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HomeMy WebLinkAboutBLD2005-00683 Garage Final - BLD Permit / Conditions - 3/16/2006 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2005-00683 OWNER: DAN ELDRIDGE RECEIVED: 4/28/2005 CONTRACTOR: LICENSE: EXP: ISSUED: 5/4/2005 SITE ADDRESS: 111 E CLONAKILTY DR SHELTON EXPIRES: 11/4/2005 PARCEL NUMBER: 321275400003 LEGAL DESCRIPTION: LAKE LIMERICK 5 TR 3 111 E CLONAKILTY DR PROJECT DESCRIPTION: DIRECTIONS TO SITE: Garage General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: Type of Constr.: VB Type of Use: SF Insp.Area: No.of Bathrooms: Occ. Group: U-1 Lot Size: Deck: Type of Work: ACC Fire Dist.: 5 No.of Stories: 1 Occ. Load: Building: Garage-Detached 576 Valuation: Building Height: 14 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: E 30.0 Ft. Shoreline: Ft. Water Body: Rear: W 122.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: N 10.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: S 56.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee KKK 4/28/2005 $154.21 S22005 Planning Review Fee KKK 4/28/2005 $155.00 S22005 Additional Plan Check Fee KKK 4/28/2005 $7.00 S22005 Building State Fee ARC 5/2/2005 $4.50 S12005 Building Permit Fee ARC 5/2/2005 $237.25 S12005 EH Plan Review CEW 5/2/2005 $35.00 512005 Total $592.96 BLD2005-00683 Please referto the following pages for conditions of this permit. 1 of 4 CASE NOTES FOR BLD2005-00683 CONDITIONS FOR BLD2005-00683 1) 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 1-800-647-0 2 The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X - . 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 Department i o V o any further inspections being performed or approvals granted. X S 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 inspections 61, . . X ' 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 removal of pWved documents will result in failure of required building inspections. X A., 5) This structure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use permit shall pplied for, reviewed and approved prior to the change. X 6) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X cr 7) 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 Building Dena r ent prior to any further inspections being performed or approvals granted. X BLD2005-00683 Please referto the following pages for conditions of this permit. 2 of 4 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 Mason Co nthordinances and building regulations. X 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 holder ha v' evented action from being taken. No more than one extension may be granted. X 18) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X . 19) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X 20) Approved rier dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. 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 fora 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 property and IC ucture for rrevv. w nd ins ect.on. OWNER OR AGENT: � /LG -- DATE: J BLD2005-00683 Please referto the following pages for conditions of this permit. 4 of 4 f - C ���� r ul 0 o CONCRETE MECHANICAL MANUFACTURED HO 0 Footi / etbacks Date By Ribbons 0 0 Date '7- S - c ,5 By kf-C Gas Piping Date By 00 w Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMIIJG Walls FIRE DEPT Date 015 t By Date By Date By PLUM ING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION Water Line Date Va I.Go 6� B y (S Date By " Date B C s EP root Zoo f Food%erg PASS e, Q ` -'0 -6S VW 0yV0 f 0ko-ft s d3115-`66 031 f(o�C� {�G-S �rrar� o N 8 O a O o O � � 00 W d 0 8) - 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 J 9) The internationnl 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 conuct with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 'd,�:., 10) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the internationg codes and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. X Z 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 permit revqca on. X � . 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 project. X . 13) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or reaul�tion, must be reviewed and approved by Mason County prior to construction. X ,,��// 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 shjjfe made prior to requesting additional inspections. X l�t� 15) All property lines shall be clearly identified at the time of foundation inspection. X ,�`,;.,�"^BLD2005-00683 Please referto the following pages for conditions of this permit. 3 of 4 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 411 No. Fifth Street//P.O. Box 186, Shelton WA. 98584 360.427.9670 ext. 352 Request for Administrative reduction in the Required Setbacks ($90.00) For administrative review, the minimum variance on a yard setback request is 5 feet from the side lot lines and 10 feet front and rear lot lines or right of way. Request for further reduction requires standard variance. Setbacks are measured from the furthest projection of the structure. Applicant/Owners: _ i le Mailing Address: E. clo'"'-a City: State: Wa . Zip: Site Address: i E. dOvwy/� �%C' 14A Telephone No.: (100) L(Z 7 !fig Parcel Number(s): 32, 1 Z 75- Yoo oc) 3 Zoning Etc. Requested Variance: a Rear • Side Yard (please circle all that apply) Requested setback variance: i. FT. An illustrated site plan is required: Your site plan must show the following: north arrow, abutting street or easements, set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical area, septir�E C E I V E D well and driveway. Show all proposed new development. CC The following circumstances must apply. JUN 0 8 2005 Front and or Rear Yard requirements: 426 Wt CEDAR ST. 1) Existing lots of record as of March 5, 2002; You must meet one of the following. (Please circle all that apply) 2) One of the following exists on the lot: a) steep slopes, wetlands, or streams present; l b) ,soils that restrict building or septic development; c lot width at the front yard line of no more than 50 feet; xffi�lot size of no more than one-fourth acre; e) a isting improvements of buildings, septic systems, and well areas. Side yard requirements: 1) Existing lots of record as of March 5, 2002; You must meet one of the following. (Please circle all that apply) 2) One of the following exists on the lot: a) steep slopes, wetlands, or streams present; b) soils that restrict building or septic development; c) lot width at the front yard line of no more than 50 feet; d) lot size of no more than one-half acre; e) existing improvements of buildings, septic systems, and well areas H:Aadministativevariance.doc (tw) February 05 l Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones. OF 5�r�tu.Ie 1�jn�s o�v e<< f'a,- cL c4 e Unal le CA r!R"e ace S��e ©r Z- rW4 e Gil tr7 �sep -� �an d t��dPe+ �ac rLid aC Owner/Agent (please indicate) Signature and date Official Use On/y Approved Date Denied Date Reason for denial: HAadministativevariance.doc (tw) February 05 1.05.030 Variances 1.05.031 Purpose The purpose of this Section is to provide a means of altering the requirements of this Ordinance in specific instances where the strict application of these regulations would deprive a property of privileges enjoyed by other properties which are similarly situated,due to special features or constraints unique to the property involved. 1.05.032 Use Variances Prohibited No variance shall be granted to permit the establishment of a use otherwise prohibited within the development area in which the property concerned is located,except as provided in Section 1.05.018(B). Applications for such variances shall not be accepted for processing or review. 