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Home My WebLink AboutBLD2024-01082 Retaining Wall - BLD Inspections - 4/24/2025 MASON COUNTY 615 W.Alder St.Bldg 8,SHELTON,WA 98584 i COMMUNITY SERVICES SHELTON:360-427-9670,EXT 352 BELFAIR:360-275-4467,EXT 352 Building,Plannin%Environmental Health,Communityilealth ELMA:360-482-5269,EXT 352 www.co.mason.wa.us INSPECTION CARD AND CERTIFICATE OF OCCUPANCY** To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bid-inspection.php Permit Number BLD2024-01082 Date Issued 09/12/2024 Issued By Project EMERGENCY RETAINING WALL REPAIR Site Address 10 N SUNDOWN DR Applicant ANDERSON DAVID E Contractor Contractor Phone Primary Code UPC IBC,IRC,IFC,IEC,IMC,& Type Permit Type BULKHEAD OR DOCK- Occupancy RESIDENTIAL -APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS. -DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED. -THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION,FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY. -ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION. -OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION. **THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.** PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET Public Works Access/Driveway Other Health Septic Well Deptartment Planning Site Inspection Department Fire Marshall Fire Apparatus Access Fire Sprinkler Auto Fire Alarm Hood and Duct Other Final Building Building Official: Community Services Designee Department Concrete Setbacks Slab Footing Perimeter R Point load Footing Footing Interior Footing Decks/Porches Foundation Stem Walls Other Rough-In Groundwork Plumbing Framing Groundwork Mechanical Plumbing Groundwork Gas Pipe Mechanical Gas Piping Shear Wall Nailing Underfloor Other Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Interior Wall Brace Panels Fire Walls Nailing Other Final Building H 11-511-57 ZN Manufactured Setbacks Setup Home Concrete Foot/Runners Final Other \C)VrA ti �- Fv�,A i-t":� �i. L61z11zkt ` I � MASON COUNTY INSPECTION RESULTS Page Department of Community Development COMMUNITY DEVELOPMENT 615 W Alder St,Shelton,WA 98584 ft—ft ft At-Center,Bu{Idin&,PI-tIt (360)427-9670 ext.352 Application S BLD2024-01082 Application Type BULKHEAD OR DOCK- Owner ANDERSON DAVID E RESIDENTIAL Parcel# 423185000011 Site Address 10 N SUNDOWN DR HOODSPORT,WA 98548 ,. x Inspector Inspection Type DateNki c 10/22/24 1.NO PLANS ON SITE.PLANS MUST BE ON SITE FOR ALL INSPECTIONS AND Nicole Norris BLD-FINAL INSPECTION 10/22/2024 FAIL ALL SPECIAL INSPECTION REPORTS MUST BE SUBMITTED TO MASON COUNTY BLD DEPT. CALL FOR REINSPECTION ONCE ITEMS ARE COMPLETE. INSPECTION RESULTS Page MASON COUNTY Department of Community Development COMMUNITY DEVELOPMENT 615 W Alder St, Shelton, WA 98584 Permit Assist in[e Center,Budding,Ptammng (360)427-9670 ext. 352 Application # BLD2024-01082 Application Type BULKHEAD OR DOCK- Owner ANDERSON DAVID E RESIDENTIAL Parcel# 423185000011 Site Address 10 N SUNDOWN DR HOODSPORT, WA 98548 Inspector Inspection Type Date Status Comments 10-29-24-J Q 1. plans that are on site are not the reviewed and county "approved " building plans. Please have the Approved RED STAMPED copy of your plans, site plan and geotechnical report available at the next inspection. Per the county permit conditions. 2. All special inspection reports are to be submitted to the county and a copy is to be on site prior to scheduling the final inspection per the county permit conditions. ** Please see county conditions pages that were signed for at the time of receiving the issued permit Joshua BLD-FINAL INSPECTION 10/29/2024 FAIL Quarders THIS IS NOT A COMPLETE INSPECTION CALL TO RE-SCHEDUAL INSPECTION WHEN CORRECTIONS ARE MADE BEFORE PROCEEDING WITH ANY FURTHER WORK 10/22/24 1. NO PLANS ON SITE. PLANS MUST BE ON SITE FOR ALL INSPECTIONS AND ALL SPECIAL INSPECTION REPORTS MUST BE SUBMITTED TO MASON COUNTY BLD DEPT. CALL FOR REINSPECTION ONCE ITEMS ARE COMPLETE. duso n 3t�IJ�oz�-b IoBZ �.G„; d �. GeoStabilization International P: 855.579.0536 1 F: 