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HomeMy WebLinkAboutBLD2006-02074 Final SFR - BLD Permit / Conditions - 12/4/2006 03 r = z -NN n- r- CD -i p a cD < cD l< T CD cn m 2 n =,� � °' o X 1 m � � ni ° v°i -� _V' ° ° o p° CD o c p m D ai CD Ne N c • o CD Nr D CD 0 zCn d (nmmzg co H-n C� ZD --q CD 0 O � c00 z c � CCom -wiz Cl) y FT p Z Z7 (n Zl Z7 NN� 0 Omy N -4nOc � O O m -4mC) Z N � � c,, rw m � Din oD0 0— OlOD own � Z OXm 0 m c k -q Cl) Cn o Z r 0 N 0o o rn m m m m m o S. Z o o c N v o a . p to • m rT 5 O a) pp n Cn Z CD p' D ^' -n CD O N 2 (7 ° � 2 3 C = C)=r OD m CD . �, -n0O° � CD GmZ (n N O O O r^ N o 0 -I `� m � m' 33 Off' m o Cn Cn U1 CNn co .. N y on 0 Z = 6 b 6 6 a — — W N 3 CDCD o p 0 x CA) OD y 3 o CD cQ CO w n 0 O O� r ,� y ° O 0 n� r a n _C O O O CD m z r 8 m m CC'?) o. � 3 r Cl) G b < o �. z G) G) < C ' ;� a m y m o °c_ m > c m m WW -DT T � O m r S a � n � 3 5 � anj CO) 0 'X' O '0 �° vyi > > > > cQ co = � IT O = CD* N N W CD fD 5. 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Box 186 Shelton,WA 98584 too RESIDENTIAL BUILDING PERMIT BLD2006-02074 OWNER: ROBERT GERICE RECEIVED: 12/4/2006 CONTRACTOR: GRICE CONSTRUCTION (360)876-0923 LICENSE: GRICECE033CE EXP: 3/18/2008 ISSUED: 1/2/2007 SITE ADDRESS: 471 E DARTMOOR DR SHELTON EXPIRES: 7/2/2007 PARCEL NUMBER: 321275300128 LEGAL DESCRIPTION: LAKE LIMERICK 4 LOT: 128 PROJECT DESCRIPTION: DIRECTIONS TO SITE: New SFR Lake Limerick General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: VB Type of Use: SF Insp.Area: No.of Bathrooms: 3 Occ. Group: R-3U Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No.of Stories: 1 Occ. Load: Building:1,400 Garage-Attached 560 Valuation: Building Height: 17 Occ. Status: Primary Basement: COVPORCH 83 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 25.0 Ft. Shoreline: Ft. Water Body: Rear: N 55.0 Ft. Slope: Ft. SEPA?: Model: Width: Ft. Side 1: E 15.0 Ft. Shoreline Desig.: Year: Serial No.: Side 2: W 15.0 Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 12/4/2006 $675.06 S22006000 Hosebibs 3 Furnace<100K 1 Planning Review Fee KKK 12/4/2006 $155.00 S22006000 Kitchen Sink 1 Ventilation Fan 3 Building State Fee ARC 12/6/2006 $4.50 Si200700o Laundry Tray 1 Dryer Vent 1 Building Permit Fee ARC 12/6/2006 $1,038.55 Si2007000 Lavatories 2 Mechanical Fee ARC 12/6/2006 $54.45 S12007000 Water Closets (Toilets) 3 Mechanical Base Fee ARC 12/6/2006 $23.50 S12007000 Water Heaters 1 Plumbing Fee ARC 12/6/2006 $89.00 Si2007000 Bath Tubs 2 Plumbing Base Fee ARC 12/6/2006 $20.00 S12007000 Clothes Washer 1 Address Fee BLJ 12/8/2006 $140.00 S12007000 EH Plan Review TW 12/11/200 $75.00 S12007000 Total $2,275.06 BLD2006-02074 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2006-02074 CONDITIONS FOR BLD2006-02074 1) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures meet the setback conditions listed. X 6 2) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocation. X oc 6 3) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. X 4) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall be made prior to requesting additional inspections. X 6 5) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. X /� V 6) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150'from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 7) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed. X BLD2006-02074 Please referto the following pages for conditions of this permit. 2 of 5 (j b 8) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X �S69) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X n6 6 10) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other 'W vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 11) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X QS G 12) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have prevented action from being taken. No more than one extension may be granted. X (�QC713) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the 'w corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removal of approved documents will result in failure of required building inspections. X ( 14) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans available then approval will W/�G' ans are no ava e on s en 1 not be ranted. In addition a re-inspection fee refer t current f h g p ( o c e fee schedule, minimum 1 hour)will be charged and must be collected by the Building Department prior to any further inspections being performed or approvals granted. X 15) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads,"all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. Mason County Building Department requires that this be completed prior to calling for any site inspections. A re-inspection fee based on rates as adopted by the jurisdiction and the international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting inspections. X BLD2006-02074 Please referto the following pages for conditions of this permit. 