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Lighting is with 6500 neon as requhc& Ail lighting and workmanship guaranteed for one year from date of installation. For a total of $3479.00 plus tax and permits 50'/o down paynlmu required to begin an work;balance due upon completion. Accept: of Pr I: The about prices, specifications amd condit' dsfaetory and are hereby acne to do the work as specified. PaymG4CX as outlined above. omer S' eptaace Authorized S' Date of Acceptance *a1�CGZIJSM CRYICeuaty/9tatae permits and fees,hidden cvadidons,angineerlag fin(if required),Federal,pals or IOW tlsooss. New Uhunination:Eloctrieian must provide dedicated gmuod and noutral per Article&M of the Nad mi Electric Code, purugraph 23.which now requires all transformers to have ooeondary ground fault pt'otomion. This is also a i!L requirement known as UL2161, Electrical ch celt to alga location by others If required. 1't+evailiug wage requirements arm root considered as a part of this estimate. Estimate is valid for 90 days. All material is guaranteed to be as spcd6W. All work to be oompleted in a worknvaniike manner aeearding to standsfd praodom. Any alteration or deviation from the above sped8eatioos involving extra coats will be executed only upon written orders,and wiU become an extra charge aver and above the estimate. Our workers are fW y covesd by Workman Is Compensation Insurance. In accordance with State of Washington laws,a Churn of Lien may be filed if payment is not received within 40 drys of invoice date. A Conditional Lien Release will be issued upon payment. MsiUdS Address: PO-Box 928 0 Silverdale 0 WA 0 98383 Street Address: 9438 WUlamette Meridian.0 Silverdale 0 WA 0 98383 (MO 613.9550'0 Fax(360)613-9515 email:gketstw@silverUnk.net 121/2" • 91/4"- 0 Z 0 m N m A 7 W y ,p wl N Co WZCD 01 Z ; m r C O =0 C q m � Z Pv rn � D O Z �IT;�k __ I I — i•F7 z O D ` 713 O 2 { o 0m D �. y m m L O C) 7� C t Y m N m = n m O m m 71 m .p r CP m C O 7a : a z = nm O >a o-1� � � oo np m 0 0 vm Z z n r" 0 0 o D �< ;' z m Z w N1 � d W, I� N �l opt Ol 1 6 z � � MASON COUNTY LI 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 INFOR ATION CONTRACTOR INFO MATIOf /� Owner Contractor Name µs+ ' N W. Mailing Address / 12M 3 Mailinq Address City SM441p, StatekA Zip Code Q$L'"'Y City 0*L6 State &* Zip Code Phone ( ) Other Ph. ( ) Phone .m—o Other Ph. ( c 0) &(3—?S7� Lien/Title Holder Contractor Reg. YAC21SCJ0107Exp. Email Address Email Address 15'rQ �_ t�a+wNtt.Na1' SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION - 12 digit Tax Parcel No. \ / Fire District Legal Description Site Address (Please include street name, street number and city) k. Directions to site Will timber be cut and sold in parcel preparation? (Yes/No) Is property located within 200' of saltwater Lake River/Creek Pond R Wetland Seasonal Runoff Stream Slopes or Bluffs C PERMANENT RESIDENCE ❑ SEASONAL RESIDENCE ❑ TYPE OF JOB - New X Add Alt Repair Other Use of Building Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?(Yes/No) V, O Describe Work rr,c Ajy-,�ec� No. of Bedrooms c No. of Bafhkoms SQUARE FOOTAGE- 1st Floor koloor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model 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. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. THE OWNER OR AGENT ON OWNER'S BEHALF,REPRESENTS THAT THE INFORMATION PROVIDED IS ACCURATE AND GRANTS EMPLOYEES OF Mason COUNTY ACCESS TO THE ABOVE DESCRIBED PROPERTY AND STRUCTURES FOR REVIEW AND INSPECTION OF THIS PROJECT. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT- I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT- I certify that I am currently regis- ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and of the ordinance reclyinaments regulating the work for which this that all work will be done in conformance therewith. No changes permit is issuedNee rk shall be done in conformance there- shall be made without first obtaining approval. with. No an m ithout first obtaining approval. X Date X Date �►-0 FOR OFFICIAL USE BEYOND THIS POINT Accepted by Planning Pd 'Ck# Date Bld Pd. Reciept No. Building Department (3 J OccGroup Type Constr. Planning Department Environmental Health Department Public Works Department Fire Marshal Valuation$ Building Permit Fee rt 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 ( ) .... TOTAL FEES MASON COUNTY ��I IT2 . 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 APPLICAN INFOR ATION CONTRACTOR INFO)RMATIO �+ Owner < Contractor Name • .*+ W. Mailing Address / OW 3 Mailin Address btysf City. StatekA Zip Code 99L''1 F City ,%mr_0 L c State &A Zip Code d31! Phone ( ) Other Ph. ( ) Phone( & — 3% Other Ph (�) L-43-7V Lien/Title Holder Contractor Reg. �U0jTj%9. Email Address Email Address 04n_q p.!tp _'yLVe%-W'Ug al- -,,SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INFORMATION - 12 digit Tax Parcel No. / ` �! / (�C Cif ('' Fire District s' Legal Description Site Address (Please include street name, street number and city) 1 CC ,^��• • Directions to site Will timber be cut and sold in parcel preparation? (Yes/No) Is property located within 200' of saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE ❑ SEASONAL RESIDENCE ❑ TYPE OF JOB - New X Add Alt Repair Other Use of Building R Is this permit submittal:the result of a Stop Work Notice,Correction Notice or other enforcement action?(Yes/No) Nn o Describe Work No. of Bedrooms No. of Bai000ms SQUARE FOOTAGE- 1st Floor anqYhoor I 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached Gµ MANUFACTURED HOME INFORMATION - Make Model Model Year E Length Width Serial No. No. of Bedrooms No. of Bathrooms I Type of Heat Purchase Price$ Replacement Unit? (Yes/No) Installer Name Certification No. NOTICE:THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ' THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. THE OWNER OR AGENT ON OWNER'S BEHALF,REPRESENTS THAT THE INFORMATION PROVIDED IS ACCURATE AND GRANTS EMPLOYEES OF Mason COUNTY ACCESS TO THE ABOVE DESCRIBED PROPERTY AND STRUCTURES FOR REVIEW AND INSPECTION OF THIS PROJECT. OWNERIBUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY ' RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT- I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT - I certify that I am currently regis- i ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and of the ordinance re irements regulating the work for which this that all work will be done in conformance therewith. No changes permit is is d an I ork shall be done in conformance there- shall be made without first obtaining approval. with. No an e e without first obtaining approval. r X Date X e Date x3 -d FOR OFFICIAL USE BEYOND THIS POINT Accepted by Planning Pd Ck# Date Bld Pd. Reciept No. Building Department Occ Group Type Constr. Planning Department Environmental Health Department Public Works Department Fire Marshal I Valuation$ ri u . I 4 � � Building Permit Fee Site Inspection i i Plan Review Fee EH Review Fee i Plumbing&Base Fee Planning Review Fee I Mechanical&Base Fee Other I t Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ) 'I TOTAL FEES