HomeMy WebLinkAboutBLD95-01466 Cancelled SFR and Garage - BLD Application - 9/29/1995 < MASON COUNTY Permit No. y
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT �7
#1 ner C y 1S �G\./15 Phone# � � z- ?
ite Address /t� C (DO �/14 e CQ t��� Fire District#
ity ZS' l�a 1 v St�f�, Zip r
Directions to Job Site /, 3 4 o k-e �
e
Pi ti
Owner Mailing Address G Lt v c 0 8 Y t .
City 0 ve e,�'� c^ f St Zip
4
Lien/Title Holder
Address
Clty St L.4-) /V Zip l
#2 Contractor Name Contractor Reg#
Address Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include re Ad
Connect to Septic? Public W to Well
Connect to Sewer Syste o System
(If residential, proof of pot bl at s required)
#4
egal Description S'Q t= � �a � P_cO tq T✓ �S ?�, / 1
#5 Building Square Footage: (existing opose
�f 1 st FI t—" 2nd FI / 3rd FI / Loft /
Basement 70` / Deck / #bedrooms / #bathrooms /
660 Garag�/ Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building &r,'0 Describe work
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUrACTURED HOME IN O A TI N
odel Year ke odel
idtho.Len Seria
# Bedroo # Bathro se of Heat
Purchase Price
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences C
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements S
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLANBELOW/
APPLICANT TO DRAW TOPOGRAPHY PROFILE B LOW
s 4�q 6
v
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. FToilets CIRCLE FUEL TYPE: Gas, lectric,`
Bath Basins �_ Heatpump, Other Gnu
Bath Tubs �3 No. Units Fees
/ Showers 3 Furn BTU
/ Hot Water Htr '_ Heatpumps
Laundry Washer _ Vent Systems
3 Sinks Spot Vent Fans
O Floor Drains No. Boilers/Compressors
QLaundry Basins HP
Dishwasher No. Air Handling Units
D Disposal cfm#
Urinals No. Fire Protection Systems
Other Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00
TOTAL PLUMBING 17 No. Other
Gas Outlets
Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $
OF 180 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. PROOF OF CONTINUATION OF WORK IS BY L
MEANS OF A PROGRESS INSPECTION. f
12
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER � D . k7 I X BY
DATE �— �2-�C DATE
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
C Approval
AA yAPlanning: >
I /10
Environmental Health:
Building Plan Review i��l
a>
O
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions:
FEES
Building Permit
Plan Check
Plumbing Fee g 00
Mechanical Fee .U -0
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other DD
Other
Building Valuation: , 7 g TOTAL FEE
to
+
1
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I ,o p
zr
4
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Date Checklist Prepared, c
r0la� " 141 t4MASON COUNTY BUILDING DEPARTMENT
PLAN REVIEWER AND INSPECTOR CHECKLIST
1991 WSEC AND V&IAQ CODE COMPLIANCE
Permit Number Address NE (oO -pt n e- Camp Sq. Ft.
Name on Permit VAV I C ti-)✓1 Contractor/Phone# b
Compliance Method: ( ) Prescriptive (option) ( ) Component ( ) Systems Analysis
Date FOUNDATION
Insp. Rev.
( ) ( ) Slab: R- (Ext.foundation down to frostline/slab bottom;or interior 24"top of slab&horizontal. Radiant under entire.)
( ) ( ) Below grade exterior wall insulation: R-
( ) ( ) Crawlspace Ventilation: (1 sq.&NFA/150 sq.ft.floor area-cross vented)
FRAMING
( ) ( ) ( ) Standard ( ) Intermediate ( ) Advanced
( ) ( ) Woodstoves and/or fireplaces: (6 sq.inches combustion air supply dud with damper direct to firebox.)
( ) ( } Standard air seal: (Bottom plate/subfloor,rim joist/mudsill,window/door frames,penetrations condition to non-condition.)
( ) ( ) Attic ventilation(I sq.ft. IA/150 sq.ft.ceiling area)
( } ( ) Spot exhaust fans: (4"exhaust-bath laundry 50 dra @.25 WG;kitchen 100 cfm @.25 WG. Vented out with dampers.)
( } ( } Fresh air ventilation: Available to all habitable rooms. Installed and operational. (Integrated forced air,windows,wall ports.)
( } ( ) Whole house exhaust fan: cfm(Intermittent system manual&auto controls/sone less than or=to 1.5 at.1 WG)
INSULATION
( ) ( ) Attic baffles installed to deflect incoming air(Rigid material resistant to wind-driven moisture,extend 12"above loose fill or 6"
above batt insulation)
( ) ( Mechanical ventilation ducts R-4(Exhaust in unconditioned space&supply in conditioned space.)
( ) ( ) Wall insulation(above grade) R- (Batts face Stapled)
( ) ( ) Wall insulation(below grade-interior) R- (Batts face Stapled)
( ) ( ) Vapor retarders on walls (Faced batt,or 4 mil poly or perm.paint.-circle one)
( ) ( ) Rim joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.)
( ) ( ) Vaulted ceiling insulation R- (vapor retarder&I"air space)
FINAL
( } ( ) Floor insulation R- (Substantial contact w/surface,supports less than or=to 24"OC,not blocking vents.)
( ) ( ) Ventilation system is operational (spot,whole house,fresh air to all habitable rooms. If integrated system,certifica,,f or%y installer is
required.)
( ) ( ) HVAC ducts in unconditioned areas R-8 (Joints sealed;mechanically fastened with a minimum of 3 fasteners.)
