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HomeMy WebLinkAboutBLD97-0885 Storage - BLD Permit / Conditions - 9/24/1997 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 IFS tI I L_ D 1 M C=a E' E::- t i M I T i OR i NSVLtGT 1 ONE r+t L PC- r" BETWE:FN 3pm AND Sam 427-7262 61_097-0885 PARCEL_ :490184400040 PLAT s DIVI BL.K a 1,0 ! JOB ADDRESS : 80/0 W L I TTt.F E=GYPT RD %"Fi-TON 'PERMIT ATI®N OWNER : JERRY GOLD`BY 426-3900 BY EXpIF; CONTRACTOR : TOc 1UR RROTHFRS 426---?41 1 %JLL & LEGAL_ s E112 $112 $E SE N tr..3u.:Y..,•s•.a!•c.-.xc:«•..:z�a:rrn-:s.�+a.�.�aor:^aa_s.r..:r. '.-::�rY^tna:rr.:.,-... AIC CLASS OF WORK . , :NEW BFDR : 0 BA 1 H r 0 JTYPE AMOUNT BY DATE RECEIPT AMOjNT t; UAIE RECEIPT TYPEOF USE — , !ACC STOR I FS . . . . . . . : 1 �,�.��::�,� -���-f�=�:����z...::m�.�:- :.• s:-- zr;!� -:_:..: �; OCCUP . GROUP — , slil Eat.DG . HE: I GHT . . : 01 .0f t FRVI 1 145.5f1 KS 09124197 45528 f TYPE OF CO NST . . s2N F I RFPI. ACES . . . . : 0 PICK 1 58,10 KS 09124197 0528 OCCUP . L.OAD . . . . : 01 WOODST'OVE 4 . . . . s 0 31FE " 4.50 KS 09!24197 45528 DWEI_I .UN 1 •TS . . . . . 0 PARKING SPACES : 0 ENCP 1 26.00 KS 09124191 45528 INSPECTION ARFA r ? 1,311DREI- 1 NF? . . . :N 11OTAt r 234.20 VA1.111AT IONr 16201 ��essn�esvc�:c.�--a.•mm-::.;cr-sroawraeaa!surx x:�sem::ar' �..:ses�:,r_arm.:a:a�r_.: r.•a•�n SUTBACKS—_ ----.--- - - TOIL.ETS . . . . . . . . . . r 0 FUEI. TYPES- - - - - BOILERS/COMP- . -- MOBIVE HOMF -- FRONT . . .W E00 .Of t RATH BASINS . . . . .. . , o t 0--3 lip 0 REAR . . . .E 5 '.0ft BATH TUSS . . . . . . . . s 01 3-15 HP . : 01 MODEL SIDE ( 1 ) .N 5 .Oft fi11()wFRIS. . : 01 FURN < 10OK BTU : 0 15-•30 HP . : 0 -MAKE S I DF (2. ) .S 200 .01ft WATER HE:ATFRS , . , . : 0 FURN >-10011< BTU : 0 30 -50 HP . : 01 SHRLINE 0 .0ft ('LOTHE'; WASHERS : 0 1=1)RN Ft OUR . . . : 01 504 HP . : 0 -YFAR---- - AREA KITCHEN SINKS 0 HEAT PUMP . . . , . . 0 LO'T S I7.E . . s FI,OOR DRAINS 0 VENT `>YSTFMS . . . . 0 EVAP COOLERS : 0 I ENGTH : 0 l3U I L.D I NG . . . ; Osf DP. 1 NK I NG FOON T . . • : 0 VENT FANS . . . . . . : 0 HOOKS . . . . . . . : 0 WIDTH . : 01 BASEMENT . . : Osf i A(1NDRY TRAYS , . . . : 0 DOMES . 1NCINtO IAT # DECKS . . . . . : Ost 1)1 SHWASHERS . . . . . . : 0 AIR HANnL I NG UNITS-- COMMI_ . I NC I N r 0 GAR;CARP :G 120rr: .f GARB 1) I SPO:>AL_S . : . r 0 `" 100010 c-fm . : 0 RFI1 OC:/REPAIR ! 0 AT/DT . in URINALS . . . . . . . . . . . 0 > 100010 oft . : 0 OTHER UNITS . : 0 M15C P1.M rivrimE:S : 0 GAS OUTt.ETS . . 0 t�SA6'�'i� 2'=.:i?i':b�"3i�i@ST'G^6T'.'Ag"R fC R1C9C::A..�OL!S:+:YT."P!.Gt3@UG8Stl1Q`SL.T.#HS}6�YSCLIST":1'>,T:_TA:iA�':S'kL'4�A/'.Rh'OY.i.'L"t�:OY-'1C LISC:'MACi•.':S�f.1Yfii'Y�'i--.�'r'!.•MTXG}E:T+?+'i'F^:::it#R3%dLGi`Y.'�CSY A"'dIIRS�_l'!5'GRIcL'.!'.'1�'y'T..tO:S+TJ'S-21 U.I'T...CTAA�::i-al.R�C1SJ�T`.lAC.•-6'XS��BPS :]T.:•:• PROJECT 9FSC1I?TION:STO1A81= AUI� DiN6 PROJECT LOCA114100E SNEtTON NAH OCK ROAD VIT TO 101 4 CORNERS 1N1E1: (01 ON AT 0AYIOV. TNIS PE1111 9ECON€8 NULL AND V014 iE WORK ON CONSTROCTION AJTNOR1110 11 NOT CONNENCFO 111910 t8O DAYS, OR 0' PONSTROCTION OR WORK IS SUSPENDED FOR A 1`10100 OF 180 DAYS AT ANY TIiIE AfTFA # IS CO#IIIENCED. EYf0ENr6 ,.;1�..iN�Ftlttn!TION OfTIOTK IS A PNOCAtSS 1WSPEf]I /ONS WITHN IV[ 180 DAY PERIOD. FINAL INSPECi10N N11 1 E'•T AFFIOVE0 RFTONE OUR O111C CAN OC 9 0 1 F 0 ,,�.�✓ 4kNEN ARAOENTr..__. •�- _ .. UAIEr . OLD_ NIIT, rev! 43/411191 (;OMP1 I ANC;E TO A TTACHFD COND I TIS RFOU I RF I) 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 AttOTHER d Groundwork ate y b S ,� date b date by D W WALLBOARD NAILING -7 date by date by Water Line FINAL INSPECTION date by date by date by ! I I I I I ! i MASON COUNTY Mason County Bldg. III 426 W, Cedar P.O. Box 186 Shelton, Washington 98584 Case No , : BLD97-0385 Fort JERRY W GOLDSBY page.- 1 1 ) The use, hand i i ng and story e+ cat hazy-irdous ma ter i a l s or flammable and combustible liquids in excess of 10 gaiicans is not allowed without the approval of the Mason County Fire Marsh . X 2) Proposed str"oture or any portion thereof greater than 30" in lieight frrrm gradF I Ine, must main a I n a minimum of 5 ' setbaal,, from a 1 I property I i nes . easement T and 1 O ' from all COun and State Road right of ways . X 3 ) Approved f or non-c:ommer-c l a l use sus a f;t+males t ac i i l tv . 4 ) All approved plans are required to he on-site for inspection purposes . if inspection is called for and plans ar-i not on site AppiovaI W11.1.. NOT be (lrarnted - In t.,ddition, a Re- i nspect i o!i fee in theamount of $32 .06 per hoar (m ► n i mum 1 hour ) will he oha rge3d and must be co ! lef:ted by this department prior, to anv further inspections being performed or approve I granto.0 . X 5 ) PURSUANT TO 1994 UNIFORM BUILDING CODE , SECTION 305 (C ) AND SECTION 513 ALL SITES MUST HAVE APPROVED NUMBFRS OR AE1C)RES:�ES PRi7V 1 TEED IN SUCH A POSITION AS TO Blz Pl A i Nl Y VIs, 161E AND LEGIBLE FROM TIE STAFET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT RFQI,I l FIFS THAT THIS BE COMPI F TFD PRIOR `TO CALL. 1 Nta FOR ANY SITE INSPECTIONS . A RE 1 NSPECT "ON FEE , BASED ON RATE: IN TABLE 3A OF THE 1994 UNIFORM Eat! I l..D I N(-i CODE. WILL BE ASSESSED i F O%VNER/CONTRV,TOR FA I I. `' TO POST AD11PU SS. ON S i TF PRIOR TO PEOUE ST I NCB INSPFCTIC X 6) THIS STRUCT I114F IS CONS I DERFD UNHF.ATFT) :aPACE (NO') TO EXCEED 1 WATT/SQt1ARF FOOT OR 3 .4 BTU/HR/SOUARF FOOT) . AT SUCH TIME THIS CONDITION CHANGES. A, CHANGE" OF USE PERMIT AND A MECHANICAL PFRMST ISHAI1. BE APPI IED FOR AND APPROVED PRIOR TO 1liF. CHANGE X � I 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 by date by date by FRAMING 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 I I MASON COUNTY Mason County Bldg. III 426 W. Cedar R0. Box 186 Shelton, Washington 98584 Z Nn in 5 1 51 1 ctn O ( n e U n I T o r m 5►a s i �► r.�u unless it "Change- of Use" permit I ,,3 as;r�woved . X _. __. 6 ) Changes to approved Liu 1 I d i ng plans t hat of fec-t comp 1 1 anf.e t the 1991 Wash i ngton StatF� Energy Code, 1991 Ventilation and Indoor Air Quailty Codes, the Uniform Fiu i I d i ng Code and/ c►r Mw4on mu.;t f,. be approved by Mason County prior t constrojot t nrsX _ i 9) CONSTRUCT ION PROCESS TO Bid F JFLD i:ORREC TFI) A" 1 0111 RED PF R MASON COUNTY EAU I 1 D I Nri DF PAR THE NT AND UNIFORM BUILDING CODE .X„ CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons dr.te by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING 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 Permit No. MASON COUNTY BUILDING PERMIT APPLICAT0N PO 426WCedar/P.O.Bo 86, Shelton, W9 8 5628 PLEASE PRINT �1 #1 Phone# ite Address tn/ T &CO .G �� .� Fire District# City St kVA54 Zip 9' �8 Directions to Job Site �( /-� K �ffiC C_'7C//� /!///��l1.��� /�Di4� iZ -750/ V Owner Mailing Address City 74 St ip Lien/Title Holder m Address C' ' Clty St ip #2 Contractor Name ! Contractor Reg #lUZjET 1f z 7 Address Expiration Date i�-/ G City St Zip Qel e#_ Phone# #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) # el No. Z.© �� - - 000 egal Description E //Z -5 �j� 52!F� �4[ .S/.f 724 r7 4U-ia'✓ Cc, #5 Building Square Footage: (existing/proposed) 1 st A 12&0_/ 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms #bathrooms / Garage / Carport / (Circle: Attached r Detached?) Other sq. ft. / #6 Use of building Describe work V`1006 F7W 2M #7 Type of Job: NewXalVAdd Alt Repair #8 MOBILE/MANUFACTURED HOME INFORMATION JUL 2 41997 Model Year Make Model Length Width Serial No. # Bedrooms # Bathrooms Type of Heat HEALTH SERVICES Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other I Show following on the site plan _ Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Direction I N, S, E, W Name of Flanking Street in relation to lot Ian ) Name of Fronting Street p p APPLICANT TO DRAW SITE PLAN BELOW MASON BUILDING INSPECTOR k L CHANGES TO APPROVJ„I_ DATE, �- \\ 3:2 "r APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW &&U Tb TW L PI_umbina Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins NHeatpump, Other _Bath,Tubs No. UnL Fees Show rs Furn BTU _Hot Wat r Htr Heatpumps _Laundry Washer Vent Systems _Sinks _ Spot Vent Fans _Floor Drains No.. Boilers/Compressors _Laundry asins HP _Dishwasher No. Air Handling Uni _D7inals sal cfm# U No. Fir . rolection System _Other _ Zixted 0' Fire Alarm Sys 50.00 / Fire S P. Sys 50.00 Permit Basic Fee 15.00 _ Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ No. Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUIREMENTS REGU- ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE Z FOR OFFICIAL USE ONLY: Accepted by: / Date: } DEPARTMENTAL .REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review Rem. �n1 --?