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HomeMy WebLinkAboutBLD2011-00133 Final Detached Garage DDR2011-00019 - BLD Permit / Conditions - 8/11/2011 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 i� RESIDENTIAL BUILDING PERMIT BLD2011-00133 OWNER: CRAIG TOMPKINS RECEIVED: 2/22/2011 CONTRACTOR: RITZMAN CONSTRUCTION LLC 3608717454 LICENSE: RITZMCLO01BU EXP: 1/2/2013 ISSUED: 3/16/2011 SITE ADDRESS: 631 NE HAVEN LAKE DR TAHUYA EXPIRES: 9/16/2011 PARCEL NUMBER: 223305000088 LEGAL DESCRIPTION: HAVEN LAKE TRS 88-89 SPC#99-02 AF#683821 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW DETACHED GARAGE WITH STORAGE ABOVE ST RT 3, L ON ST RT 300/ NORTH SHORE RD, R ON BELFAIR TAHUYA RD, R ON HAVEN WAY TO HAVEN LAKE DR TO SITE ADDRESS 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 Lot Size: Deck: Type of Work: ACC Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:0 Garage-Detached 1,344 Valuation: Building Height: 26 Occ. Status: Seasonal Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 42.0 Ft. Shoreline: Ft. Water Body: HAVEN LAKE Rear: N 50.0 Ft. Slope: Ft. SEPA?: Yes Model: Width: Ft. Side 1: E 5.0 Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: W 52.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Laundry Tray 1 Plan Check Fee GMM 2/22/2011 $427.54 S12011000 Water Closets (Toilets) 1 Planning Review Fee GMM 2/22/2011 $205.00 S12011000 Water Heaters 1 EH Plan Review GMM 2/22/2011 $103.00 S12011000 Building State Fee LDK 3/10/2011 $4.50 S12011000 Building Permit Fee LDK 3/10/2011 $657.75 S12011000 Plumbing Permit Fee LDK 3/10/2011 $26.10 S12011000 Plumbing Base Fee LDK 3/10/2011 $24.70 S12011000 Total $1,448.59 BLD2011-00133 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR B LD2011-00133 CONDITIONS FOR BLD2011-00133 1) All surface water and potential runoff from site preparation, buildings, or driveways will be controlled and treated on site, shall not adversely affect any adjacent properties, nor increase the velocity flow entering or abutting to any state or county culvert or ditch system or roadway. X )ok 2) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 112R 3) Temporary erosion control measures must be implemented to prevent water qual_ iry_degradation of adjacent waters or properties. Silt fencing must be installed and maintained until upland vegetation has become established. X '& 4) The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules, and the Mason County Shoreline Master Program. f�QQ X 5) All construction and demolition debris must be removed from the shore area after project completion. Proper disposal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X Lt 6) 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 1 k 7) This structure has NOT been reviewed or approved as an Accessory Dwelling Unit(ADU): A second dwelling unit detached from an existing single-family dwelling for use as a completely independent or semi-independent unit with provisions for cooking, eating, sanitation and sleeping. ADUs are required to meet the requirements under Mason County Development Regulations 17.03.029. X Y—a 8) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures meet the setback conditions listed. X T' 9) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Site,Plan"to ensure these structures are shown and meet the setback conditions listed. X BLD2011-00133 Please referto the following pages for conditions of this pennit. 2 of 5 10) Retaining walls needed to support a surch rg such as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 11) 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 1-800-647-09,32. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. x V_X 12) 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 p ' r to any further inspections being performed or approvals granted. X S 13) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X V1 k 14) 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 o ed documents will result in failure of required building inspections. p X 7C 15) 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 heapplied for, reviewed and approved prior to the change. X 16) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X ' 17) 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 BuildingDepartment prior to any further inspections being performed or approvals granted. ,* 18) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer's installation instructions. x BLD2011-00133 Please referto the following pages for conditions of this permit. 3 of 5 19) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting 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. By calling for a final inspection of the building permit the owner/agent/contractor i acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 20) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/Reserve requires a 10ft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. No foundation drains within 30ft, down gradient of drainfield/reserve area. X )i 21) 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 international c� odes and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. X 11112 22) 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 X charged and shpal be collected by the Building Department prior to any further inspections being performed or approvals granted. 23) 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 revocation.)e U 24) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your Xproject. r[l 25) Placement of structure must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X 26) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or, -regulation, must be reviewed and approved by Mason County prior to construction. BLD2011-00133 Please refer to the following pages for conditions of this permit. 4 of 5 27) 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 hall be made prior to requesting additional inspections. 28) All property lines shall be clearly identified at the time of foundation inspection. X��- 29) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. X 1D1}- 30) 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 have prevented action from being taken. No more than one extension may be granted. X Ut 31) 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 Vii This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is b means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and rants employees of Mason Count access to Y P 9 P 9 P P 9Y the above described property a—n�d-structure for review and inspection. OWN ER OR AGENT: 7i]� ars�4 � ,., DATE: 16 BLD2011-00133 Please referto the following pages for conditions of this permit. 5 of 5 00 0 CONCRETE MECHANICAL r MANUFACTURED HOME G o Date Cv — ( By r� Footings J Setbacks Gas Piping Ribbons o Intenor Date By Interior-Date By Date By 0 ! wExterior Dater)_ I By Exterior-Date By Set-up N Point Load!Isolated Footings INSULATION Date By n BG r SLAB INSULATION Date DEPARTMENT Date By Data By Foundation Walla l' +n ��� �A•df-� Floors Date By Date S_, —I By Date By DECKS FRAMING Walls Date By Dal , _ / By Date 4 PROPANE TANKS PLUMBING vault Date y Date By OTHER Groundwork %,P, Attic ..L gY I Date By Type. Date Date By D.W.V DRYWALL Type Date / By Int.Brace Wall Date By W �� — V3J,ftCt) y� f" Date sy FINAL INSPECTION m Water Line Fire Seperation IV v Date By Date By Dale r p �/ By C Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Done By Comments w CD o 8 i iYv j LI/ vf/ 0 s G-�Divr/ puiv tf' O Lo p S ,�231r/i,/ 6..,v�7/-yc�L <nnA< X q- 6 vli > ,c �— ">L 0 f,� ezzo f1 mc Yit 7 ® FL > T � (/�'r9 c;.y 11VS _/kC_Zx j 17',eC; lle t Lm f /rL 'V / - ' Name Parcel# + BLD#lot 1 - W l 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 surfacez. '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. 