HomeMy WebLinkAboutCOM2010-00070 Drive Thru - COM Application - 7/28/2010 MASON COUNTY PERMIT NO.
BUILDING PERMIT APPLICATION
426 W. Cedar• P.O. Box 186, Shelton, WA 98584 �
Shelton (360) 427-9670 • Belfair(360) 275-4467 • Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailin Address E�.� Mailing Address
City State U,!L =Zip Code^ City State Zip Code
Pho � -Lf k\ -Uya r Other Ph. `?k�G-.y l4`j k Phone Other Ph.
Contractor Reg. # Exp.
s E Mail Address
94uac9lic.# Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Water System Name of Water System
PARCEL INFORMATION- 12 Digit Parcel No �' Fire District
Legal Description
o Site Address(Please include stree name,street number and city) V
Directions to site `
Will timber be cut and sold in parcel preparation? Ye o
Is propert within 200'of Saltwater y_Lake River/Creek t Pond G
Wetland %I , Seasonal Runoff ,Stream Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB New Add Alt Repair Other PRIMARYRESIDENCE ❑ SEASONAL ❑
Use of Building ��'' Describe Work N XK � rx i, kAM�
No. of Bedrooms No. of Bathrooms Square Footage- 1 st Floor:&k d Floor
3rd Floor Basement Deck Covered Deck ' 1[her Sq.ff.
Garage Attached Detached Carport Attached Detached
AN %ACTURE HOME FO MATION ke odeI Year
L ngt idth erial N o. of Be oomof Bathroo s
Tye at Purcha e Pr' e$ epelficl-,ation
ment it? es
Ins ler N e 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 on owners behalf,represents that the information
provided is accurate and gran employees of Mason County access to the above described property and stricture for review and inspection.
OF CONTINUATION WORK IS BY MEANS OF A PROGRESS INSPECTION. _
i X 0 ? C Date
Owner/Owners Re resents ve ractor indicate which one
FOR OFFICIAL USE BEYONDJW9 POINT Accepted by: Date
DEPARTMENTAL REVIEW APP OVED DENIED NOTES
Building Department -9-
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal 6--9=
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
MASON COUNTY PERMIT NO�y /
BUILDING PERMIT APPLICATION 0
426 W. Cedar• P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 • Belfair(360) 275-4467 • Elma (360) 482-5 69
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner ' -C � Company Name
MailinQ Address � 1& QA Mailing Address
City State 01\_Zip Code_ City State Zip Code
Phon U �� -���a� Other Ph. �,�G. �lQ`j k Phone Other Ph.
Oenf_ �r Contractor Reg. # Exp.
€ffia�-ess E Mail Address
p4uBr%-1 .# grp$• Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Water System Name of Water System
PARCEL INFORMATION- 12 Digit Parcel No Fire District
Legal Description
o Site Address (Please include stree name,street number and city) ,
Directions to site � - -,
Will timber be cut and sold in parcel preparation? Yes o
Is property within 200'of Saltwater �Q� ?Lake River/Creek ��= Pond�`—
Wetland -s Seasonal Runoff ] Stream , Slopes or Bluffs ] 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB New." Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building '�`� Describe Work ���— x/�
No.of Bedrooms No.of Bathrooms Square Footage- 1st Floor:j(CC�a#1A)Ad Floor
3rd Floor Basement Deck Covered Deck tt fher Sq.ft.
Garage Attached zxm�Detached Carport Attached Detached
II�ANgACTUREb HOME JkFO MATION, ke 777 odel Year
Length Width serial N ' o. of Bedroom N . of Bat pro s
Type pf Fi, at �` Purcha\e Pr e$ epl ement it?/'Yes/ o
Installer Ne ��— �/ ification 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 on owners behalf,represents that the information
provided is accurate and gran employees of Mason County access to the above described property and structure for review and inspection.
PRODE OF CONTINUATION WORK IS BY MEANS OF A PROGRESS INSPECTION.
1 X .! Date �I \f'
Owner/Owners Re resentalive ractor indicate which one
FOR OFFICIAL USE BEYOhQ TFO POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Departme t
Public Works Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing& Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation$ TOTAL FEES
PERMIT NO! L,)11 1 zo —
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION 4n00 ID
426 W. Cedar- P.O. Box 186, Shelton,WA 98584
'. v\k Shelton (360)427-9670- Belfair(360)275-4467• Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailin Addres Mailing Address
R'ittat Zip Code City State Zip Code
b�rre Other Ph. C"t-�kj`�51 Phone Other Ph.
Lien/Title Holder Contractor Reg.# Exp.
E mail address AJ\�— Lc Q RP)f ��-t -QMy�f�"�° E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic: Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District
Legal Description
Site Address (Please include street name, street number and city)
Directions to site
Is property within 200'of Saltwater Lake River/Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs > 15%
TYPE OF JOB - New Add Alt Repair Other Use of Building
Location of Fixtures/Units - 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:ElectriG_ LPCz_ Natural Gas_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heatpumps
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/PelletStove
Dishwasher Kitchen Exhaust Hood
Hosebibs Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OVNVER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of
such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this
permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is
required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained
permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X Date:
Owner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department CG'
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
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MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/Ventilation Compliance Application
d Owner. Telephoner _ Parcel*
Type of project ( ) New Residence ( ) Addition ( ) Remodel
Total Sq. Ft. 15 Floor floul Basement:
of heated area::
Heating System Type: • Electric wall heater O Electric Central Furnace O LPG Furnace
O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type:
O Other: Specify
Glazing 0 Prescriptive Option see reverse side circle one: 1 II IV
Percentage: Compliance
Method O Component Performance , Chapter 5— Calculation worksheets required
Check one:: 0 Systems analysis, Chapter 4
0 Whole House Ventilation system 0 Whole House Ventilation using a Heat
using exhaust fans&window or wall fresh air Recovery Ventilation System (M1508.7)
Ventilation vents (M1508.4)
System
Check one O Whole House Ventilation Integrated O Whole House Ventilation using a supply fan.
with a Forced Air System (M1508.5) (M1508.6)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windows:
Windows: Total Sq. ft.
Doors:
Doors: Total Sq. Ft
Total window and door area
Total window& door area /(divided by)total sq.ft of heated area = %of glazing
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR(360)275-4467 Elma (360)482-5269
FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2006 Washington State Energy Code (WSEC)
Implementation of the 2009 Edition has been postponed until January 1, 2011.
Washington State Ventilation & Indoor Quality Code
Ventilation code provisions are now located in the 2009 International Residential Code (IRC),
2009 International Mechanical Code (IMC), and the 2009 International Building Code (IBC)
as appropriate for the intended use.
Code Compliance Application Form
The following information will be required for the WSEC and ventilation code plan review:
1. Complete the Washington State Energy Code/Ventilation code application located on the reverse side.
2. The window and door schedule should include all windows, skylights, sliding glass doors, french doors and
any other door with 50% glass or more. Use rough opening dimensions of windows and doors to calculate
size. It is always helpful to list the u-factors of windows and doors, if known. If you do not know u-factors,
the plan reviewer will assume all window & door glazing will have a u-factor of .35 or less. When using the
area weighted average method to comply with prescriptive-path include calculations with submittal
documents.
3. On your building plans note the location and fuel type of heating system, water heater, location of exhaust
fans (bathroom, laundry, kitchen, etc.) and R-factor of proposed insulation for walls, floors, ceilings, and
slabs. Outdoor lighting, permanently mounted to a residential building or to other buildings on the
same lot shall be high efficacy luminaires or motion sensor with integral photocontrol photosensor.
All linear fluorescent fixtures must be fitted with T-8 or smaller lamps, but not T-10 or T-12 lamps.
To verify compliance, provide lighting information on plans.
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. Additional WSEC
and VIAQ compliance information is also available on the WSU-Energy Program website at:
http://www.energy.wsu.edu/code/
Prescriptive Requirements °,' for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing Ll-factor Vaulted Wall Wall Wall
Area% of Door Ceiling Ceiling3 Above interior exterior Slab s
Option Floor Vertical Overhead" Factors 2 senote
Grade 4 below 4 Below Floor 5 on
o el
grade Grade Grade
I 10% .32 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
II* 15%* .35 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
IV Unlimited
Single Family Res .35 .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. 352 for footnote information. Log &solid timber wall with a min.avg.thickness of 3.5"are
exempt from the above grade wall insulation requirements. Vaulted ceilings shall be limited to 500 sq.ft. of ceiling area for any
one dwelling unit.
MAW MAWN COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLI$-T---/-,
Owner's Name: A Date: Reviewed By: w
Documents:
Building permit application complete STORM WATER WORKSHEET COMPLETE?❑
Planning intake checklist complete
Site plan includes allowable building area, roof overhands, decks, etc.
Fire apparatus access road info required: Yes/No
Energy code application O Electric wall heater O Electric central furnace O LPG Furnace
O HP w/elec. Furn. O HP w/LPG furn. O Boiler(heat type)
O Other: Specify
Mechanical/plumbing application—WATER HEATER fuel type/location:
Engineering? Yes/No - Snow Load: Seismic:
Stock plan: APPROVED Snow Load: Seismic:
Manufactured Homes—4 FLOOR PLANS
Foundation type: ❑ ANSI/Manf.Method ❑ Engineered footing/found. ❑ Basement
Decks: ❑ Covered? ❑ Uncovered over 4 x 6 and 30"? - construction plans required
Construction Plans:�3 COMPLETE SETS
Plans legible Recognized scale [Elevation views Cross section
Foundation plan Roof framing plan c l Floor plan—use of rooms noted(all floors)
%floor framing—all floor le els ❑ Deck framing including covered porch framing
Plan Details:
Roof framing details, truss layout may be needed(hip and girder location shown)
'� Wall framing—does bearing wall height exceed 10'(engineering may be required). f I
�`Floor framing: floor joists 2 x(-,a spacing? I CO floor beams: `--�x,'?j
Window headers: typical header 4 n J-,, Garage door header:
Foundation: footing size,reinforcement 1 Z X ( Z xij
'--® Concrete walls—does concrete wall height exceed 8'? (engineering may be required)
-40 Landings at all exits? Less than 30"above grade? Y/N
---p Heated by furnace—location:
-E Fireplace/stove information shown—fuel type: Location(s):
Window sizes marked on plans
61( raced wall panels(shear walls)marked on plans?
"',9 2-story garage: (engineering may be required) I"story of two story D1 —451/%D2—55%
COMMENTS:
ENGINEERING REQUIRED
❑ Braced wall panels/brace wall lines are not marked on plans (R602.10)
❑ Amount and location of bracing does not meet minimum required in Table R602.10.0
DESIGN CRITERIA: All notes and details required as a result of the engineered analysis shall be transferred onto proposed building plans.
Wind 85 MPH, Exposure B(unless proven otherwise). Seismic Zone: ,Snow_psf.
IRREGULAR BUILDINGS R301.2.2.2.2
Irregular portions of structures shall be designed in accordance with accepted engineering practice. A portion of a building shall be
considered to be irregular when one or more of the following conditions occur:
❑ 1)Exterior braced wall line or B WP cantilevered or offset by more than 4'
❑ 2) a.Roof/floor is not laterally supported on all edges b.Portion of roof/floor extend>than 6 ft beyond the braced wall line.
0 3)End of BWP extends more than 1 ft over an opening more than 8 ft in width below.
0 4)Opening in a floor or roof exceed the lesser of 12 ft. or 50%of the least floor or roof dimension.
0 5)Portions of floor level are offset vertically
❑ 6)Shear wall lines do not occur in two perpendicular directions.
❑ 7)When a story above grade includes masonry or concrete construction(fireplaces/chimneys/veneer)entire_story shall be
designed in accordance with accepted engineering practice. Wpermit tech checklist-02-05-2008
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Name V. Parcel#1 ,, /� 1 1�T ��l/�_<��.� BLD#
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.
'Common 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 Length X Width = Area 'All dimensions in feet
Buildings X
X = Measurements for buildings are taken at the
X _ perimeter of the farthest projections(example:
eaves/gutters)
X =
Driveways X
X = 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)
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
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-
des ibed property for review and inspection as may be required.
X Owner/Agent/Contractor(circle one)Date: a
bd I
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.
Pagel of 2
w
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:
http//www.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