�c L.2 d57 A3r✓ow Lec. 2l QJ Qj Occupancy Group:_ Type of Const: Fire Marshal Other: Special Conditions: FEES 3- Building Permit Z L) 4206 Plan Check Zo Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee S� Other &WO, Other Building Valuation: �� C)c TOTAL FEE a V r Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences t Structure Setbacks., Driveways IN Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Indicate Direction I N, S, E, W Name of Flanking Street in relation to lot plan ) Name of Fronting Street p APPLICANT TO DRAW SITE PLAN BELOW 7 r� MASON BUILDING INSPECTOR �- CHANGES SUBJECT TO APPRO'J„;_ --DATE 1 1 \ 2 C,► N Ilk P,3 U-ria-p-L4 v\ �\ D2 G\, APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW w�' • ti lv ID R'S NAME s BRANCH BUILDING LOCATION �•$� a '41le�ez:!r/5;7 &TE l 7 AND COUNTY _�/l�/��//lam A PHONE Show bay spacing, open bays, partitions, including doors, windows, skylites, vents, sheds, etc. Show type (clearspan, rows of poles, etc.) . Show concrete slabs and thickness. Show metal type (aluminum or steel) and color. Show north direction. D .7 a S15� SFP MASON WILDING INSPECTOR APPROVED El,, �� TN NS MV CHANGE SUBJECT TO A R® AI. S7.OR 6 SlT�eE DATE 47 , Su �yAN V,"//MUS.r MIT CN ' ♦ �Ser 11R C/pNGES Fp V WA�HI CTQN L` CURRINT ERFpRryi1 G WORK 4 STATE CODES lJ FB-4 O I I I I I 1 � 0 � � N g o En c-4En > UUl s o Z m N m O v Gi Z (D /z --1 � lam• n ; T� �Fov,.a� � . co q � Z c1 �f j b1 G s c�r1� � f r �� �, cri w ILn ro s --- lCl - a —4 ✓ • F' A BU��p1NG ��i,Rp�AL ' , • ' pN SU'alto�3 CHANGES Qri �! - - . 29 CUACE ROOF METAL PURLINS TO CLOCK '►ti/(J) 60 / 2X6 PURL114S O 24" R O. C. D©L l.IF �X6 BLOCKS O 24" O. C. / TRUSS -(J) 160 EA CONEC770,,!/ 2;: JOTS I- 17FFCI`:ER 2X6 GIRT O 24 " O. C. CLOCKS 1 EA SIDE - 2X6 L C!R T 04©" O. C� 6X6 PT POST 120 Iltlti! O POST (4) 120 EA 29 CU.'tCE WALL �� L EIJD MIN r .I _- --- ,tiL�PEO EARTH -- -- � _�� PCURED CONC T»3-VA95C427-006 ART 7O2I:R :STAR •:LY:. N4 27-1995 ems. �s!y <<�EO1O•Ccj, •,,:�"•ttv� �j,V' �, _'430* i 3CP4 .ES: 1IP4 .ANALYSIS ._�,. �\�.`�ytry f�'.� i ;-rp• t� 'v`. a CP :HCRO LIVE LOAD 25.00 ?Sf _M -L,17c SE41ES: _OVM= 1 't^.P C;'.CRD jSAD LOAD 4.00 ?SF 7 :C A '64 ?SI SRGSS �l.�-�kL�`�'•s SOT CHCRO DEAD !CAD 1.00 =SF C c..A '51 PSI GROSS '�rtr+��♦ �1�;r:3. + � -' f //t�'�• N 1'-�"� TOTAL UNIFORM LOAD 30.00 ?Sf �..Q _ �� '✓'' � '�� i,q�t' '1, _ 'BUSS SPACIIG: 6.00 FT. l=*4T7%S !SAD DURATION FACTOR 15: rUR�:4 SP4CiNG: 24.00 IN. CENTi-3S _ '1 2(6 OF MSR 1800f-1.5E 2_ACT.=\S: /E2T HCR. 4IN.3R --- 3E'1_ AF'=". =70 :NO CA S ACC=?'A C'c =�C 31 2X6 OF MSR 180CF-1.6E ?659 .0 5.30 IN. - _ --Y -__ ^uE_:_V _�_ U1 2X4 HEM-FIR STAND 2659 0 5.30 'N. - �^ " OED�N. i a�» Hv SEAL. 3" y= NCA N C E 4 MY 'OP AXIAL SOT AXIAL E3 AXIAL aE3 AXIAL MAX:.MUH S?AC•NG -=?AL 3PA2:V3 7F 3C7-Ill -C :N -_`•_-:`1 _ MEMBER FORCE LSR ME49ER CP•CE :BR MEYSE2 =CRC= L3R MEMBER FCRCE _3R _ __ _ -_ __ - — 1- 2 -6034 T1 5- 6 5715 31 7- Z -1309 '41 7- 3 142S W1 =' :0 - ^30^. G,�`=- ?� :N ,CHa-_3S1Cv aEOL=-_Sr_a`=?a_ _aa�_`;G 2- 3 -5140 T1 6- 7 3907 81 6- 3 *428 U1 6- 4 -1309 U1 �- '`4 p -' N -NT=`'. j 3- 4 -5140 T1 7- 1 5715 31 :C rV,&V N MBCP 2949. 4- 5 -6034 T1 — SPLICE: 7- 6=T405 ° y PLATES - � � ti� 3' -1"-1- S' -' -� J 9' -' 0 '-_ 3' - - 12 Q J � y vo -• _:vc :A as:aaT:oa 30T:•C!I :3CAD. 1 ]:GBT ;AG3 METAL 10CF::4 .AND ?UAL:Vs. 3 -2Q3,1 T412 I ic5i \T405= �tT405= l 3. 