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Fail Date Date Done By Comments CD a m 0 8 Q o" U 0 a m O o CONCRETE MECHANICAL MANUFACTURED HOME � o Date By O Footings!Setbacks Piping RibbonsGas O ointerior Date By Interior-Date By bato `.,�G' try x 0) Exterior Date By Exterior-Date By Sat-ate INSULATION O Paint Load d Isolated Footin e _ © — B y �(,� r BG.1 SLAB INSULATION Date By Data By FIRE DEPARTMENT m Foundation'Walls Floors [fate By Date By Data By DECK FRAMING waft Date By Date By Data By PROPANE TANKS PLUMBING vault Data By Date By OTHER Groundwork Attie Date By Data By Type' Dater By DRYWALL t3.wu Typo: Int Brace Wall Gate By W Dote By Date By FINAL INSPECTION d Water Line Fire Seperation C Date By Data By Date By O m 00 Pass or Request Inspect. c Type of Insp. Pall Date Date Done By Comments � oile CD O One, Z-170 Z-Za Lag "97,0 <r cc 3 �,e / /tie) -� v � tt _ ASS z 2� iv 2d lv iV�� rIyl I IC7 . rim oz� Z' ,11 2 lI T_ I .= �f` L'l:Sf7" �-�` Ow �_i ,, se /mot r r7 fa, htkA,06a `�' Ql"w fi 2 131 S� " Icy 1 J �r1 - �'i Z:� ��� a^ jA_f ,(('e q r/0- do 0 1 Permit# _ _��j / MASON COUNTY ,OGC--2-01a `000le-)-BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Jab Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been ,4ound: Items listed below must be corrected to gain compliance P11? 2cn- ''•- 4,'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 CJ please contact our office ® Make corrections, items will be checked on next inspection regarding possible structural 1 o Z= / damage incurred by recent "natural/man made This is not a complete inspe tion disasters.This is NOT Date 2-— 9 �0 �_ Department CORRECTION NOTICE. Inspector��fs DO NOT REMOVE THIS TAG Q7 `O Cd Z b7 � CA � to v' td G7 b7 � � Ld b7 CD ti CD c. CD o o 0 CID CD CD Cam , cCo uto .i P' no CD 0000 x ti c�ccoo n CD CD CD 0 CD w r mCD CD �. TP7, CD : < .o a o CD' CDTF = CD � o a. 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The letter was incorrectly dated June 11, 2012. 1 have a date stamped it received on 2.14.2012 and authorized extension of both the building permit(BLD2008-00261)and fire sprinkler permit)FIR2008- 000065) for 6-months until 8.17.2012. Occupancy of the manufactured home IS NOT approved until the fire sprinkler system is inspected and operates and the building inspector has approved occupancy by inspection. Debbera Coker Mason County Building Department Building Inspector IV/Code Enforcement Phone: (360)427-9670 ext 510 FAX: (360)427-7798 e-Mail: DLC@co.mason.wa.us PO Box 186 426 West Cedar Street Shelton, WA 98584 >>> <andyfa-g.com> 2/16/2012 11:19 AM >>> Dear Debra I have not heard from you about our conversation on tuesday. I am concerned because the deadline is tomorrow and you were suppose to get back to me if a inspection is needed at this time? Did you receive our letter we sent you on 2/11/12? Please call me as soon as possible. Thank you Andy Frankhauser 360-286-5536 RECEIVED <e . _ . Jane (A5!00 Mason County Building Dept Attn:Debra Coker P.O.Box 186 Shelton,WA 98584 RE: Gale Brooks&Andrew Frankhauser Permit#BLD2008-00261 Residential FIR 208-00065 Dear Ms Coker: Per our conversation we are not living in the home at 20 E.Sherwood Hills Rd N Allyn WA. We are living in the 5"'Wheel at this location as you indicated this is ok to do. In regards to the sprinkler system,we are tackling this one first. We have bought some of the parts and need to purchase more parts. I am getting bids from plumbers and electricians at this time and doing further research. This turned out to be a bigger project than expected and the cost is more than anticipated. Due to the economy and lack of fiords and being unemployed makes it tough getting this done. we have been purchasing necessary parts to complete this costly and timely project.We are asking for your understanding and not allow these permits to expire. Sincerely, Andrew Frankhauser Phone:360-286-5536 Email: andyff(&g.com ro i `�LSA Fj T CLASS Fo2f E� i { 1iV 00 =P K UJ z - P` 010 C co �iF t. {9� V R' C Q � (T'^t C c°o b7 b td y o td Cd ji�jIII°III'III' w w o o y :a UP 5' CD �3 co �7 0 C7 ILIA 0 co co cC 5 co � o CCD ."3• '3 n O N CID CD CDb C3 �• � n Oo n �• � � "� VIIIIIili6 ° CD D Q _ o i � N N ❑ � lull'"" fill II ° C co cc N Pulllll9i �- PD rw CD $� o o = fD N0 o oOQ ul =� coo w p' hlliPl co 0 00 C 00CID O `C N v N N P6 F..� �..� wCD C) w o p a o N r N co N p o CD co p a _ w t3' ts " ¢ o cn k °u i;Ills CID CD < CID (D a+lllIII uo d N d O d sii w CD mv � � � I„dV9lVlllllll w I d o � c �x or..i• b qQ CD 0 n CD n N � N '""� N � N N Illp�illlllplllll' to J N O N ¢ N N t ca. V�o N N N N w n 0 o p oo - � o 9 N O � Iiti'iii a N 'I ' Case Number: Mason County Investigation Report Form Parcel Number: 19 / ,, // Violation Site Address: OW s 12 Al i llg Al " Property Owner(s): - 4z� e'er- Phony#: Mailing Address: Ro,-j rc_YY Tenant/Contractor/Operator on site: Directions to Site: Description of Concern: ����� ly re Under the provisions of the Public Disclosure Law, RCW 42.56.240, the complainant may indicate a desire for disclosure or non-disclosure of their identity. If non-disclosure is chosen, this portion of this form will not he released to the public unless this case is filed in court. If filed,your name will he disclosed if you are a witness in the case. Mason County investigates possible violations on a complaint basis only. Therefore,the name of the person filing the complaint should be provided. Please check one of the following: ❑ Please do not disclose my identity. I understand that disclosure may be required by court order or if this matter goes to court. ❑ You may disclose my identity. Name(please print): Phone: ( ) y Address: Street City State Zip Signature of Complainant: Date: THIS SECT N FOR MASON COUNTY USE ONLY Complaint Received by: �� % v / 3tf Date: Complaint Received by: Whone ❑ Email ❑ Web Site ❑In Person Department of Concern: V'Building ❑ Planning ❑ Fire ❑ Public Works Environmental Health: ❑ Solid ❑ On-site ❑ Wells ❑ Food ❑ Other Investigation Date and Findings: hFFi9 � � / Date Closed: Reason Closed: Initials: x9 'fix•„ 4'', " - /a' ^ yry 04 + ' al Ow ad„ ► r a MI t _ VlZ r E lij Ll III: I � „ � I s a , G - .�'V119���Ipppp�I�I III III ,III I ,III VI d b. � _ +;� h�11kIMId�I IIr'rl��Y�aw��^TM a� IIIr�I.IIIIIII,iI�III� — i rr &illl �. .�'I`I I I III '�oII IIII I I I a n ys I f ill V!IIIII II, aul'I��r I I i I III III — _ .`.�1u I I �rr=wlw:, r ,III I III hill I�r +Flau4p 116 I =r _M1{IIIII,IIIIIIII „: = IIIII _ '� IP,IIIIII r 5 m,dr II �' I ~��., Il ly,t r ��IhIII IIIVII I I I{ I•'i I I IIIVI pI ;�,i Ir I llullll — — alp I '�dk 11I u�l'� �c f All �'?kvw II rf IiIIII I I I IIIII,,III IV II,� — = II I{, �dr�tl Illtllf IIIII I I III I Sul I _ 6`���y l�I�I�Ih III q,IIrIII,IIIII III i I I rM. � I i '- i I - r�IPIIIIIIIVI l I� Ir" IIIIIIII ti�uHH I r Y I — sr a I L:pIIIII�I III �,a E IIIIIIII li u � r '',. r t I " I _ �x I��VII a VII111141I°I I .. .. 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(1_Zip Code c1Ss R 12. Phone- .,U-S `-62Q6 her Ph. Phone_ j(60-47.4-3 I;L9 Other Ph. Lien/Title Holder M,0 CTcsr,c.1. Contractor Reg. #M i KE Ss 1611 If Exp w . E mail address-(orc�nkanlp-al can L.Co • `" E Mail Address Drivers Lic.# DOB 2-j6�S N Drivers Lic.# DOB_Y=Q-.'ram SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septi Existing Septic Connect to Water System Name of Water System Well�_Water System Name of Water System r PARCEL INFORMATION-12 Digit Parcel No Fire District Legal Description T R Df„-A n7 Surtx � //oss La?A o P#k I SyS , RI= 14ggDV Site Address(Please include street game,street number and city) Dire ions t site w 3 So. a a ; k „� t,,,a.,r amad r ►/a fo W k,�K oyre,�r,. ' tir V 14 t^ k Will timber be cut and sold ifi par el pre a�ation? e /No Is property Within in 200'of Saltwater_ Lake � River/Creek �� Pond Wetland /L Seasonal Runoff 4b_Stream PLC) Slopes or Bluffs ] 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Y a 90 TYPE OF JOB -New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Describe Work No.of Bedrooms No. of Bathrooms Square Footage-1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION-Make A4LM "AkSOR Model N 4 P-';149 B9 Year.?= Length �1$ Width 2 1 Serial No.-P H 26q 711 No.of Bedrooms__'41 No.of Bathrooms_ Type of Hea Pur ase Price$ Replacement Unit? Yes/No' Installer Name Certification No. OQ Sid OVVNER/BUILDER A knowledges submission of inaccurate information may result in a stop work order or permit revocation,gdmowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or fhe work ission from the to apply for this permit conduct the work proposed. The owner or a o in the application,I have obtained � � dove gent on owners behalf,represents that the information Fg1 MEANS�Aa PROGRESS WSpEC77pN.��'and structure for review and inspection. IXF— Date: `" "� Owner/Owm (eprehentative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted byzaQAq LLDate 3-`]-� DEPARTMENTAL REVIEW APP OVED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee , 00 Site Ins ction Plan Review Fee EH Review Fee Plumbing& Base Fee Planninq Review Fee Mechanical&Base fee Other Wood/Gas/Pellet Stove Fee State Fee so violation Fee Pre-Paid at Submittal V uational $._.5 Z_.. �$-.._Z - - - - -- - - TOTAL FEES o A M t ,O o .9 N CO Uj>- SO Lu ei 1 • "t o U $ �1 • �' C Y vi fil .C) y ez F G. .� �✓ � �� ._yam vf1 - i O (,t') Q-1 O O o $ co XCO =O o '3 ' cn ^ �[ W m �Q V Ncr W S R 4 Q 1re � Q c U �- X-` I-- '` °f 0-LLI % M 2 u� o c!> CL ui E- e z0 ZV Q� ate Nuj CLV! SM IVAO o Z LO G MEN ,.f�. 74 �► : . FT KFAI i�iii i w n HHOI i`�'t0�rr��i �'� � riii►ii► ►L ° �,�� _ ' ► .Vl 7 !! ' f• Sri■ilr i ��,!��i �i� %i�1�� �a��i�i�i zz f � � ►� ►�� OS ;Fsor�r���► �� r�r�r�r��rr rt ���'���iiii"►�lii ���� lr��� illii��iii�i��'�ri.... 'r ACCESS & GRADE INSPECTION _or-,&o 43om a CQ ADDRESS TO INSPECTOR DRIVEWAY ACCESS Length: Width: Surface: Size of turn-around: Condition of shoulders: Vertical clearance: ) need post at end of driveway with reflective address numbers GRADE,OF DRIVEWAY % OF ROAD + I J2_ % ROAD ACCESS Length: Width: Surface: Condition of shoulders: Vertical clearance: ( ) BURN PERMIT REQUIRED FOR LAND CLEARING FIRE. ( ) LOT INSIDE SMZ, 4X4 FIRES ONLY. ( ) LOT INSIDE UGA, NO OUTDOOR BURNING PERMITTED. LOT TOO SMALL FOR: BURN PERMITS 4X4 FIRES 2x3 FIRES. PASSED ( ) FAILED ( ) ON HOLD ( ) REMARKS (continue remarks on back MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT FIRE MARSHAL Mason County Bldg. III,426 West Cedar Street PO Box 186, Shelton,WA 98584 Shelton (360)427-9670 Belfair(360)275-4467 Elma (360) 482-5269 On the web: http://www.co.mason.wa.us March 12, 2008 GALE BROOKS 10673 FAIRVIEW BLVD SW PORT ORCHARD WA 98367 Permit Number: BLD2008-00261 Parcel No.: 122307590261 Dear Applicant, A representative of the Mason County Fire Marshal's office conducted an inspection of the parcel referenced above to verify compliance to Mason County Building Code, Chapter 14.17 Standards for Fire Apparatus Access Roads. A copy of the standards and addressing guidelines referenced in the standards are enclosed. P AN Rc-VIcW Rr--QUIRc--MmNT COMMENTS: 1. During the inspection the Fire Warden found that the access road does not comply with Section 14.17.110 that reads as follows: "A fire apparatus access road which is newly constructed or existing, and which is in excess of 14% grade, and which is greater than 150-ft from a primary access point intersecting with a County or State road right of way, to new residential or commercial construction will require an automatic fire sprinkler to be installed." A condition concerning the required fire sprinkler system will be placed on the building permit referenced above. A separate permit shall be required and approved. In addition the Fire Marshal's office shall complete the fire sprinkler inspection prior to the framing inspection request. If you have questions please contact the Mason County Fire Warden's office at (360) 427-9670 ext. 459. Denny Skinner Fire Warden Mason County Department of Community Development Encl.: Title 14 Mason County Building Code, Chapter 14.17 Standards for Fire Apparatus Access Roads Address Posting Requirements Guidelines for Private Road Signing Comments: 3/12/2008 1 of 1 BLD2008-00261 THIS PARCEL INCLUDES PLANS, BLUEPRINTS OR OVERSIZE IMAGES LARGE FORMAT IMAGES HAVE BEEN STORED IN FILE CABINETS) UNDER PARCEL NUMBER PARCEL # / 22 75 CASE SiT� �LAt�� �SP/? Iti'�Lf/ NORTHWEST RESIDENTIAL FIRE INC. 360 754-6475 3503 South Bay Rd N.E.#139 Olymp' 9 800 640-9463 DESIGN CALCULATIONS (NFPA 13D) Sheet No: �_of RESIDENTIAL FIRE SPRINKLER SYSTEM Date:_+12�aIO�C By: t,�� ctor's Reg. #NWRESFS085BA Activity# j Project Name:C�a OImaCS IiYz' J� �nU ?i� Y .Floor Level: l Project Location: Elev._of Spkrs: Available Water Supply: _2,q_g.p.m. at: p.s.i. Location: Max Sprinkler Spacing:14 ft.x ft. Sprinkler I.D.: C_ ONE-SPRINKLER DESIGN: TX f.Pi in : Min. Flow: g.p.m.; Min. press: to,2p.s.i. PVC PVC TWO-SPRINKLER DESIGN: Steel (Sch. 40) Min. Flow: 2g_g.p.m.; Min. press: I L-�, p.s.i. Copper K, L, M(Circle one) CALCULATIONS CALCULATIONS 1 Sprinkler flow: System demand= 14- gpm 2 Sprinkler flow: System demand= gpm PIPING(1 spkr flow) PIPING (1 spkr flow) TOTAL x UNIT = TOTAL TOTAL x UNIT = TOTAL DIA. LENGTH FR LOSS FR LOSS DIA. LENGTH FR LOSS FR LOSS Service(PVC) ` aC)` 0?)52. Service(PVC) 0A 1t+1 System(CPVC) J° r0 0, _ _9�1 System(CPVC) Plus 15% •11 Plus 15% 2 .fig FITTINGS &VALVES (I spkr flow) FITTINGS &VALVES (2-spkr. Flow= gpm) DIA.& UNIT LENGTH UNIT TOTAL DIA.& UNIT LENGTH UNIT TOTAL TYPE QTY X EQ.LEN. X E.Q.LEN.X F.R.LOSS=F.R.LOSS TYPE QTY X EQ.LEN. X E.Q.LEN.X F.R.LOSS=F.R.LOSS N Cho i -D o wia _o Meter Friction Loss (Size= -" ) 0 JA_ Meter Friction Loss(Size Sprinkler Pressure Required 10, Sprinkler Pressure Required [D 1,10 Elevation Head Loss( 9 ft X 0.434) 3 1 Elevation Head Loss(,:5:1 ft X 0.434) 3,9 , TOTAL System Pressure Demand TOTAL System Pressure Demand 5� TOTAL Supply Pressure Available kJ le TOTAL Supply Pressure Available Affordable Fire Protection For Your Family & Home INSTALLATION AND MAINTENANCE INSTRUCTIONS � :SYSTEM 111 SOUSOR WFDT/WFDTH. Vane-type 3825 Ohio Avenue,St.Charles, Illinois 60174 Det ectors 1-800-SENSOR2.FAX_630-377-6495 Waterflow Detectors www.syshemsensor.h:om specifications Contact Ratings: Two sets of SPDT (Form C) 10 A @ 125/250 VAC rv; 2.5 A 24 VDC Triggering Threshold Bandwidth (Flow Rate): 4 - 10 GPM Static Pressure Rating: 250 PSI (Max.) Dimensions, Installed: WFDT- 45/m"H x 3=4"W x 63/4"D WFDTH - 45A6"H x 3/j6"W x 63/4"D Operating Temperature Range: 32°F- 120'F (0-C-49°C) Shipping Weight: 2.6 lbs. Enclosure Rating: WFDT- NEMA Typ?4, as tested by UnderwAters Laboratories, Inc. (UL) OP56� WFDTIi - Indoor use only, as tested by UL (IP10) The WFDTH can be installed between 2x4 stud wall construction. U.S. Patent Number: 5,213,205;4,782,333; 3,845,259 hnpwtmd Approximate Teo Depth Requirements Please Read Carefully And Save (see Figure 1) This instruction manual contains important information Tee Depth Threaded Sweat Poly 13 CPVC CPVC/Spears CPVC/Cemral about the installation and operation of waterflow detec- 1 x 1 x 1" 21te" 13/4' wA 2'/1' 215bi~ 2"W 21/2- 2'/e WA N/A WA NIAtors. Purchasers who install waterflow detectors for use by.' t yz x 11/2 x V 2'14" 24 2'h" WA NIA NIA others must leave this manual or a copy of it with the user. 2 x 2 x 1" 3'/4" 044 WA N/A MIA wA Read all.instructions carefully before_beginning. ur 3.lMounfing: imenslatiM AcZ N CWMT, Use vane-type waterflow detectors in wet-pipe systems 11C only. DO NOT USE IN DRY-PIPE, DELUGE, OR PRE- ACTION SYSTEMS. The sudden inrush of water in such systems may break the vane off or damage the mechanism. Do not use in potentially explosive atmospheres. Do not 31 leave unused wires exposed. q=,,. Pdndpies Of Operation I E I Tea A-%P- - � gend t of Pa"o Tree) een Top of Vane-type waterflow detectors mount to water filled pipes .� Tee ew eonom a. in sprinldeF systems.Wafer flow m-the ptpedeflects a vain. -- Deflection of the vane produces a switched output, usually after a specified delay. Tee Depth Tea FNtlng Role,fo Tea DetMh All WFDTs have a-pneumatically controlled mechanical Table delay mechanism- Delays are noncumulative; they reset if p,asticV,ne the flow of water stops before the entire delay has elapsed:. w0126-01 All detectors will activate on a sustained flow of water installation Guideliines greater than 10 gallons per minute (gpm) but will not acti- Before installing any waterflow alarm device, be thorough- vate if the flow rate is less than 4 gpm. ly familiar with: Compatible Pipe Tees/Risers NFPA 72: National Fire Alarm Code The WFDT and WFDTH fit 1"to liAe'NPT threaded ferrous NFPA 13: Installation of Sprinkler Systems and brass, 1" to 2" sweat brass, Ile polybutylene plastic NFPA 25: Inspection, Testing, and Maintenance of and 1" pvc plastic tees having a 1" threaded NPT branch ; Water-based Fire Protection Systems NFPA 13D.- Standard for I and 2 Family Dwellings and (see Figure 1 and chart for recommended tee depths). For Manufactured Homes 2" cast and malleable threaded tees use 2" paddle (p02- 0023-000) provided. NFPA 13R: Standard for Multi-family Dwellings N770.05-00 1 156-0480-OIOR Figure 3. Field wiring: 0 0 OTK'61"°°r GI"'°1F 0 . n' " NOTE: Common and B connections will ewt close when vane is deflected,i.e., A a coronerrs when water is flowing.Dual switches C041 T sr HO M GOB permit aped tions to be combined -REASWITCH 1 SWITCH 2 O 0 O A B A CONTACT RATINGS 125/250 VAC 10 AMPS 24 VDC I 2.5 AMPS WFDTH WFDTH —WFDT WFDT— _J r B B B B To nonsilenceable - end-of-line resistor Initiating zone of listed FACP cots , colt coat , cow --------------- Typical FACP Connectlon B To power soauh i¢ local yyi�th beil heft Break wire as shown for supervision of connection. DO NOT allow stripped wire We129-00 WFDT and WFDTH leads to extend beyond r.-witch assembly switch housing.DO NOT Typical Local Belt Connection loop wires. Field wiring NOTE: Set the delay to the minimum required. to prevent AWAHNitdG false alarms due to flow surges. High Voltage. Electrocution Hazard. Do not handle live AC wiring or work on a device to which AC power is After extended service, parts of the detector may become applied. Doing so may result in severe injury or death. worn reducing the delay time and causing false alarms. If this happens, increase the delay. If the delay is already at When utilizing switches at voltages greater than maximum, replace the mechanical delay assembly. Refer to 74VDC or 49VAC ry means to provide all-pole Maintenance section for ordering replacement parts. disconnection must be incorporated in the fixed wiring, such as a circuit breaker. Figure 4. Delay adjustment dial: 1. The WFDT and WFDTH have two SPDT switches. Switch Table of dial settings embossed here. contacts (COM and B) are closed when water is flowing See below. and open when water is not flowing.Connect the switch- es as shown in Figure 3 depending on the application. Delay adjustment chat V.,� , 2. When connected to a listed sprinkler/fire alarm control 0 panel, the initiating circuit must be non-silenceable. 3. A ground screw is provided with all units.When ground- ing is required, clamp wire with screw in hole located between conduit entrance holes. See Figure 2. Mechanical Delay Adjustment The pneumatic delay is preset at dial setting 2 at the fac- Dial selling 1 0 1 i 1 2 1 3 1 4 Dial selling 5 tory. To adjust the delay, turn the adjustment dial on the Seconds tl 0 15 30 45 55 seconds so-90 delay mechanism. Turn clockwise to increase the delay, NOTE:Retard time may 90 counterclockwise to decrease the delay. Delay can be w0122 ao exceed Adjust and seconds. verify that adjusted over a range from 0-70 seconds. See Figure 4. time does not exceed 90 seconds. N770-05-00 3 156-0480-OIOR ® INSTALLATION L*RICO ' USED FOR PVC PIPE ONLY. INSTALLATION INSTRUCTIONS MODEL # 108 SERIES -- - - - - -TWO HOLE STRAP HANGER o PIPE HEAD DIAMETER(0) HEX SCREW 1. SNAP PVC PIPE INTO HANGER. DIMPLES HOLD PIPE IN PLACE. 2. MOUNT HANGER TO UNDER SIDE OF BEAM WITH SCREWS PROVIDED. 3. MAY ALSO BE USED ON TOP SIDE OF BEAM. PART NO. PIPE DIA. (SEE BELOW) 1080075EG 3 4 rr PIPE 1080100EG 1 1080125EG 1 1 4 HEX HEAD SCREW DIAMETER(0) 1080150EG 1 1 2" 1080200EG 2" SCREWS PROVIDED WARNING: 1. Caddy"Fasteners that are manufactured using spring sled components may be used only in a non—corrosive indoor environment. Only non—spring steel fasteners that have protective coatings may be used otherwise, as specified. 2. Fas ers teners must he used only in the manner depicted in the Mustrations that accompany it and must not exceed static load ratings noted. 3. fastenore designed for use with a variety of industry standard building materials, strucl4 d shapes. and mechanical components. For the fastener to work properly, these Hens must meet the appropriate industry standards. (Examples:ANSI,AISC,AISQ 4.The buyer and/or installer is responsible for. a.Application in conformance to local codes. b.The integrity of structures to which the fasteners is attached,including their capability of safely accepting the bads imposed, as evaluated by a qualified engineer. c.thing appropriate industry standard hardwore as rated above. 5. Failure to observe these spec7Kotans may cause product molfunction rmAtng in property gomage or bodily injury. ERICO Products at the time of shipment are warranted to conform to any apple written description furnished to the Buyer by ERICO.and to be tree from delectf in material and workmanship. NO OTHER WARRANTY, WHETHER EXPRESS OR 11APIIED,(INCLUDING ANY WARRANYY OF MERChWiF—ABIUTY OR FITNESS). SHALL EXIST IN CONNECTION WITH THE SALE OR USE OF ANY ERICO PRODUCT. SAftIY INSTRUC11ONS:AN safety regulations«grired by the job site must be observed. Special attention should be given to the following instructions. While worlong or on the job site: rtr.�rrrrr.ry,�r� rr.rr rr�w..rrr.r► rr p.�t.r Mr..r r•.w,1P�./�/f�..wr lr+rr.r+wawwrrr. rwr+M TECHNICAL SUPPORT PHONE: �• ( 0) CADDY 02000 ERICO, INC. CfS296A PRINTED IN U.SA (1-8-800-252-2339) IF SSM/SSV Series SYSTEM Alarm Bell* Models Available -77 UL/FM Models SSYl?a6 SSM 246 SSM 24-8 SSM 24-10 _ SSV 120-6 SSV120-8 SSV120-10 ULC/Canadian Models SSM 24-6A SSM 24-8A SSM 24-10A SSV120-6A SSV120-8A SSV120-10A Weatherproof Hack Bolt WBB Product Overview Approved for indoor and outdoor use System Sensor's SSM and SSV series bells are low current, high decibel notifi- Low current draw cation appliances for use in fire and burglary systems or other signaling appli- cations. High dB output Reliable Performance. The SSM and SSV series provide loud resonant tones. Three sizes available 6", 8", 10" The SSM series operate on 24VDC and are motor driven, while the SSV AC and DC models series operate on 120VAC utilizing a vibrating mechanism. DC models are polarized for use with Simplified installation. For indoor use, the SSM and SSV series mount to a supervision circuitry standard 4 inch square electrical box. For outdoor applications, weather- proof back box, model number WBB, is-used. Mount directly to standard 4"square electrical box The SSM and SSV series come pre-wired, to reduce installation time. The SSM series incorporate a polarized electrical design for use with,supervision circuitry. Engineering Specifications Model shall be a SSM or SSV Series alarm bell. Bells shall have underdome (� strikers and operating mechanisms. Gongs on said bells shall be no smaller ULC F"� than nominal 6"/8"/10" (specify size) with an operating voltage of 24VDC or usrl:n """�' 120VAC (specify by part number). Bells shall be suitable for surface or semi- S4011 CS549 3005255 flush mounting. Outdoor surface mounted installations shall be weatherproof (using optional WBB weatherproof electrical box). Otherwise bells shall mount to a standard 4"square electrical box having a maximum projection A of 2%"' Bells shall be located as shown on the drawings or as determined by approved 7135-1209:164 the Authority Having jurisdiction. Dells.shall be listed for indoor/outdoor 331-01-E 7135-1209:100 use by Underwriters Laboratories and the California State Fire Marshal, and approved by Factory Mutual and MEA. ES-F-85OU -SPECIFICATIONFEBCC® Series 85OU Double Check Valve Assemblies «: with Union End Ball Valves , t f Size: 1h" -2" (15mm - 50mm) Series 850U The FEBCO Series 85OU Double Check Valve Assemblies are designed for Capacity non-health hazard applications. End Connections—NPT ANSI/ASME B1.20.1. 1P+ id Y(15mm) 138 20 Pressure—Temperature 0 103 is P o 0 10 Maximum Working Pressure. 175psi(12.1 bar) 34 5 Hydrostatic Test Press: 350psi 1241 bar) a o Temperature Range: 32OF to 140°F(0°C to 600C) a n 23 31 45 57 68� kh poi Y4 (20mm) Materials 0 20 Valve Body: Bronze y tau 15 10 Elastomers: Silicone 34 5 Springs: Stainless Steel o ° 0 5 10 15 2D 25 30gpm Models o 19 39 57 76 95 1141pm Wye-Strainer r� 20 1M psi20 1"(25mm) • y 103 15 Approvals—Standards 69 10 s 34 5 • ANSI/AWWA Conformance(C510-92) 40 50 fin gpm • Approved by the Foundation for Goss-Connection Control and Hydraulic ° °° 1° 2 30 0 38 766 114 151 190 221�m Research at the University of Southern California. �� 103 20 8 H 1� is 69 10 1015 864.5 34 5 454 120 Typical Installation ° °0 20 40 a1 too 454 pm 76 151 227 304 319 1pm kPa SERIES 85OU 18*-r(15-50mm) 13820 t'h"(40mm) Outdoor Installation tat 15 o 69 10 i 34 5 12"Min.(300mm)Clearance ° ° ° 20 40 s° W too 120 gpm to Fixed Structure 0 76 151 227 304 M 454 Ipn j W psi 2"(50mm) b 138 20 I w 103 15 o 69 to 12 34 5 ( Row INN ° ° 0 30 60 90 120 I50 180 gpm 0 114 m 342 49 5711 680 Ipu Job Name Contractor Job Location Approval Engineer — Contractor's P.O. No. Approval Representative FEBCO product specifications in U.S.customary units and metric are approximate and are provided for reference only. For precise mea- surements,please contact FEBCO.FEBCO reserves the right to change or modify product design,construction,specifications,or materials without prior notice and without incurring any obligation to make such changes and modifications on FEBCO products previously or subse- quently sold. • Model F1 Res 44 SWC (1O,i.6Omm To - 1 i/a-(JI.75irnn)Alprimum 3O4.8Omm] io W.01 f7r hny PUSH ON COVER. THEN tt Dimension TURN TO AaWS.T UN72 `'. IIGHi AGAINST WAU_ 1'X 1/2"Reduco rt 3a' Recommended •'�^ _--'_`� Watt Ho/e .2 5/16' � �® 251811[57.9amm) -.;.-- [66.6Bmm] Dia. �--T- J 5/16- ... (ea.lamm] 7fIRN COLLAR UHTR ACHT AGAINST SPRWRL£R WRENCH BOSS. `" 1 21/32- f [15.BBmm] 1.]SFWT -ril 1/2"(13.7Omm] • Adjustment F1 RES 44 SWC Fig.5 Technical Data: F1 Res 44 SWC Spriri CoverTemp. MaxThread TMP- wing Max Pressure Ambient Temp. K Sprinkler S¢e ng o f � oC psi(bar) of Factor Length t inch(mm) (R'/2)T 155 68 135 57 175(12) 100 38 4.4 2.45(62) ' Sprinkler Ceiling to- Flow Pressure Deflector 9pm kkwdffkzti( ) P (fir) Num M 12 x 12 3.6x3.6 13 49.2 8.7 0.60 14 x 14 4.3x4.3 14 53.0 10.2 0.71 16 x 16 4.9x4.9 4-13 (101-52) 17 64.3 15.0 1.1 16 x 18 4.9x5.5 19(71.8) 18.7 1.13 16 x 20 4.9x6.1 23 87.1 27.4 1.89 R3531 12 x 12 3.6x3.6 14 52.9 10.2 0.71 14 x 14 4.3x4.3 6-1 15 56.7 11.7 0.81 16 x 16 4.9x4.9 (152-305) 18 68.1 16.8 1.16 { 16 x 18 4.9x5.5 20 75.6 20.7 1.43 7. -7 5_ -1'Q Z C0 BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development, or redevelopment" with more than 2,000 square feet of impervious surface'. 'Redevelo ment means,on an already developed site, the creation or addition of impervious surfaces, structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity, and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. Open, uncovered retention/detention facilities shall not be considered as impervious surfaces. = *. .......................... :. Surface Type Length X Width Area All dimensions in feet Buildin s X = lacy X = Measurements for buildings are taken at the X = perimeter of the farthest projections (example: X - eaves/gutters) Drivewa s X X = Length of drive begins at the right of way X = Parking Areas X Any paved, gravel or packed area per definition above table Patios/VValks = X = Any paved, gravel or packed area per definition X = above table Others X = X - the total Err►pe ,sus area of the pr aposeci site X = tlevelprrient rs r At tf f.5d 'I"et <:::::.a 1.:.1.t�..:.rvt�t��::�: .: ::. .:::. . .:::: ::..:::. :. ::..:....:..:...::>::><:>: If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read, acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owner's legal representative,or the contractor. I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet, please read, acknowledge and sign the information provided on page 2 of 2. Page I of 2 Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14, Chapter 14.48 of the Mason County Code(MCC) regulates compliance requirements for Stormwater Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website: hAp//www.co.maso n.wa—us/code/commiss oners/index.htm Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE 0 kff—The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT. 450 Mail: P 0 Box 1850, Shelton WA 98584 Physical: 415 N 6th St, Shelton WA 98584 If this development has, or will have, a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this, or any