3 of 5 Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, �6116) connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X 17) All property lines shall be clearly identified at the time of foundation inspection. X 18) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 19) Per 2003 IRC - SECTION R905- REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance with the applicable provisions of this section and the manufacturer's installation instructions. X 1,620) Per 2003 IRC - SECTION 1609 -WIND LOADS- 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIND SPEED (3-SECOND GUST)the wind speed for Mason County is 85 MPH. X 21) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 22) The approved site plan is required to be on-site for inspection purposes. If an inspection is requested and the approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. X fiS6 23) This parcel is located in a smoke management zone. Please contact a fire warden at (360)427-9670 ext. 459 for further information. X 1`<G 24) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: IV, Window (Max U-Factor):0.40, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.40 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-30, Slab Insulation R-10. X C25) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands. Silt fencing must be 1 installed and maintained until upland vegetation has become established. X BLD2006-02074 Please referto the following pages for oonditions of this permit. 4 of 5 26) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which is proposed to be located within 25'of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project. X 27) This parcel is located in a smoke management zone. Please contact a fire warden at(360)427-9670 ext.459 for further information. �W X This permit becomes null and void if work orconstruction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. / OWN ER OR AGENT: _-� DATE: BLD2006-02074 Please referto the following pages for conditions of this permit. 5 of 5 o CONCRETE MECHANICAL MANUFACTURED HOME m o Date By rn Footings !Setbacks Gas Piping Ribbons N Interior Date By Interior-Date By Date By m Exterior Date B y Exterior-Date B Set-up O INSULATION Point Load J Isolated Footings Date By W BG!SLAB INSULATION M Data By Data By FIRE DEPARTMENT X Foundation Walls Floors Date By Date By Data By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING Vault Data By Date By OTHER Groundwork Attic Date By Date By Type:Date By D.W.V DRYWALL Type: InL Brace Wall Date By W Date By Date By FINAL.INSPECTION G Water Line Fin Separation C Date By Date By Date By O m dY Pass or Request Inspect. c Type of insp. Fail Date Date Done By Comments y a try 7 o ,b /Z?�T v a 8 a 0 0 m q 0 r � � 00 A 0 CONCRV MECHANICAL MANUFACTUREDHOME Footin f If" Gas P�piin'g Ribbons i N Ir icx Dot#e BY r� Interior-Date By Date By •% Exterior Bate BYh� Exterior-Daft B s Point toad I Isolated Footings INSULATION Set-up Dee B RI BG i BLAB INSULATION y Date By _ Data By FIRE DEPARTMENT M Foundation Walls Floors Date By Date - B Data Q.. By DECKS FRa+4MIN _ Data By D8te -7p-00 By f ✓ Data -D� PROPANE TANKS PLUMBING Vault mate By Date By OTHER Groundwork Ante Type- DRYWALL B Date By - Date By DRYWALL D.w.v rype- int Bruce Wail Ctate , B B i)ate By :. � . FINAL INSPECTION 2 wager Fire Sops ration Dote 9 D By Date By Date �Z7 ByID � PAS or Request Inspect. b Type of Insp. Fall Dow Date Done By CommentsCD o Sao{; ice-oS �{3 a$ 4- -o$ 5r POti' 1 t 2 v �S S�k -back. - 1 3-r�Fs �(- -�� T� s �F:crr -a fl rd. o Sete- 8 r V� j JA t N O A� CD 4 �Z-?f oc-/ LJOL S�;e� -YT ass O �y rr 5 Vi cis Z5 lyb aU 0/jo vl-cad 'a/ar r APPROVED Ltop I MASON COUNTY DCD PLA NING SITE PLAN REQUIRED TO BE ON ITE HA GES SUBJECT TO APPRO L BY _Date 3©` D� I a4g�4 PLANNING '� - - ---- rt--A EPA'' v .door �1u V 1 4 2006 RMC SYSTEM DESIGN FOR: DEBLAR ENTERPRLs>iCEW \�� ADDRESS: 32/275 3c�Qo 17'S Tedmical aonsutt� PARCEL NUM80t: j g /V y �0 I L,»v..^". 866 868 6775 LOR'DATA-Lv'f Z !� 3W.273.t M FAX ` ~ PERMIT APPUATTON#: enmi: garty0debiwx= ,.Wcri MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT WSEC/VIAQ Compliance Application Owne ✓� Telephon Q arcel#�Jo �7S��/c� Type of project (vKew Residence ( )Addition ( ) Remodel Total Sq. Ft. 1S Floor: 2 Id floor: Heated Basement: of heated area:: Heating System Type: O Electric wall heater VElectric Central Furnace O LPG Furnace O Heat Pump with electric furnace O Heat pump with gas furnace O Boiler, specify fuel type: O Other: Specifv Glazing Prescriptive Option see reverse side circle one: 1 II I V Percentage: Compliance Method O Component Performance , Chapter 5— Calculation worksheets required Check one:: % O Systems analysis, Chapter 4 O Whole House Ventilation system O Whole House Ventilation using a Heat Ventilation using exhaust fans&window or wall fresh air Recovery Ventilation System (VIAQ 303.4.4) System vents (VIAQ 303.4.1) Check one O Whole House Ventilation Integrated O Whole House Ventilation using an inline with a Forced Air System (VIAQ 303.4.2) supply fan. VIAQ 303.4.3) Window & Door Schedule (If needed, attach an additional sheet) Total Manufacturer Room/location U-Factor Size Quantity Square Feet Windows: J Windows: Total Sq. ft. Doors: Doors: Total Sq. Ft Total window and door area Total window &door area /(divided by)total sq.ft of heated area = %of glazing MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Permit Assistance Center SHELTON (360) 427-9670 BELFAIR(360)275-4467 Elma (360)482-5269 FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us P.O. Box 186, SHELTON 98584 2004 Washington State Energy Code (WSEC) 2003 Ventilation and Indoor Air Quality Code (VIAQ) effective July 1, 2004 Code Compliance Application Form The following information will be required for the WSEC and VIAQ plan review: 1. Complete the Washington State Energy Code/Ventilation and Indoor Air Quality Code (WSECNIAQ)application located on the reverse side. 2. Complete the window and door schedule on the reverse side. Include all windows, skylights, sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening dimensions of the windows and doors. Information about the U-factor of the window will also help to expedite the energy code review. If you are complying with the WSEC by prescriptive path and are using the area weighted average method you must include your calculations. 3. On your building plans note the location and fuel type of water heater, location of exhaust fans (bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and slabs, 4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 352. Additional WSEC and VIAQ compliance information is available on the internet at: http://www.energy.wsu.edu/code/ Prescriptive Requirements °,'for Group R Occupancy Climate Zone 1, Table 6-1 Glazing Glazing Ll-factor Door Wall Wall Wall Area%of Vaulted Above interior° exterior Slab° Flo Vertical Overhead" Factors Ceiling Ceiling3 Grade below 4 Below Floors on Option FI z 12 grade Grade Grade I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10 II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 IV Unlimited Single Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 (R-3)Only *Reference Case/Call(360)427-9670 ext.352 for footnote information. Log&solid timber wall with a min.avg.thickness of 3.5"are exempt from the above grade wall insulation requirements. MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 , Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us / ' APPLI T INF R TION CONTRACTOR I ORMATIO 1 l Owner U r Company Name Yl r6kL'( y Maiti dd ss Ma d`re�,s 10 City (�1' I' Stat Zip Code City U�� t to Zip Code P h o n e,, Ot er Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. � Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. Fire District _ Legal Description L-?�Vlo LIM!9fli4 0111154h Site Address (Pleas include street name, s r et num er and ) 1 Y OC>/ Y Directions to site , � S� — On 1'�_4r4rj Y Will timber be c0t and sold in parcel p aration? es/No Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs �" 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB New A d Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building � Describe Work No. of Bedrooms--No. of Bathrooms 5 Square Footage- 1st o 4DO 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage. > _ Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Acknowledges 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, 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 the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 d ys or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS O ROGRESS PECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Date: /1`27-©6 Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by:C�'I(-C,/ Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department v�LX�P fX Fire Marshal FEES Building Permit Fee / Site Ins ection Plan Review Fee EH Review Fee I Plumbing & Base Fee 61 ° Planning Review Fee Mechanical & Base fee 7-7 • Other Wood /Gas/ Pellet Stove Fee State Fee Violation Fee D L N� Pre-Paid at Submittal Valuation $ S TOTAL FEES PERMIT NO. �d "-UD(o " 0,1 07� 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 On the web www.co.mason.wa.us APPLICAsIT.INFORMATION CONTRACTOR INFORMATION Owner "<t w( Company Name t' „ Mailing Address !�" Mailln dr�s City, ('[ � ate(,t_, Zip Code City' ) " fat Zip Code Phone Other Ph. Phond D �tePh. Lien/Title Holder �� ! ! < Contractor Reg. K I xp. E mail address E Mail Address '*— Drivers Lic.# DOB Drivers Lic.# DOB f_-3`('`7 SEPTIC INFORMATION - Connect to New Septic Existing Septic. Connect to Sewer System Name of Sewer System PARCEL INFORM AT ON- Digit Parcel No, Fire District Legal Description _64 r '._/I y7eMlw Site Address (Please include streetname, street number ancLc ty) r c a Y. --o r iS�7 K-� — o n ► - Directions to site / Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric_ LPG— Natural Gas Heat Pump_ Toilets Type of Unit No f Units Fees Bathroom Sink — Furnace Bath Heatpp um s Showers bs Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other / Other /r Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowledges 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,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 the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: //"dZ�—O� Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date i-LA-e Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group-Type Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES