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Home My WebLink AboutBLD2009-00999 Final SFR - BLD Permit / Conditions - 9/8/2011 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 1 Mason County Bldg. III 426 W. Cedar P O. Box 186 NP10 Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2009-00999 OWNER: BRETTA COVEY RECEIVED: 11/17/2009 CONTRACTOR: -2614 LICENSE: ALLIAH'943NW EXP: 8/19/`2"01100 ISSUED: 12/15/2009 SITE ADDRESS: 140 NE PINE TREE LN TAHUYA p-nbyea( (p/� I/�� a5 Ye l�al IO� EXPIRES: 6/15/2010 PARCEL NUMBER 223315300008 l k !! ( n / LEGAL DESCRIPTION COLLINS LAKE#4 TR 8 � � Y� JTT M "�' I' PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW SFR ST RT 3 TO BELFAIR, L ON ST RT 300/ NORTH SHORE RD, R ON BELFAIR TAHUYA RD,R ON COLLINS LAKE DR TO PINE TREE LN, FOLLOW TO THE END General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: VB Type of Use SF Insp. Area: No. of Bathrooms: 2 Occ. Group: R-3/U Lot Size: Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: 2 Occ. Load Building:1,232 Garage-Attached 528 Valuation: Building Height 25 Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline & Planning Information Make Length: Ft. Front: S 50.0 Ft. Shoreline: Ft. Water Body Rear: N 37.0 Ft. Slope: Ft. SEPA?: Model: Width: Ft. Side 1: E 61.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No Side 2: W 46.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Oty, Type Oty Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee GMM 11/17/200 $813.38 S12009000 Hosebibs 2 Ventilation Fan 3 Plan Check Fee GMM 1 111 712 00 $813,38 S120090o0 Kitchen Sink 1 Woodstove 1 Planning Review Fee GMM 11/17/200 $205.00 S12009000 Lavatories 2 Dryer Vent 1 EH Plan Review GMM 11/17/200 $103.00 S120090o0 Water Closets (Toilets) 2 Water Adequacy Plan Review GMM 11/17/200 $41.00 S120090o0 Water Heaters 1 Building State Fee LDK 12/1/2009 $4.50 S12009000 Bath Tubs 2 Building Permit Fee LDK 1 21112 00 9 $1,251_35 S12009000 Clothes Washer 1 Mechanical Permit Fee LDK 12/1/2009 S122 20 S120090o0 Mechanical Base Fee LDK 12/1/2009 $28 50 S12009000 Plumbing Permit Fee LDK 12/1/2009 $93.20 S120090oo Plumbing Base Fee LDK 12/1/2009 $24.70 S120090o0 Total $3,500.21 BLD2009-00999 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2009-00999 CONDITIONS FOR BLD2009-00999 1) 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 foun ation drains within 30ft, down gradient of drainfield/reserve area. X. , �-- 2) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 3) 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 4) 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/d ra infield 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 is acknowled ng that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 5) 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 ��2 6) 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 7) Proposed structure(s) must maintain a minimum of a 5' setback from all property lines, easements and 25'from all County and State Road right of ways. Setbacks are measured from the furthest projection of the structure. X �L�L BLD2009-00999 Please referto the following pages for oonditions of this permit. 2 of 5 8) 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 1-800-6�47-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. 9) 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 z i 10) 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 X removal approved documents will result in failure of required building inspections. 11) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 12) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the "approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X 13) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the underside f e roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X 14) Per IRC -SECTION R905- REQUIREMENTS FOR ROOF COVERINGS- R905.1 Roof covering application. Roof coverings shall be applied in accordance with the applicable provisions of this section and the manufacturer's installation instructions. X 15) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 16) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X �' BLD2009-00999 Please referto the following pages for conditionsofthis permit. 3 of 5 17) 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 all be collected by the Building Department prior to any further inspections being performed or approvals granted. 18) 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. X�-- 19) Installation of heating equipment in single family residences shall meet the requirements of the current Washington State Energy Code. The furnace to be installed shall not exceed 150% of the heating and cooling design load. Heating and design load calculations for the purpose of sizing HVAC systems are required and shall be calculated in accordance with accepted engineering practice, including infiltration and ventilation. Design calculations shall be available for inspection during the framing inspection. Warm-air furnaces shall have a minimum efficiency of 78%AFUE or higher or 80% combustion efficiency. All ducts shall be securely fastened and sealed with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric systems or tapes installed in accordance with manufacturers installation instructs ns Duct tape is NOT permitted as a sealant on any ducts. Ducts in unheated spaces shall be insulated to R-8. X 20) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 21) 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 22) 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. 23) All property lines shall be clearly identified at the time of foundation inspection. X BLD2009-00999 Please referto the following pages for conditions of this permit. 4 of 5 24) 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 ordinances and building regulations. 25) 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 26) 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 - 27) Retaining walls needed to support a surcharge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X /ILL 28) 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. 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 anytime after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structurefor review and inspection. OWNER OR AGENT:" A ( DATE: BLD2009-00999 Please referto the following pages for conditions of this permit. 5 of 5 00 o ! CONCRETE MECHANICAL MANUFACTURED HOME fJ d T� m Footings I Setback Dat® L BY l Ribbons M Gas Piping _< o Interior Date By interior•Date By Date By Exterior Date f-,� a By Exterior-Date By Point Load/Isolated Footings INSULATION Date By BG f SLAB INSULATION --- - Date BY Date By FIRE DEPARTMENT D Foundation Walls Floors Date By Deter 2 Y By Data By DECKS FRAMING �) �7 Walls Date By Date 2, �v By� Data J' Z� JS`/v By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Date By Date l Z � Q By Type- ,. . Date DRYWALL By V D Type- Date Brace Wall Y Date B 100 Oate �l BY Date BY FINAL INSPECTION p n i Water Line Fire Seperation IVo Date By Date By Date 7-6''// By /J O m � Pass or Request Inspect. c CD Type of Insp. Fail Date Date Done By Comments CD C S riT rt'.Af=r'1 cC CD Cn v 0 _ a iL Cn 2- -1,5!v LDr- 4 rw SAW 0 GPlot 1"= 30' Owner: Bretta Covey Legal: Lot 8 Collins Lake Div.4 Parcel # 22331-53-00008 Permit#: Job# 09-4423-5 37 i VIN r u ABA 2r � a6 i r► Q 0- �x J N pine, �e� Rd1�tS 1Dy ' A, P - MASON (.Ap� PLANNING: g €A� Ln LNA GESrSiJC,3,;- ."- h.. �` ALL SETBACKS ARE MEASURED BY '"'�'N( AAQTE FROM THE FURTHEST ua e PROJECTION OF THE BUILDING PLANNN RECEIVED 7 Z009 MASON COUNTY Jun 15 10 02:04p Don Woolliscroft 360-426-0509 p.3 �A ,goo j 4n •n V V C> I I C \J I r MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/VIAQ Compliance Application Owner. �� Telephone: Parcel#: a�� _ 53 Type of pro' ct ( ) New Residence ( )Addition ( ) Remodel Total Sq. Ft. 15 Floor: 2 floor: Heated Basement: of heated area:: -? 41-i C Heating System Type: 0 Electric wall heater O Electric Central Furnace O LPG Furnace O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type: O Other: Specify Glazing Prescriptive Option see reverse side circle one: I if Percentage: Compliance 30 Method O Component Performance , Chapter 5— calculation worksheets required Check one:: O Systems analysis, Chapter 4 dP Whole House Ventilation system O Whole House Ventilation using a Heat Ventilation using exhaust fans&window or wall fresh air Recovery Ventilation System (vL4Q 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: e Windows: Total Sq. ft. Doors: Doors: Total Sq. Ft Total window and door area Total window&door area /(divided by)total sq.ft of heated area = %of glazing WSEC/VIAQ COMPLIANCE FORM Owner: Covey Residence Telephone: Parcel#: Type of Project: P New Residence ❑Addition ❑Remodel Date: 10/29/2009 Total Sq. Ft. of Heated Area: 15`Floor: 616 2"d Floor: 616 Basement: Heating System Type M Electric Wall Heater ❑Electrical Central Furnace [:1 LPG Furnace ❑Heat Pump with Electric Furnace ❑Other(Specify): ❑Heat Pump with Gas Furnace ❑Boiler,Specify Fuel Type: Glazing Pctg. Compliance Method prescriptive Option No. 4 ❑Systems Analysis,Chapter 4 13.56% Check One: ❑Component Performance,Chapter 5-Calculation Worksheet Required Ventilation Whole House Ventilation System ❑ Whole House Ventilation System System using exhaust fans&window or wall fresh air vents(VIAQ 303.4.1) using a heat recovery ventilation system(VIAQ 303.4.4) ❑ Whole House Ventilation System ❑ Whole House Ventilation System Check one: integrated with a forced air heating system(VIAQ 303.4.2) using an inline supply fan(VIAQ 303.4.3) Windows U- Quan- Size 1/2 114 Exe- Area UA Brand Window Type Room Value ti w H Rd. Rd. Tri mpt (S. F.) Value Milgard-Classic SI.GI.Door LE/CL Dining 0.270 1 6 ° 1 6 10 ❑ ❑ ❑ ❑ 41.00 11.07 Milgard-Montecito Horiz.Slider CULE Kitchen 0.310 1 3 ° 1 3 ° ❑ ❑ ❑ ❑ 9.00 2.79 Milgard-Montecito Horiz.Slider CULE Bath 0.310 1 3 ° 1 ° ❑ ❑ ❑ ❑ 3.00 0.93 Milgard-Montecito Horiz.Slider CULE Utility 0.310 1 3 ° 311 ❑1 ❑ ❑ ❑ 9.00 2.79 Milgard-Montecito Horiz.Slider CULE Living 0.310 1 6° 5 ° 1 ❑ ❑ [11 ❑ 30.00 9.30 Mil ard-Classic SI.GI. Door LE/CL Bedroom 0.270 1 6 ° 6 10 ❑ EllI ❑ 41.00 11.07 Milgard-Montecito Horiz.Slider CULE Bedroom 0.310 1 6° 3 6 ❑ ❑ ❑ ❑ 21.00 6.51 Milgard-Montecito Fixed CULE Stairwell 0.330 1 3 ° 3 ° ❑ ❑ ❑I ❑ 9.00 2.97 ❑I ❑ ❑I ❑ ❑ ❑ 1:11 ❑ ❑ ❑ Ell ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Q. ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Ell ❑ ❑ ❑ 1:11 ❑ ❑ ❑ <- Check Here if windows, skylights or doors are continued on an additional sheet Target Weighted U-Value for Windows=0.35 1 Total Window Area/Total UA: 1163.00 47.43 Weighted U-Value=Sum(UA)tTotal Window Area (not including exempt windows) Weighted U-Value 0.291 Skylight U- Size Exe Area UA Skylight Brand Model Number Room Value Quant. w F H mpt (S. F.) Value Mil ard-Classic Sk lite LE/CL Bath 0.270 1 2 ° 2 ° ❑ 4.00 1.08 Target Weighted U-Value for Skylights =.58 Total Skylight Area:/Total UA 1 4.00 1.08 Weighted U-Value=Sum(UA)/Total Skylight Area (not including exempt Skylights) I Weighted U-Value 0.270 Door U- Size Exe Area UA Brand Model Number Room Value Quant. w T H mpt (S. F.) Value Generic Steel/Wd. Frame- No Glass Garage Entry 0.160 1 3 ° 6 8 ❑ 20.00 3.20 0 8 ❑ Target Weighted U-Value for Doors=.20 Total Door Area/Total UA: 20.00 3.20 Weighted U-Value=Sum(UA)tTotal Door Area (not including exempt doors) I Weighted U-Value 0.160 Total window &door area 187.00/(divided by)total sq.ft. of heated area 1232 = 15.18% of glazing (& Doors) Single glazed, ornamental or garden window or door up to 1% of floor area may be exempted Foster and Williams Associates Analyst: JB J Name / (-0 ut Parcel# c�j33 BLD#oZnO Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development, or redevelopment', with more than 2,000 square feet of impervious surface 2. '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 ID X X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X = X If the total impervious area of the proposed site X __ development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) If the Total Impervious Surface Area is LESS THA"00 Square Fee , ease read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described p /77 roperty yffor review and inspection as may be required. X �'1,,�( Owner/Agen ontract (circle one)Date: / /' '0 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 1 of 2 r Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at: Phone:(360)-427-9670 EXT.450 Mail: P 0 Box 1850,Shelton WA 98584 Physical: 415 N 6th St,Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone:(360)-427-9670 EXT.352 Mail:P 0 Box 1666, Shelton WA 98584 Physical:426 W Cedar St,Shelton WA 98584 A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 MASON COUNTY PERMIT NOALA i BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 JQ 1Q VL 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 Itire-H-4 a Company Name o'2ie Mailin Address A. O arbor Mailing A dress D ,Dox 2too City State1,,14- Zip Code "r 7_2 City e State Zip Code Phone342 320 49-20 Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. #A11,41 '?f3 4 kJ Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic X Existing Septic Connect to Water System x Name of Water System LL1, r l9 ke Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No / - • c1000 K Fire District_, Legal Description "' y Site Address(Please include street name, _street number and city) L f c 1-4. Directions to site 16-1 .r _/0 Coll.;' !.¢k-- Will timber be cut and sold in parcel preparation?Yes OLD- Is property within 200'of Saltwater Lake 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 CK SEASONAL ❑ Use of Building__JFQ Describe Work No. of Bedrooms. .'7 No. of Bathrooms A Square Footage- 1 st Floor t24 2nd Floor 3rd Floor oo.�-- Basement Deck ,�3Y Covered Deck Other Sq. ft. Garage _.a��""��— Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATI N OF WORK IS BY MEANS OF A PROGRESS INSPECTION. x Date: //—/7-O 9 16- Owner/Owners Representative/ ontra indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date 1 DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Q MIX- Planning Department Environmental Health Department �(p Public Works Department Fire Marshal FEES Buildina Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO.�L_jd U09 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 INFORMATI N CONTRACTOR INFORMATIONd /l�Owner � Company Name c �`�c e- Mailing Address Mailing dress G'Dx Ba City State Zip Code City al-A*v► State Zip Code Phone Other Ph. Phone ! Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic_ Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No 21- 5_ - o ooa Fire District 2. Legal Description Site Address(Please include street name,street number and city) Directions to site Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New L Add Alt Repair Other Use of Building Location of Fixtures/Units- 1 st FIooL4L: 2nd Floor —3 Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG_Natural Gas_Heat Pump_ Toilets Tyne of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs a Heatpumps Showers Spot Vent Fan 3 Water Heater I Propane Tank Clothes Washer Ga utlets Kithen Sinks f as(PelletStove I Dishwasher Kitchen Exhaust Hood 1 Hosebibs Dryer Vent I Other Other Base 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 party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X, Date: // '/7-o 7 Owner/Owners Representative Qont (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by; 'n` anning Pd Ck# Date I ` Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department 12//ILI' Occ Grou 3 Type Constr. k� 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