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Home My WebLink AboutBLD2005-00824 Cancelled Convert Upper Storage Area to Living Space - BLD Permit / Conditions - 9/28/2016 Inspection Line(360)127-7262 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 RESIDENTIAL BUILDING PERMIT BLD2005-00824 OWNER: MIKE BROWN RECEIVED: 5/19/2005 CONTRACTOR: LICENSE: EXP: ISSUED: 7/7/2005 SITE ADDRESS: 1431 NE COLLINS LAKE DR TAHUYA EXPIRES: 1/7/2006 PARCEL NUMBER: 223315100016 LEGAL DESCRIPTION: COLLINS LAKE#2 TR 16 PROJECT DESCRIPTION: DIRECTIONS TO SITE: CONVERTING UPPER STORAGE AREA TO LIVING SPACE. COLLINS LAKE DRIVE TO VERY END - PROPERTY ON LEFT. General Information Construction &Occupancy mation Square Footage Information No.of Bedrooms: Type of Cons r.. V-B Type of Use: SF Insp. Area: No. of Bathrooms: Occ. G R-3/ U Lot Size: Deck: Type of Work: REM Fire Dist.: 2 No. of Stories: 2 Occ Lo Building:984 Garage-Attached 984 q Valuation: Building Height: 26 cc. S s: Primary Basement: Manufactured Home Information Setback Inf ation_ Shoreline& Planning Information Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body: SEPA?: Rear: Ft. SIo t: Ft. Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Year: Sepal No.: Side 2: Ft. Comp. Plan Desig.: Plumbing Fixtures FEES IUI -hanical Fixtures Type Qty. Type e By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee CMH 5/19/2005 $306.83 B12005 Hosebibs 2 Gas Outlets 2 Building State Fee MRG 6/1/2005 $4.50 S22005 Kitchen Sink 1 Propane Tank -N"". 1 Building Permit Fee MRG 6/1/2005 $472.05 S22005 Lavatories 1 Propane Stove 1 Plumbing Fee MRG 6/1/2005 $61.00 S22005 Showers 1 Dryer Vent 1 Plumbing Base Fee MRG 6/1/2005 $20.00 S22005 Water Closets (Toilets) 1 ' Mechanical Fee MRG 6/1/2005 $91.50 S22005 Water Heaters 1 �. Mechanical Base Fee MRG 6/1/2005 $23.50 S22005 Bath Tubs 1 ,. EH Plan Review CEW 6/27/2005 $75.00 S22005 Clothes Washer 1 Total $1,054.38 BLD2005-00824 Please referto the following pages for conditions of this permit. 1 of 4 i _ CASE NOTES FOR BLD2005-00824 CONDITIONS FOR BLD2005-00824 1) 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 Dep;altment prior to any further inspections being performed or approvals granted. X 2) 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 insFechons. F, 3) 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 rerrjq�al of approved documents will result in failure of required building inspections. X�� 4) 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 134P.fN Department prior to any further inspections being performed or approvals granted. X '.��' 5) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: IV, Window (Max U-Factor):0.40, Skylight (Max U-Factor):0.58, Do,?n'�(Type/Max U-Factor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10. X I,,f�' 6) In buildings of unusually tight construction, fuel-burning appliances (excluding cooking appliances and domestic clothes dryers) shall obtain combustion air fm"M outside in accordance with the international codes. x BLD2005-00824 Please refer to the following pages for conditions of this permit. 2 of 4 7) Stock Plan Identification number: _This project is approved subject to the provisions identified the Mason County Stock Plan Policy. The site plan approved by the Planning Department, original building plans, and all attachments approved by the Mason County Building Department shall be available for the Mason County Building Insppctor at each required inspection. X RZ) I 8) 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. X Phio 9) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. X114411) 10) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All Propane tanks between 125 and 500 gallons must be located a minimum of 10'from any building, property line, public way, possible source of