970.245.7737 www.geostabilization.com GeoStabilization International- April 171h, 2025 Mr. David Anderson 10 North Sundown Drive Hoodsport, Washington 98548 Project No. 244118WAON SUBJECT: CONCRETE COMPRESSIVE STRENGTH TESTING RESULTS FOR 10 N. SUNDOWN DR. [PARCEL 423185000011] SLOPE STABILIZATION, LAKE CUSHAMAN, WA CONCRETE MIX DESGIN Access Limited Construction"ALC" placed structural concrete for the slope stabilization using wet-process pneumatic application process. The Mix was provided by Miles Sand & Gravel of Puyallup Washington. Project requirements specified 3000 psi shotcrete in accordance with ACI 506.2. ALC placed Miles Sand & Gravel mix code 15SHOT4-5000; GSI reviewed the mix design finds it to meet project requirements. The mix design is Attachment One of this letter. CONCRETE STRENGTHS Per project requirements a shotcrete test panel should have been produced during initial placement. The test panel may have been produced but it was not submitted for compressive strength testing per ASTM C39. In lieu, ALC obtained 3 concrete cores directly from the in-place structure on 4/11/25. The cores were tested by Materials Testing & Consulting, Inc of Olympia Washington. The average compressive strength of 5320 psi is significantly greater than the project required 3000 psi. Please find the compressive strength test results in Attachment Two of this letter. tc Thank you, FF Aw AS GeoStabilization International, LLC °� Q. T r� O c.> Z Digitally signed by Jeff Segar =J GUS, i.0 E .p ✓'� •r �4 � Jeff.Segar@gss. 22024774 w Q ills o=GeoStabilization OCENG`�`�� Daten2 0 25 t025a -JeHSegar TURAL NAL 08.26:59-05*00' E`1 Derrick Hayes`, PE, GE Jeff A. Segar, PE, SE Principal Engineer Chief GeoStructural Engineer Licensed in OR ATTACH:1- Shotcrete Mix Design 2-Shotcrete Compressive Strength Test COPY. Project file. Jeff Segar, PE. SE(GSI),Jace Schluckebier AL C) GeoStabilization International. PO Box 4709, Grand Junction, CO 81502 1 Phone: 855.579.0536 Fax: 970.245.7737 Main Office Address: 543 31 Road, Grand Junction, CO 81504 GeoStabilization International •� 000* P: 855.579.0536 1 F: 970.245.7737 www.geostabilization.com GeoStabilization International- ATTACHMENT 1- CONCRETE MIX DESGIN GeoStabilization International. PO Box 4709, Grand Junction, CO 81502 1 Phone: 855.579.0536 Fax: 970.245.7737 Main Office Address: 543 31 Road. Grand Junction, CO 81504 VOFFICE:253.833.3705 FAX:253.833.3746 400 Valley Ave NE MILES Puyallup,WA 98372-2516 SAND&GRAVEL MIX SUBMITTAL Date Issued : 04/18/2025 Customer: Access Limited Con Project: 10 North Sundown Dr Slump: 3" max Mix I.D.: 15SHOT4 Design fc: 5000 psi Specific Batch weight SSD Material Absorption Gravity Material (Ibs) Volume 1.25 2.67 ASTM C-33#8 848 Ibs. 5.09 2.14 2.65 ASTM C-33 Sand 1,983 Ibs. 11.99 3.11 ASTM C-595 Type IL(Cement) 705 Ibs. 3.63 2.65 ASTM C-618 Class F(Fly Ash) 50 Ibs. 0.30 1.00 ASTM C-1602 Water 292.0 lbs. 4.68 %Air (design) 5.00% 1.35 MasterAir AE 90(AEA) 1- 20 oz. MasterPolyheed 997 or 980(MRWR) 13- 70 oz. W/C Ratio: 0.39 Density: 143.4 Design Volume: 27.05 Notes: •ASTM C 94(5.6)"The purchaser shall ensure that the manufacturer is provided copies of all reports of tests performed on concrete samples taken to determine compliance with specification requirements. Reports shall be provided on a timely basis." •Miles S&G does not accept data for concrete not tested in accordance with ASTM standards •Point of placement,for mix conformance,is at the end of the discharge chute of the mixer. •Miles S&G is not responsible for changes in the mix due to placement methods. •Concrete placed that exceeds the maximum design slump,is placed at the risk of the contractor and owner. `When NOT delivered by MILES,and MILES agrees to batch concrete based on Customer's order,the performance of the concrete becomes the sole responsibility of the Customer at the time of batching.Customer understands that MILES provides no representations or warranties,either express or implied,of merchantability,fitness for a specific purpose,or otherwise with regards to any concrete