u t e reviewed and approved by Mason County prior to construction.
X
23) The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the Uniform Codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspect or: II b ade prior to requesting additional inspections.
24) All propane tanks must be installed in accordance with the Uniform Fire Code and all applicable Mason County ordinances. All propane tanks must meet
the install t' irements and minimum setbacks as listed in the Mason County Fire Marshal's Standards for the Installation of Propane Tanks.
X
25) All propane tanks must be installed in accordance with the Uniform Fire Code and all applicable Mason County ordinances. All propane tanks filled on
site must be located a minimum of 10'from any possible source of ignition (electrical outlets, electrical fixtures, compressors, etc), mechanical system air
intake (direct vent appliance, ventilation air intake, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. Propane tanks
less than 125 gallons must also be located a minimum of 5'from any building opening (foundation vents, windows, doors etc), property line or easement.
If a prop to is exposed to probable vehicular damage, protective bollards must be installed.
X
26) All propane tanks must be installed in accordance with the Uniform Fire Code and all applicable Mason County ordinances. All Propane tanks between
125 and 500 gallons must be located a minimum of 10'from any building, property line, public way, possible source of ignition (electrical outlets, electrical
fixtures, compressors, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. If a propane tank is exposed to probable
vehiculaAqpma protective bollards must be installed.
X
27) Fuel piping sh II be inspected after the installation of gas piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the
time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall
not be qs the final inspection has been performed and approved by a Mason County building inspector.
X
BLD2002-01389 Please referto the following pages for conditions of this permit. 4 of 5
28) Owner/applicant must obtain a seperate per ' or a placement of any size propane tank serving a fixed appliance within a dwelling structure or unit
prior to the placement of the tank. X
Tr
29) 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 County o s and building regulations.
X
This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means of a progress inspection.The owneror the agent on the owners behalf,represents that the information provided is accurate and grants employees of Mason County access to
the above described property and structure for review spection.
OWN ER OR AGENT: DATE:
BLD2002-01389 Please referto the following pages for conditions of this permit. 5 of 5
co
o CONCRETE MECHANICAL MANUFACTURED HOME
CD
Date
Footings/Setbacks Gas Pi to By Ribbons C
o Interior Date By Interior-Date By Date By Z
00 Exterior Date By Exterior-Date B X
co ��_._.__a_._ Set-up « O
Point Load/Isolated Footings INSULA71ON Date By �
BG l SLAB INSULATION
tarF By Data By FIRE DEPARTMENT <
Foundation Wails Floors Date By
Z
Date By Data By DECKS
FRAMING Walls Date By
rate By Data By PROPANE TANKS
Vault PLUMBING Date By
Date, By OTHER
Groundwork Attic
Date By Date — ByType:
Date By
Q.W.V DRYWALL Type:
Int Brace Wall Date By i3
Date By Date By r
FINAL INSPECTION v
Water Line Fire Seperation N
Date By Date By Date By O
m IV
Pass or Request Inspect. c
Type of Insp. Fail Date Date Done By Comments
CD
00
CD
CD
0
8
2L
0
0
05'
co
0
MASON COUNTY Dept. of Community Development
Mason County Bldg. 3 426 W. Cedar P.O. Box 186
Shelton,WA 98584
Notification of Permit Cancellation
December 09, 2005
KEVIN MOHUNDRO
23837 44ST AVE S
KENT WA 98032
Case No.: BLD2002-01389
Parcel No.: 223047790101
Project Description: RESIDENCE
Dear Applicant:
Upon review of our records,the Mason County Permit Assistance Center has identified that your
building permit application has been approved and ready to issue or placed on hold since 12/9/2005.
Once approved or placed on hold, permits are valid for 6 months.
If you intend to obtain this permit,you must make arrangements to do so within ten (10)working days
from the date of this letter. If we do not hear from you within the that time, your permit will be
cancelled and a building inspector will make a site visit. In the event that your project has been
completed and a permit was never issued, you will be assessed penalties as allowed under Mason
County Title 14 and Mason County Title 15
If your project has been cancelled or if you wish to withdraw the permit, please notify me as soon as
possible at(360)427-9670, ext.616. Thank you for your cooperation.
Sincerely,
a",W 4e4-m�
Charell Holcomb
Mason County Department of Community
Development
no clnfa C
Y'e
-r
,-� wu` �
FEB-12-2003 08:07 P.02/02
kA
f OZ�I
REVISED
DATE
601
CHANGES �,qs
SUBMIT CHANGES FOR APPWVU S/�E•O+C
PRIOR TO PERFORMING WQ41A n
°� sso �'�RF.. �C40
fo BF 9
R�
riw�of
0
rOF �
a
ho )
Q
APP !OVED y�► S
PLA PLOT EVISION ' MASON BUILDING IJISPECTON � yi
V ED CHANO SUBJECT TG 11pppQy
DATE J ».w._..tote► �O
613 ' � TOTAL P.02
I
A,- 0ES1Gi*' S Ui*1Lh**i1TE0
STOCK PLANS ■ CUSTOM DESIGN
September 10,2003
Mason County
Department of Community Development
P.O. Box 186
Shelton,WA 98584
To whom it may concern:
Answers to the plan review requirement comments:
10 Th;,log siding will be removed and shake siding over conventional framing will be used.
The logs used in the upper floor framing are not structural. They are used as a facade only. O to
+� Any bearing on headers constitutes a dead load only and was considered in the calculation of the
llt�headers and beams. C
4. GLB will be pressure treated.
Agree with request.
If you h y questions,please feel free to contact me directly.
i erel
V nonr. ell
rincipal
Kevtvi tiohU11a -6 q l "163
■
COL<<�tirtogt r�a ev 11 Z 3101 , ■
19613■81 st Ave S - Suite F - Kent, WA 98032 ■ (253) 872-2580 ■ Fax: (253) 872-3649
■ Email:designstudio@designsunlimited.com ■
A
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Processing/Inspections/Addressing
Mason County Bldg.III 426 W.Cedar
P.O.Box 186 Shelton,WA 98584
(360) 427-9670 Belfair (360) 275-4467 Elma (360) 482-5269 Seattle (206) 464-6968
April 2, 2003 R
� 1 g 1003
Designs Unlimited SS.
19613 81 st Ave. S. A26 41 CEOA
Suite F
Kent, WA 98032
Re: BLD2002-01389
Dear Kevin,
Thank you for submitting the building permit application referenced above. In order to
complete the building department review additional information will be needed which is
listed below:
PLAN REVIEW REQUIREMENT COMMENTS:
1. Contact an engineer or other design professional who can provide you with a
drawing detailing how the proposed "log siding" will be attached to the
conventionally framed house as submitted. Have engineer/design
professional address how the additional weight of the logs will impact both the
wall framing and the foundation below. Also have engineer/design
professional show an attachment method that will not compromise the water
impervious barrier of the felt paper or tyvek (to be installed between the logs
and the sheathing).
2. Provide calculations for the 6"o logs shown as floor framing for the second
floor. Specify species, grade and moisture content of logs. What is the
purpose of the glulam beams shown (under ?) the logs. It appears that the
proposed 2x car decking would run parallel to the glulams and not provide
support for the decking.
3. Log floor framing members are shown bearing on bedroom #2 header and
kitchen header. Provide calculations to show that 4x10 H.F.#2 headers at
these locations will carry the loads imposed on them from the logs and floor
decking above.
4. 5-1/8"x10-1/2" GLB shown as supports under the bridge on the second floor
must be pressure treated or the exterior deck must have an impervious
membrane. The glulam beams as shown are not to be used in areas
exposed to weather.
5. Plans show stick framed roof. If you decide to use engineered trusses notify
the building department prior to setting the trusses and provide truss
engineering on site for inspection.
Please address these items and submit 2 sets of plans/calcs as needed. When you
have compiled the requested information please submit 2 sets of revised plans/calcs it
to the Mason County Building Department. Plan review will be rescheduled after the
revised information has been received.
If you have questions please contact me at (360) 427-9670 ext. 561.
Since y,
Sheri A. Crawford
Mason County Building Department
Building Inspector/Plans Examiner
CC: Vern-Designs Unlimited, property file
April 2, 2003
Kevin & Roxanne Mohundro
23837 41 st Ave. S.
Kent, WA 98032
Re: BLD2002-01389
Dear Kevin,
Thank you for submitting the building permit application referenced above. In order to
complete the building department review additional information will be needed which is
listed below:
PLAN REVIEW REQUIREMENT COMMENTS:
1. Contact an engineer or other design professional who can provide you with a
drawing detailing how the proposed "log siding" will be attached to the
conventionally framed house as submitted. Have engineer/design
professional address how the additional weight of the logs will impact both the
wall framing and the foundation below. Also have engineer/design
professional show an attachment method that will not compromise the water
impervious barrier of the felt paper or tyvek (to be installed between the logs
and the sheathing).
2. Provide calculations for the 6"o logs shown as floor framing for the second
floor. Specify species, grade and moisture content of logs. What is the
purpose of the glulam beams shown (under ?) the logs. It appears that the
proposed 2x car decking would run parallel to the glulams and not provide
support for the decking.
3. Log floor framing members are shown bearing on the bedroom #2 header and
kitchen header. Provide calculations to show that 4x10 H.F.#2 headers at
these locations will carry the loads imposed on them from the logs and floor
decking above.
4. 5-1/8"x10-1/2" GLB shown as supports under the bridge on the second floor
must be pressure treated or the exterior deck must have an impervious
membrane. The glulam beams as shown are not to be used in areas
exposed to weather.
5. Plans show stick framed roof. If you decide to use engineered trusses notify
the building department prior to setting the trusses and provide truss
engineering on site for inspection.
Please address these items and submit 2 sets of plans/calcs as needed. When you
have compiled the requested information please submit 2 sets of revised plans/calcs it
to the Mason County Building Department. Plan review will be rescheduled after the
revised information has been received.
If you have questions please contact me at (360) 427-9670 ext. 561.
Sincerely,
Sheri A. Crawford
Mason County Building Department
Building Inspector/Plans Examiner
I _
MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner: Telephone: Parcel#:
Type of project (9New Residence ( ) Addition ( ) Remodel
Total Sq. Ft. 1$ Floor : 2 nd floor: Heated Basement:
of heated area:: q 3 -9 9
.Heating System: w LP& ate,
Glazing Prescri tive Option see reverse side circle one: I II III
Percentage: Compliance
Method O Component Performance , Chapter 5— Calculation worksheets required
Check one::
• % O Sys ems analysis, Chapter 4
Whole House Ventilation system O Whole House Ventilation using a Heat
Ventilation usi g exhaust fans&window or wall fresh air
Recovery Ventilation System (vrAQ 303.4.4)
System vents (vIAQ 303.4.1)
Check one
O Whole House Ventilation Integrated O Whole House Ventilation using an inline
with a Forced Air System (v1AQ 303.4.2) supply fan. v1AQ 303.4.3)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windows:
a
Windows: Total Sq. ft.
Doors: -,3 aq e'7
Doors: Total Sq. Ft UU
Total window and door are
Total window 8 door area 50`(P 3/t(divided by) total sq.ft of heated area `�� �� /oof zing
r
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)275-4467 SEATTLE (206)464-6968
ELMA(360)482-5269 FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2001 Washington State Energy Code (WSEC)
effective July 1, 2002
2000 Ventilation and Indoor Air Quality Code (VIAQ)
Code Compliance Application Form
The following information will be required for the WSEC and VIAQ plan review:
1. Complete the Washington State Energy Code/ Ventilation and Indoor Air Quality Code
(WSECNIAQ)application located on the reverse side.
2. Complete the window and door schedule on the reverse side. Include all windows, skylights,
sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening
dimensions of the windows and doors. Information about the U-factor of the window will also help
to expedite the energy code review. If you are complying with the WSEC by prescriptive path and
are using the area weighted average method you must include your calculations.
3. On your building plans note the location and fuel type of water heater, location of exhaust fans
(bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and
slabs,
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 284. Additional
WSEC and VIAQ compliance information is available on the internet at:
www.energy.wsu.edu/buildings/
Prescriptive Requirements °,'for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing U-factor Wall Wall Wall
Area %of Door Ceiling Vaulted Above interior° exterior Slab
4
Option Floor „ U e 2 Ceiling3 Grade below 4 Below Floors on
10 Vertical Overhead Factor 12 grade Grade Grade
I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
* 0 .58 .20 5-38 "R-21
- - R-10
III Unlimited
Single
Family Res .40 .58 .20 R-38 R-10 R-30 R-10
(R-3)Only
'Refe nce Case/Call (360)427-9670 ext.284 for footnote information. Log &solid timber wall with a min. avg.thickness of 3.5 ar
ex
Request To Revise An Approved Plan
Permit Number: BLD200-�, - Named �YIO��� ►'�tvo
Parcel Number 3 0A50LV/ J 2 /g6101 Phone Number ( )
Project Address Mailing Address
Please provide a complete, detailed description of the proposed revisions to the approved plans:
Are the site building plans, approved by Mason County,
included with this application? ❑ Yes ❑No
Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes 0 No
Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes 0 No
Does the plan contain an engineer's or architect slateral 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 ❑No
If Yes, Is a revised site plan, drawn to scale, included with this request? ❑ Yes ❑ No
Additional Information:
Applicant's signature Date:
Received by: __Date:
ice Use Only
Forward to departments indicated below: Approval/Date Original Valuation:
❑ Building Additional Valuation:
q Ft x
❑ Planning Sq Ft x
';�Anvironmental Health C4,,," Total New Valuation:
❑ Public Works Additional Fees:
Additional Plan Review 5(o 80
Additional Conditions/Comments: Additional Building Permit
Additional Plumbing
Additional Mechanical
Other flmylinl
Total Amount Due: s-1010-60
PERMIT NO.: BLDr 6b9—Z13 81
MASON COUNTY
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 Seattle 206 464-6968
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Contractor Name
Mailing Address Mailing Address
City State Zip Code '1903Z.,. City St4td Zip Code
Phone( ) Other Ph. ?r2 '_)'`2,9( Ph.(� ther Ph.0
Lien/Title Holder Contractor Reg. #
Address Expiration
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic- Existing Septic Connect to Sewer
System Name of Sewer System Well - Water System Name of
Water System 4 C O ,
PARCEL INFORMATION-12 di it Tax Parcel No. 4 / / O is
9 � /O/ Fire District
Legal Description (a).f .:>,S
Site Address(Pleas include s r et name street number and city) 0
j
to site 171 e l fcc; _ d� —
i r t Mat &.uk- FR1ack&mtzh-Tahu11!2- 9f(,
Will timber be cut and sold in parcel preparation? (Yes/No)
Is your property within 200' of the following: Body of Water (Name)F-P/C/tC10 Saltwater
Lake 9K; River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
PERMANENT RESIDENCE U SEASONAL RESIDENCE❑
TYPE OF JOB New Add Alt Repair Other Use of Building hF�.l tt_h(G
Describe Work
No. of Bedrooms_2,.._No. of Bathrooms_,c- SQUARE FOOTAGE-1st Floor_77JL 2nd Floor
3rd Floor Loft Basement Deck - -ethef sq. ft.
Garage Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model 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.
t�.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
�1 PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
J information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. first obtaining approval.
X ` ate "''a 7 C./ X Date
11 FOR OFFICI USE BEYOND THIS POINT�L
Accepted by Date#� ubmittal Amount Due 1 Receipt No.
Oo DEPARTMENTAL IREWEW APPROVED DENIED:.! CfJIVDITIOfV CODS
. ..:..........
Building Department c �,
Occ Group Type Constr. v(�%
Planning Department
Environmental Health Department
IJ Public Works Department
!9� Fire Marshal
Valuatio -�
FEES
Building Permit Fee �� `� Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee g ® ® Planning Review Fee
Mechanical& Base Fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal ( )
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 Seattle 206 464-6968
APPLICA -INFORM ION CONTRACTOR INFORMATION
Owner Contractor Name
Mailing Address __ l'r Mailing Address
City�`� State Zip Code City State Zip Code
Phone(?,,M, )QZ�J-2,27-70ther Ph.( Other Ph.(�
Lien/Title Holder Contractor Reg. #
Address Expiration
SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of
Sewer System
i
PARCEL INFORMATION-12 digit Tax Parcel No. Fire District
Legai Description
Site Address(Please include street name, street number and city) Mr kjZ4e4— Marf
Directions to site
Is your property within 200' of the following: Body of Water(Name) OW Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
TYPE OF JOB New Add Alt Repair Other Use of Building
Location of Fixtures/Units 1 st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric
Type of Fixture No. of Fixtures Fees .. LPG Natural Gas Heatpump �"^y
Toilets Type of Unit No. of Units Fees
Bath Basins Furnace
Bath Tubs '' °l Heatpumps
Showers Vent Fans
Water Heater _� 1 Propane Tank c.40 i
Laundry Wsher T ' Gas Outlets " /J.�S
Sinks 3c Wood/Gas/Pellet Stovep41tE.)
Dishwasher Direct Vent? �,.3c
Other Other
Other Other _
Base Fee 0_00 Base Fee • `
TOTAL PLUMBING III TOTAL MECHANICAL_f _
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. 019 —"� first obtaining approval.
X Ile Date ! — ,.. X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No.
pEPARTME�ITRE R }l l>> »':` >..... ::Af'PRLa Q R NIED CQNOTTION CODES
Building Department
Occ Group Type Constr.
i
Planning Department
Other
Other
FEES
Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee _ Other
Mechanical& Base Fee J Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( '
Violation Fee TOTAL FEES
IL
f
MASON COUNTY PROJECT SITE INFORMATION
Case No.
Name /// ➢�/tll+/1/IL'///CG�//��/L� PARCEL NUMBER3d7 77����d� Date
SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the
site plan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Well Location (including adjacent) Drainage Plan
Names of Streets Easements
Names of Fronting Streets Septic System
DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line.
adjacent property line4 I 0 ; <-adjacent property line
1 �.0 r I
1\ k OHwM
Lott'SOlt
Tropvssd
V ` �►
♦� Y
1
I ;
adjacent property line-> M7 U l A Q ' <-adjacent property little
SAMPLE SITE PLAN
adja�nt property lined 3io� E-adjacent property line
1 D go' �ti Rve gel
FMO
ff-4
jP sapt: -�1
1 1
/50--'-�I
I
VACAfuT 1 c>nrtAc cs I %
30 I i
1 p0.oPosCD T AbR ZCLLLTLL O0.AL I
I 1F—40-�I \ �• I
.r
f r 1 L •aLL
I x /DO'
I Lw�G.LL I
adjacent property lined Fad'acent ro en' line
TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the
degree of slopes. See sample topography profile.)
SAMPLE TOPOGRAPHY PROFILE
&
Sh r.eLt'L�YC_
�..�.�^
&S't'ar'LL. *G
510pa t-o¢
V� dis+a�aa
to �
3�o
Sq• �'
Signature Date T '�—