( ) ( ) Pipe insulation R-3 (Hot and cold lines in unconditioned areas-service or recirc.see Table 5-12).
( } ( ) SHW heaters: (NAECA label,separate power or gas shut-off,on R-10 pad if electric in unconditioned or on concrete.)
( ) ) Heating system type: Q t?G+-r 1 CG WO-l) h ea"P�i5
( ) ( ) Radon monitor on site with instructions.No. - Supplied by MCBD
( } ( ) Thermostat: (Heat range 55-75;AC 70-85;both 55-85. Backup heat controls(lockout)prevent simultaneous operation of primary system.)
( } ( } Solid fuel appls.: (Glass/metal tight-fitting doors;dir.comb.air source,or 4"dia.dampered,indir.source for existing coast.)
( ) ) Ground cover: (6 mil black polyethylene or approved equal lapped 12"at joints,extending to foundation wall.) -
( } ( } Penetrations(All exterior wall and ceiling penetrations sealed to drywall-plumbing,exposed beams,wall receptacles,fans,recessed lights.)
( } ( ) Ceiling Insulation R- _(Insulate&weatherstrip access,baffle to prevent spillover-no cardboard)
( ) ( ) Vapor retarder paint if a vapor retarder was not installed when insulation was installed.
GLAZING
Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. Inspector- Verify window
information during field inspections. Include skylights, glass doors and all other glazing on this form. Use rough opening
area for calculations.
Date
Size Quantity Area S . Ft. U-Value Manufacturer Rev. Ins .
5040 av
ads d ! 1 /5
o -;3o
&C40 f
01090 s I�' t 114
l610 Total glazing area:
Total conditioned area: /
Percentage glazing: Verified:
DOORS
Plan Reviewer-List opaque doors by type(solid core,insulated,etc.)quantity,U-value,and manufacturer. Inspector-
Verify door information during field inspection.
Date
Type/Quantity U-Value Manufacturer Rev. Insp.
Signature of Building Inspector: Date of Final Inspection:
J'
MASON COUNTY BUILDING DEPARTMENT
1991 WASHINGTON STATE ENERGY CODE
AND
VENTILATION AND INDOOR AIR QUALITY CODE
OWNER �f A y^15 A I21 V l-S TELEPHONE
COMPLIANCE INFORMATION
TYPE OF PROJECT: (�VIEW RESIDENCE O ADDITION O REMODEL O OTHER
AREA(SQ.FT.) 1ST FLOOR I2 Zj 2ND FLOOR HEATED BASEMENT 7
Note: Heated basements must be insulated and finished to meet minimum energy code requirements.
TOTAL SQUARE FOOTAGE OF CONDITIONED (HEATED) AREA 9 Z
COMPLIANCE METHOD:
O PRESCRIPTIVE PATH -- circle option-- I II III IV V VI VII VIII
Glazing percentage (total glazing area divided by total conditioned area)
O COMPONENT PERFORMANCE -- Chapter 5 — attach documentation and worksheets
( ) SYSTEMS ANALYSIS — WATTSUN 5.2 -- attach documentation and worksheets
WATER HEATER
(''Electric water heater () Gas water heater
HEATING SYSTEM:
ELECTRIC RESISTANCE /
() Electric Central Furnace Iectric Wall Heaters ( ) Baseboard Units
() Radiant Panels ( ) Other
OTHER FUELS
( ) Heat Pump with electric furnace ( ) Heat pump with gas furnace ( ) Gas Furnace () Oil Furnace
( ) Other ( ) Boiler System (indicate type)
Make Model
Size AFUE HSPF
VENTILATION SYSTEM:
(bf'Sllp of and Whole House () Central Ducted System O Integrated with Furnace
() Heat Recovery System (air to air heat exchanger -- heat recovery heat pump)
GENERAL NOTES:
Your building plans should indicate certain compliance measures: framing to be used (standard,
intermediate, advanced); type of vapor barriers being used; location of furnaces, hot water tanks and
other equipment; location of solid fuel burning appliances, fireplaces and thei;combustion air duct runs;
and termination points of exhaust ventilation fans.
I
WINDOW & DOOR SCHEDULE
WINDOWS
INCLUDE ALL WINDOWS, SKYLIGHTS, SLIDING GLASS DOORS, FRENCH DOORS AND
STORE DOORS. ANY WINDOWS IN DOORS (LESS THAN 50% OF AREA) MUST BE
TAKEN OUT OF THE DOOR AREA AND PUT INTO THE WINDOW AREA ON THE
SCHEDULE.
BRAND MODEL U-VALUE QUANTITY SIZE TOTAL SQ. FT.
TOTAL WINDOW AREA �>
DOORS
BRAND MODEL U-VALUE LOCATION SIZE TOTAL SQ. FT.
TOTAL DOOR AREA �fl S
i
October 24, 1995
Chris H. Davis
NE 10186 West Old Belfair Highway
Bremerton, WA 98312
RE: NE 60 Pine Camp Rd
BLD 95-1466
Dear Mr. Davis :
Our office has received your file for review of the Washington
State Energy code and Ventilation and Indoor Air Quality code.
The energy code application submitted with the permit application
indicates that the basement will be heated. If this is the case,
wall insulation in the basement will be required. To complete the
energy code review we need information about doors and windows
which are planned. We also need to discuss insulation
requirements in the basement .
Please contact Toni Hermansen or myself at 427-9670 EXT 284 . In
the meantime, your permit has been forwarded to the Environmental
Health Dept. for review of the septic and water systems.
Sincerely,
Debbera Coker
Energy Code Specialist