provided hereunder.Customer hereby knowingly and intentionally releases,indemnifies,and holds MILES harmless from and against any and all claims,actions,liabilities,and costs for performance,personal injury or property damage resulting from concrete provided hereunder. Remarks: shotcrete For the purpose of monitoring performance; in accordance with ASTM C-94, please send copies of all compressive strength reports to: Eliiah.Mayer(a_miles.rocks Submitted by: Sam Tomaro Miles Sand & Gravel Company WWW.MILES.ROCKS Y VOFFICE:253.833.3705 J FAX:253.833.3746 400 Valley Ave NE MILES Puyallup,WA 98372-2516 SAND&GRAVEL Concrete Cylinder Report Concrete Mix ID:IMUS1116, ACI 318 Performance Approval S ec'd Strength: 5,000 Modification Factor. 1.000 Number of Tests: 30 Standard Deviation: 966 Average Range(P51): 653 Fcr=Fc+1.34(s): 6,295 Standard Deviation: 966 Fcr=Fc+2.33(s)-500: 6 751 Coefficient of variation,V. 10.4% Within-Test Std Dev(PSI): 579 Within-Test Coeff.of Var. 6.2% Average 2.03 ', 62 32 5,470 7,040 Batch-to-Batch Std Dev(Psi): 773 Nax: 3.00 7.8% 88 72 8,140 9,290 Batch-to-BotchCoeff ofvar. 8.3% Min: 0.00 0.0% 0 0 3,280 5,580 Date Slump Air CT AT 7 Day 28 Da 1 03/11/25 2.25 7.0% 63 40 6,440 7,360 2 01/22/25 2.00 7.8% 61 30 6,270 7,550 3 10/28/24 2.00 5.5% 63 45 6,190 7,310 4 07/30/24 2.25 75 70 4,710 6,170 5 07/30/24 2.50 80 72 4,340 5,990 6 07/29/24 2.00 75 67 4,090 5,580 7 07/29/24 2.00 82 67 4,510 5,850 8 02/19/24 2.00 5.9% 58 43 8,140 9,290 9 02/08/24 1.75 4.5% 60 42 6,970 8,760 10 12/27/23 2.50 5.0% 65 32 6,310 6,900 11 11/02/23 2.25 71 59 7,130 9,000 12 11/02/23 2.00 67 56 7,190 8,630 13 03/31/23 2.50 7.2% 63 42 5,680 6,860 14 08/22/22 3.00 88 68 5,520 7,280 15 06/22/22 3.00 64 60 4,900 6,040 16 01/26/22 3.00 60 46 4,990 6,770 17 09/27/21 3.00 76 54 5,300 7,020 I8 09/27/21 3.00 76 57 5,060 6,820 19 08/17/21 6,480 6,330 20 11/06/20 3,280 5,980 21 10/07/20 6,530 22 06/18/20 1.50 5.4% 59 4,370 6,220 23 05/19/20 2.00 65 5,600 6,760 24 03/27/20 2.00 4.9% 62 4,720 6,730 25 03/26/20 1.75 4.8% 64 4,590 6,550 26 03/18/20 1.50 5.2% 64 5,790 7,120 27 03/18/20 2.00 69 6,180 8,100 28 03/18/20 2.00 70 3,920 7,340 29 03/16/20 2.00 69 4,800 6,290 30 09/27/19 3.00 5.2% 81 5,230 7,960 Miles Sand & Gravel Company WWW.MILES.ROCKS seoscemu=acia..i�ce...ecio.,ai vvv4w.geostabilization.com ATTACHMENT 2- CONCRETE COMPRESSIVE STRENGTH GeoStabilization International. PO Box 4709, Grand Junction, CO 81502 1 Phone: 855.579.0536 Fax: 970,245.7737 Main Office Address 543 31 Road, Grand Junction, CO 81504 Compressive Strength of Concrete Report 0#:CC15/200000 Report Date: 0 4:41-00 Test Method:ASTM C 39 Sample:3398 w TON"S T=Wn•COINULY06.Or- Olympia Client: Project: 2118 Black Lake Blvd.SW Access Limited Construction 25SO68 Olympia,WA 98512 1102 Pike Lane Q.C.-Sundown Anderson Slope Phone:(360)534-9777 Oceano,CA 93445 Lab Work Olympia,WA Sample Details Set#: 1 Technician: Contractor Batched: Specimen Size: 3"X 6" Cast By: Contractor Sampled: Specimens In Set: 3 Date Cast: 04/11/25 Cast: Truck/Ticket#: N/A/N/A Sampled From: Other Truck Empty: Contractor: N/A Placement Method: Placement Time: Location Placement Location: Various Location Details: Unknown Batch Log Specifications Strength: 0(psi) On-Site Admixtures: None Field Measurements Weather: Consistency: Slump Plastic Unit Weight: Air Temperature(F): Concrete Temp(F): Air Content: Load Volume: Lab Test Results Testing Lab:Olympia,2118 Black Lake Blvd.SW,Olympia,WA,98512 Specimen Test Test Field/Lab Average Cylinder Cylinder Max Load Strength Fracture Break Capping Number Age Days Date Cure Days Diameter(in) Area(in') (Ibs) (psi) Type Remark Method 1-1 4 04/15/25 4/0 3.69 10.69 56,032 5,110 1 G 1-2 4 04/15/25 4/0 3.69 10.69 64,829 5,860 1 G 1-3 4 04/15/25 4/0 3.69 10.69 56,043 4,990 1 G Test Age Average Strengths(psi):4 Day-5320 Capping Methods Tested By:Oly Lab(1,2,3) G:Gypsum Caps(ASTM C617) Checked In:04/15/2025(1,2,3) X M 9 E [I [I TYPE 1 TYPE 2 TYPE 3 TYPE 4 TYPE 5 TYPE 6 As a mutual protection to clients,the public and ourselves,all reports are submitted as the confidential property of clients,and Page 1 of 1 authorization for publication of statements,conclusions or extracts from or regarding our reports is reserved pending our written approval. Mason County Permit Document Reviewed for Code Compliance BLD2024-01082 Mason County Building Department Special Inspection Requirements 1 MASON COUNTY COMMUNITY SERVICES BLD2024-01082 Anderson Slope 10 N. Sundown Drive, 423185000011 Permit Number Project Title Project Address/Pareel Number Applicants of projects requiring Special Inspection or Testing per Chapter 1704&1705 of the International Building Code, as amended by Washington State. Please acknowledge and return this form to the Mason County Permit Center. THESE INSPECTIONS ARE NOT PERFORMED BY THE BUILDING DEPARTMENT AND MUST BE PERFORMED BY QUALIFIED SPECIAL INSPECTORS, HIRED BY THE OWNER AND APPROVED BY THE COUNTY PERMIT CENTER. Individuals certified in a special inspection category by Washington Association of Building officials(WABO)or individuals employed by a recognized testing laboratory and under the direct supervision of a Registered Professional Engineer are typically considered qualified at the discretion of the local jurisdiction having authority for enforcement. BEFORE A PERMIT CAN BE ISSUED: The Owner or his/her representative, on the advice of the responsible Project Engineer or Architect, shall fill out completely, sign and submit two (2) copies of the attached "Structural Tests and Inspection Schedule"to this Department for review and approval including any requirements related to the Mason County Municipal Code. The Owner, General Contractor, and Inspection/Testing Agency, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing. 1. Inspection/Testing Agency shall submit names and qualifications of on-site Special Inspectors to the Building Inspection Permit Center for approval PRIOR TO PERMIT/S BEING ISSUED. 2, All Special Inspections shall be noted on the approved plans or attached approved documents. 3. All special inspections shall be approved by the County or as recommended by the Engineer of Record (EOR). 4. It is the responsibility of the General Contractor to review County approved plans for additional inspection or testing requirements that may be noted or required per IBC as noted on approved plans. 5. The General Contractor is responsible for proper notification to the Inspection/Testing Agency for items listed on this form. 6. Special Inspectors shall provide detailed reports on company letterhead to the Building Inspector of all required inspection activities. These may also be provided when the inspector visits the jobsite for the scheduled inspection but must be completed before the subject of inspection is approved by the building inspector. 7. Copies of all ongoing laboratory and testing reports shall be sent directly to the Building Inspector by the Inspection/Testing Agency or other responsible party within a reasonable time to test results. 8. BEFORE A CERTIFICATE OF OCCUPANCY APPROVAL CAN BE ISSUED: The Inspection/Testing Agency shall submit a FINAL REPORT LETTER stating that all items requiring testing and inspection have been fulfilled and reported and a final inspection report shall be provided. A copy of the statement is to be maintained at the jobsite for the Building Inspectors review prior to final inspections. Page 1 of 4 Y Special Inspection Requirements MASONCOUNiY wadi COMMUNITY SERVICES ACKNOWLEDGEMENTS Prior to issuance of a building permit, the Owner, on the advice of the Project Engineer or Architect, shall complete,sign,and submit this form to the County Permit Center. Declaration of Owner I,as the owner of the project,declare that the testing agency firm/s or individual/s listed herein are hired by me to perform "Special Inspections" and/or"Structural Testing" in accordance with the provisions of the International Building code(IBC)Chapter 17. Owner(print) Owner(Signature) (date) Declaration of Registered Professional Architect/Engineer I, as the design professional in responsible charge of the project listed herein, declare that the special inspection listed herein are required for this project in accordance with the provisions of the International Building Code(IBC) Chapter 17. Jeff A. Segar, PE, SE o WAS ti °F Architect/Engineer(print) cl �e o z Architect/Engineer Stamp/Signature(date) o , Digitally signed by Jeff Segar ?G 22024774 �cz DN:C=US,E=Jeff.Segar@gsi.us, 0�� cTURALENGI 1� O=C-+eoStabilization International, NAL��G CN=Jeff Segar Date-2024.09.09 13:18:18-05'00' Testing Agency Name/Contact Building Department spoke with owner on 9/10/24. info: Owner stated FOR to conduct special inspection. See attached special inspection schedule attached The Special Inspection/Testing Agency listed above must have a current Portfolio of Qualifications on file with the County prior to performing work. Declaration of the General Contractor I,as the General Contractor of the project,agree to comply with the"Contractor Responsibility"items noted herein. General Contractor(print) General Contractor Signature (date) Page 2 of 4 Special Inspection Requirements MASON COUNTY .. _ . COMMUNM SHRVICis See attached Special Inspection Table Required Special Inspections International Building Code; Chapter 17: A completed and signed copy of pages 1 through 4 of this form shall be submitted to the "Permit Center' prior to building permit approval. Engineer shall check the applicable items: ❑ Special inspection of fabricated items 1704.2.5 ❑ Submittals to the building official 1704.5 ❑ Structures over 75' in height located in Seismic Design Category D, 1704.6.1 ❑ Structures classified as Risk Category III or IV located in Seismic Design Category D, 1704.6.1 ❑ Steel construction&structural Steel 1705.2.1 ❑ Cold form steel deck 1705.2.2 ❑ Open-web steel joists &girders 1705.2.3 ❑ Cold form steel trusses spanning 60 feet or greater 1705.2.4 ® Concrete construction 1705.3 &Table 1705.3 t4 Shotcrete 1705.3 ❑ Welding of reinforcing bars 1705.3.1 ❑Material Tests 1705.3.2 ❑Masonry Construction 1705.4 ❑Empirically designed masonry, glass unit&masonry in Risk Category IV 1705.4.1 ❑Vertical masonry foundation elements 1705.4.2 ❑Wood construction 1705.5 ❑High Load Diaphragms 1705.5.1 ❑Metal-plate connected wood trusses spanning 60 feet or greater 1705.5.2 ❑ Soils 1705.6&Table 1705.6 ❑Driven deep foundations 1705.7&Table 1705.7 ❑ Cast in-place deep foundations 1705.8 &Table 1705.8 ❑Helical pile foundations 1705.9 ❑ Fabricated items 1705.10 Page 3 of 4 Special Inspection Requirements MASON COUNTY Asliak AL COMMUNM SERVICES See attached Special Inspection Table ❑ Special inspections for wind resistance 1705.11 ❑ Structural wood 1705.11.1 ❑Wind resisting components 1705.11.3 ❑ Cold formed steel light frame 1705.11.2 ❑ Special inspection for seismic resistance 1705.12 ❑ Special inspection for structural steel per 1705.12.1 ❑ Seismic force-resisting systems 1705.12.1.1 ❑ Structural steel elements 1705.12.1.2 ❑ Special inspection for structural wood per 1705.12.2 ❑ Special inspection for cold-formed steel per 1705.12.3 ❑ Designated seismic systems 1705.12.4 ❑Architectural components 1705.12.5 ❑ Plumbing,mechanical& electrical components 1705.12.6 ❑ Storage racks 1705.12.7 ❑ Seismic isolation systems 1705.12.8 ❑ Cold-formed steel special bolted moment frames 1705.12.9 ❑ Testing for seismic resistance 1705.13 ❑ Structural steel 1705.13.1 ❑ Seismic fore-resisting systems 1705.13.1.1 ❑ Structural steel elements 1705.13.1.2 ❑Nonstructural components 1705.13.2 ❑ Designated seismic systems 1705.13.3 ❑ Seismic isolation systems 1705.13.4 ❑ Sprayed fire-resistance materials 1705.14 ❑Physical and visual tests 1705.14.1 ❑ Structural member surface conditions 1705.14.2 (1705.14.3 through 1705.14.6.3) ❑ Mastic&intumescent fire-resistance costings 1705.15 ❑ Exterior insulation&finish systems(EIFS) 1705.16 ❑Fire-resistance penetrations and joints 1705.17 ❑Penetration firestops 1705.17.1 ❑ Fire-resistant joint systems 1705.17.2 ❑ Testing for smoke control 1705.18 ❑ Testing Scope 1705.18.1 Page 4 of 4 i IV Project Quality Inspection and Testing an Anderson Slope: 10 N. Sundown Drive Parcel: 42318S000011 244118WAON To whom it may concern, The following table shall be used during construction for the above-entitled project. SPECIAL INSPECTION REQUIREMENTS TYPE FREQUENCY REFERENCE IBC CONTINUOUS PERIODIC STANDARDS STANDARDS Submittals to Building Officials: - - 1704.5 Shotcrete mix design Verify use of required mix design Prior to placement ACI 318 1904.2, 1908.1 Inspect shotcrete placement Initial placement ACI 318:26.5 1908.1 technique Shotcrete Panel:24"x24"x6" Initial placement ASTM 1140M Shotcrete compressive strength - 28 day ASTM C39 Soil Nail grout mix design:mud - Once per day during ASTM D4380 balance drilling Soil nail testing - X - By Engineer MASON COUNTY Permit No:l7td 1 o L4- 01052 COMMUNITY DEVELOPMENT Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:David E.Anderson NAME:Robar%tf<gerson MAILING ADDRESS:3223 Donnelly Dr.SE MAILING ADD S:10225 stmoor Drive,Suite 205 CTTY:Olympia STATE:WA ZIP:98501 CITY:Westminster ATE:CO ZIP:80021 PHONE#1:(240)620-3627 PHONE:(855)579-053 CELL: (206)458-8213 PHONE#2:(206)852-2478 EMAIL:rob@gs' EMAIL:pidave27@gmail.com L&I REG EXP. PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑ NAME Use Property owner Information above EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 423185000011 ZONING LEGAL DESCRIPTION(Abbreviated) Lake Cushman#3 TR 11 FIRE DISTRICT 18 SITE ADDRESS 10 N.Sundown Dr. CITY Hoodsport DIRECTIONS TO SITE ADDRESS US highway 101 N,L on Lake Cushman Rd.to Sundown Dr. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESQ NO❑ SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR 0 OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) IS USE: PRIMARY❑ SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(Whole Bldg)Q YES(Part[sl of Bldg)❑ NO❑ DESCRIBE WORK repair retaining wall SQUARE FOOTAGE:(proposed) 1 ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES 0 NO❑ Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOE] EXISTING SQ.FT. EXISTING BEDROOMS 2 PROPOSED BEDROOMS N/A TOTAL BEDROOMS 2 OWNER 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 and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,Including any easement holder or parties of Interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permitlapplication becomes null&void if work or authorized construction Is not commenced within 180 days or If construction work Is suspended for a period of 180 days. 7ERM71 F CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS APPLICATION OF 80 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY Permit Nw1,411 l AM- 0I0S2 COMMUNITY DEVELOPMENT Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:David E.Anderson NAME:Robert ' gerson MAILING ADDRESS:3223 Donnelly Dr.SE MAILING ADD S:10225 stmoor Drive,Suite 205 CITY:Olympia .STATE:WA ZIP:98501 CITY:Westminster ATE:CO ZIP:80021 PHONE#1:(240)620-3627 PHONE:(855)579-053 CELL: (206)458-6213 PHONE#2:(206)852-2478 EMAIL:rob@gs' EMAIL:pjdave27@gmail.com L&I REG EXP. PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑ NAME Use Property owner Information above EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 423185000011 ZONING LEGAL DESCRIPTION(Abbreviated) Lake Cushman#3 TR 11 FIRE DISTRICT 18 SITE ADDRESS 10 N.Sundown Dr. CITY Hoodsport DIRECTIONS TO SITE ADDRESS US highway 101 N,L on Lake Cushman Rd.to Sundown Dr. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESQ NO❑ SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE E] RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR 0 OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Eta) IS USE: PRIMARY❑ SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part[s]ojBldg)❑ NO❑ DESCRIBE WORK repair retaining wall SQUARE FOOTAGE:(proposed) I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC El SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE?, YES 0 NO❑ Ijyes,attach completed Water Adequacy Form PERIIvfETER/FOUNDATION DRAINS PROPOSED? YES❑ NOE] EXISTING SQ.FT. EXISTING BEDROOMS 2 PROPOSED BEDROOMS N/A TOTAL BEDROOMS 2 OWNER 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 and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,Including any easement holder or parties of interest regarding this project.The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void If work or authorized construction is not commenced within 180 days or If construction work Is suspended for a period of 180 days. PROOF,OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTMTY OF THIS (' ERMIT APPLICATION OF)l80 DAYS OF MORE WILL CAUSE THE APPLICATIO`N7 TO BE EXPIRED.(MASON �� v�' "✓ COUNTY CODE 14.08.42) /�J/ � X y Signature of OWNER(Must be sinned by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY Permit N°: I d aoa+ DlUSZ COMMUNITY DEVELOPMENT Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:David E.Anderson NAME:Robert gereon MAILING ADDRESS:3223 Donnelly Dr.SE MAILING ADD S:10225 stmoor Drive,Suite 205 CITY:Olympia STATE:WA ZIP:98501 CITY:Westminster ATE:CO ZIP:80021 PHONE#1:(240)620-3627 PHONE:(855)579-053 CELL: (206)458-8213 PHONE#2:(206)852-2478 EMAIL:rob@gs' EMAIL:pjdave27@gmaA.com L&I REG EXP. PRIMARY CONTACT: OWNER E] CONTRACTOR❑ OTHER❑ NAME Use Property owner information above EMAIL MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 423185000011 ZONING LEGAL DESCRIPTION(Abbreviated) Lake Cushman#3 TR 11 FIRE DISTRICT 18 SITE ADDRESS 10 N.Sundown Dr. CITY Hoodsport DIRECTIONS TO SITE ADDRESS US highway 101 N,L on Lake Cushman Rd,to Sundown Dr. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESD NO❑ SNOW LOAD:_Psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE I] RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR 0 OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) IS USE: PRIMARY❑ SEASONAL E] NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(Whole Bldg)E] YES(Partla)ajBldgl❑ NO❑ DESCRIBE WORK repair retaining wall SOUARE FOOTAGE:(proposed) I ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE?, YES I] NO❑ Ijyes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NOO EXISTING SQ.FT. EXISTING BEDROOMS 2 PROPOSED BEDROOMS NIA TOTAL BEDROOMS 2 OWNER 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 and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permitlapplication becomes null&void if work or authorized construction is not commenced within 180 days or If construction work Is suspended for a period of 180 days. PRO "F CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTMTY OF THIS e�PERMIT APPLICATION OF 80 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X 0/z'31 x:�y Signature of OWNER(Must be sinned by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE I TAGS/NOTES/CONDTITONS BUILDING DEPARTMENT -�(�•2 PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH 0 Total Balance Due: $ H 64 .�4 Permit M 31d 2-624 - 61002- Applicant: t7Iq wlel /A nd"6o n Checked Contractor's Registration Who was contacted?: Date Contacted : Via Phone or Email?: Contacted by: 1�1�U1G'� �- Id•2�-I Other Associated Cases Fee Amount (3 I TN.. 5,. -- TOTAL: $ �� 6I .54 11�llafi$VN"�wlYY. �0�M-UVT UNITF l' M!*r sc i MsorrQnky.l;ldgj ,:6fildttieet. �,�' � S•h��texn,,.i�ir�,9�5�� . C## UEUI;�;t1 PE'�l '1' #� lTt�l '9�•a Ana .•' .. :......:: ..:. . . . ....: . . . I M Nfilt�tfii � 'e� � � " I!V9 2 :.;fit�sttttde$Lt ( .Mtia LlW?tt83F!@�E; f0]C1 >3�iJtJf�ti¢ e1 repaC 'EtprfiFftrer� ga f nfative r TAhr•r•0wo.6to i Ax roc v nc h .irt it a rafli1tR , ��i:u�afv.. :ood docram lffia'. tYeez' ty �s : dieova :naax+ e A$ettfi: j Mason County Mason County - Division of Community Development 615 W.Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov B DD2024-01082 BULKHEAD OR DOCK- RESIDENTIAL PROJECT DESCRIPTION: EMERGENCY RETAINING WALL REPAIR ISSUED: 09/12/2024 SITE ADDRESS: 10 N SUNDOWN DR HOODSPORT EXPIRES: 03/11/2025 PARCEL: 423185000011 APPLICANT: ANDERSON DAVID E OWNER: ANDERSON DAVID E 901 MOUNTAIN VIEW DR 901 MOUNTAIN VIEW DR SHELTON,WA 98584 SHELTON,WA 98584 1.240.620.3627 VALUATIONS: FEES: Paid Due Project Valuation (BID, 50000.00 $50,000.00 Technology Surcharge $23.00 $0.00 ESTIMATION..) State Fee-Residential $6.50 $0.00 Plan Check Fee $453.06 $0.00 Planning Residential Review $275.00 $0.00 Fee Building Permit Fee $697.01 $0.00 Total: $50,000.00 Totals : $1,454.57 $0.00 REQUIRED INSPECTIONS Foundation Wall-Pre-Pour Inspection BLD-Final Inspection CONDITIONS The stamped 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, 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 Department prior to any further inspections being performed or approvals granted. All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor increase the velocity flow entering or abutting to any state or county culverting/ditching system or road way. 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. Printed by:Genie Mcfarland on:09/12/2024 11:48 AM Page 1 of 3 Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BULKHEAD OR DOCK- RESIDENTIAL BLD2024-01082 * 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 charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. * 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 contact the Mason County Public Works Department prior to construction at Ext 450 * All building permits shall have a final inspection performed and approved by 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. * All other necessary permits from Mason County, Washington State, Federal Agencies, and/or other agencies/groups that are required for this proposed development and construction must be obtained PRIOR TO DEVELOPMENT AND CONSTRUCTION. * Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Code 14.28 and 14.17. * All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may grant one or more extension of 180 days, upon the receipt of a written extension request prior to permit expiration. Letter must indicate that circumstances beyond the control of the permit holder prevented action from being taken. * All construction must meet or exceed all local and state ordinances in addition to 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. * 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. * 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 1-800-647-0982.The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. * 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION UNLESS OTHERWISE APPROVED. * All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. Printed by:Genie Mcfarland on:09/12/2024 11:48 AM Page 2 of 3 Mason County Mason County - Division of Community Development 615 W.Alder St. i10 Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BULKHEAD OR DOCK- RESIDENTIAL BLD2024-01082 * The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. All applicable recommendations and specifications shall be applied to the development on this site. Any deviation requires stamped written approval from the registered design professional responsible for the report/assessment, and may require special inspection by same. Structures and/or land modifications (grading, cuts, fills, etc.) required in the geotechnical report/assessment, may require a separate permit. The geotechnical report/assessment shall remain attached to the approved building plans. * In addition to the inspections required in IBC, Section 110, the owner, the engineer or architect of record acting as the owner's agent shall employ one or more special inspectors who shall provide inspections during construction on the types of work listed under Chapter 17 and as specified by the design professional. The special inspectors duties& responsibilities shall be as specified in Chapter 17. Special inspection reports shall be submitted to the Mason County Building Department, 615 W Alder St, Shelton WA 98584 and available for inspection. Inspection reports shall be completed and submitted to the dept. in a timely manner and shall be submitted prior to the framing and final occupancy inspections. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state/local law regulating construction or the performance of construction. Issued By: Contractor or Authoriz 4dgent: ��=�1�- � Date: Printed by:Genie Mcfarland on:09/12/2024 11:48 AM Page 3 of 3