2Common 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 all Parcel Stormwater Site Plan is Required Total Impervious Surface Area(sum of all are s) 1 If the Total Impervious Surface Area is LES H N 2000 Square F ,please read,acknowledge and sign below. Based Upon the information you have provide to er lan 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- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: 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. Page I of 2 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 Stoft Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" s 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/d ra infield system ybu 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 �4, �•�L�2 00 PLANNING: ALL SETBACKS ARE MEASURED FROM THE FURTHEST �► PROJECTION OF THE BUILDING Iko LANNING G 'su tic- 5y5 9N4 WwTPe PREviovSe-y r QQ,`�� ,`� �J � ..��_� �• ��6'Ira'1J;�t'•�� �Nt� INSS�CL�� co KJA Z 5� 10 �._. '' APPROVE( o MASON COUNTY DCD PLANNING \A 0- O SITE PLAN REQUIRED TO BE ON SITE Q CHANGES UBJECTTOAPPROVAL Date J _ o , e o• r A ••. s NcT� X s %d� RECEIVED 1 ty' R 2� 2011 MASON! COUNTY llkw TO C© G 9 A P 1+ �f i " ��3Qa n1; GRRRCs� -_-- �, i o 100 i 3S' I o ►o 4 3 oo BCpMD A T UP N 04/27/2011 08:54 3607698304 RITZMAN CONSTRUCTION PAGE 01 t RECEIVED ` IN L 7 2011 RITZMAN CONSTRUCTION, LLC MASON ` NTY. 7273 Danner Rd.S.E.,Part Orchard,WA 98367 (360)871-7454 Fax(360)769-8304 Fax To: l,Cr From Mike Ritzman Fa)u � ' ,� .�. Pages: 3 Pho„" 13 Urgent 13 For RwAaw A Please Reply Asup 0 Please comment •Comments: 47 2 7-he- /.o�/ �` f�LL-i GAL-- r G.��L,-7.1/t�-f/ ��! i�"/"A✓ .fn ��✓/� �. tea,( zl�' 04/27/2011 08: 54 3607698304 RITZMAN CONSTRUCTION PAGE 02 Harvey L., Miller, Jr. Post Office Box 95 Southworth, WA 98386-0095 26 April 2011 Building Department Mason County Post Office Box186 Shelton, WA 98584 Subject: Tompkins Detached Garage 631 NE Haven fake Drive Building Permit BLD 2011-00133 Gentlemen_ Enclosed is revised Sketch Page 8 of 10 showing changes in response to Items 1 and 2 of your Inspection Correction Notice of 25 April 2011 for the subject project. M14 WA 'Q OVAL Harvey L Miller, Jr Structural Engineer Enclosure: Revised Sketch 8 of 10 4ALCULATION: DATE: PAGE f -Lot I cv- c:r,,n-vD 14Q Pot-,, N\J CE 7 5z 12- All 0 L fD PIO,,Aj il,; SAP Iql T0 'Fii-j.6Tul*.,oZ --j 21 D `a MJ r Jay of w L2 A,IL \j IST K, -T- Sol L.- UP, h I ' MASON COUNTY Mason County Permit Center Use: G� DEPARTMENT OF COMMUNITY DEVELOPMENT DDR 2.D I 411 N. Fifth Street/P.O. Box 186, Shelton WA 98584 360.427.9670 ext. 352 Date Rcvd Off. 1A 12.011 Request for Administrative Variance for Reduction in the Required Setbacks (M 15.00) For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction requires a standard variance. Setbacks are measured from the furthest projection of the structure, including roof eaves. Applicant/Owners: O ✓l Mailing Address: U C City-� State: WA Zip: TelephoneQ31ed &11'' y8 IFj Email: If this reduction is tied to a building permit, please give permit case number. BLD 2,0 11 - 001� J Parcel Number(s): a�'�j3� ♦50 ' i0ion BF� Zoning Site Address: LQ 3 I n E 4 1 V.CA, 11WA5 priy e Requested setback variance: 5� ft. ❑ Front ❑ Rear Side ft ❑ Front ❑ Rear ❑ Side ft. ❑ Front ❑ Rear ❑ Side ft ❑ Front ❑ Rear ❑ Side Front Setbacks—From access easements and road right of ways. Minimum 10 feet. Rear Setbacks—From the rear property line. Minimum 10 feet. Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations. 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 areas, septic, well and driveway. Show all proposed new development. IACommunity DevelopmentTACNARIANCES\Admin Variance.doc Edited on 7/ FRONT AND OR REAR YARD REDUCTION REQUESTS: For existing lots of record as of March 5, 2002; You must meet one of the following: 2) One of the following exists on the lot (check all that apply): ❑ 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-fourth acre; ❑ e) existing improvements of buildings, septic systems, and well areas. SIDE YARD REDUCTION REQUESTS: For existing lots of record as of March 5, 2002; You must meet one of the following: 2) One f the following exists on the lot (check all that apply): a) steep slopes, wetlands, or streams present; ❑ b) soils that restrict building or septic development; ❑ c) lot width at the J, ont yard line of no more than 50 feet; 4l lot size of no more than one-half acre; e) existing improvements of buildings, septic systems, and well areas. Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2.5, 5, 10, or 20 zones. % ML �' - Owner/Agent(please indicate) 7- 9-c,j I Signa e Da O icial Use Only Approved by: Date Denied by: Date Reason for denial: IACommunity Development\PAC\VARIANCES\Admin Variance.doc Edited on 7/ ;1ASON COUNTY PERMIT NO. l/ '�` L BUILDING PERMIT APPLICATION ��4r1 }26 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 )}/ - �- (rRIST'tif (on?p iNS Company Name R1T-,z_W1AN Mailing Address _3 2 5 3 au rr _ Mailing Address?LZ3 City State_W Zip Code 9 R 3/C-) City PC&-0CC.i��r4&a State �_ Zip Code � Phone 60 -3 5 7-0$/ _Other Ph. Phone 360-C 7 f< '7`l S 4 Other Ph. Lien/Title Holder luoty Contractor Reg. #R[r?-ta4LLw i R Exp.TT 2 ,I z E mail address j Ik_ Taovje k f►jS a>m V5►.N I 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__X_Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No 727 o Fire District `2 Legal Description Site Address (Please include street name, street number and city) V t�µU Directions to site L� _`L v pyJ oin7 I KA%l 45 Will timber be cut and sold in parcel preparation? Yes/0 Sly 6-5 CrW — Is property within 200' of Saltwater Lake X River/Creek Pond 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 Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL Use of Building Describe Work No. of Bedroom No. of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor sement Deck Covered Deck Other Sq. ft. Garage ached Detached —.X—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 F CON7INUATI IS BY MEANS OF A PROGRESS INSPECTION. X r Date 2 2- n, wners Re rese ative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date �- O-ka lit DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department to E Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planninq Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES PERMIT NO. V A46011 * W!5�? MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670•Belfair(360) 275-4467•Elma(360)482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION OwnerCA41Go- + KA151_1QE Tdyt-yie DNS Company Name KfE jAAj �% c- C-'4\j ��- Mailin Address S 3 L� �£ ✓l� Mailing Address 72 73 13t4'N 6" K S r City GIZ►'n c�J State LA) Zip Code a 43/C7 City ��L ,�?State L J Zip Code c C 1 Phone.360-9 77- 0E1 t°3 Other Ph. Phone 3610-13 21 - 7�fS`4 Other Ph. Lien/Title Holder /�o�t� Contractor Reg. #P t t t- two 1 3UExp. 11_7- 1 Email address 0 K- TO*110 Ki&JS COM GAS 6/y�u 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 71 333 L73 73w 9 s Fire District Legal Description ItiW1-r J LI94-4F_ T'2S 815- P>`l Site Address (Please include street name, street number and city)#V ' 631 Po4Y&O L k OR V 9 _S_B b Directions to s)te/U -SHWE -P/�SV 960_'�K S`VI PPAR < TWAE SELEA-19 TA ��/1g fZc9 � 7ry►4N RICN ►v To Pc W v I- -0- Ord E 14 & *- PA23DIK IdA60i tTf-o Is property within 200' of Saltwater Lake X —River/Creek Pond R1 Gl Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New,__X__Add Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floor 2nd Floor Basement Garage_X.—Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fi es Fees Fuel Type:Electric—LPG_Natural Gas_Heat Pump_ Toilets (r - PROOFOFC07ATIOType of Unit No. of Units Fees Bathroom Si Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water HeateU Propane Tank Clothes WasGas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher I I Kitchen Exhaust Hood Hosebibs Dryer Vent Other / 1) � Other ase Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 parry 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.t��OF WO BY MEANS OF A PROGRESS INSPECTION ./ X I ' �. Date: L 2_L_7 i 1 I wn /Ow s epresentative/Nntractor (indicate which one) FOR OFFICIAL USE BEYONCITHIS POINT Accepted lanning Pd Ck# Date 2 Bld Pd Receipt No. DEPARTM NTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. 10 fi tA1( Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES I