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Lien/Title Holder Contractor Reg. # WASHIES9710B Exp. 09/02/07 E mail address E Mail Address Drivers Lic.# DOB 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. 420125400012 Fire District Legal Description Site Address(Please include street name, street number and city) 12 E Cherry Park, Shelton 98584 Directions to site ct c� f.fr'rif.t a t r ({ =� J 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 X Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets 1-15ft.for gaslogs $. Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee ' TOTAL PLUMBING 1 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 a�QTIN d grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OFTI F ORK IS BY MEANS OF A PROGRESS INSPECTION. X �� Date: 14 Owner/O\NnW Re resentati e/Contractor (indicate w ich 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 Ins ection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES o CONCRETE MECH ICAL MANUFACTURED HOME > o Date " 'r Li Z Footings r Setbacks m07 Rltorts C7 Gas Piping ,/� Interior Date By Interior-Dat�e������ By/I�if►'L Date By Z _. p Exterior Date By Exterior-Date By Set- 0 co INSULATION Point Load;Isolated Eoot ngs Date By m BG t SLAB IItiSULAk'�iC3N1 Date By Data By FIRE DEPARTMENT � Foundation Walls Floors [sate By > cat By Data DECKS X FRAMING Walls Cate By Date By. Data By PROPANETANKS PLUMBING Vault Data By Data By OTHER Groundwork Attic Data By Data By Data By D.w.v DRYWALL T`ypee Int.Brace Wall Date By 00 Sate By D ByI— FINAL INSPECTION � v Water Line Fire Sepe►ati s o Data By Date By Dato By o m `° Fuss or Request Inspect. o Type of Insp. Fail Date Cate ®rune By Comments o 0 0 6 v cn cn 8 a 0 cn 0 U m r� :x 0 MASON COUNTY Department of Community Development RESIDENTIAL INSPECTION CARD and CERTIFICATE OF OCCUPANCY* PO BOX 186, 426 W Cedar ST, Shelton WA 98584 General Questions: (360) 427-9670 ext 352 Inspection Requests: (360) 427-7262 Permit Number BLD2007-01508 Date 08/21/2007 Issued By Project WATER HEATER, GAS OUTLET Site Address 12 E CHERRY PARK SHELTON Applicant KATHY VAN DENOVER Contractor License Number Con. Phone Expiration Date Primary Code Occupancy Division Use Single Family Type of Construction Occ. Load Public Works Access/Driveway Other Health Dept Septic Well Planning Dept Site Inspection Fire Marshal Fire Apparatus Access Fire Sprinkler Auto Fire Alarm Hood and Duct Other Final Building Dept Building Official: Barbara Robinson Concrete Setbacks Slab Footing Perimeter Ret.Wall /Bulkhead Footing Interior Footing Decks/Porches Foundation Stem Other Rough-In Groundwork Plumbing Plumbing Groundwork Mechanical Other Groundwork Gas Pipe Gas Piping Framing Mechanical Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Nailing Interior Wall Brace Panels Fire walls Other Final Building Manuf. Home Setbacks Setup Concrete Foot/Runners Final Other APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS *THIS STRUCTURE MAY NOT BE USED FOR OCCUPANCY UNTTL ALL APPLICAB!F FINAL INSPECTIONS ARE COMPLETED DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVALS ARE GIVEN. POST THIS CARD IN A CONSPICUOUS PLACE ON THE FRONT OF THE PREMISES CONVENIENT FOR MAWNG REQUIRED ENTRIES. ALL PERMITS EXPIRE 180 DAYS AFTER PERMIT ISSUANCE OR 180 DAYS AFTER LAST INSPECTION ACTIVITY IS PERFORMED. OWNER/AGENT IS RESPONSIBLE FOR CALLING FOR ALL INSPECTIONS PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMT MUST BE MET.