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Kn>trght: School Dist. #311 Contractor Name All) r6 a-�=-+►e Mailing Address 229$7 W Matlock Brady Rd Mailing Address' V I to L city Elaa State WA Zip Code` 98341 CityffiDd'C.:44 p StaWjA Zip CodeftiA Phone A6O ) 426-6767 Other Ph. (_j Phone Other Ph.( ) Lien/Title Holder Same Contractor Reg.#, R r-1.02 j 12j2— Exp.j±jj6f0 E-mail.Address fXBmcey lomk.wednat.eda E-mail Address SEPTIC/WATER SYSTEM INFORMATION-Connect to-New Septic Existing Septic 2< Connect to Sewer System_Name of Sewer System Well Water System dame of Water System PARCEL INFORMATION-12 digit Tax Parcel No. fa 20 2.2.._ / 33 . / 6[ Fire District 1;1-•-... Legal Description <Jnt ttnt F X cal 7Q) �F 'fir ZC -2 yK / IVC Alt _>c C ?1_t� SL'Z Site Address(Please incluude�street name,street number and city) Directions to site..119R`7 tit M 4K 10 t IQ P.rural I� - ct-+ v tau Will tirnber be cut and soil in parcel preparation? (Yes/No & take River/Creek Pond Wetland Seasonal Runoff Stream Slo 'ter Bht PERMANENT RESIDENCE Q SEASONAL RESIDENCE❑ :>� TYPE OF JOB-New Add Aft Repair Other X Use of Building 6,0,4 N S-1 UAAL Is this permit submittal the re0ft of a Stop Work'Notice, orre f4ortn or other enforcement action?(lfes/No) r Describe:Work fWt&t t c x,r� fh caM P�.�a s cs -pv caot No.of Bedrooms No.of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Fkoor Loft Basement Deck Other sq.ft. Garage Attached Detached Carport____..;_Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No.of Bedrooms No.of Bathrooms Type of Heat Purchase Price$ Replacement Unit?(Yes/No) Installer Name. Centro No. 01 -- NOT E. I DAYS OR IF CONSTRUCTION WORD IS SUSPENDED OR ABANDONED FOR A PERio of 19D t)AYS 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 acxxsss to the above described properly and structures for review and Inspection of this project.Owner/BuNderadmowledges submission of inaccurate information may remit in a stop work order or parr f[ 5'o �n�ent of such is by signature below. OWNER AFFIDAVIT-1Y that-I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify then as a the Cont000r Registration Law.RCW 18.27 and am aware of the ordi- contractor in the State of Washington and that I am aware c rdk we nano requirements for which thispermtl is issued and that all work will be requirements regulating the work for wh� Rem*is loued and all done in conformance therewith.No changes shall be made without first work shall be dorwin conformance thererirRli Nddhanges"I be made obtaining approval. without first obtaining approval. X Date 1p b Q FOR OFFICIAL USE BEYO IS INT / Accepted by Date Amount Due ReiM No. Btdldirig Department Oce Grci' T Constr.r Planning Department Environmental Health Departrnerlt PublNc Works peent.=' �r r Fire Marshal ; Valuation 3 FE"Idg Pem�rit Fee S �Inspection eview Fee' EH Review Fee Planning Review Fee nical&Base Fee _ Other Gas/Pellet'Stove Fee _ State Fee Violation Fee Pre-Paid at Submitta4 ( ) t TOTALS May 02 03 01 : 17p Bowers Construction, Inc. 360-249-4939 p. 2 0 Gi 1l tV XL Pt L. CONTRACTOR C3�o� �49-4SE�3 FWX BCDG 100 MOIVTEZlSANC b. WA Aj�886a FAX(360)2494939 ESTIMATE Date: 05/02/03 To: Mary M. Knight School 1 Each single 16 Gage door and 14 Gage frame. Includes: New But Hinges,Door Closer,Threshold, and glass. 2 Each pairs of 16 Gage doors and 14 Gage frames from cafeteria. Includes: New continuos hinges,Exit devices, Cylinders,Door cosers, and thresholds. 2 Each pairs of 16 Gage doors and 14 gage frames from exterior. Includes: New Continuos hinges,exit devices,cylinders, mullions, door closers,weatherstripping, and thresholds. We will include: ' Demolition New framing or lintels Finish carpentry Finish paint Disposal of existing doors, frames,and hardware. Washington state sales tax Total 29,755.32 Jeff Bowers OCT 142003 HEALTH SERVICES em N