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C 00 f+ *3 ? p (P 0 m '` O `"i Q` 00 � m 3 4 f C43® 10 Q o f .1' •+ c Piso tit A C to ef+ I � l CONCRETE MECHANICAL MANUFACTURED HOME CD co ___ . •b Date o Footings /Setbacks Gas Piping r Ribbons v o Interior Date By Interior-Date By Date B, Cl) v' ------ --- Exterior Date By Exterior-Date By Set-up Point Load 1 Isolated Footings INSULATION Date Bti n BG!SLAB INSULATION -- —� Date By Data By FIRE DEPARTMENT N Foundation Wails Floors Date By Date By Date By DECKS -- — FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING vault Data By Date _By OTHER —� Groundwork Attic Date By Date ByType.Date t?y D.W.v DRYWALL Type- By Brace Wall Date By, Date 6y Date By FINAL INSPECTION Water Line Fire Separation r Date By Date By Date g f3 C t3YT to m �D Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments c _,w,!5k a 8 o' 0 m 0 Case Activity Listing 8/12/2008 ' 8:14:36AM Case #: BLD99-00305 Assigned Done Activity Description Date I Date 2 Date 3 Hold Disp To By Updated l?pdated By BLDA010 Application received 4/20/1999 4/26/1999 None DONE KW 4/26/1999 KW BLDB135 Addressing 4/26/1999 4/27/1999 None DONE GMM 4/27/1999 GMM BLDB138 Planning Pre-Review 4/27/1999 4/28/1999 None DONE MMS 4/28/1999 MMS BLDB200 Environmental Health Review 4/26/1999 4/29/1999 None DONE CEB 4/29/1999 CEB see condition BLDB134 RLC Review 5/5/1999 None N/A AHB 5/5/1999 AHB II i BLDB130 Planning Review 4/28/1999 5/5/1999 None DONE AHB 5/5/1999 AHB i REMODEL WITHIN THE EXISTING BUILDING. AHB BLDA910 Meeting 5/24/1999 None RECV SKM 5/24/1999 WLC Recived new plans from applicant,the plans were not stamped and will be required to be stamped prior to approval for issuance.I will begin review. I BLDBl l0 Building Plan Review 4/26/1999 6/2/1999 None DONE SKM 6/2/1999 SKM SENT TO FIRE MARSHAL I BLDA100 Approved For Issuance 6/2/1999 None DONE KS 6/9/1999 KS i I I i i BLDB009 Fire Marshal Review 6/2/1999 6/4/1999 None DONE DLS 6/4/1999 DLS i i BLDA500 (F)Issue building permit 6/9/1999 None DONE KS 6/9/1999 KS Ii Page I of 2 CaseActivity..rpt Case Activity Listing 8/12/2008 8:14:3 6AM Case #: BLD99-00305 lip Assigned Done Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By BLDC100 Inspection 6/28/1999 6/28/1999 6/28/1999 None FAIL TFR 6/29/1999 KW FRAMING AND PLUMGING FAIL 1.URINAL CAN NOT BE DRAINED THROUGH WATER CLOSET VENT.2.FIND OUT WHAT TYPE OF FLUSH O METER TO B USED ON URINAL AND SUPPLY INSULATION INSTRUCTIONS,TO SIZE SUPPLY.3.WATER TES TO BE W 50 PSI WATER GUAGE ONLY GOES TO 30 PSI AND 25 PSI IS WHAT IS SHOWN.4.ENGINEERING SHOW 1/2 BOLTS TO BE INSTALLED ON PLATES.W/NUTS AND WASHERS.5.INSTALL GATE VALVE ON WATER HEATER ON COLD SUPPLY 6.AT EXHAUST FANS EYEBROWS ON EXTERIOR OF BUILDING BACK DRAFT DAMPERS DO NOT CLSOE. BLDC125 Framing inspection 7/9/1999 7/9/1999 7/9/1999 None PASS TFR 7/12/1999 KW BLDC120 Underground plumbing insp. 7/9/1999 7/9/1999 7/9/1999 None PASS TFR 7/12/1999 KW BLDC150 Wallboard inspection 7/16/1999 7/16/1999 7/16/1999 None FAIL TFR 7/19/1999 KW 1.GREEN BOARD IS NOT ALLOWED ON CEILING UNLESS FRAMED ON 12"O.C.OK TO TAPE ALL EXCEPT CEILING. BLDC150 Wallboard inspection 7/30/1999 7/30/1999 7/30/1999 None PASS TFR 8/2/1999 KW BLDC100 Inspection 9/30/1999 9/30/1999 None DONE DWH 10/1/1999 KW HOME MADE WALL DAMPER OPENS WITH FAN ON 9/30/99 WENT OVER PROJECT WITH HAROLD. BLDA560 Permit Cancelled 10/3/2001 None DONE KW 10/18/2001 KLW Page 2 of 2 CaseActivity..rpt 8/12/2008 Case Activity Listing 8:20:13AM Case #: ENF99-00075 i� Assigned Done Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By ENFA010 Complaint received 4/12/1999 None 4/13/1999 TLG I ENF13002 Site investigation 4/12/1999 4/12/1999 4/12/1999 None DONE TFR 4/13/1999 TLG I photo taken. stop work posted inside. Talked to Chief Green on site I ENFB003 STOP WORK POSTED 4/12/1999 None TFR 4/13/1999 TLG ENFC004 Complaint Resolved 1/26/2004 None DONE TLG 1/26/2004 TLG BLD99-00305 issued 6/99 I I Page 1 of 1 CaseActivity-rpt I I C011CRETE IEMANWAL , "OM FOOD-Sebaok date by Rlbbo m date by Gn Fog date by Wad dole by Set Up !tort INSULATION dab by by ROM Final dale by date by �;P —r:!I — / by �—y� yy FIRE DEFT. PUUIEM ( , dam by date by Gmtmdwork Aft OTFIER me by dW by D.W.V. wAluft N1lN.INc3l Koo 7-7:7t w 7dam b7/ atar Line ,,/ FINAL I ISPECTION dace by datg by -dde by rn _moo l 1' ;tip` �rmit#. = - MAsoN cquNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 NOT ocation Fro :uct,ure has been inspected by Mason Coun BuildinFtfolt�►wing VIOLATION of Coun � 9 Department .,_ County Laws and Ordinances has been • Items Listed below must be corrected to gain code compliance Z!� ©� -�GY,�/ I I u are hereby notified that the above correction FORE PROCEEDING WITH ANY F s shall be made FURTHER WORK ,all for re-inspection when corrections are made before continuing ake corrections, items will be checked on next inspection K to Z3Mp�ieate C. E X�is is spection Department GO Inspector -12 ---------------- E THIS TAG Building Permit# BLOT MASON COUNTY 4 BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 W-Ulff- M Job Location FD Z y6C:3 ©c-o ,*zr5V,,y7 , oej/z This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been ;fond: Items Listed.below must be corrected to gain code compliance (/R/ep"I'e— F 0 iPcac�i r wA B"y u?/i+-�f� d- .S'd�G✓ /n�1�449-Ti'O•- /�ST?v�Tr�yt - Tc� �fi2..E AT �- G ..� �- cr/ � 2 d T17 Q� .Y,s"'T LL�iO c9 •✓ w vT.S /✓ J�t�?S. 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 06.0 Date - Z R'- ,- Inspector 7-R . NOT VE T", G i --., FORM MUST BE COMPLETED IN INK PERMIT NO.: PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedaf/P.Q.Box 1W,Shelton,WA 8861�4 Shelton 60 27.0670 BaUalr 275d467 Elea 4 206 8 APPLICANT INFOa.R A N CONTRACTOR INFOR A ON y Owner Contractor Naive Mailin dd ss Mailing Address City State jj Zip Code City &ttate Zip Code Phone Other Ph.(_ Ph.( Other Ph.(_� Lien/Title Holder Contractor Reg.# Address Expiration SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. / / QSd Fire District Legal Description Site Address(Please inclqdp street n e, stre t n ber and city) Direction site Is your property within 200'of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets Type of Unit No. of Units Fees Bath Basins �_ Furnace Bath Tubs Heatpumps Showers �C Vent Fans Water Heater / Propane Tank Laundry Wsher Gas Outlets Sinks Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other 10ther Othe _ Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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 strictures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that 1 am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No hanges shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X -Dde FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. Fartment T Constr. partment Other Other NX '.:.'4yt.}4♦ ..5.�-'ii.. .•v;:}'L.L;'.•.;.. r j: :.i'?.+.•if.i .... .:.Nit...... .. .` .: .. ' Permit Fee Site lospsction Plan Review Fee UFC Plan Review Fee Phimbing&Base Fee Other Mechanical&Base Fee Other Wood /Gas/PeNet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES xr 41 PERMIT NO.: BLD MASONx`COU NTY t Z� BUILDING PERMIT APPLICATION r 4426 Wa tae! /P.O.Box 186,Sheltqn,WA 98584 etton 36 %-567�'4Belfair(36012764W.Elms 60 402-5269 Seattle 206 64-6968 APPLICANT INFORM 10 CONTRACTOR INFORMATION Owner lci Contactor Name Mailin,tmss­ tA4.. Mailing Address ty City _ #"`'•• State Zip Code City ^t,5tb Zip Code Phone340 11`Other Ph.( ) Ph.( ) Other Ph.( ) Lien/Title Holder ontractor Reg. # Address Expiration ' SEPTICIWATER SYSTEM.i14FORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of �. ater System PARCEL INFORMATION-12 digit Tax Parcel No. / / / Fire District Legal Description Site Address(Please irkqjude street names;, street number and city) ,° ✓.'Y Directions to site toot ' old Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200 of the following: Body of Water(Name) , Saltwater Lake River/Creek j Pond We*tfand Seasonal Run Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Ar Describe Work No. of Bedrooms No. of Bathrooms SQUARl FOOTAGE-1 st FI o 2nd Floor Ord Floor - Loft Basei`nent De+rk, .; Other � —sq. ft. � +� Garage Attached Detached Carport ' Attached Detached MOBILE HOMEJNFORMATION-Rllake Model Model Year Length Width Serial No. Al/it _No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/N6) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAY$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. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval first obtaining approval. X Date -- 9 —" X Date as FOR OFFICAAL USE BEYOND THIS POINT Accepted by Date �/ � ub i tal Am e Receipt No� 'f 1�-- � : Build �g.�f�nent c i ` e Planning Department Environmental Health Department Y 2fi4'� G�¢ti 3 OZc7 Public Works Department tx i Fire Marshal k� Valuation $ 4. ....:.::.:::.:::.:::.:..::.::.::;.:;:.:}.:�.:iv::i:v::::.:::i•:i•::•::::;.:v::.:::.:i ::•:•:.:.:.:.:•:.:•:•.•:•�,•:• :::v:::::.:::•:.•.•:.;::.::.:.:...:.:.::r:.::.:..�.:.::..:.:....:::•::: .::::::::: :: ...........:::: :::: .::::::::::::: . ::::::.::.:::::.......... :.... ;: : Y::: ::. : ::::::: :: . ................. : , ; . : - i:.. i .....: :: : � c::•:::o;::;;;:•ii:.>:::;;•i:•i:;>:>r'<;;<:::>iri:i:>ii: n : : : .: � :<t:i:»:2:::i;>i:i:>:M::»i<i>:•'::;:4:::YB4»:•iii;:>i{:C.i;i�?• �.�::::•:::;:v:::::::.::::•.:........................................................................................................................... ... Building Permit Fee Site Inspection Plan Review Fee. UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other Wood/Gas/Pellet Stove Fee Other k Violation Fee Pre-Paid at Submittal TOTAL FEES PERMIT NO.:. BLD ,b3o 5 MASON,COUNT :..; VAb I x , BUILDING PERMIT APPLICATION w. ` 41I$ �iP.O.Box 186,Sheltona W>f 98584 ' ' ' G 7 -Sefton� IA7efilifair 364 275-4467 Elora 69 82-5269 Seattle 206 464-6968 C AFPLICANT INFORM-,TI CONTRACTOR INFORMAT ON I Owner + Contr#Ictor Name Majlin ddr ss11P Wild$Address City State Zip Code City to Zip Code j Phone :Z?S� 11 Other Ph.( � h.( er Ph.( ) Lien/Title Holder- Contractor Reg. #'s Address f 7 777 l SEPTICIWATER SYSTf:=M t14FORMATION-Connect to New Septic Existing -e Connect to Sewer System Name of Sewer System Well Wa>:�Wm Name of Water System C j PARCEL INFORMATION-12 digit Tax Parcel No: y Fire_District Legal Description Site Address(Please ineJude street narr ;stre t number and city Directions to site V old EZ& ill timber be cut and sold in parcel preparation? (Yes/Noj Is your property within 200' of the following: Body of Water.(Name) _Saltwater Lake River/Creek ` Pond Wetland Seasonal R n. Stream Slopes or 4 Bluffs I f TYPE OF JOB`New Add Alt Repair Other Use of Building r r } Describe Work No. of Bedrooms No. of Bathrooms LSQUARE FOOTAGE-1stfl 0 _2nd Floor I 3rd Floor Loft Basement - Detk__j. Other l Garage Attached Detached_Carport Attached eta' ed j MOBILE HOME INFORMATION-Make odel Model Year Length Width Serial No. A11A No. of Bedrooms No. of Bathrooms i Type of Heat Purchase Price$ Replacement Unit ?(Yes/No) Installer Name _/- Certification No, Ef NOTICE:'THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DA1' OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COM�ts (CE1). PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,repre that the information provided is accurate and grants employees of Mason County access to the above described property and structures feview and inspection of this project. Acknowledgment of such is by signature below: j OWNER AFFIDAVIT-1 certify that 1 am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-(certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance i requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is,issubd and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall to made without approval first obtaining approval. k X bate_ .y X Date w. i FOROFFICJAL USE BEYOND THIS POINT Accepted by Date ub al Am Receipt No tom+ l� w x Y 4 k� yet a o rd rrn^ � - 'z'.,*... >�- * _ � "�.i n _ '+� '�...may'1 _ #��• ,¢' r - I . e. "hAr. t �f t Planning:Department i Environmental Health Department f Public Works Department Fire Marshal C •Y r Valuation$ F 9_2 ?r f ,... .,e-..:...:... .......r:-::....::.:,........ } .. .:::. .:....:.......................... .... e,}........... >:--'---' ...:.r•sp'.,..... r.:. <,+- ,...;...:-:-:::..:.•..:v-:..•: -...:}: -v..r.�•i?:rb:}:•`.' .!:s:.>::-:?is�:'?:::::>:L}cF`.`r:= is<'9'`<:::"?$:`.::';.�:#:i<::fia'.`f.`�yi,• :`:-�' Building'Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee P Plumbing &Base Fee Public Works Review Fee E M;Z,5nical&Base Fee: Other k Wood/Gas/Pellet Stove Fee Other ' Violation Fee Pre-Paid at Submittal r TOTAL FEES' -,� �.- -�' fix_ �.. -•�.�t'U�.Y{,�, � ��j� `' MASON COUNTY PLUMBING/MECHAN[CAL PERMIT APPLICATION , 4t$,W.CiedarlP.O.Box 186,Shelton,WA 99584 Shelton 360 27-9670 Selfair 360 275 Elma 364 2.6269 Seattle 206 64-6968 A C T lNF CONTRACTOR.INFOR A ION ©A Contractor Name MaHin dd ss"" " pll MaiNng Address £ -- ate ,tip Code City ate Zip Code f'Ifone ' er Ph.( Ph. Other Ph.(, Lien/I` Holder Contractor Reg. Address a Expiration SEPT It INFORMATIt"3N-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System' a RCEL`1NFORMATION-12 digit Tax Parcel No.: / /' d p Fire Distri 'Legal Description Site Addfiess(Please includ e,street n ben and city) Direction site . Is;your property within 200'of a following:,Body of Water(Name) Saltwater Lake River/Cree Pond Wtiand Seasonal Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair r_Other Use of Building Location of Fixtures/Units 1st:Floor_„ 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric yqe of Fixture No. of Fixtures Fens LPG T Natural Gas Heatpump , Toilets , Type of Unit No. of Units +� ' Bath Basins J 7 Furnace Bath Tubs Heatpumps Showers 7' Vent Fans 0 Water Heat-r �T Propane Tank Laundry her Gas Outlets =—�—, Sinks Wood/Gas/Pellet Stove DishWa."►#fer„ Direct Vent? Oth Other Other _ Other Base,Pee zo Base,Fee 2z°O k TOTAL PLUMBING 35 TOTAL MECHMNIAL' 'G•S ~ A Fl:OOR PLAN-AND PLOT PLAN'MAY BE REQUIRED,DEPENDING ON TH ME OF I TUI ItJNIT. NOTICE: THIS PER . ES NULL A, IF WORK DR CONSTRUCTION AI1T�2ED IS NOT COMMENCED YMITHNt*DAYS OR IF. CONSTRUCTION IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMI�AENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf.rep s 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 Acknowledgment of such is by signature below: F OWNER AFFIDAVIT, that f aM exempt from the requir of the. CONTRACTOR'S AFFIDAVIT4 c ert(y that I am currently registered as a Contractor Registration Lave RCW 18.27 anal arnaware of the once cantractorin the State of Washington sand that I am aware of the ordieance requirements'far WWI this permit is Ghat a0 work will be done in requ rerne regulating the for whi. this perm8 and Il work conformance therewitic No °made wilfro�tt fir shall .bone k�, race t erwy�tl�;'Mo-ram bevaade appfrnlal. ,•ia.' ' first aMx� �. _. - FOR OFFICIAL USE BEYONb THIS POINT Accepted by Dat ubmlttal A buntpue� Receipt No, ..»x�a r_=,*'y?:Sr�t.-7o-� "`2 r,. .a•.•.;<:.:?:..:<; n..,,:=•:•a,:-r:'S:r:- -:y: �'• rl4i`.s. S`.'*Y"..�. .:i.4."-.:. .i..:>. '^..:r`:-``� ::.o.:{-t.. :Y•:\�::.1 f cc.::. :=:<r.::�rh-t:-: ,PtannIn§ Other q Permd Fee ,. e Plan Review Fee E t` UFC Plant14 F Plumbing&Base Fee,� Other �r , f R RIC S S . Medranlgl&I3ase:Fee ,. ��" `"r ' Ww&G;4&?ellet Stove Fee at, r TIT NO.:' 'BLD l `� MASON.COU N� BUILDI1.NG, PE MIT- A#PPLCATIO►N -� �` r d ,;. �S •r $4�• 1: )P.gw,Rox186,SheltG4 W32945296858 4S eale�lob 46;4-6968telton 9 '., APPLICANT INFORM A 1014 CONTRACTOR INFORMATION Owner C lon(.r or Name Mailin ddr ss lylaliiXAddress City u.' :} State Zip Code City t to Zip Code Phone �91X.—O0 Other Ph.( °) Ph,( Other Ph.( lef r 6:11 ._." r Lien/Title Holder Contractor Reg.'# Address . Exlratio / / SEPTIC/WATER SYSTEM 1NFdRMATION-Connect to New Septic Existing Septic Connect to Sewer h, System_Name of Sewer System Well Water System Name of titer System i ,PARCEL INFORMATION-12 digit Tax Parcel No. f / 11 d.S Q Fire District " Cegai Description Site Address(Please i ude street na street umber and city) �C Y` ' Directions to site v�. c Will timber be cut and sold in parka preparation*? (Yes/NoJ Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Ru o Stream Slopes or I.Bluff TYPE OF JOB New Add Alter Repair T_„Other Use of Building 045*0 Describe Work , Na of Bedrooms No. of Bathrooms SQUARE FOOT -1st Floor 2nd Floor _; 3rd Floor_ ^Loff��;B.asernent Deok Other 1 sq. ft. Garage Attached Detached Carport Attached Detached MOBILE'HOME INFORMATION-make. odel Model Year. Length Width Serial No. No. o droomS No. of Bathrooms Type of Meat Purchase Price $ 7" eplacernenf Unit?(Yes/No) Y Installer blame CECT. Certification N ' NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK"OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN iii)DAY$OR IF CONSTRUCTION WQRK 1S SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCEEY PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner;or agent on owner's behalf,represents that 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. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-f certify that t am currently registered as a` contractor Registration Law RcW 18.27 and am aware of the ordinance contractor in the State of Washington and that l am aware ofthe•ordinance requirements;or which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work ` conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith: No changes shall be made without approval. / first obtaining approval. X,;` Date X bate FOR"OF,FrI/ , 'L USE BEYOND THIS POINT Accepted by Date Su i al Amo a Receipt No. Ae srou e jr P`ianning 00j: rt ent Environmental Health Department Public Works Department I Fire Marshal Wal�atio'n 0 :•Y4:i:•i:::iTii: ::i:J.::i:-:''+.•i- •:v'i•?i'vi'i:iii Building'Permit'Fee Site Inspection Plan Review Fee UFC Plan Review Fee a ,oZ Plumbing & Base Fee Public Works Review Fee 'Mechanical &Base Fee ' Other w Wood/Gas/Pellet Stove Fee Other r. Violation Fee Pre-Paid at Subml al " ;,. . TOTAL FEES Date: July 27, 1998 To: Mason County Health Department , Al Everson From: Mike Greene Re: Crew bathroom We propose to add a crew bathroom and shower. The present building was built in the 1970s. Originally, the building had a large community hall for community meetings and weekly bingo games. Bingo ended three years ago. During Bingo the occupancy was up to one hundred people per night. Since the end of Bingo three years ago, hall usage has dropped significantly. We wish to add a bathroom for the career staff who work 24 hour shifts. They presently share a bathroom with the public. We are not adding usage, just adding a new location. We would rather not make changes to the existing system. It could potentially make the project cost prohibitive. When we upgraded the Collins Lake Fire Station we cut the number of outside meetings in order to avoid changing the septic system. We would like to be able to do the same thing at our main station. With the decreased usage and the fact that the career staff are not going to have to share a bathroom with the public, we hope to avoid changing the drain field. Mason County Dept. Health Services APPROVED Initials Date