Permit#
Garfield County,WashingtonRec'vdBy
300 S. 19th Street
POBox160, Pomeroy,WA 99347
WasthisApplication submitted due to a"Notice of Violation"?
Phone: (509) 843-1301 -Fax: (509) 843-1412YESNON.O.V. #
License #
OWNER/BUILDER INFORMATION / I certifythat I, asowner/builder, amexempt fromthe requirementsof the statecontractor'sregistration law, underRCW 18.27.090. I have read, understandand will complywith the termsof thisBuilding Permit.►PropertyOwnerSignature:
CONTACTPERSON / PERSON TO CONTACT:NAME:PHONE #
* ISSUEDPERMITSAPPROVEDPLANSNEEDTOBEPICKEDUPINTHEOFFICEUNLESSOTHERWISEREQUESTED*
If you would like your permit sent to you or an agent - priority postage fees may apply
Invoice Fees To:() Will Pick-Up() Send To:
Parcel #
Physical Address:_City/Zip
Property Use: []Residential[]Non-Residential[]Commercial[]Industial[]Other
[] House[] Garage[] Carport[] Storage[] Deck[] Addition[]Shop[] Barn [ ] Manuf. Home [ ] Cabin [ ] Remodel [ ] Repair [ ] Move/Relocation [ ] Commercial
[] Other (specify)
PROJECTINFORMATION
Type of Structure[ ] Log [ ] Stick [ ] Pole [ ] Straw
[ ] Masonry[ ] Other
Existing # of BdrmsProposed # of BdrmsBldg Height_# of Stories# of Baths
Heat Source
Building Dimensions of all newconstruction ( All floors including basement):Furnace[ ]
X=SQFt BasementElectric[ ]
X=SQFt 1st FloorHeat Pump[ ]
X=SQFt 2nd FloorPropane[ ]
X=SQFt Gar/CarportWood[ ]
X=SQFt Other/DecksOther[ ](describebelow)
Total SQFeet
I herbyapplyfor a Plan Reviewand Building Permit. I have read all application materialsand submitted two setsofComplete Plans.Theabove information istrue and correct to the best of myknowledge.
►Owner's Signature: / Print Name: / Date:►Applicant/Agent Signature: / Print Name: / Date:
GARFIELDCOUNTY/CITYOF POMEROYOWNERAFFIDAVITREGARDINGCONTRACTORREGISTRATION
Date
BuildingPermit Number
1.He/She,_,isthe owner orauthorizedagentof theownerofpropertylegallydescribedwiththis parcel
number,.
2.Thathe/sheisanapplicant foraGarfieldCounty/Cityof PomeroyBuildingPermit at theabovelocation.
3.Thathe/sheis awarethat the StateContractors RegistrationAct requires allpersons doinganyworkas contractors toobtainacertificateof registrationfromtheWashingtonStateDepartment ofLaborandIndustries.
4.Thathe/sheis awarethat itisunlawfultodoanyworkasacontractorwithoutacertificate ofregistrationandthataviolationofthis requirementisacriminalmisdemeanor.
5.Thatallconstructionwork completedpursuant totheproposedbuildingpermitforthepropertydescribedabovewillbe donebytheowner orownersofthepropertyorthat theowner acting as theirownGeneralContractor asallowedbylawwillhireonly licensedsubcontractors orotherwisebefullyresponsibleastheEmployerforcompliancewithallfederal andstate lawsand regulationsinregards toworkers compensation, liabilityinsurance,socialSecurity and otherrequiredandreportablewithholding.
6.That theproposedconstructionworkisnot beingdonewiththeintentionorforthepurposeofsellingtheimprovedproperty. If abuildingpermitisobtainedbyan applicantorcontractorwhofalsifies informationtoobtainanexceptionfromthecontractorregistrationrequirements,suchbuildingpermitshallbeforfeited, RCW18.27.110.
Applicant/PropertyOwner’sSignature
Permit#StaffInitials:
PLANREQUIREMENTCHECK LIST
****INCOMPLETEPLANSWILL NOT BEACCEPTED****
PLANSMUSTBEDRAWNTOSCALEANDLEGIBLE (1/4”=1’)
MARKN/AIFDOESNOTAPPLY
FOUNDATIONS
[]FOOTINGSDEPTH/WIDTH/REBAR[]FRAMINGANCHORSSIZE/PLACEMENT
[]WALLSWIDTH/HEIGHT/REBAR[]CRAWLSPACEVENTILATION/ACCESSRESIDENTIAL/RADON
[]SLABS
REQUIREMENTS
DEPTH/WIDTH/HEIGHT/
[]GROUNDCOVER6MILBLACKPLASTICREQ’D
PRESSURETREATED
[]PIERS
[]SIZE
[]DETAILS
SHOWCROSSSECTIONSDETAILS
FRAMING
FLOORS1ST2NDWALLS-1ST2NDFLOORS
SIZE/SPACING/SPANS/
SIZE/SPACING/HEIGHT/
[]SUPPORTBEAM
[]STUDS
[]JOISTS
FLOOR
SIZE/SPACING/SPANS/SPECIES/GRADE
[]EXTERIORSHEATHINGSIZE/MATERIAL
[]HOUSEWRAPTYPE
[]
SHEATHING
SIZE/MATERIAL[]SIDINGTYPE
[]WALLBRACINGDETAILS/NAILING
[]HEADERSDOOR/WINDOW/SIZE/SPAN
LOADBEARINGPOINTS[] / ATTACHMENT / CONNECTIONS / [] / GLULAMHEAVYBEAMSLOGS / SIZE/SPACING/SPAN/GRADE/SPECIES
[] / HANGERS / NAILING/TYPE / [] / CROSSSECTIONS / DETAILS
[] / BRACKETS / TYPES
FLOOR PLANS
[] / DOOR/WINDOW / PLACEMENT/SIZE / [] / ROOMS / SIZE/TYPE(KITCHEN,BEDROOM,LIVINGROOM,ETC)
[] / BEDROOMS / SMOKEALARMS/EGRESSWINDOWS / [] / ROOMCEILINGHEIGHTS / MIN7FT/MIN6’8”ABOVEBATHROOMFIXTURES
[] / SAFETYGLASS / WITHIN24”OFDOORS/CHECKALLOTHERLOCATIONS / [] / LOCATIONSOF / WOODSTOVES/PROPANESTOVES/HVAC/WH/APPLIANCES/PLUMBINGFIXTURES
[] / GARAGE
SEPARTATIONS / DOORTHICKNESS/MIN1-3/8”/½“SHEETROCK / [] / CEILING / ACCESS
[] / LIVINGSPACEABOVEGARAGE / 5/8TYPEXSEPARATION / [] / STAIRS / LOCATION/CROSSSECTION/RISE/RUN/HEADROOM/WIDTH/HANDRAILS/GUARDRAILS/HEIGHT/SPACING
ROOFS
[] / CEILINGJOIST / SIZE/SPACING/SPANS/ / [] / SHEATHING / SIZE/MATERIAL
[] / RAFTERS / DETAIL/SPACING/TRUSSES/STICKFRAME / [] / ATTIC / VENTILATION
[] / BEARING / LOCATIONS/POINTS / [] / RIDGE/VALLEY/HIP / BOARDSIZE/BEAM
[] / SLOPES / PITCH / [] / ROOFING / TYPE
WSECREQUIREMENTS
[] / SLAB/FOUNDWALLS / R-VALUEEXTERIORR-10INTERIORR-21 / [] / WHOLEHOUSEVENTILATION / FRESHAIR/EXHAUSTFANS/WHOLEHOUSEFAN/FURNACE/FRESHAIRTO
RETURNSIDE
[] / FLOOR / R-30 / [] / VAPORBARRIERS / MIN4MILCLEARPLASTIC–0R–PVAPRIMER
KRAFTFACED/FACESTAPLED
[] / WALL / R-21 / [] / CAULK / ALLPENETRATIONSINTOUNCONDITIONEDSPACES
[] / CEILINGS / R-30/VAULT
R-38/FLATCEILING / [] / PROVIDE / MIN1”AIRSPACEABOVEROOFINSULATION
[] / WINDOW / U-VALUES / [] / ALLPLUMBING / WATERLINESINSULATEDINUNCONDITIONEDSPACES
[] / HEATSOURCE
ELEVATIONS OFSTRUCTURE –NORTH/SOUTH/EAST WEST
[] / WINDOWS/DOORS / [] / SLOPE/ROOFPITCH
[] / FINALGRADE / [] / DECKS/PATIO/PORCHES
[] / FIREPLACES / [] / SKYLITES
ENGINEERED AND ARCHITECTPLANS
[] / ENGINEERED / PROVIDECALCULATIONS/EACHPAGESTAMPEDANDSIGNED / [] / ARCHITECTURAL / EACHPAGESTAMPEDANDSIGNED
REMODELS
[] / SHOWEXISTING / STRUCTURALDETAILSFOUNDATIONDETAILS / [] / FRAMING/ROOFINGON / REMODELS/ADDITIONS
[] / FLOORPLAN / WINDOW/DOORS/ROOMS / [] / DISTINGUISH / NEW FROMEXISTING
ALLCHANGESORREVISIONSTOAPPOVEDPLANSMUSTBEAPPROVEDPRIORTOCONSTRUCTION
SITE PLAN
To the best of myknowledge, this site plan depicts accuratestructure placement, distances,roads,driveways, landfeatures,and otherpertinent development information for myproposal.
Applicant Signature andDateSigned
SITEPLANREQUIREMENTS
Drawsiteplanontheattachedgridpaper;Siteplansmustincludedrawingofthefollowing:
- Measurementofproposedstructurestoallpropertylines.
- Measurementfromproposedbuildingtocriticalareas.
- Measurementofthedistancebetweendrivewayandnearestpropertyline.
- Landownersnameandtendigitparcelnumber.
- NorthArrow
- Anydriveways,roadsorstreetsandtheirnames.
- Allexistingandproposedstructuresanddistancebetweenbuildings.
- Criticalareas(streams,rivers,ponds,wetlands,floodplain,etc.)
- Proposedsiteofsepticorouthouse,drainfieldandwelllocations(ifapplicable).
Disclaimer:Thisformandreviewdoesnotvestanapplicationforanytypeofpermitnorisitfinalapprovalforanyproject.Changesinfederal,state,orlocallaw,codeorrulemayinvalidatethefindings/determinationsofthisapplication.Finalapprovalmaybegivenonlyafteracompleteapplicationwithallattachedpermitsandrequirements)issubmitted,feesarepaid,andfinalreviewbythePublicWorksDepartment, Health District, Sheriff’sDepartmentand BuildingInspector are completed and approved.
Note:Theapplication,andalldepartmentalpermitsandallowancesarevalidforaperiodof12monthsfrom thedatereceivedunlessotherwisevestedbyabuildingorotherdevelopment/constructionpermit.
HOWTOGETTOTHEBUILDINGSITE
Directions to the site:
Use the space belowto provide a detailed drawing showing the location ofyourbuildingproject. Showallroads and road namesleading to the project. Showmileage. StartfromPomeroy.