ignition (electrical outlets, electrical fixtures, compressors, etc), and/or any weeds, grass, brush, trash or any other similar combustible materials. If a propane tank is exposed to prob�le vehicular damage, protective bollards must be installed. i X 111) Fuel piping shall be inspected after the installation of fuel piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall notbq used until the final inspection has been performed and approved by a Mason County building inspector. X �Yi�r' 12) The placement of small propane tanks are not normally subject to a permit review by the Planning Department; however, propane tanks are subject to Planning Department regulations. Such regulations primarily consist of setbacks from shorelines and features considered to be critical areas (streams, wetlands, slopes, etc.) If you think wph features exist on or nearby your property, please contact the Planning Department so that exact setback requirements can be determined. X� 13) 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 Ma§,on County ordinances and building regulations. X (r. 14) 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 hold5r have prevented action from being taken. No more than one extension may be granted. X , I BLD2005-00824 Please referto the following pages for conditions of this permit. 3 of 4 TI ispemiit 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 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 prcjp rty anti structure for review and inspection. OWNERORAGENT: ' t, DATE: BLD2005-00824 Please referto the following pages for conditions of this permit. 4 of 4 s ti '7' o CONCRETE MECHANICAL MANUFACTURED HOME Footings/Sucks N CD Date 3-j By/G Ribbons C) Date 7 Gag Piping Date By � Foundation Wails Date By Set-up Date By INSULATION Date By BG%Slab Insulglon Floors FINAL I NSPECTION Date BY Date By Date By FRAMING "is FIRE DEPARTMENT Date - By T Date c -/ .;'c-. By rl Date By PLUMBING Attic OTHER GroundworkorGroundworkDate R 2T bG By Date -,f.,5�r-By WALLBOARD NAILING Date By D.W V Date 3 .z 3G� By Water Line FINAL INSPECTION ' '^ Date By Date _3)3j bC� By L1Qk— Date By m s Type of Insp. Pass[Fail Request Date Inspect. Date Done By Comments 0 v, /ass O a Z o 0CD E'r + � Or, ry �� 1�1L � m JTT7Fv fl VI/ �uiidirig Permit # P-s--�� 4 MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location ,l li 4 / 3 / CC> C-C--/en/s c_,/v This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance 'T/ c�> v i L J3=L�v� � �pc�i/-✓C,� i4/P,� /f'�'t�t�/!,�O �4i G i�/O /S'� 8' �Z tr/c> C� e-'4/G 3/ ' 8' `' o/1 /j,E S�l�n� T C -91-11� CC' - � i/� y.l' f ✓�'�i9MS r 7� You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department - 2 Date 7 Z L —01 _ Inspector moos E44T M44V T 1 - , TA o 05/Puilding Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location )143) N: r' Ca(AK S iA I IR-� A This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been f o u �: Items Listed belo must be corrected to gain code compliance 4 �ctc� Se.►�—� �-� �� .' w,�Tom.t �• T�'v 1H�� I.• � � �' M�►� ate- �•. ,� �o ,ram All ✓L C I�G�� 'ri /' iC/�k� t/� r ,v► ✓► l wS�r4 I f' 'NL 514 Q i r 90 s Q— �� cbV VGa Ll i(yA e-4 iJ r N� ` Mari G ►- �r� 1 s -�o lam—, � - You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department Date Inspector Dn NOT REMnVE THIS TAG 13(ilding Permit # r-.LS' '� MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTI E Job Location /3�6=4 �`�/ C�� l3 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been f nd: Items Listed below must be corrected to gain code compliance llic� � ova M You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing Make corrections, items will be checked on next inspection OK to Cl C/,� -l"�c�S 1�T C�/'9 -( . This is no(a complete inspection Department 1�C Date Inspector 772- . DO NOT .MOVE T 1 ,,qw TAG Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location y31 )V,C ��1�,�s L/L Q�, Ef6l-j Al If This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found Items Listed below must be corrected tp gain code compliance OVA (L1 0-14 ors; Ce,12 fyo" R r ex,.,oeA 0ria-r— Grz*K C'ra ia� ,7,o La v r S u". .c-ttit( �rt— -t collar- a-t L,i�c s-fL)� ��7,1^w -p (�u� Qit 71/1 , T 6-b !✓ (S k a 1 f "efc c l e, f Plod L, V— all c�lo•�u, l �� r- ��.clu �' have �a�� s,rr,4 ke•2 elt Dn L;z�' r �ls ark. & ✓,,crk�, You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing �Q Make corrections, items will be checked on next inspection OK to '"�-e.,p C1 C41 ❑ This is not�a complete inspection Department SLJ) Date — ' Inspector LM-- ■ �� V 4 OT ► lpmM44V T t T ' ,slqi EMS ■ RonM r. ON ■ I■■■■MEMO OEM MEMEN MEINME MINES 111�OO■■�1Mi■� ME ■ ■ N■■ ■■■■ ■Ne ■u■■1■ , ■■■■■■■■E" ■■■MM■■■N M■■ON ON N---a 0 0 1 M■MM ■111NM■■■/.I111' I■■M2 MONO■■■ i ■ 1 M■NNE 111 1IS MMWtl �i1 1�■■ ■ t�� ■ loil■ �!' mm" ll M ■ L MIMI , ��1i ■1oil l� �MM 11 111 ■■■ ■ . • I�� w■■MOM■M ■MOM■ -; . : : ■�fili� ,��MM MOON■■ ■ Mfg /�IMM a ■■ ■ ■ ■ ■ MMM ■MOM■■■ ■ r., y iIy ■■ �� .. .:......�.......�_�■I MONO■ ■ Ono I MEN sm ■ • ■�tlMEN No om OEMline SPA I��I:�II®i�iiilj�NEiii■iiiei�lt , I■■■■■ ■■ ■■■■■■■■�ii ■■■■■■ ��ii■■ a ■■■■■ ONE ■■■ ■ I ■■■■■■■■■■ III■■■■■ am ---- ■_■■_■t._ ■■■■■■■ -��■� r ■■ ■■■■■■■■N I ■■■OMEN R Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar P.O. Box 186 (360) 427-9670 Local (360)482-5269 Elma rioShelton, WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection November 07, 2007 MIKE BROWN 16201 THIRD AVE. NE SHORELINE WA 98155 Case No.: BLD2005-00824 Parcel No.: 223315100016 Protect Description: CONVERTING UPPER STORAGE AREA TO LIVING SPACE. The Mason County Department of Community Development is currently reviewing all permits that are expired and have not been approved for occupancy and use. Pursuant to Mason County Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required under the 2006 International Building Code and your property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections will result in enforcement actions. To bring your site into compliance, you must schedule an inspection. One (1) $64.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you will be charged $64.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 359. Sincerely, Terry Ryan Mason County Department of Community Development Cc: Property File November 07, 2007 BLD2005-00824 3/23/2006 Case Activity Listing 7:1o:s7AM Case #: BLD2005-00824 Assigned Done Activitv Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By BLDA010 Application Received 5/19/2005 5/19/2005 None DONE CMH 5/19/2005 CMH BLDB201 More Info Letter-EH 5/26/2005 None DONE CEW 5/26/2005 CEW BLDB210 Water Adequacy 5/26/2005 6/9/2005 None DONE CEW 6/9/2005 CEW need signed wa6/9/05remodel BLDB110 Building Plan Review 5/19/2005 6/14/2005 None DONE MRG MRG 6/14/2005 MRG Needed a deck plan to complete the permit with me.MRG notified about correction 6/l/05 mrg BLDA800 Documents Received 6/15/2005 None DONE RTB 6/15/2005 RTB recieved water adequacy form forwarded to CEW 6-15-05 RTB BLDB201 More Info Letter-EH 6/16/2005 None DONE CEW 6/16/2005 CEW The septic system is on a different parcel than the building.We will need a recorded declaration for onsite sewage BLDB200 Environmental Health Review 5/19/2005 6/27/2005 None DONE CEW 6/27/2005 CEW need approved 2br septic design 6/16/0 5 septic system being used is on different parcel.Will need a recorded declaration.Need satis maint report.6/27/05rec recording and satis pumpers report 131-DA100 Approved for Issuance 6/29/2005 None DONE CMH 6/29/2005 CMH BLDA500 Issue Building Permit 7/7/2005 None DONE KKK 7/7/2005 KKK BLDA540 Print Inspection Card 7/7/2005 None DONE KKK 7/7/2005 KKK Page 1 of 2 CaseActivity..rpt 3/23/2006 Case Activity Listing 7:1o:s7AM Case #: BLD2005-00824 � olo Assigned Done Activitv Description Date i Date 2 Date 3 Hold Disp To By Updated Updated By BLDC110 Footing Inspection 7/4/2005 7/8/2005 None FAIL TFR 7/14/2005 KLW FOOTING AND BG DWV FAIL, 1.PLANS SHOW 6 X 20 GLUE LAM AT 31'8"OFF WALL FROM STREET LAMIS NOW AT 15'-8"I THINK YOU PLAN ON MOVING IT OUT IF SO I BELIEVE 3 FOOTINGS ARE REQRUIED AT GRID 15'8"AND TWO AT GRID 31'8"OR RESUBMIT PLANS SHOWING CORRECT LOCATIONS OF BEAMS AND#OF APPROVED POSTS AND LOCATIONS,5 SHOWN NOW ONLY 3 INSTALLED,2.ALL DWV EXPOSED TO CONCRETE MUST BE SLEEVED,DO NOT POUR. BLDC110 Footing Inspection 7/11/2005 7/18/2005 None PASS TFR 7/20/2005 KLW FOOTING AND BG DWV PASS BLDC120 Underground Plumbing 7/11/2005 7/18/2005 None PASS TFR 7/20/2005 KLW BLDC140 Framing/Plumbing/Mechanical 3/9/2006 3/13/2006 None FAIL LDK 3/14/2006 MRB SUPPY PASS--DWV/FRAME/MECH FAIL 1.FIRE BLOCKING NEEDED AT TUB DRAIN 2.REMOVE AND REPLACE SANTEE IN HORIZONTAL POSITION AT TUB DRAIN WITH COMBO OR WYE 3.INSTALL SOLID BLOCKING AT MAN DOOR ON UPPER FLOOR BETWEEN HEADER AND TOP PLALTE 4.REPLACE PAPER FLEX DUCTING IN ATTIC WITH METAL FLEX OR RIGID 4"DUCTING 5.KITCHEN HOOD DUCTING TO BE 6"RIGID PIPING ALL DUCTING TO BE SEALED AT JOINTS AND WITH 3 SCREWS PER JOINT EXCEPT DRYER DUCTING 6. WILL NEED TO INSTALL FRESH AIR 80S OR 200S BY FINAL IN EACH HABITALBE RMS BEDROOM/LIVING AREA 3 REQUIRED 7.DRYER DUCTING NOT RAN 8.CAULK AND SEAL NOT COMPLETED 9 COMBUSTION AIR FOR FIRE PLACE NEEDS TO BE RAN TO EXT BLDA510 Reprint Building Permit 3/23/2006 None DONE PIB 3/23/2006 PIB Page 2 of 2 CaseActivity-rpt MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Permit Assistance Center SHELTON (360)427-9670 BELFAIR(360)275-4467 Elma (360)482-5269 FAx: (360) 427-7798 WEB SlTE:.www.co.mason.wa.us P.O. Box 186, SHELTON 98584 2003 Washington State Energy Code (WSEC) 2003 Ventilation and Indoor Air Quality Code (VIAQ) effective July 1, 2004 Code Compliance Application Form The following information will be required for the WSEC and VIAQ plan review: 1. Complete the Washington State Energy Code/Ventilation and Indoor Air Quality Code (WSECNIAQ)application located on the reverse side. 2. Complete the window and door schedule on the reverse side. Include all windows, skylights, sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening dimensions of the windows and doors. Information about the U-factor of the window will also help to expedite the energy code review. If you are complying with the WSEC by prescriptive path and are using the area weighted average method you must include your calculations. 3. On your building plans note the location and fuel type of water heater, location of exhaust fans (bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and slabs, 4. Questions? Call Mason County Community Development at (360)427-9670 ext. 284. Additional WSEC and VIAQ compliance information is available on the internet at: www.energy.wsu.edu/buildings/ Prescriptive Requirements 0,1for Group R Occupancy Climate Zone 1, Table 6-1 Glazing Glazing U-factor Door Wall Walt Wall Area%of Ceiling Vaulted Above interior4 exterior Slab Option Floor Vertical Overhead" Factors 2 Ceiling3 Grade below 4 Below Floors on 12 grade Grade Grade I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10 II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 Unlimited IV Family Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 (R-3)Only 'Reference Case/Call(360)427-9670 ext.284 for footnote information. Log&solid timber wall with a min.avg.thickness of 3.5"are exempt from the above grade wall insulation requirements. MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/VIAQ Compliance Application Owner: Telephone: 7 _ Parcel#:.ZZ3�3 1 s-1 112 Type of project ( ) New Residence ( )Addition Remodel Total Sq. Ft. 15 Floor: 2" floor: Heated Basement: of heated area:: Heating System Type: X Electric wall heater O Electric Central Furnace O LPG Furnace O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type: ther: Specify— Glazing ,aPrescriptive Option see reverse side circle one: I' II IV Percentage: Compliance Method O Component Performance , Chapter 5— Calculation worksheets required % Check one:: O Systems analysis, Chapter 4 0_ Whole House Ventilation system O Whole House Ventilation using a Heat Ventilation using exhaust fans&window or wall fresh air Recovery Ventilation System (VIAQ 303.4.4) System vents (VIAQ 303.4.1) Check one O Whole House Ventilation Integrated O Whole House Ventilation using an inline with a Forced Air System (VIAQ 303.4.2) supply fan. VIAQ 303.4.3) Window & Door Schedule (If needed, attach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Windows: 41O Lie.- 3 Z igl AA c'� O ECEIVED BE R OFFICE Windows: Total Sq.ft. Doors: Doors: Total Sq. Ft Total window and door area Total window &door area /(divided by) total sq. ft of heated area �ty ! _ • °/aof glazing MASON COON FY PERMIT N0. 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/i/ t �= �ii r is 'il /' Company Name Mailing Address 1( L f- Mailing Address City State � ,: Zip Code City State Zip Code Phone `. ' L 11 ',=Other Ph. Phone Other Ph. Lien/Title Holder L Contractor Reg.# Exp. E mail address E Mail Address Drivers Lic.# QOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System 'F Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description I /' ,_ == �" Site Address (Please include street name, street number and city) ! + ?I Directions to site Will timber be cut and sold in parcel preparation?Yes/fl ' Is property within 200'of Saltwater Lake y 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 o ,��zh L PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building r , Describe Work 11 , , �z�rT i"'/? No.of Bedrooms ? No.of Bathrooms ' Square Footage- 1 st Floor 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 appl' �e�]�Iyq�bta' d permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,repreirt tbeE3Ne4 MItion provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PRQDF OF ONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. 'MAY 19 2ons X Date: Owner/Owners Representative/Contractor indicate which one IBELF FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW AWqV D GbEN1ED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Buildinq Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee PlanningReview 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. -- 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 Owner { `�.'4' %t'<?�, Company Name Mailing Address Mailing Address City �P e- tate!,,2Z Zip Code City State Zip Code Phone 7q '�?3A Other Ph. Phone Other Ph. Lien/Title Holder LA;'- - Contractor Reg.4 Exp. E mail address 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. 7 et G Fire District Legal Description Site Address (Please include street name, street number and city) c,f? 1 rl)r Directions to site r r?/ e r. 14r 7 > F_ viJi> r Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff-Stream-Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPCL_ Natural Gas_ Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL O✓VNER/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 arid-inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. I Date: WAY 19 ?nn; X Owner/Owners Representative/Contractor (indicate which one) BELFAIR FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning I'd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group-Type Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Ins ection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES