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HomeMy WebLinkAboutBLD2011-00412 Cancelled Garage to Living, Addition - BLD Permit / Conditions - 6/22/2011 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT P o : (360) 27-9670,ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2011-00412 OWNER: DENNIS GALE RECEIVED: 5/19/2011 CONTRACTOR: LICENSE: EXP: ISSUED: 7/13/2011 SITE ADDRESS: 181 E VINEYARD CREST RD GRAPEVIEW EXPIRES: 1/13/2012 PARCEL NUMBER: 121087890050 LEGAL DESCRIPTION: TR 5 OF SURV 11/150 EX TR 1 OF SP#1802 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Change existing garage to living space with addition and attached carport ST RT 3, R ON GRAPEVIEW LOOP RD, R ON EKERT RD, GO STRAIGHT AT THE STOP SIGN. R ON VINEYARD CREST RD TO SITE ADDRESS ON THE LEFT General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 1 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R3U Lot Size: Deck: Type of Work: ALT Fire Dist.: No. of Stories: 1 Occ. Load: Building:1,828 Carport-Attached 396 Valuation: $ 144,282.08 Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 50.0 Ft. Shoreline: Ft. Water Body: Rear: N 14.0 Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: E 36.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: W 100.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 2 Ventilation Fan 5 Plan Check Fee GMM 5/19/2011 $809.74 S12011000i Lavatories 2 Propane Tank 1 Planning Review Fee GMM 5/19/2011 $205.00 S12011000i Bath Tubs 1 Gas Outlets 2 EH Plan Review SJC 5/19/2011 $103.00 S62011000i Showers 1 Woodstove 1 Water Adequacy Plan Review SJC 5/19/2011 $103.00 S62011000i Water Heaters 1 Exhaust Hood 1 Fire Warden Review GMM 5/24/2011 $73.00 S120110001 Clothes Washer 1 Dryer Vent 1 Building State Fee DLC 6/20/2011 $4.50 S120110001 Kitchen Sink 1 Building Permit Fee DLC 6/20/2011 $1,245.75 S12011000i Dishwasher 1 Mechanical Permit Fee DLC 6/20/2011 $219.40 S12011000i Hosebibs 2 Mechanical Base Fee DLC 6/20/2011 $28.50 S 120110001 Plumbing Permit Fee DLC 6/20/2011 $93.20 S12011000( Plumbing Base Fee DLC 6/20/2011 $24.70 S1 201 1 0001 Total $2,909.79 BLD2011-00412 Please refer to the following pages for conditions of this permit. Page 1 of 6 CASE NOTES FOR BLD2011-00412 CONDITIONS FOR BLD2011-00412 1) 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 1-800-6A7-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X (� 2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available 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 must be collected by the Building Department prior to any further inspections being performed or approvals granted. X (7 3) Ownej/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 4) 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 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 f approved documents will result in failure of required building inspections. X C/ 5) 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 BLD2011-00412 Please refer to the following pages for conditions of this permit. Page 2 of 6 6) WSEC option 3, 3a and 5a: Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric wall mount, Compliance Method: Prescriptive option III, using option 3A, Table 9-1: Window(Max U-Factor):0.28, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-38, Ceiling Insulation R-38 advanced or R-49 standard, Vault Insulation R-38, and Slab Insulation R-10. In addition the following credit from Table 9-1 shall be completed: Options 3A and 5A electric water heat EF .93 or higher and plumbing fixtures as follows: lavatory sinks max.1.0 gal/min, kitchen sink faucet(s) max. 1.75 gal/min., and showerheads max. 1.75 gal/min. X �v 7) A permanent certificate, completed by the builder or registered design professional, shall be posted within three feet of the electrical distribution panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 503.10.2, and air leakage results if a blower door test was conducted. Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 0.00030 Specific Leakage Area (SLA) when tested with a blower door at a press of 50 Pascals (0.2 inch w.g.). Testing shall occur at any time after rough in and after installation of penetrations of the building envelope, including penetrations for utilities, plumbing, electrical, ventilation, and combustion appliances and sealing thereof. The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is not required for additions less than 750 square feet. Reference WSEC 105.4 Certificate and 502.4.5 Building Air Leakage Testing. Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2009 Certificate" and are available in %,or%sheets. The Mason County Permit Center will also have some available. X 8) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or installed in or around swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps). Reference WSEC 505. X 9) WIND LOADS - Roof coverings shall be designed and tested to withstand the maximum basic wind speed. The basic wind speed for Mason County is 85 MPH. X L� BLD201 1-0041 2 Please refer to the following pages for conditions of this permit. Page 3 of 6 10) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer's installation instructions. X 11) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. `NOTE if Stormwater Management option "A" was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting 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. By calling for a final inspection of the building permit the owner/agent/contractor is acknowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X L��� 12) The use, handling and storage of hazar ous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X 13) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged nd shall be collected by the Building Department prior to any further inspections being performed or approvals granted. XL 14) 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 19 v cation. X C,l� 15) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency (ORCAA). It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos containing materials have been identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the owner or operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044 /800.422.5623 www.orcaa.org X 16) 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. C71 X BLD2011-00412 Please refer to the following pages for conditions of this permit. Page 4 of 6 17) 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 i 18) 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 Inspect r shall be made prior to requesting additional inspections. X L l 19) All propane tanks must be installed in accordance with the International Fire Code and all applicable Mason County ordinances. All propane tanks must meet the installation requirements and minimum setbacks as listed in the Mason County Fire Marshal's Standards for the Installation of Propane Tanks. X 20) Fuel piping shall be inspected after the installation of fuel piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system shall not be used until the final inspection has been performed and approved by a Mason County building inspector. X /G 21) Epoxy grout required and specified on the approved building plans shall require a special inspection. The special inspector shall be the engineer of record or their authorized representative, a WABO Certified special inspector, or certified testing laboratory. In addition a Mason County Building Inspector may perform the inspection provided holes are prepared in accordance to manufacturer specifications that are available on-site during inspection Special inspectors shall inspect the installation of grouted construction anchors as stated in the manufacturers specifications. An inspection report shall be prepapd and submitted to the Mason County Building Department prior to the framing inspection of the project. x C ` 22) All property lines shall be clearly identified at the time of foundation inspection. X C� 23) 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 CQ my ordinances and building regulations. X Gi 24) 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 C/� 25) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM OR ROAD WAY. X c �` BLD2011-00412 Please refer to the following pages for conditions of this permit. Page 5 of 6 26) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 27) Temporary erosion control measures must be implemented to prevent water quality degradation of adiacent waters or properties. Silt fencing or straw matting must be installed and maintained until upland vegetation has become established. X U 28) All construction and demolition debris must be removed from the site after project completion. Prop r disposal of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X - 01 This permit becomes null and void if work or construction 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. OWNER OR AGENT: DATE: Z/,2'// BLD2011-00412 Please refer to the following pages for conditions of this permit. Page 6 of 6 o CONCRETE MECHANICAL MANUFACTURED HOME y r Footings!Setbacks Date By Ribbons Gas Piping - o Interior Date By Interior.Date By bate By v Exterior Date .�� By Exterior-Date Bt-up T — Z N _ Point Load I Isolated Footings INSULATION Date By Z BG/SLAB INSULATION Date By Data By FIRE DEPARTMENT Foundation Walls Floors ,)S Date By Date By Data Lq /y By cov, DECKS FRAMING i /L Walls Date By Date By Data By PROPANE TANKS PLUMBING vault Date a.y p Date By OTHER GLGi1t: i 1C Attic iv Dete By Type- Date By Data By o.W.v DRYWALL Type- Date Brace Wall Date By 100 � Date of / Z� By (�) Date By r m FINAL INSPECTION v m Water Line Fin Separatism Date By Date By Date By s Pass or Request"' eque Inspect. c Type of Insp. Fail Date Date Done By Comments CD o A:-17x-b Z e,-tjL o / GC14vC.,o - U) f0/i'G'c ' ° Cn �r�-t� IIG,I Z ZT JZ Ztt Z LNL ire ►G�,1 ZS 3 z >�� Srti,�,s ,r�t C�. kirk b14U < I�u�I P4cS I eA wasp _ ► I /� -�L - L lr / r v co 0 F�ertr�it'# y It160q)Z MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE 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 compliance Sec:1 6A PAf LjA ,l .J 44-v— fti A n A A—6%n ham.. s,'fC'i Ovr-.i a 4-rLl�vG' . - � � w�u✓L �`v.r OG� S v t.- 0,01 IA-1 1•` s -r c• Ad a,, Yli-s S r/ L�Gk r G I 1 f r- ✓�t 7U �vG— ! i-f • a , v it ti.� ,'mac. c.c ri 1 rS f�• I c r 1/i' w h Y. tic s �T ✓ti 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 ❑ please contact our office ® Make corrections, items will be checked on next inspection regarding possible structural ® OK to I^ f-ei• damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOTa Date 2I2,1 I l-L- Department CORRECTION NOTICE. Inspector L,0)C� DO NOT R A&IV ' ' THINqft, TwoME Permit# MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found- Ite s listed below must be corrected to gain compliance cam a S i - C1 r( 7, o G 9, ` II on ® T ov tidT O�r"� a � 1 � � - ono � — !� D�sT'o.✓ / You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK PA Call for re-inspection when corrections are made before continuing ❑ please contact our office Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "naturaUman made" ❑ This is not a complete inspection disasters.This is NOTa f CORRECTION NOTICE. Date-3 ' l y` � z- Department � l Inspector D* NjT , 'Iml* z4 ' ' THI , , T A Permit# MASON COUNTY BUILDING /II 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location /Q/ V/1! y'f�TOI � This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items list d below must be corrected to gain compliance I/Y GL vy -t- w //1/S' GL oar DL C- 4 _ !i✓ O S s o ` o /J9r/ 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 ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural1man made" ❑ This is not a complete inspection disasters.This is NOT a Date Department CORRECTION NOTICE. Inspector . /r9i✓ Do d* OT ' rIJU ' ' T I T" ems MASON COUNTY PERMIT NO. plCl •�JIJI1` 00`71 1 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 APPLIC NT INFORMATION CONTRACTOR INFORMATION Owner 1 S a. - Company Name Maif g Address O Mailing Address Cit ti' 'tip Stak 'J Zip Code y City State Zip Code PhonQ� ?761 ''ram _� Other Ph. Phone ther Ph. Lien/Title Holder OWLIP,112 Contractor Reg. # Exp. E mail address a E Mail Address Drivers Lic.# 'k 3 PK DOB i0 .12'E 0 Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic— Existing Septic Connect to Water System Name of Water System Well---Z Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel Ni - q 0 0,,:;-0 Fire District Legal Description Site Address (Please include street name, street number and city) S Directions to site o rNF Will timber be cut and sold in parcel preparation? Yes/ o 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?Ye o TYPE OF JOB - New Add_X Alt Repair Other PRIMARY RESIDENCE jRr SEASONAL ❑ Use of Building Describe Work o t= u E Rom -E- No. of Bedrooms No. of Bathrooms�Square Footage- 5��p I� zs� r DO 3rd Floor % Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport ! Attached X 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. PROOF F CONTINU ON OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: S ' `7 Owner/Ow rs Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Dat 2D DEPARTMENTAL REVIEW cAPPROVED DENIED NOTES Building Department Q - Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee S. Site Inspection Plan Review Fee G EH Review Fee Plumbing14& Base Fee d Plannin Review Fee Mechanical & Base fee --a Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal O 7 Valuation $ TOTAL FEES (AD PERMIT NO_, � I l - MASON COUNTY PLUM BINGNECHANICAL PERMIT APPLICATION 426 W_Cedar- P.O. Box 186, Shelton,WA 98584 Shelton (360)427-9670-Beffair(360)275-4467-Elma(360)482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner 1 S 2Y I iJ Company Name Mailing Address Mailing Address City State_L Zip Code City State Zip Code Phone? O 3 J a u(obcf Other Ph. Phone Other Ph. Lien/Tiitle Holder Contractor Reg.# Exp. E mail address /a- - CO M E Mail Address Drivers Lie. UDOB Drivers Lie.# DOB SEPTIC INFORMATION -Connect to New Septic Existing Septic. Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No I f 0 D Fire District Legal Description Site Address(Please include street name,street number and city) l — Directions to site R Is property within 200'of Saltwater I Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building C o r u Location of Fixtures/Units-1st Floo 2nd Fioor Basement Garage Corr' s oset ro �o PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Elect' LPG ,�` tural Gas_Heat Pump_ Toilets 2- Type of Unit No.ofUnds Fees Bathroom Sink Furnace Bath Tubs �_ Heatpumps Showers Spot Vent Fan ►�j Water Heater Propane Tank Clothes Washer Outlets 2_ Kithen Sinks _�_ W ellet Stove Dishwasher 1 en Exhaust Hood j Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OVVT E /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 appftcation.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 worts 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 CONTINUATIPN OF WORK IS BY MEANS OF A PROGRESS INSPECTION. �] / X Date: Owner/Owne -presentative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date _Bid 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 4 27S, O1 i�►ZoP, l�N-L • 255.33 -- � S z +ur ' MAY 2oil PLhNNING . .f N 5� PLANNING: � MEASURED I� t - SETBACKS ARE , � ;ALL �j FROM THpo E FURTHEST PROJECTION ©F THE BUILDING \41 � I v APPROVES PLANNING MASON COUNTY pCD PLA�1N SITE PLAN REQUIRED TO BE ON SITE `�- i CHANGES SUBJET TO APPROVAL By q c - v . . K '7 1 "' i -------------- 1 `{