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Box 186, Shelton,WA 98584 427L96701#-800-562-5628 PLEASE PRINT #1 ne -" ` fi? }� (ty Phone# ,a3 to oZ7S- ZO "�"' " ire%trict I ite,:AddresS' i. ty St�_ P Directions to Job Site° - � `�� �.1 VC Tt�F1QAC+[C� Tisy i�fl 3 , Tv" LE_ i�fi oN Dni C onl ��S� C? Ct�.J T n1 0 FAOZ57V VACo-'-AP'E- Q T 1 T Owner Mailing Address ST St—AgA—Z1p��5��— City I�1 YPJ Lien/Title Holder 15 S Address G - S0 I o City Mr-fZCE12 I SLAJQ D St— —lap #2 Contractor Name &L-L F)F 15LE Y C�,o�►_�-i 04110 PA Contractor Reg#61<1 113 C[00: Address o'230 N E m ?a W ooD CT Expiration Date 3 / .� / City F7) Lr-NIV_ _St #3 If septic is located on project site, include records. ' Connect to Septic? v, Public Water Supply Well Connect to Sewer System? Name of System ` (If residential, proof of potable water is required) Description - A. . Antes I WEIPT r #5 Building Square Footage: (existing/proposed) 1st FI 133 3 / V55 2nd FI / 3rd FI / _Loft / Basement / Deck / #bedrooms Z /_-3 #bathrooms / zt Garage j____--- -Carport-1— (Circle:Attached aL1�Deettaacched?) Other sq. . / 1 #6 Use'of building f' C DR-00 W\ , 60kT*g_OV UA K I T C-\4E a , Describe work F-Y, , X1 1 #7 Type of Job: New Add _AK _Repair O #8 Ze MANUFACTURED HOME INFOT TION /�l A— Make Mar h D msType of HeatIce$ #9 dicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream lla ars ater Season Othe� Show following on the site plan Lot Dimensionr� Existing Stru�turog Fence Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed,irr provett#eri*, Easements Name of Flankdng Street' _ Indicate Directional by (N. S, E. W)' Name of Fronting Street In relation to plot plan APPLICA _ Ti LII�fig. 1J ; ^VN � ' 1 � (� o� Pt � A - 3,o Fee. APPLICANT TOADRAW TOPOC3RAPHY PROFU BELOW .. Plumbing Fi�c_tu_res�$3.25 each) � _ Meet lures(S6.50 each) No. Toilets 3.25� CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other a Bath Tubs NgL ULU IShowers • Fum BTU _Hot Water Htr _ Heatpurnps _Laundry Washer _ Vent Systems 190 S'b 1 Spot Vent Fans 6.5 Floor Drains _Laundry Basins HP Dishwasher No. Air Handling Units _Disposal cfim# Urinals Fire Protection Systems , _Others Auto. Fire Alarm Sys i000 Fixed Fire Supp. Sys Permit Basic Fee 16.25 Auto Fire Sprink Sys 00 TOTAL PLUMBING $ Z9.2S No.. Other Gas Outlets--- Wood, Gas, Pellet Stove NOTICE:THIS PERMIT.BECOME&WULL AND VOID IF WORK OR CONST*iUCTM AUTWWWD IS NOT COM- ME WITHIN 180 DAYS IF CONS TRUCTIONOR Permit Basic Feb 16.25 WORK�$USPENDED OR OR A&NMDONEDFOR A PERK9D i OF-t6Elt-GAYS AT ANY-TIME AFTER-WORK IS COM- TOTAL MECHANICAL $ZZ��� MENCED.lI'RO OFwUATON�OF WORK IS BY MnkNS OF A=PRODf�EM INS�ON. OWN $AFFIDAVIT CONTRACTORS AFFIDAVIT- - I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE I CERTIFY THAT I AM A CURRENTLY REGISTERED MEWMS O=,,'SHE CONTRACTORS REGISTRATION LAW . CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW:1&0, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHEORDIi ERE©UNIEMENTSREGU ORDI Ui1NEE REQUIREMENTS FOR WHICH THIS PER- LATINGTHEWORKFOR WHICH THE-P-ERMI•TISSSUED; MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN_CQNFORIl1ANGE CONFORMANCE THEREWITH.NO CHANGES SHALL BE THEREWITH.NO CHANGES SHALL BE MADE VWTHOUT' MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM IME BUIL.D1f4G THE BUILDING DEPARTMEN DEPARTMENT." - X OWNER X BY DATE �� DATE ,DEWT ENTAL REVIEW FOR OFFICE USE ONLY t �Y. Approved Cond. Hold 4 Approval Planning Environmental Health: Building Plan Review Occupancy Group: Type of C&ist: . Fire Marshal: Other: Special Conditions: FEES 1�:3 27"?tea gill!Ae Building Permit Plan Checfc ,00 Plumbing Fee ., ZQt- Mechanicif Fee zz:105 Wood/Gas/Pellet Stove - Radon Monitor Violation Fee R Site Inspection Building State Fee _ Other E$f- Other Building Valuation: rTOTALFEEE IVA Building Permit # K=1Q03 QN OOOUN" BUII OM 0 426 W. CEDAR SHELI"'M9 WASHMOTON 985M (360) 427-9670 C W- wWT- Ino Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code compliance .. to al c'�Or- _ (E) f hca. �rwf y '' .t4. ) 3� e rate ,, him, rm�. fr r ock You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK L\Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑OKto Department D I el s= Date z Inspector Building Permit # COUNTY BusAN i 0 426 W. CEDAR SHECT , WASHI MN 98584 (360) 427-9670 EL a Wt T-l' '10"'N ,' r Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code compliance I, Aa6s . 2, t1...-�. .�- �� .�� � -�-�U,y✓ y Q''�it �lCc opt �.3z.�L, Li►c,k Sj.,:,2 oGtJt,AcJ' b&,YJ 1; e ice,(C L ,t- ,�' I104 �s tj yj 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 a Make corrections,items will be checked on next inspection OK to �.n_.'�.../'- 4-e- c,"-C-Cp-�--Qr� Cl Department / ZA- Date Io l(o— Inspector 1,