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HomeMy WebLinkAboutBLD2005-01251 Final SFR - BLD Permit / Conditions - 7/10/2006 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 Shelton, WA 98584 e (/'i RESIDENTIAL BUILDING PERMIT BLD2005-01251 OWNER: PATRICK BLAIR RECEIVED: 7/25/2005 CONTRACTOR: HI LINE HOMES LICENSE: HILINH*981BT EXP: 1/13/2006 ISSUED: 8/17/2005 SITE ADDRESS: 341 NE SIDES WY BELFAIR EXPIRES: 2/17/2006 PARCEL NUMBER: 223117600230 LEGAL DESCRIPTION: TR 23 OF SURVEY VOL 4/19-22 PROJECT DESCRIPTION: DIRECTIONS TO SITE: New SFR Bear Creek Dewatto Rd. to Effendahl Pass Rd. Turn left on Sides Way to property. Property corner on left side 850 ft. from Efendahl Pass Rd. General Information Construction &Occupancy Information Square Footage Information o. of Bedrooms: 3 1 ype ot Uonstr.: VB Type of Use: SF Insp. Area: No. of Bathrooms: 3 Occ. Group: R-3U Lot Size: Deck: Type of Work: NEW Fire Dist.: No. of Stories: 1 Occ. Load: Building:2,318 Garage-Attached 624 Valuation: Building Height: 17 Occ. Status: Primary Basement: COVPORCH 108 Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft. Front: S 140.G Ft. Shoreline: Ft. Water Body: No Model: Width: Ft. Rear: N 353.0 Ft. Slope: Ft. Shoreline Desi Side 1: E 154.0 Ft. g.: Not Applicable Year: Serial No.: Side 2: W 112.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type e By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 7/25/2005 $278.27 S22005 Hosebibs 3 Furnace<100K 1 Planning Review Fee KKK 7/25/2005 $155.00 S22005 Kitchen Sink 1 Ventilation Fan 4 Building State Fee ARC 8/2/2005 $4.50 522005 Lavatories 3 Heat Pump 1 Building Permit Fee ARC 8/2/2005 $1,391.35 S22005 Showers 1 Dryer Vent 1 Mechanical Fee ARC 8/2/2005 $72.35 S22005 Water Closets (Toilets) 3 Mechanical Base Fee ARC 8/2/2005 $23.50 S22005 Water Heaters 1 Plumbing Fee ARC 8/2/2005 $96.00 522005 Bath Tubs 2 Plumbing Base Fee ARC 8/2/2005 $20.00 S22005 Clothes Washer 1 EH Plan Review CEW 8/10/2005 $75.00 S22005 Address Fee GMM 8/10/2005 $140.00 S22005 Total $2,255.97 BLD2005-01251 Please refer to the following pages for conditions of this permit. Page 1 of 5 IL .Now Inspection Line(360)327-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 f 1rf;0 RESIDENTIAL BUILDING PERMIT BLD2005-01251 OWNER: PATRICK BLAIR RECEIVED: 7/25/2005 CONTRACTOR: HI LINE HOMES LICENSE: HILINH*981 BT EXP: 1/13/2006 ISSUED: 8/17/2005 SITE ADDRESS: 341 NE SIDES WY BELFAIR EXPIRES: 2/17/2006 PARCEL NUMBER: 223117600230 LEGAL DESCRIPTION: TR 23 OF SURVEY VOL 4/19-22 PROJECT DESCRIPTION: DIRECTIONS TO SITE: New SFR Bear Creek Dewatto Rd. to Effendahl Pass Rd. Turn left on Sides Way to property. Property corner on left side 850 ft.from Efendahl Pass Rd. General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: 3 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3U Lot Size: Deck: Type of Work: NEW Fire Dist.: No. of Stories: 1 Occ. Load: Building:2,318 Garage-Attached 624 Valuation: Building Height: 17 Occ. Status: Primary Basement: COVPORCH 108 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 190.0 Ft. Shoreline: Ft. Water Body: Rear: N 303.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: E 154.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: W 112.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures FEES Mechanical Fixtures Type Qty. Type WLY. type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 7/25/2005 $278.27 S22005 Hosebibs 3 Furnace<100K 1 Planning Review Fee KKK 7/25/2005 $155.00 S22005 Kitchen Sink 1 Ventilation Fan 4 Building State Fee ARC 8/2/2005 $4.50 §22005 Lavatories 3 Heat Pump 1 Building Permit Fee ARC 8/2/2005 $1,391.35 S22005 Showers 1 Dryer Vent 1 Mechanical Fee ARC 8/2/2005 $72.35 S22005 Water Closets (Toilets) 3 Mechanical Base Fee ARC 8/2/2005 $23.50 S22005 Water Heaters 1 Plumbing Fee ARC 8/2/2005 $96.00 S22005 Bath Tubs 2 Plumbing Base Fee ARC 8/2/2005 $20.00 S22005 Clothes Washer 1 EH Plan Review CEW 8/10/2005 $75.00 S22005 Address Fee GMM 8/10/2005 $140.00 S22005 Total $2,255.97 IBLD2005-01251 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD20 0 5-01 2 51 CONDITIONS FOR BLD2005-01251 1) The internatioanl 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 such roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X` 1�> 2) 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 DDe tme�t prior to any further inspections being performed or approvals granted. 3) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. 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 international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting insp f ns. X- a 4) 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 re v f approved documents will result in failure of required building inspections. 5) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. > 6) 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 Bui ' Department prior to any further inspections being performed or approvals granted. BLD2005-01251 Please refer to the following pages for conditions of this permit. 2 of 5 7) 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, Do�,Jype/Max U-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. 8) Stock Plan Identification number: 2003-0059 This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department, original building plans, and all attachments approved by the Mason County Building Department shall be available for the Mason County Building Ins,;=tor at each required inspection. L- 9) 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). `X_— 10) 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 chshall be collected by the Building Department prior to any further inspections being performed or approvals granted. 11) 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 Per i vocation. 12) 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 proipelL X ter ' r 13) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordip or regulation, must be reviewed and approved by Mason County prior to construction. X ` BLD2005-01251 Please referto the following pages for conditions of this permit. 3 of 5 14) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. 15) All property lines shall be clearly identified at the time of foundation inspection.gC 16) 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 Ma5W Co�un�ty ordinances and building regulations. n 17) 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 holdertave prevented action from being taken. No more than one extension may be granted. 18) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, co to , and flashing. Install metal connectors approved for contact with the new types of pressure treated material. 19) OWNER MUST SHO ' F OF SATISFACTORY WELL LOG AND WATER SAMPLE PRIOR TO TEMPORARY/PERMANENT OCCUPANCY OF THE RESIDENCE. 20) 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 1-80r 0-64� The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. 21) W u it is not to be degraded to the detriment of the aquatic environment as a result of this project. . , 22) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting).X-- 23) A ved er dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. BLD2005-01251 Please refer to the following pages for conditions of this permit. 4 of 5 '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 anytime 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 proper�Land structure for review and inspection. OWNER ORAGENI�"— �T DATE: 45'11-0S BLD2005-01251 Please referto the following pages for conditions of this permit. 5 of 5 �I I r CONCRETE r MECHANICAL MANUFACTURED HOME 'i=OOtings 1 Setbacks Gate By Ribbons Date By Gas Piping Date By Poundation Walls Date By Set-up Date By INSULATION Date By BG I Slab Insulation Floors FINAL I NSPECTION Date By Date By Date By FRAMING Wails FIRE DEPARTMENT Date By Date, S By Date By PLUMBING Ati OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.'V DAte By v Date By Water Lino FINAL�I NSPEBTION ante By Date By Date By s Type of Insp. Pass/Fail Request Date Inspect. Date Done By Comments m a 0 4—V er, a) y 0. L. O_ L- C _ O j•• 4Lw 11 Z _ j� ° 'n N I W— " ,0 N C "dCRETE MECH I AL MANUFACTURED HOME _ p T fiodings!Setbacks De l By L Ribbons N Date 1 �(�k�By ,t ;> ��i ng Date By U' Found"n Walls Date By Set-up Date„ 56/6c' By lip,- INSULATION Date By BG 1 Stab Insulation Floors FINAL INSPECTION Date By Date By gate By FRAMING walls FIRE DEPARTMENT Date S -oG By T�/t Dace � .�. By .� rate By PLUMBING atdc OTHER Groundwork C]at,e By Date By WALLBOARD NAILING I)MM Date Date O B y 6 Water Lige FINAL INSPECTION Date By Date ����6y Gate By m 6 Type of Insp. Pass/Fail Request Date Inspect. Date Dane By Comments CD �r t>�► - cc CD o� o� r r a-1 D 8 aM Ss Z- [ace-c��.� o�rr�,•v-� o CD yes J�r"6 O C �u�.Fi�O cF`v r�"'S 2"L 3 CADS l0 4 El ZS v 0 SEE pgEu c N 31291C& -7 lD N2 /�bT E- -Few F,z.EO3 5A� WAtl31 29 Oy6 ° A 58 Re-/ F-fE w 4%. RE:-- —QgE _ � o wi¢4 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/ VIAQ Compliance Application Owner: Telephone: Parcel#.. , rdf rick tit . Id,r .fir t( ?7 ,-1 7 ?a3i r74 vo ` 3p Type of project ( New Residence ( ) Addition ( ) Remodel Total Sq. Ft. 15 Floor : 2n, floor: Heated Basement: of heated area:: Z 3 I 0 Heating System: RECFPJ .- -- Glazing O Prescriptive Option see reverse si e �ir'clb;ione: I II III Percentage: Compliance Method O Component Performance , 69§ *r&=�Qycu/ation worksheets required i I Check one.-...- O S stems analysis, Chapter 4 Whole House Ventilation system O Whole House Ventilation using a Heat Ventilation using exhaust fans &window or wall fresh air Recovery Ventilation System (VIAQ 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 (VIAQ 303.4.2) supply fan. VIAQ 303.4.3) Window & Door Schedule (If needed, attach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Windows- V/N a,tv ,(SEA.' - 5�X 5� ' 5 I Ceateoom ' "x5 Z P5 (-,Y ea f Ree m C? X 3" 3o Ift eeb'd 4vem , ,X S�" l 30 Q Sler r3ed 6'X`/� � ,2 uslef- i'tfh 3'x 3' / 9 C10-1111 keel" 3'x 3 ' l 9 Sri i� /Pv�irr1 G n S 2- Windows: otal Sq. ft. �5_ Doors: Doors: Total Sq. Ft Total window and door area Total window &door area Z��7.��/(divided by) total sq. ft of heated area Z 3 1 SS = %of glazing 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 (WSEC/VIAQ)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 our building Ian t y g 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° Option Floor Ll s 2 Ceiling3 Grade below ° Below Floors on Vertical Overhead Factor 12 grade Grade Grade 1 120 .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10 11* 15%' .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 Ill Unlimited Single Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 (R-3)Only 'Reference Case/Call (360)427-9670 ext. 284 for footnote information. Log& solid timber wall with a min.avg.thickness of 3.5"are exempt from the above grade wall insulation requirements. TG RECEIVE[ li j,,Vy� ndow Schedule HiL INE for 2318 plan H O M E s 426 �.<. ' , Niline F�omes of Centralia Manufacturer: Milgard Windows Inc. Model: Classic Series Type: Vinyl U-Value = .36 Windows Quantity Size / Handing Glazing area Total S . Ft. Location width x height 1 5'0 x 5'0 25 25 Den 1 5'0 x 5'0 25 25 Bedroom 3 1 4'0 x 4'0 16 16 Bedroom 2 2 2'6 x 5'0 12.5 25 Great Room 1 6'0 x 5'0 30 30 Great Room 1 6'0 x 5'0 30 30 Media Room "1 6'0 x 4'0 24 24 Master Bedroom 1 3'0 x TO 9 9 Master Bath 1 TO x TO 9 9 Utility Room 2 2'6 x 5'0 12.5 25 Dining Room 1 2'6 x 5'0 12.5 12.5 Dining Room 2 2'6 x 50 12.5 25 Dining Room 1 2'0 x 5'0 10 10 Entry Total glazing area 265.5 sq. ft. 265.5 - 2318 = .114 X 100 = 11% Glazing Area y Conditioned floor Area Glazing Percentage If a sliding glass door option was chosen, switch the appropriate window w/the sliding glass door and use the calculation below. 1 6'0 x 6'10"sgd 41 41 Appropriate Room 282.5 - 2318 = .121 X 100 = 12% Glazing Area i Conditioned floor Area Glazing Percentage All other doors,windows 8 skylights do not need to be calculated do to the fact they meet all minimum requirements. FORM MUST BE COMPLETED IN INK PERMIT NO BLD PLE HARD, MASON COUNTY ' zT 1 V f. , C)I f BUILDING PERMIT APPLICATION l ' 2 5 20011,r 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 —` Shelton(3601427-9670 Belfair 360 275A467 Elma 360 482-5269 Seattle 206 464-6968 AP0EE1��JF,GRMATION CONTRACTOR INFORMATIO Owner K-7)lrc+r J Contractor Name d Mailinr Add:ess 224�0 5t�; Letice. F_lu+ci kcl Mailin Address 2 NAVE, City ')i-f Or�hrl r-cl State WA Zip Ccde cl�34�'7 Cify �1 _ Zip Code Phone(lif;,C) ).S:?C- - IL42fc Other Ph.(_J Ph.( 2S?, )_SqQdfJLfOther Ph ) LieniTille Holder Veot't_Lr . n y Contractor Reg. # NILIAII- � g� 1 Address_/ L) A/ - + - e" 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 PARCEL INFORMATION-12 digit Tax Parcel No. .;2 3 j / I7,60f Q;`30 Fire District Legal Description T!� 23 6F 341,QVEY V4)L 4l iq -22 Site Address(Please Include street name, street number and city) S�r11,t l.ilnu TlhLT Directions to site r5r e IC- :� 1 o l 'e .t S vi_,ek �'— — ij Will limber be cut and sot in pa cel preparation? (Yes/No) tits Is your propeity within 200' of the following: Body of "later (Name) N© Saltwater lU el Lake_L,,u Diver/Creek uc+ Pond RIG Wetland 'C+ Seasonal Runoff A6 Streamer Slopes or Bluffs t ) PERMANENT RESIDENCE SEASONAL RESIDENCE❑ TYPE OF JOB Ne\v_Add Alt Repair Other Use of Building I?ems r cis { Describe Wolk No. of Bedioomsf No. of Bathrooms2'/4 SQUARE FOOTAGE-1st Floor,; /� 2nd Floor 31d Fluor (_-% Lott 0 Basement h Deck— _Other U., sq ft.23ig Garage S qS Attached ,e,_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 5 Replacement Unit ?(Yes/No) Installer Name Certification No. NOTICE: THIS PERMil'BECOMES NULL 8.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 intormation 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 signaluie below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the 'CONTRACTOR'S AFFIDAVIT4 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 confor nce therew h. No changes shall be made without approvalfirst oL•taini r I X t J"`� Cale 7- � _=� x ate FOR OFFICIAL USE BEYOND THIS POINT Accefaed by Date Submillai Amount Due Receipt No. DEPARTMENTAL°REVIEW APPROVED DENIED CONDITION CODES Building Department , Occ Group Type Constr. i 1 � �I� G Planning Department I Environmental Health Department v ti y.�r �- H ze' , 00 I I Public Works Department i j FORNIRMESC E IVE&ED IN INK PERMIT NO. PLEASE PRESS HARD MASON COUNTY 5 NUMBING/MECHANICAL PERMIT APPLICATION �2 fir�; CEDAR ST 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-446. Elma(360)482-5269 Seattle(206)464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner � 170r IcI< 0-731 CA 1 r Contractor Name 910AX F161VIF5 Mailing Address 2'2[.,0 ;u LcaKc Flor(I Rd Mailing�ddress // "o aQF City Koi t Or c hex r cl State I Zip Code c�< �6," Z City VYA} �U State W Zip Code Phone _ " O lv 1,42- Other Ph.(_ Ph.( 2S3 ) 940-I$yg Other Ph.� Lien/Title Holder eMurr t­)C(nl< Contractor Reg. # NILINH cgs 1 Address c !J'' Expiration it / o"7 / o$ SEPTIC INFORMATION-Connect to New Septic�_Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 digit Tax Parcel No. 2—30 Fire District Legal Description 7(7- 23 OF 5t 1 ZVCV tIC L 4/1<-t -2-Z Site Address (Please Include street name, street number and city) T 'Tcthtu WA r - Directions to site ' k A l , n r � ePeri h rP-r_OUrh 11 (timer 85LEt- FEca, EIteadah1 Is your property within 200'of the following: Body of Water (Name) n/c) Saltwater A; J Lake ti() River/Creek A;Ct Pond A, (e) Wetland c) Seasonal Runoff AL Stream Slopes or Bluffs A;�> TYPE OF JOB New Add Alt Repair Other Use of Building�k; !�,nyle 6am,4 ee-"e4lne-e Location of Fixtures/Units 1st Floor /-/ 2nd Floor Basement Garage Closet e PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No.of Fixtures Fees LPG Natural Gas Heatpump j( Toilets ;3 Type of Unit No.of Units Fees Bathroom Sink 3 Furnace p Bath Tubs ( Heatpumps 1 Showers Z Spot Vent Fan r Water Heater i Propane Tank b Clothes Washer Gas Outlets p Kitchen Sinks I Wood/Gas/Pellet Stove 0 Dishwasher / Kitchen Exhaust Hood f Hosebibs / Dryer Vent 1 Other G Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 approyal.--- first obtai pr )( i� Date 7� x Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. r1FPARTMFNTA€'REVIEWI APPROVE© %DFNIFn I MNDITION;rnnFC