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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date by
Foundation Walls date by Set Up
date by INSULATION date_ by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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CONCRETE MECHANICAL MOBILE HOME I
Footings-Setback date by Ribbons I
date by Gas Piping date by
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
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CONCRETE
MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date by
BG/SLAB Insulation Floors Final
date FRAMING by date by date by
Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
Building Permit MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
j/ ; .5 " .
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 code compliance
AQ
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 �7
❑ This is not a complete inspection Department
Date l d Inspector
T
DO NOT REMOVE THIS TAG
41(
FORM MUST BE COMPLETED IN INK PERMIT NO.: M�
PLEASE PRESS HARD 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 Seattle 206 464-6968
APPLICA T INFORMATION CONTRACTOR INFORMATION
Owner Hoaotl t5aiA.3n Contractor Name (D1 ,C- e-r�i ve
el
Maili Add ess e- MailingAddress =
Cit G� State Z' Code City " lAL-V-A StateLlq ZIp Cod
Phone ii*1ther Ph.( Ph. : Y they Ph.
Lien/Title Holder Contractor Reg. #
Address I Expiration
SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of
Sewer System
PARCEL INFORMATI N-12 digit Tax Parcel N . 7- 1 / / ( m.2- Fire District
Legal Description
Site Address(Please include street Name, street number and city)
Directions to site
Is your property within 200' of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or
Bluffs
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) MECHA�I6ALJ �Biel Type: Electric
Type of Fixture No. of Fixtures Fees LPG_ ( Natural Gas _Heatpump
Toilets Type of Unit �� No. o� Fees
Bath Basins Furnace fS,45
Bath Tubs Heatpumps
Showers Vent Fans
Water Heater 1 cc Propane Tank
Laundry Wsher Gas Outlets 2- 5.SG
Sinks Wood/Gas/Pellet Stove
Dishwasher Direct Vent?
Other Other
Other Other
Base Fee ,G'G' Base Fee 2510 UT
TOTAL PLUMBING ,1', TOTAL MECHANICAL�?�
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
aaal. first o in g approval.
x Date
J
FOR OFFICIAL USE BEYOND THIS POINT ''
Accepted b Date Submittal Amount Due b Receipt No.
'IIE�ARTft�EE#dTAE:#Z1w11iE11Y:>::;:;.3:r APPROVED >:DENIEt}.::.; .....!
Building Department M(3 ►DS 4
Occ Group Type Constr.
Planning Department
Other
Other
Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee Other
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( )
Violation Fee TOTAL FEES