other,parcel.You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT. 352 Mail: P 0 Box 1666, Shelton WA 98584 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor. I further acknowledge at the ' tion provided is accurate and employees of Mason County are granted access to the above- descri r erty f revie pection as may be required. ✓/ X Owner/Agent/Contractor(circle one)Dater� — Page 2 of 2 Mason County Planning Intake Checklist Owners Name: Y L' Date: 3_9-'O8 Project: m Reviewed By: Proposed use(s)of structure(s) Commercial Development: YES NO' PLANNER: GBM TSW PBC RDH RE JMS _, Site Plan: North Arrow ❑ Survey required in All UGA — ❑ AF# ❑ Monuments operlyDimensions: c3(o� X T fpr Streets and Driveways Shown. Road name: uctures shown with setbacks and use � ell Location eptic and Drain-field Shown with setbacks I su ace water(streams, ponds, shoreline, wetlands, natural or historic drainage, defined drainage ditch CAMnr1U nt UJA4pJL.�o2 ,a' Topography(slopes),,641 L4--Flo 4b ` k-L, noe+hwes ❑ Minimum Structure S acks (Dir ion/Setback): , F: 80 _ — R: ''4(D/ !✓ S1: 16101 i) S2: [,�Q ,e Utility and Drainage Easements: Yes No(if yes enter condition #5022) Other Easements �A, : -PraRat9e / +1eatpum p ❑ Does site plan show landings/a4 II exits. e� ❑ Variance applied for: Yes / No - parkin spaces allgtted. Yes No ❑ County Access Permit Needed (add condition #0010) \ _ ❑ State Access Permit Needed (add condition #0020) Standard Conditions to be added to all Building permits that planning reviews: #5019 and #0700 Site Access: Are there any impediments (dogs/gates)that my restrict access to your site? G Is the site clearly marked? How? ❑ Address t A+- Or(UGWA ❑ Name 1 Zoning: ❑ Other: Plan: Rural Zonin UGA Zoning: Rural ❑ RR 2.5 5 0 20- ❑ RT/RTC ❑ R-1 ❑ R-5 ❑ HC ❑ BI ❑ RAC ❑ RMF ❑ Unknown ❑ R-1P ❑ R-10 ❑ LTA ❑ VC ❑ Allyn UGA ❑ RC 1 2 3 ❑ Agricultural ❑ R-IR ❑ PD ❑ FR ❑ T ❑ Belfair UGA ❑ RI ❑ In-holding ❑ R-2 ❑ PF ❑ MU ❑ MHP ❑ Shelton UGA ❑ RNR 0 LTCFL ❑ R-3 ❑ POS ❑ GC 0 BP ❑ Tribal ❑ GC-CI Critical Areas: (streams, ponds, shoreline, wetlands, steep slopes) Shoreline Designation: )(N/A ❑ Urban ❑ Rural ❑Conservancy ❑ Natural ❑ Unkown Water Body (type of water if unnamed): SEPA: Yes/ N Unknowns } Flood Plain: YES/NO Unknown Map# Aquifer Recharge: YES/NO Unknown)Map# Tarts/Cases: RLC/SPI Case: r 6-Year Dev. Moratorium: YES/N� Eagle Nest Tag: YES NO ' Other YES/NO Revised: 02-07-2008 I:\PLANNING\PAC\PLANNING INTAKE MASON COUNTY RESIDENTIAL PLANS SUBMITTAL CHECKLIST Owner's Nam ,, "Date: --3_7_ (1S Reviewed By: Documents—�,� \ding Permit Application Complete STORM WATER WORKSHEET COMPLIRTE? ' Melanning Intake Checklist Complete plan includes:Allowable building area,poof.,overhangs,decks,etc. V _ e Apparatus Access Road info required? Yes No v Energy Code Application Form-O Electric wall heater O Electric central furnace O LPG Furnace O Heat pump with electric furnace O Heat pump with LPG furnace O Boiler(heat type 0 Other:Specify: _Engineering? - lirauon-WATER HEATER FUEL TYPFJLOCATION C C —Engineering? Y o Snow load: c;)1:� Seismic. _a Stock Plan—approved snow load: Seismic: Manufactured Homes-4 FLOOR PLANS Foundation Type: ANSI/Manufacture method 'Engineered footing/foundation n D Basement ) U Decks: Covered? n(D Uncovered over 4 x 6 and over 30"? n_ GA Construction plans required. Construction Plans: . 3 COMPLETE SETS Plans 'Ile _Recognized Scale _Elevation Views _Cross Section _Fo lion tan oo raming plan _Floor Plan-Use of moms noted(all floors) or Framing Plan_ floor leve ' cluding craw ace eto, c200 S.F.??; Deck FramingP _ ' f tan,incl cov.porch Plan Details. _Roof framing details,truss lay-out may be needed (Hip and girder location shown) Wall Framing-Does bearing-wall height exceed 10'?(Engineering may be required) _Floor framing: Floor joists: Floor` ns: _Window headers. Typical header. _Foundation:footing size,reinforcement Concrete Walls-Does Concrete Wall HeightRAveed 81?(Engineering may be required see details) _Landings at all exits?Less than 30"aboyograde?Y/N _Heated By Furnace-Location of FWAr ce _Fireplace/Stove Information.Shbwn-Fuel TypeT Location(s): _Window Sizes Marked on-fans _ Braced wall pane shear walls)marked on plans? 2-storyg (Engineering maybe required) I'story of two story D1=45%,D2_55% COh�p�ry r a: ENGINEERING REQUIRED Braced wall panels/brace wall lines are not marked on plans(R602.10) _ Amount and location of bracing does not meet minimum required in Table R602:10.1 DESIGN CRITERIA: All notes and details required as a result of the engineered analysis shall be transferred onto proposed building plans. Wind 85 NTK Exposure B(unless proven otherwise). Seismic Zone: Snow__.psf. IRREGULAR BUILDINGS R301.2.2.2.2 Irregular portions of structures shall be designed in accordance with accepted engineering practice. A portion of a building shall be considered to be irregular when one or more of the following conditions occur:. 1)Exterior braced wall line or BWP cantilevered or offset by more than 4' 2)Roof or floor is not laterally supported on all edges 2A)Portion of roof or floor extend more than 6 ft beyond the braced wall line. 3)End of B WP extends more than 1 ft.over.an opening more than-8 ft in width below.. 4)Opening in a floor or roof exceed the lesser of 12 ft.or 50.%of the least floor or roof dimension. 5)Portions of floor level are offset vertically 6)Shear wall lines do not occur in two perpendicular directions. 7)When a story above grade is includes masonry or concrete construction(exc:fireplaces,chimneys,and veneer). When this applies the entire story shall be designed.In accordance with accepted engineering practice. :\permit tech.building checklisst.doc Revised 11-30-2007 . ,•tI .•tit 1:; 1/.'. (.lj I� "1y �II.,'�•1 1;11i`�n ! 1'a�:ll. I�, , ',_;�. �1° :il'. ',�i�•' 1 1r1. '(.111'. { ':�• 1 .. i tl;!'A1 1 Mt. i�-I t (A I 'i1't!V l el tnvlronrrlaHr�lltea!!i+ 1'(+►r;fr�relll[►al#h fit)f t(t)( '(;GO,ll t1-I.1'nN,WA 00r ild LOCAL(300)42MM6.0 f1k:1,1'Alri(330)775•44137 / �)�a�ll:,t��itarl I'tjt' I.)i)iZCi('iitltlftfltli`I of �t�t)f�l.l)tt:�' tAX(3oo)4a.� rrg:t 111 0 dolorrn)natlon cent he 1-110do until 1 art 16 ally Nmp919S.. 2 Co np)ate only the pottlnn of flail 2 applying to tho typo of viper SYt+t0111 ulllitted. 3. jypnj t eon11�1at@(S pjlp�i. ttwr,with.altitchn�anle to the hoallh mportrr+nnt lot rov inu 1'Al'i'i 1: �I�Ei11c� Intlt'iarct�l I�i[�tttl3t;��tiic� r���h��s�2 No"110 of/�>phcflnt_ Mallinq Addrritsa...-... I'c c pllonrt ..... . Asooaaor'a Paructl N1,1011310r e-1putilloicommum"Y (, © t)rroli , tta.kMolf-for t�t>Pllc®tsar► ([�Ov rtrOttn)r WAto �ystrtrn t7 or mbrd 131110119 permit connsetloney, Land u69 SPIDIMdtlon If GO.. (! irrdivldunl wale?not One lens conncttlon; I o Divinion or laml• I If ao. ' well I 0 01 PBrool9'r. .A . ')PL 1 sprin®/et►rf1oo•Nato► u Boundary line adjustments ft Othor(OxmWA).. ... ...._ ...,- I cn Other(explain)_ '"It you hevo rrlflra then one rGaidrlrten fleplaottment tpleoen Indicate norm of malor ayalcr,► oonniolod to thin Wall,Qh®nit the Public, box• 1 UolovI U opp11096to no e1:.Inaturt+requited) VART 2: Water Syntorn Inform Intioll (;0mDioto ti)o section appropriate for the tyq©of watOt t3ystollI being o;tflluatad Putlflv Wq1tr*,yste1F>t - Name of Water 8yatem..._.. e._ _.__... ....-. _-.. ...-.--.... Water Facility Inventory(WNI)Number Vt0iiA e. I (write"norle'for two party) (atn lite,manager•ol'tit:s water sv.tem.The wMer 6yatetn has h:.e 1 u roxod ror ., �,services. There are preeontly ..1... cunnectio 1(e)in ue0.1 hi$will be the,�__ conncatton. CI I Ain the mmiti et of this syatern.l'ht;cunrlocti(►n will be lot' radc or ohango the use of im existing connec,'tlon on this symmil(ft:ra leationel to ful;tlm .I'Inn9C indicate r n the Rtilowlug limo the nature of this change Thia water system Is able And willing to provide water to this(there)connevion(3)without cxrecding the litnite or'the water system /for any thrills set by and loco]re-gu scion. t3lgntiture of Water Syet®m Mnnager...�w updur April IOU. I1 1: ,'1, ,•,�,,:: tl.'. lit 1` }'I;f:l { :ilk- 1; 4, - I` I:1(Ii lit[aividuld WIff iE ,vvt, IPtctter vvroll ropolt(I ii€r0h to avol1,)RI loll i Oeptll It w�tl oilnaclty tole(Btltann tit r�ppflcal+on) .Sii%1" . . ..�p'i he urell(/r'il/IYdlienl)A1�61»is 4Yb,tcaiii+cl►yfes?s ntlift,iN,IQlhs i tolls-cor►slrkC®cl ►16616 Gnm thorn taste are notrul on ttu) werof w011 roptw. Re-lugs riprn these torts will be excopted Nthewahrr wig ra)art cannot Wlocatuilbythe,npPll'Wt0"011evrrtartvlJlrWrx)rt does not have g peolty(eat a well ot)ppetty test whrolr provides stabuttotlon Ofdit tydown all reooyert+tl , rrlue►bz a/)erl,�rrq¢l.b y a!_canwd.Cgn(rrJctvr. I3at1efamory bacteriological test twtvc6 to npn11ca11on) t►trllvlNual �)rlrr[I/.�3u[r'c;cct Water WO01 poll-nit (ottoch to tippllcirtiort, MothoL'I of(lielrtfection (I I roNtl')0 w0tpr Nt alrote f 2t 6 onn9teee AMLitrt na9ed On IND rotlavd nU oboefv1+tionytay anchor P U P AUMOR OF OTAMMEN1 _.. -.0AT' IN Ar0I710N TO PROMING'K AUOv 61A76%IgNT,11if.Ar'P6 CANT MLc N06D Tp AAPJ?40C AN Oil 9015 IN9PEC7tON 0V THE HGA1.7-1 06PAWIRN7 ant•A YA DfdMMINA7iON Oc AD70UX.f. I)0prartuli0nt+Al ut3c- orlly. Dt) tiot writo WOW thin 11110 PART 3:I-leslth Uoparbilent Evaluation (Staff Use Only) SATISFACTORY DETERMINATION:ApPllcant's water supply appouro adequate to meet the needs of itti intended us,a. rh1.9 dFJfd►rrmlBtJpt1 A Adufv9s ndcquocyoftho dlshlbutlon systom,17uarantoe ran sttaquatti supply�of wm(ot iml0rifteiy inlo the.'uhtre. Ur pulila,11ee cotrnplinnce with nil apphoo�blo WDOC water ronouroo requlat/orls. UNBATio ACTORY UE:Ti cnMINATION:Applicent'ti water supply does not nppanr adequato to 1,noel the needs of Its intended use for the following reason (h): RE-VIVVVI R'8 SIGNATURE! � .tea___._ . DArtE_ und.t:.tio.0 X06