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BLD2009-00216 Revised - BLD Permit / Conditions - 4/22/2009
Request To Revise An'A ro q pp ved Plan Permit Number: BLD200q - (���� Name_ P',a mw S,4 kyg 61i Parcel Number 1 G s 6 55 phone Number daytime (3 3(4 t)_S 4 q 9�- Project Address Mailing Address Please provide a complete, detailed description of the proposed revisions to the approved plans: C r1 q e ' O f c� t �� 6 '(��S r "I( e 0 Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No Are the approved site plans included? ❑ Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ No If Yes, Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note:No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes ❑ No If Yes, Is a revised site plan, with all new setback dimensions included with this request? ❑ Yes ❑ No Additional Information: Applicant's signature Date: Office Use Only Received by: Date Sent Assigned To Approved By Date Original Valuation: $ Additional Valuation: $ P.FE..WH. Sq.Ft. x$ $ �f4 � 4 � U`� Sq. Ft. x$ $ Z� �D� ^ , Total New Valuation $ LL Additional Fees: Additional Planning Dept. $ Additional Plan Review $ Additional Conditions /Comments: Additional Building Permit $ Additional Plumbing $ Additional Mechanical $ Additional E.H. Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ a- a '� ( I- Goe atia ri jNINNVId g3-37IBIr S EY, 16 10 n RECE ED PLA L EVISION JAN 3 0 2013 R v DATE_ I --3(� 426 W. CEDAR ST. Scpr �'" Z6 G TO BE KEPT IN THE 'b Zb , APPROVED PARCEL FILE MASON CUUN I DCD PLANNING } SITE PLAN cdclo. , CHA�V S UE I Da te GI •�a h 5`Z� ,; sa u • �� hri !i`V U �• of west' �ti p DE ON SITE `U TO APPROVAL n L By aterP N ! eMIER 39 Ab _ . o i f ' i�8'-S'l- B5�s3 tv ,� L° p6(s p� sp TO BE KEPTa (b za IN THE PARCEL FILE cor�ui� Ca�,c In (3as:,J. e s0 G t/IJe!'' ISO CA�Zr O MASON �,--ANNING SITE Fli-A. �6 TO BE ON SITE C,1A: , 'UBJLG, TOAPPROVAL n ( L By Date20 PST' eM1ERIF �Z •i �ti• •� ' l a � SIX_ i r-- , S IA6 0 i C o{5 33-3 7 f3 f K S cX �°� Profit vos ARP ED P(a�s � g� MASON CD PLANNING SITE PLAN EDT SI T CHANGES SUBJ PPR AL By d lb L6 30 CoNcUr - i CJr�u'r � �� ,�• Cctcl� (3vs;,J, I ! i G3• s f 5��s * 0 NT' mPtY�Q, eMIER •�F Eti" ' /►w4 50 F 39 Qo„x� o r MASON COUNTY Mason County Permit Center Use: 4 DEPARTMENT OF COMMUNITY DEVELOPMENT DDR -v 06 411 N. Fifth Street/P.O.Box 186, Shelton WA 98584 360.427.9670 ext. 352 Date Rcvd ' -3 - Request for Administrative Variance for Reduction in the Required Setbacks ($115.00) For administrative review, the minimum variance on a setback request is 5 feet from the side yard lot lines and 10 feet for front and rear lot lines or any access easement. Request for further reduction requires a standard variance. Setbacks are measured from the furthest projection of the structure, including roof ea utters. Applicant/Owners: kn 01 1 ai 1n Address: �. 3G X 1©c `4 City. OrC h CI State: �!N Zip: Telephone: m _ 3LP 0 3 46 Email: If this reduction is tied to a building permit, please give permit case number. BLD (7. Cp Parcel Number(s): o�c�UC_> J f _ 05 0 33 Zoning 1 ) ' — Site Address: 31 OA-rCl 1 f1 aCZ ( � )rl- T Requested setback variance: 15 ft. Front ❑ Rear ❑ Side ft ❑ Front ❑ Rear ❑ Side ft. ❑ Front ❑ Rear ❑ Side ft ❑ Front ❑ Rear ❑ Side Front Setbacks—From access easements and road right of ways. Minimum 10 feet. Rear Setbacks—From the rear property line. Minimum 10 feet. Side Setbacks—From the side property line. Minimum 5 feet except for certain shoreline designations. An illustrated site plan is required. Your site plan must show the following: north arrow, abutting street or easements, set backs to all property lines and existing buildings, slopes, surface water, wetlands, critical areas, septic, well and driveway. Show all proposed new development. IACommunity DevelopmentTACWARIANCES\Admin Variance.doc Edited on 7/16/10 OFRONTND OR REAR YARD REDUCTION RE UESTS: g lots of record as of March 5, 2002; You must meet one of the following: 2) One of the following exists on the lot (check all that apply): ❑ a) steep slopes, wetlands, or streams present; ❑ b) soils that restrict building or septic development; ❑ c) lot width at the front yard line of no more than 50 feet; ❑ d) lot size of no more than one-fourth acre; Xe) existing improvements of buildings, septic systems, and well areas. SIDE YARD REDUCTION REQUESTS: For existing lots of record as of March 5, 2002; You must meet one of the following: 2) One of the following exists on the lot (check all that apply): ❑ a) steep slopes, wetlands, or streams present; ❑ b) soils that restrict building or septic development; ❑ c) lot width at the front yard line of no more than 50 feet; ❑ d) lot size of no more than one-half acre; ❑ e) existing improvements of buildings, septic systems, and well areas. Explain how these circumstances preclude a reasonable development proposal from meeting the setback standard for Rural Residential 2•.5, 5, 10, or 20 zones. �u E 4c 41V_ 1 NG6--h' v � 4tu- t US E rL.P-x ciwC Id Uu-, to r ; -4' ,,1-4 6A C 0 JCS qij_- s t)nlir7vi-A IA-, 10 c.6 4 cyk-- Owner/Agent (please indicate) Si nature Date Official Use Only / Approved by: Date �[ � t Denied by: Date Reason for denial: I:\Community DevelopmentTAC\VARIANCES\Admin Variance.doc Edited on 7/16/10 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar P.O. Box 279 Shelton, WA 98584 1� RESIDENTIAL BUILDING PERMIT BL 2009-00216 OWNER: PIONEER BUILDERS INC < RECEI D: 3/26/2009 CONTRACTOR: PIONEER BUILDERS, INC. (360) 874-2311 LICENSE: PIONS 22KE EXP: 11/ 3 D: 4/9/2010 SITE ADDRESS: 31 E CARDINAL CT ALLYN EXP S: 11/6/2011 PARCEL NUMBER: 85105033 LEGAL DESCRIPTION: LAKEWOOD PLAT I BLK: 5 LOTS 33-37 (LOT 47 BELWOOD ES TES) PROJECT DESCRIPTION: DIRECTIONS TO SITE: New residence w/attached garage. Hwy 3 to Hwy 302 to Belwood Ln. and E. on E. Cardinal. General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: V-B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U-1 Lot Size:16,000 Deck: Type of Work: NEW Fire Dist.: 2 No.of Stories: 1 Occ. Load: Building:1,320 Garage-Attached 538 Valuation: $ 149,250.24 Building Height: Occ. Status: Unknown Basement: cov. deck 56 Manufactured Home Information ormation Shoreline&Planning Information Make: Length: Ft. l=rpnt.y 15.0 Ft. Shoreline: Ft. Water Body: �: .-. SEPA?`.No Slope: 600.0 Ft. Model`. Width: Ft. Side 1: W 28.-d Ft. Shoreline Desig:" Not Applicable Year: _ Serial No.: Side 2: E 25.0 'Ft. Comp. Plan Desig:: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 2 Furnace<100K 1 Plan Check Fee KKK 3/26/2009 $824.30 S2200900000001 Lavatories 2 Ventilation Fan 3 Planning Review Fee KKK 3/26/2009 $205.00 S2200900000001 Bath Tubs 2 Exhaust Hood 1 EH Plan Review KKK 3/26/2009 $41.00 S2200900000001 Water Heaters 1 Dryer Vent 1 Water Adequacy Plan Revi KKK 3/26/2009 $41.00 S2200900000001 Clothes Washer 1 Address Fee KKK 3/26/2009 $ 173.50 S2200900000001 Kitchen Sink 1 Building State Fee RTB 4/6/2009 $4.50 S1201000000001 Dishwasher 1 Building Permit Fee RTB 4/6/2009 $ 1,273.75 S1201000000001 Hosebibs 2 Mechanical Permit Fee RTB 4/6/2009 $67.50 S1201000000001 Mechanical Base Fee RTB 4/6/2009 $28.50 S1201000000001 Plumbing Permit Fee RTB 4/6/2009 $93.20 S1201000000001 Plumbing Base Fee RTB 4/6/2009 $24.70 S1201000000001 ADJUST--Plan Check Fee RTB 4/6/2009 $3.64 S1201000000001 EH Plan Review ADR 4/22/2009 $62.00 S1201000000001 Building Permit Fee KS 11/13/201: $636.88 S1201200000001 Total $3,479.47 BLD2009-00216 Please refer to the following pages for conditions of this permit. Page 1 of 5 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 t� RESIDENTIAL BUILDING PERMIT BLD2009-00216 OWNER: PIONEER BUILDERS INC CONTRACTOR: PIONEER BUILDERS, INC. (360) 874-2311 LICENSE: PIONEI'222KE EXP: 6/11/2011 RECEIVED: 3/26/2009 ISSUED: 4/9/2010 SITE ADDRESS: 31 E CARDINAL CT ALLYN EXPIRES: 10/9/2010 PARCEL NUMBER: 122085105033 LEGAL DESCRIPTION: LAKEWOOD PLAT I BLK: 5 LOTS 33-37 (LOT 47 BELWOOD ESTATES) PROJECT DESCRIPTION: DIRECTIONS TO SITE: New residence w/attached garage. Hwy 3 to Hwy 302 to Belwood Ln. and E. on E. Cardinal. General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: V-B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U-1 Lot Size:16,000 Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,320 Garage-Attached 538 Valuation: Building Height: Occ. Status: Unknown Basement: cov. deck 56 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 25.0 Ft. Shoreline: Ft. Water Body: SEPA?: No Rear: N 42.0 Ft. Slope: 600.0 Ft.Model: Width: Ft. Side 1: W 28.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: E 25.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 3/26/2009 $824.30 S22009000 Hosebibs 2 Furnace<100K 1 Planning Review Fee KKK 3/26/2009 $205.00 S22009000 Kitchen Sink 1 Ventilation Fan 3 EH Plan Review KKK 3/26/2009 $41.00 S22009000 Lavatories 2 Dryer Vent 1 Water Adequacy Plan Review KKK 3/26/2009 $41.00 S22009000 Water Closets (Toilets) 2 Address Fee KKK 3/26/2009 $173.50 S22009000 Water Heaters 1 Building State Fee RTB 4/6/2009 $4.50 S12010000 Bath Tubs 2 Building Permit Fee RTB 4/6/2009 $1,273.75 S12010000 Clothes Washer 1 Mechanical Permit Fee RTB 4/6/2009 $67.50 S12010000 Mechanical Base Fee RTB 4/6/2009 $28.50 S12010000 Plumbing Permit Fee RTB 4/6/2009 $93.20 S12010000 Plumbing Base Fee RTB 4/6/2009 $24.70 S12010000 ADJUST--Plan Check Fee RTB 4/6/2009 $3.64 S12010000 EH Plan Review ADR 4/22/2009 $62.00 S12010000 Total $2,842.59 BLD2009-00216 Please refer to the following pages for conditions of this permit. 1 of 5 l CASE NOTES FOR BLD2009-00216 CONDITIONS FOR BLD2009-00216 1) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 711, 2) 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 & 3) 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 4) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or properties. Silt fencing must be installed and maintained until upland vegetation has become established. X 5) 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 ackAiowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X _ M 6) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X a 7) 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 BLD2009-00216 Please referto the following pages for conditions of this permit. 2 of 5 8) Owner/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 9) 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 of approved documents will result in failure of required building inspections. X A 10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 11) 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 12) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the underside of the roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X & 13) 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 ackpowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 14) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X —fkN 15) 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 --#\ BLD2009-00216 Please referto the following pages for conditions of this permit. 3 of 5 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. X �^ 17) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County X ordinance or regulation, must be reviewed and approved by Mason County prior to construction.rr 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 X Inspector shall be made prior to requesting additional inspections. 19) All property lines shall be clearly identified at the time of foundation inspection. X " 20) 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 21) 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 pre nted action from being taken. No more than one extension may be granted. X _w" 22) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X ` NL 23) 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 Y ` 24) 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 Sits Plan"to ensure these structures are shown and meet the setback conditions listed. X T BLD2009-00216 Please referto the following pages for conditions of this permit. 4 of 5 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 str ture for review and inspection. OWNER OR AGENT: -1S�L DATE: BLD2009-00216 Please refer to the following pages for conditions of this permit. 5 of 5 1 {�( c4- 4-7 o4oP,; . (-ois 33•-'3'7''6 14KY Ptofi ( Uoi Z. a-L P(a(-s �"1 32, lY To E KEPT IN THE a �b zb s PARCEL FILE. ee- Cprtcq E - CJf1a�r � i CG�Gk 3,o s;d. e SO G-1R(nct n h �z i Sa of wnsy 'Ll 3E ON SITE �s`� °o C;i:, =• UE L-,�rTOAPPROVAL By Date 'a WER ocrocco 3� s f 9 ! 5 A- 0 A 110 o CONCRETE MECHANICAL l MANUFACTURED HOME 0 o Date � /�c.J ByT2 Z m Footings I Setbacks Gas Piping Ribbons rTl o Intenor Date By Interior-Date ��� BY���_ Date By M N Exterior Date ©� B Exterior-Date By cat_ 03 Point Load I Isolated Footings` INSULATION Date By c BIG I SLAB INSULATION r Date By Data By FIRE DEPARTMENT m Foundation Wails Floors Date By ;0 Date G—G'zI By /Z Data 7 By DECKS N FRAMING / walls Date By Z n Date Dy . Data By PROPANE TANKS PLUMBING Vault Date By Date °�' OTHER Groundwork Attic Date .; �� By � Type. Date By Date By D.W.v DRYWALL Type. Int.Brace Wail Date By W Date — 3 BY Date By FINAL INSPECTION m Water Line Fire Seperation NC Date By Dale By / p Dale t / By /'� m � Pass Or Request Inspect. e Q Type of Insp. Fail Date Date Done By Comments s - _ Sir ►t �1 )0,445 Iy,,7 4L 0 - �, JER PIONI----� i, I ' I I- I> E= R S, I N L 3 (A AA I L��A/ September 3, 2010 Mason County Department of Community Development PO Box 186 Shelton, WA 98584 To Whom It May Concern: We would like to request an extension on BLD2009-00216. We are still planning on building on this lot but are waiting for more favorable market conditions. Please let me know if you have any questions. Respectfully yours, Bryan J Uhler m" Cp47awm g- Post Office Box 1094 Port Orchard,Washington 98366 • 360-874-2311 • Fax 360-874-0287 •www.pioneerbuildersonline.com Building Permit # - CO2-/6 MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location -3) C,-t This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been ound: Items Listed below must be corrected to gain code compliance %e o0 0 ©✓� � / - won- — r. it r_c /rQ ' S /J'.i�i//oi/G- ,c3 c- S Arc Q4 ,r9OMl 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 ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department SC,A Date / -30—1 2 Inspector DO NOT REMOVE THIS TAG Building Permit # 0-7-&C>21�1 MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 ORRECTION NOTICE Job Location`3f t'� G C—'� 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 code compliance - - / 4/ f 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 ❑ Make corrections, items will be checked on next inspection OK to ❑ This is not a complete inspection Department ? Date , �1�� Inspector moos VOOT M44V THI T, " ,� F'erriii # ��!C . 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 fo nd: Items listed below must be corrected to gain compliance I'A r-re �Ii�eR Lr �C! ��i i.t f1 j.,rr.�E-.fL v rG�:.✓�.� ��r�l�'f u+�C_ A, 1 st /*I 1 IrJ.'✓`c !1'r T t,K,-f i '' C3 Q 7"aJi— 1 L 1 = I IL I T -eo{�✓�•?► S `'%1 `4 1 4 ,, l di r�TA-C4v.✓c AA i 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 "natural/man made" ❑This is not a complete inspection disasters.This is NOTa CORRECTION NOTICE. Date 3 ��'( Department L Inspector acs f m1uT , Movllf THUft, T' G Inspection Line(360)127-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2009-00216 OWNER: PIONEER BUILDERS INC CONTRACTOR: PIONEER BUILDERS, INC. (360) 874-2311 LICENSE: PIONEI*222KE EXP: 6/11/2011 RECEIVED: 3/26/2009 ISSUED: 4/9/2010 SITE ADDRESS: 31 E CARDINAL CT ALLYN EXPIRES: 10/9/2010 PARCEL NUMBER: 122085105033 LEGAL DESCRIPTION: LAKEWOOD PLAT I BLK: 5 LOTS 33-37 (LOT 47 BELWOOD ESTATES) PROJECT DESCRIPTION: DIRECTIONS TO SITE: New residence w/attached garage. Hwy 3 to Hwy 302 to Belwood Ln. and E. on E. Cardinal. General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: V-B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3, U-1 Lot Size:16,000 Deck: Type of Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building:1,320 Garage-Attached 538 Valuation: Building Height: Occ. Status: Unknown Basement: cov. deck 56 Manufactured Home Information Setback Information Shoreline&Planning Information : y Make: Length: Ft. Front: S 25.0 Ft. Shoreline: Ft. Water Body: No Rear: N 42.0 Ft. Slope: 600.0 Ft. Model: Width: Ft. Side 1: W 28.0 Ft. Shoreline Desig.: Not Applicable Year: Serial No.: Side 2: E 25.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KKK 3/26/2009 $824.30 S22009000 Hosebibs 2 Furnace<100K 1 Planning Review Fee KKK 3/26/2009 $205.00 S22009000 Kitchen Sink 1 Ventilation Fan 3 EH Plan Review KKK 3/26/2009 $41.00 522009000 Lavatories 2 Dryer Vent 1 Water Adequacy Plan Review KKK 3/26/2009 $41.00 S22009000 Water Closets (Toilets) 2 Address Fee KKK 3/26/2009 $173.50 S22009000 Water Heaters 1 Building State Fee RTB 4/6/2009 $4.50 S12010000 Bath Tubs 2 Building Permit Fee RTB 4/6/2009 $1,273.75 S12010000 Clothes Washer 1 Mechanical Permit Fee RTB 4/6/2009 $67.50 S12010000 Mechanical Base Fee RTB 4/6/2009 $28.50 S12010000 Plumbing Permit Fee RTB 4/6/2009 $93.20 S12010000 Plumbing Base Fee RTB 4/6/2009 $24.70 S12010000 ADJUST--Plan Check Fee RTB 4/6/2009 $3.64 S12010000 EH Plan Review ADR 4/22/2009 $62.00 S12010000 Total $2,842.59 BLD2009-00216 Please refer to the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2009-00216 CONDI11ONS FOR BLD2009-00216 1) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 2) 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 1-800-647-098j. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X Q 3) 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 4) Temporary erosion control measures must be implemented to prevent water quality do gradation of adjacent waters or properties. Silt fencing must be installed and maintained until upland vegetation has become established. X : 5) 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 aowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X V11 6) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are re wired for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X 7) 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 BLD2009-00216 Please referto the following pages for conditions of this permit. 2 of 5 8) Owner/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 '`9) 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 of approved documents will result in failure of required building inspections. X A 10) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X 11) 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 12) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the underside ojf�he roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X 13) 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 ackyiowledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X � t� 14) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 61N 15) 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 4 BLD2009-00216 Please referto the following pages for conditions of this permit. 3 of 5 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 6 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 _-V 17) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County X rdinance oar-regulation, must be reviewed and approved by Mason County prior to construction. 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 Inspector shall be made prior to requesting additional inspections. 19) All property lines shall be clearly identified at the time of foundation inspection. X �^ 20) 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 01^ 21) 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 $"` 22) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X A 23) 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 24) 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 Sit Plan" to ensure these structures are shown and meet the setback conditions listed. X ' �-. BLD2009-00216 Please referto the following pages for conditions of this permit. 4 of 5 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 str turee for review a d inspection. OWNER OR AGENT: DATE: BLD2009-00216 Please referto the following pages for conditions of this permit. 5 of 5 Named \ yet Parcel# �a.�[1�—l 1 ®5 C�� 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 2. 'Redevelopment 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. 2Common 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. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X = X = Measurements for buildings are taken at the X — perimeter of the farthest projections(example: eaves/gutters) X = Driveways X = y 51) X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X = X If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Tota71mperviods'Surfke"Are6(sum ofatfareas) 3 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't_�y,��Qr� 1 r�C. 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: http//www.co.mason.wa—us/code/commissioners/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 SE A) ✓ 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. 13) 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. 1 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- descri ed property o review and inspection as may be required. q X Owner gent/ 9ntractor(circle one)Date: Page 2 of 2 MASON COUNTY PERMIT NO. V�k 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 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Company Name 15i ! Mailing Address' x ` Mailing Address City�w� 0 Stated_ Zip Co( City State Zip Code Phone3bu `1 19 2111 Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg. Exp. Email address ctb ,l tr5j 1.c: ;s.+ E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to Ne! Septic ✓ Existing Septic Connect to Water System -1" Name of Water System N i r ' Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No. l�:�i5-� �-1 {,�yh ; Fire District Legal Description Site Address(Please.include street name,street number and city) (�- iN LA Az Direction _to site ), .r �� - w ' I Wi I timber be cut and sold in parcel preparation?Yes/ Is property within 200' of Saltwater Lake River/Creek Pond _ Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% V11) Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye o TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building 5 i>D Describe Worker G�� Ncr No. of Bedrooms > No. of Bathrooms 0—Square Footage- 1 st Floor i S (J 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage L=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 1 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. PROD OF NUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X 71 ' � Date: ► -3 Owner/6wners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department Environmental Health Department (� Public Works Department / Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee 7, EH Review Fee Plumbing & Base Fee a� ?6 Planninq Review Fee Mechanical & Base fee 7 Sly' �G Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES MASON COUNTY PERMIT NO. 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 we "MO APPLICANT INFORMATION CONTRACTOR INFORMATION Owner '�;o,i-i 3 I Aka.ti,),r• Company Name Mailing Address'2 0 _1111, l S oq Mailing Address City3 r,-� 0.-1 V', a State_16L _Zip Code `t, ?1 l City State Zip Code Phone ",L Other Ph. Phone ther Ph. _ Lien/Title Holder Contractor Reg. #May l=T Exp. CT- E mail address LEA E Mail Address Drivers Lic.# D&iI Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No I Fire District Legal Description Site Address (Plea e incl de street name,street number and city) > I ca " I L n. 6.111.n Directions site o 1 Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% n TYPE OF JOB -New ✓ Add Alt Repair Other Use of Building Location of Fixtures/Units- 1st Floor— 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNIjS Type of Fixture No. of Fixtures Fees Fuel Type:Electric ✓✓_LPG—Natural Gas_Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink Furnace i Bath Tubs _ Heatpumps Showers t) Spot Vent Fan _3 Water Heater I Propane Tank Clothes Washer I Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher I Kitchen Exhaust Hood t Hosebibs Dryer Vent I Other Other 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.1 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. PrFOF NUATiON OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. Planning Department 7 r4 4 0 Environmental Health Departme FEES Plumbing& Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/ Pellet Stove Fee Other Violation Fee TOTAL FEES