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Cn D HOME CONCRETE MECHANICAL MANUFACTURE Date Footings f Setbacks G By Ribbonsas Piping By C)C) Intenof Date By interior-Date By. Date C/) cO Exterw Date By Exterior-[date By Set-up < m Point Load I Isolated Footings INSULATION Date By m Date By BG I SLAB INSULATION FIRE DEPARTMENT z Foundation Walls Data By Floors Date By Date By Data By DECKS FRAMING Walls Date Br Date 13,y Data By PROPANE TANKS Vault Data Y PLUMBING Date By OTHER Groundwork Attic Type- Date By Date By Date 9 y DRYWALL Type. D'W:v Int.Brace Wall Date By 00 Da*1 e By Date By 17- (D FINAL IN SPEC' ON m Fire Sepe ration (n Water Line CD (D coUalp By Date By Date By Pass or Request I nspect. C> 0 COMO ent w 5 Type of Insp. Fail Date Date Done By -4 0 D (0 cn cn 0 :3 21: 0 :3 cn 0 3 co 0 Permit# MASON COUNT 1 BUILDING 111 426 W. C DAR SHELTON, WASHINGTO 98584� (360) 427-9670 coRREcTi NomricE Job Location Z eA&jrz� - This structure has been inspected by Mason ounty Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to g in compliance You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FUR HER 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 damage incurred by recent ❑ OK to "natural/man made" ❑This is not a complete inspection disasters.This is NOTa CORRECTION NOTICE. Date - 2 - Department Inspector THIS Tay DO N OT REMOV • iR }� MASON COUNTY PERMIT NO. J.J2 DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US 360)427-9670 Shelton ext.35 Mason County Bldg. III,426 West Cedar Street ) l275-4467 ar ext.352 360 ext.35 PO Box 279, Shelton,WA 98584 )482-5269 Em BUILDING PERMIT APPLICATION OWNER INFORMATION: CONTRAC OR INFORMATION: NAME: -� NAME: MAIL G ADDRESS: MAILING A DRESS: CITY: C� TE: CITY: STATE: IP: PHONE:e D/—� EL -sC44q 1 PHONE: CELL: EMAIL EMAIL: L&I REG# E —/—/— PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) •- / -OoD FIRE DISTRI T I` LEGAL DESCRIPTION(ABB VIATED) SITE ADDRESS / D � CITY DIRECTIONS TO SITE ADDRESS d G1,42 IS PROPERTY WITHIN 200 T: SALTWATER F]DOES PROPER HAVE SKE ❑OPE(S)WITHIN I30❑0 FT OF TH POND E WETLAND SEASONAL NO FF REAM E PROJECT-G ATER THAN 14% YES❑ NO ❑ TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATIONS R PAIR M OTHER ❑ USE OF STRUCTURE(RESID NCE,GARAGE ETC.) E �157 i IS USE: PRIMARY S ASONAL n NUMBER OF BEDROOMS /A/ NUMBER OF BAT ROOMS � DESCRIBE WORK eA-- S UA FOOT GE: 1 ST FLOOR�Cq•ft. 2ND FLOOR sq.ft. 3RD FLOOR s ft. BASEMENT sq.ft. DECK — sq.ft. COVERED DECK sq.ft.STORAGE sq.ft ft. OTHER sq.ft. GARAGE sq.ft. A TACHED ❑ DETACHED' CARPORT sq.ft. ATTACHED ❑ DETACHED❑ MANUFACTURED H ME INFORMATION: *4 COPIES OF THE FLOOR PLA MAKE MODEL AR LENG H WIDTH BEDR OMS BATHS RIAL NUMBER OWNER/BUILDER acknowl dges submission of inaccurate information may res t in a stop work order or perm revocation. Acknowledgement of such is y signature below.I declare that I am the owner,o ers legal representative,or co tractor. I further declare that I am entitled to re eive this permit and to do the work as proposed.I ve obtained permission from E 11 the necessary parties,including any easeme it holder or parties of interest regarding this project. he owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access t the above described property 3nd structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 dttA/77 sp d for period of 180 days. PROOF OF C NTINUATION OF WORK IS B MEANS OF IN PPLICATION OF 180 DAlyS WI INVALIDATE THE APPLIC ION. X Da XOWN R/ FRESENE`1C NTRACTOR Print Name (CIRCLE TO INDICAT DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE 1 "fNOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL MASON COUNTY PERMIT NO. DEPARTMENT OF COMMUNITY DEVELOPMENT UILDING•PLANNING•FIRE MARSHAL 360 427-9670 Shelton ext.35 WWW.CO.MASON.WA.US ) Mason County Bldg. III,426 West Cedar Street 360)275-4467 Belfair ext.35 .. ..., 185� PO Box 279,Shelton,WA 98584 360)482-5269 Elma ext.35 PLUMBING & MECHANICAL PERMI APPLICATION OWNER INFORMATI N: OMRINFORFORMATION: NAME: t 7MAILING ADDRESS: d S:CITY: b3 o TZIP: STATE: IP: ELL: 3DCELL:PHO E:� Qi�6 JEMAIL: EX . PARCEL INFORMATIO PARCEL NUMBER(12 DIGIT NUMBER): — LEGAL DESCRIPTION(AB REVIATEM: e5 �— SITE ADDRESS: a L CITY: DIRECTIONS TO SITE AE DRESS: AZ o -- v TYPE OF JOB NEW ADD ALT REPAIR OTHER USE O UILDING LOCATION OF FIXTURES ITS—1sT FLOOR_2ND FLOOR BA MENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANIC) UNI Type of Fixture No.of Fix es Fees Fuel Type:Ele c LPG Natural Gas Heat Pump_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heatpump Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kitchen Sinks Wood/Gas/Pel I t Stove Dishwasher Kitchen Exhaw t Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PL BING _ I rOTAL MECHANICAL OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by ignature below.I declare that I am the owner,owners legal representative,or contracto.I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtaine permission from all the necessa parties,including any easement holder or parties f interest regarding this project.The owner or authoriz d agent represents that the infor-nation provided is accurate and grants employees f Mason County access to the above described prop y and structure(s)for review an inspection.This permit/application becomes null&void if work or authorized construction is not comme ed within 180 days or if constru tion work is suspended for a period of 180 days.PR OF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACT VITY OF THIS PERMIT APPLICATION 18 DA ILL INVALIDATE THE APPLICATION. X Q FS- o p car t Dal X ' j, Nan i 7-►f Owner caner Representative/Contractor Print Name (indicate rrej DEPARTMENTAL REVIEW APPROVED DATE DENIED 1 DATE TAGS/NQT S/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL X TI O2D-I 0o D = r,o � X (Q � W - m 0 N XZ r Z o G� X Z cn N C A G � N n p o W = m - xC) 0 Q z o N n C7 W W D C7 N CC NCC n X p CJi X > o = X_ N � � T � = W �n X m = m � � X o _ 1 N i k & f e $ h h p � aa i 8 CR b3 E � a: