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Date By li Date By FINAL INSPECTION Water Line Date By D ate y Date B v B Y Cl) o 0 0 I v ca cn w 0 o a r 0 r r �CD d o o o 3 N lu O �I d Ire q r Fo o CONCRETE MECHANICAL MANUFACTURED HOME r� Footings I Setbacks Date B y Ribbons Date By Gas Piping Date By 0 Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINAL INSPECTION aU Water Line Date By Date By Date By / L _ T o s m 0 La w 0 n 0 Ll r r L d 0 N o � O kA O � N O N O 0 1 i Building Permit# p2 -f�/Z U MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 3 / e-,. — This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been fund: Items Listed below must be corrected to gain code compliance / dl�/�� /tip G /-0"/ 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 1 3C-10 Date / ��G _6 Z Inspector TA DO NOT REMOVE THIS G FORM MUST BE COMPLETED IN INK PERMIT NO..t\1 N PLEASE PRESS HARD MASON COUNTY 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 Seattle 206 464-6968 APPLIC T INFORMATION l- CONTRACTOR INFORMATION Owner C• I O r� Contractor Name Mailing Address V Mailing Address City A State LOR Zip Code 8SR F, City State Zip Code Phone a7�-9) a Other Ph.(SW )a71-0 o Ph.( Other Ph.( Lien/Title Holder_Comrn noorbk 'CQ n 12 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. / / nC;C)t�Jc'S Fire District Legal Description L Site Address(Pleas include street name, stye number and city) Directions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Adder Alt Repair Other Use of Buildings; Location of Fixtures/Units 1st Floor_—,2&_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 Vent Fans Water Heater Propane Tank Laundry Wsher Gas Outlets Sinks Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other Other Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 3`- 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 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-1 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 Zr which this permit is iss ed and that all work will be done in requirements regulating the work for which this permit is issued and all work LXapproval nfo rman nhe with. o cha es s 11 be made without first obtaining shall be done in conformance therewith. No changes shall be made without first obtaining approval Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted bc] +ate Submittal Amount Due 3o Receipt No, VY $�1 b p #` E... :.o MI�:::::::::.::::::::::::::::::::::::::;.:::.;:.;:.;:.;:.:.�iI�D�"f:Ct?3U:. Building Department Occ Group Tvpe Constr. i Planning Department Other Other y+� Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal Violation Fee TOTAL FEES e ' PERMIT NO. MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9870 Belfair 360 275-4467 Elma 360 2-6269 Seattle 206 464-6968 lAPPLIC&NT INFORMATION CONTRACTOR INFORMATION Owner C' CA Contractor Name n Mailing Address Mailing Address cit—Y2�— �L- Stated Zip Code City State Zip Code Phone =7a-91 a Other Ph.(3W ) r-v Ph Other Other Ph.( Lien/Title Holder C.onnM .1�7'F p. uad.?, r , Contractor Reg. # 11 Address I Expiration SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. O,� S"L_/ / �r�r���c, Fire District Legal Description Site Address(Pleasel include street name, stre umber and city) Directions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 1 TYPE OF JOB New Adder_Alt Repair Other Use of Building w ,ram 2 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 Vent Fans Water Heater Propane Tank Laundry Wsher Gas Outlets Y Sinks Wood/Gas/Pellet Sttiove !3C Dishwasher F s Dirdct_Vent?� :_ Other . - Other Other = Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 30 A FLOOR PLAN AND PLOT(PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. NOTICE: THIS PERMIT BECOMES NULL&)(DID IF WORK OR CONSTRUCTION AUT+IORIZED 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. 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 requirementsior which this permit is iss ed and that all work will be done in requirements regulating the work for which this permit is issued and all work conirorman her h. o cha es s 11 be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS POINT I Accepted b e�Submittal Amount Dueb� 3—L Receipt No.� I Building Department Occ Group Type Constr. ' Planning Department Other Other :. ... Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other t Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal Violation Fee TOTAL FEES t MASON COUNTY PERMIT NO.:T= PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elms 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner C-,f C s Contractor Name �. Mailing Address =ry,+ r.; •a �_ ;- f Mailing Address City State; s'`: Zip Code 1 City State Zip Code Phone( Other Ph.( , , ) 4: Ph.( Other Ph.( Lien/Title Holder!, ,n i ri _ 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. Fire District Legal Description Site Address;(Pleaselinclude street name, stre mber and city) , Directions to site Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or BI uffs 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) 1. 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 ^"" " k_ Furnace Bath Tubs Heatpumps Showers Vent Fans Water Heater Propane Tank Laundry Wsher pas Outlets � Sinks Wood/Gas/Pellet Stove Dishwasher L��- - -7, 7-_ eft Vent?+ -f Dir 1 Other r _ Other Other ---- Other Base Fee Base Fee TOTAL PLUMBING j TOTAL MECHANICAL �O A FLOOR PLAN AND PLOTPLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. NOTICE: THIS PERMIT BECOMES WILL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT�COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENbED 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 f2r which this permit is iss d and that all work will be done in requirements regulating the work for which this permit is issued and all work conformanc erewith. chan es sh I be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X Date r /J X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted loyn.N, o%r ir oat Submittal Amount Due Receipt No. �-1 M .....APPi#�V­ Building Department ................................ Occ Group Type Constr. Planning Department Other Other Permit Fee ..... Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal Violation Fee TOTAI FEES