1.05.034 Granting of Variances Authorized A. The Board of County Commissioners shall have the authority to grant a variance from the provisions of this Ordinance when, in their opinion,the conditions set forth in Section 1.05.036 have been met. The Board shall have the authority to attach conditions to any such variance when, in their opinion, such conditions are necessary to protect the public health, safety or welfare,or to assure that the spirit of this Ordinance is maintained. B. The Administrator shall have the authority to grant a variance from the provisions of this Ordinance when the granting of such variance will result in a measurable deviation of ten(10%)percent or less from the provisions set forth in this Ordinance. In issuing such variance,the Administrator shall make a positive determination that the conditions set forth in Section 1.05.035 have been met. The Administrator shall have the authority to attach conditions to any such variance when, in his(her)opinion, such conditions are necessary to protect the public health, safety or welfare,or to assure that the spirit of this Ordinance is maintained. C. The Administrator may allow a reduction in the required front yard setback by administrative variance under the following circumstances: for existing lots of record as of March 5, 2002,where physical attributes of the lot (such as steep slopes, wetlands, streams, soils; lot width at the front yard line of no more than 50 feet or lot size of no more than one-quarter acre; and existing improvements of buildings, septic systems, and well areas) preclude a proposed development from meeting the 25-foot front yard setback standard. The front yard setback shall be the minimum necessary to accommodate a reasonable development proposal,but not less than 10 feet distance from the property line or any easement boundary. The Administrator shall document in the property file the rationale for said administrative variance decision. D. The Administrator may allow a reduction in the required side yard setback by administrative variance under the following circumstances: for existing MASON COUNTY DEVELOPMENT REGULATIONS June 2003 -scale, � � z s �3 K ~) 1 I ;, 1 i a I a SITE IPLA N F ;i CHANGES U JE T 7 D A P' V Y Ct 4 l, TOPOGRAPHY PROFILE: Direction: Scale: Approval: for office use Building Permit number: Building: Owner/Applicant: Date of Planning: Parcel Number: application: Env. Health: i T- i r I ti ' ' V (�q MASON COUNTY RESIDENTaPLANS SUBMITTAL CHECKLIST Owner's Name: 0 Date: '�/- -2 `' Reviewed By: Documents: RECEIVED Building Permit Application Completed 'Planning Intake Checklist Completed, APR 2 8 2005 Ri DEN Site plan includes:Allowable building area,roof overhangs,decks,etc. Fire Apparatus Access Road info required? Yes/Co426 W. CEDAR !Energy Code Application Form-O Electric wall heater O Electric central furnace O LPG Furnace O Heat pump with electric furnace O Heat pump wit4 LPG furnace O Boiler(heat type O Other: Specify: Mechanical/Plumbing 907 cation-WATER HEATE FUEL TYPE Engineering? Yes Snow load used: Seismic Design Category:/DP or D2 Geotechnical report or assessment? Yes No 1 Construction Plans�3 COMPLETE SETS Plans Legible Recognized Scale Elevation Views v Cross Section 0:dation Plan _Roof Framing Plan _Floor Plan-Use of Rooms Noted _Floor Framing Plan-all floor levels represented? Loft,crawlspace,etc. Deck Framing Plan,including covered porch roof framing plan Plan Details: e v1� oof franung details,truss lay-o�mayye needed 0-0— Wall Framing-Does bearing-wall height exceed 10'?(Engineering may be required) Floor framing: Floor joists: I Floor beams: aZWindow headers. Typical header: qX 6 'Foundation: footing size,reinforcement ALP oncrete Walls-Does Concrete Wall Height Exceed 9'?(Engineering may be required) Landings at all exit levels? <30"above grade? (i�7—/ N —Heated By Furnace-Location of Furnace Fireplace/Stove Information Shown-Fuel Type? XlWindow Sizes Marked on Plans '�C 2-Story Garage? (Engineering maybe required)R602.10.1, 1'`story of a two story: D1—45%,D2—55% Braced wall panels(shear walls)marked on plans or lateral engineering?(Plans may not be approved if not provided) COMMENTS: IRREGULAR BUILDINGS(Unusual Shape)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 BWP cantilevered or offset by more than 4' 2)Roof or floor is not laterally supported on all edges 2A)Portion of roof or floor extend more than 6 ft.beyond the braced wall line. 3)End of BWP extends more than I ft.over an opening more than 8 ft in width below. 4)Opening in a floor or roof exceed the lesser of 12 ft. or 50%of the least floor or roof dimension. 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(exc: fireplaces,chimneys, and veneer). When this condition applies the entire story shall be designed in accordance with accepted engineering practice. 2003 IRC Plans submittal checklist simplifie"ORD W71WPANELr D OUT OF PLANE REQUIRED BRACE WALL PANEL DCTERIOR BRACED oo —o;sEcnoN VIEW SECTION VIEWBRACED PANFJ.BouiF PLANE . - MORE THAN 1 F7 MORE THAN 1 FT EXTERIOR ELEVATION EXTERIOR ISOMETRIC • For SI:1 foot:30/.8 mm . 4FT WITH 2x12 . BRACED WALL PANEL EXTENSION OVER OPENING B&SHALLLLOONT MORE THAN M LY 8 IRREGULAR SUPPORT Ilr=__ =- rr------- I I lir== I B2 II II I01 II II 11 I� SECTION THRU CANTILEVER aFT WITH 2x12 SECTION THRUSETBACK LL—___=JL=____�J For SI:1 imb uA mm•1 foot.304.9 mm MORE THAN B1/2 IS IRREGULAR Figure Rm2a=m PLAN VIEW PLAN VIEW BRACED WALL PANELS SUPPORTED BY CANTILEVER OR SET BACK Figure R3012.2.2.2(8) . OPENING LIMITATIONS FOR FLOOR AND ROOF DLAPHRAGYS ........... I I I I I FLOOR JOISTS CANNOT BE L------J, jF �, TIED DIRECTLY TOGETHER TIED TICO D JOISTS CANNOT BE ------ IRECTLYTOGETHERR ------ �I II II II II II II II . I II T LL_`====J======Jjl _ II DASHED LINE INDICATES I I I1 BRACED WALL LINE BELOW LI- U THERE IS NO BRACEDtL PLAN VIEW WALL LINE OOF THIS EDGE E RSum R8012222� SECTION VIEW SECTION VIEW FLOOROR ROOF NOT SUPPORTED ALL EDGES - Figure R3012222(� - • PORTIONS OF FLOOR LEVEL OFFSET VERTICALLY BRACED WALL LINES ARE rf=_==1.r==_�, NOTPERPENDICULAR it II 11 I I ROOF OR FLOOR SHALL BE PERMITTED U \\\\ \\\\ I I TO EXTEND UP TO 6 FEET BEYOND THE BRACED WALL LINE NO BRACED WALLPANEL ABOVE PERMITTED AT THIS LOCATION PLAN VIEW FwSL•ItD.w 304.8mm. PLAN VIEW ROOF OR FLOOR EXTENSION Figure R3MBOND BRACED WALL LINE (8) Figure RS012222 BRACED WALL LINES NOT PERPENDICULAR Mason County Permit Assistance Center AOA Planning Intake Checklist Ps Na :me i c1 Date: y- z E_01- �ect: � �„r � Reviewed By: Commercial Development: YES &0 Comments: Planner: GBM TSC CMM (!�� SG Site Plan: North Arrow Q, Property Dimensions: GG ' X ('S— �f Streets and Driveways Shown.Road name: C/4 �( All Existing Structures shown with setbacks HLULIVED ,,< WelfLocation, Septic and Drain-field Shown with setbacks APR 2 8 2005 Identify all surface water(streams,ponds, shoreline,wetlands, etc.) Topography(slopes) 426 W. CEDAR ST. Proposed Structure Setbacks (Direction/Setback): F: _L/ _30' R: L_j / /�I' S1: /0 ' S2: Utility and Drainage Easements: Yes if yes enter condition#5022) Other Easements uc:,c-c ,d\ Accessory Appurtenances tt c ett o County Access Permit Needed(add condition#0010) o State Access Permit Needed(add condition#0020) Standard Conditions to be added to all Building permits that planning reviews: #5019 and#0700 Are there any impediments that may restrict access to your site? (dogs/gates) Shoreline and Planning Info Setbacks: Shoreline: Slope: Shoreline Designation: Comprehensive Plan: Rural Zoning: Not Applicable ❑ Agricultural <' RR 2.5�J_4O 20 ❑ Urban ❑ In-holding ❑ RMF ❑ Rural ❑ LTCFL ❑ RC -1 2 3 ❑ Conservancy �( Rural ❑ RI ❑ Natural ❑ RAC ❑ RNR ❑ Unknown ❑ RCC-Hamlet ❑ RT ❑ Urban Growth Area ❑ MPR ❑ Unknown ❑ Unknown Water Body(type of water if unnamed): SEPA: Y s N nknown,— Flood Plain: YES N Unkno ap# Aquifer Recharge: YES NO nknown Map# Tags/Cases: RLC/SPI Case: 6-Year Dev. Moratorium: YES COO / Eagle Nest Tag: YES NO Other YES Addressing: Check box if needed ❑ Reviewed by: Revised:02-04-2005 I:\PLANNING\CHARELL&RENEE\PLANNING INTAKE MASON COUNTY PERMIT NO. 1 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 APPLIC NT INFOR ATIQN CONTRACTOR INFORMATION Owner E ✓ Company Name Mailing Q�ddr ss 'E- r. Mailing Address City SI1 tate Zip Code�u-sg`�— City State Zip Code Phon �� Z Other P Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address F%+ S a Aj E Mail Address Drivers Lic.# Z I 'Z011p to DOB i L-1-70 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. 2,1 --vq 00003 Fire District Legal Description L d 3 Of: take S" Site Address (Please include street name, street number and city) 1111 1! C! k'/ Clkellq, Directions tp site AJ i-, c. Le GI`-. Will timber be cut and sold in parcel preparation. Yes/ o Is property within 200'of Saltwater AJO Lake River/Creek Na Pond N0 Wetland�Q—Seasonal Runoff_�VQStream 0 Slopes or Bluffs > 15% �QO Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB Id- NewAdd Alt Repair Other PRIMARY RESIDENCE [D SEASONAL ❑ Use of Building Dctte Describe Work 2u Y Tye No.of Bedrooms No.of Bathrooms Square Footage- 1st Floor S 7(0 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make F les4�0o Model Year Length Width Serial No. No.of Bedrooms—3 No.of Bathrooms Type of Heat H V A L Purchase Price$ Replacement Unit? Yes/No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent 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 CONT ION WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: H'Z� Owner/Owners 4presentative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee -z 3 -7. Site Inspection Plan Review Fee EH Review Fee Plumbinq & Base Fee PlanningReview Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee S� Violation Fee NO - IC, Pre-Paid at Submittal Valuation $ 1 9CtS . 25 TOTAL FEES 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 Mailing Address Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address E Mail Address Drivers Lic.# DOB 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. ~ % i .5ki 00r, >S Fire District Legal Description Site Address (Please include street name, street number and city) I t I - Directions to site L - 9.4 Will timber be cut and sold in parcel preparation?Yes/ o Is property within 200'of Saltwater L Lake River/Creek �A-Ad Pond kQ Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% �t3� 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 No.of Bedrooms No.of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make ,a,4£ Model Year Length Width Serial No. No.of Bedrooms No.of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent 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: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department S Environmental Health Department 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 MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 426 W. Cedar • FO. 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 1}(A", F ; Company Name Mailing Address #{ -ir t Mailing Address City State Zip Code City State Zip Code Phone Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address eCf E Mail Address Drivers Lic. # DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic 'xisting Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. .._.7 -'5't? r:r>3 Fire District Legal Description 1 `f Site Address (Please include street name, street number and city) Directions to site Lic r Will timber be cut and sold in parcel preparation?Yes/ o Is property within 200'of Saltwater A-10 Lake River/Creek . /y Pond •L 0 Wetland 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 x Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building •1 d; . Describe Work No.of Bedrooms No. of Bathrooms Square Footage - 1 st Floor r 7 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent 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. Date: Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department 4-- Public Works Department Fire Marshal FEES Building Permit Fee Site Ins ection 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 5/4/2005 10:44AM Fees Associated With 1plo Case#: BLD2005-00683 Due Type Description Revenue Account Number Date Paid QY Fees Paid History PLCK Plan Check Fee 001.125.140.345.83.00.0000 4/28/2005 KKK 154.21 154.21 0.00 Plan Check Fee 001.125.140.345.83.00.0000 4/28/2005 KKK 0.00 0.00 PLRV Planning Review Fee 001.125.145.345.83.03.0000 4/28/2005 KKK 155.00 155.00 0.00 Planning Review Fee 001.125.145.345.83.03.0000 4/28/2005 KKK 0.00 0.00 ADPC Additional Plan Check Fee 001.125.140.345.83.00.0000 4/28/2005 KKK 7.00 7.00 0.00 Additional Plan Check Fee 001.125.140.345.83.00.0000 4/28/2005 KKK 0.00 0.00 STFE Building State Fee 650.170.010.386.00.05.0000 5/2/2005 ARC 4.50 0.00 4.50 PRMT Building Pernut Fee 001.125.140.322.10.00.0000 5/2/2005 ARC 237.25 0.00 237.25 EHPR EH Plan Review 150.300.000.346.50.54.0000 5/2/2005 CEW 35.00 0.00 35.00 Total Fees: $592.96 Paid:$316.21 TOTAL REMAINING DUE: $276.75 S l✓ 7 Page 1 Of 1 CaseFees.rpt