5 IN - _ :N -' 2 -0" 3FG 3ni: f f 30 -0 f SCALD: I 10'-5"-1 9'-1"-9 10'-5"-4 FT-.2483" 203903v7 ;a3 General Notes,unless otherwt a noted above. Fumis^ s Ca soar may be required to compensate*or actual dead'cad Trusses with sioosa 5ottom -ras are subiect'0 1or•Zcr:at coo�(of tnis oast n tQ the puil�ing estaner and :ont,sC.or as.action uectwp racing ano permanent wicinq ar9 r.'Ays aisoiacaments inter!Sansre"r a-onzentat`orces;o-ne tot Chet/aporo,gl in 0 verification of conformar'cs wit" required. Aster to T�Handling Installing Ana ractrq-Mid-y.l. oeannps.Loc:ivons of,aterai �veo?rac:r.o'9quire%* yes;st daOrOpnate SuddtnO codes Ind ow per's specihc3pors. �?s:qn Handle and arep with care.tTo ngt erect or use lamajea:russes. pueklidq are.ndtcatea�n:he•'sa GestgA by�:xl. U�r.;n -or ,*ads and Oinlensi 3 snarl pa ver tied epv bw ainqa des:Fe;-'i Do not Cut,7rnt Or 3tter:russes. rc4 and hottom:ncn,s, 7eanr9qs,3nchora�e, 7raetrt 1-7 ^s:at.3t:on. Ov-atn' esign CalClltetiOns are avatlaole from Lumberma`e L.i s nCluatng those with^iagy0ar-AS nr.rWinq,require.ontinuous rUSse3 tiatl be...anurac;u s 3 ne saec:f car.ong .>r ?' --1 n a ror s:rues, •�hicn's a eo onent.it snail:e '3ter3i support isheatXi g or ounins'i .runs reaction and bracing C4 aD r Stantlard•or Netai ste annectea Wood ••jsn 2ST- ntegQrates:nto the ow ainq do eaten�19th^.a0 0:V s forces final as transterred to the owidirg structure. 323i .ate orientation 3 sn0.`- :v ::at3 sigt ctr9cttcr. ?r9r :OntormanCe with.lppraorat'S an IN StanOa":s. 0'.�st3r.g3rds•9r_•ate iiate'•e^.t soaciticm!ons1•,.,:10rC ::usses snail be yysedd in enclosed building n iron-cc.r7J:siva L U M B E P M A- i E 1pllcas small oe oc31-a at : .1:arei'engtm V.. ar1`nronme9ts with adsauaLa antilation. wicutat90 , Ca. truss Diates is specirtea 3na—anutactured by Lurroerr-ata, -srteetton .or rvD if snow llpaC does not exceed L,3C0-ar a 0t.:eaan it •.0:1y T:i1:^A*.-9,1 00 muses, U14B for root trusses with ceuings gnu �'�Y(•�9.�` � 1 CC�S TPt-Tr!uyss?'atQ instttu(e ., I Ad for overnangs and roof trusses without aiitngs. NOS'•Nayonai Jesign ooecr Caton`or Wood Construction � t GARY YANDO,DIRECTOR S TA MO N DEPARTMENT OF COMMUNITY DEVELOPMENT u = o T z PLANNING - SOLID WASTE - UTILITIES 0 N Y y BLDG. I a 411 N. 5 n'ST. • P.O. BOX 578 �° SHELTON, WA 98584 • (360) 427-9670 rasa.. 'i DISCLAR4ER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD, LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS: The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by that Order, the undersigned property owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting actions', which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid. Date (Parcel No. or Legal Description) G Pro pe wner's signature(Notarized) (or the County may accept the signature of the owner's authorized agent upon proper proof of authorization) r ACKNOWLEDGEMENT CERTIFICATE(INDIVIDUAL) STATE OF COUNTY OF On this day of , in the year , before me Notary Public, personally appeared personally known to me to be the person whose name is subscribed to this instrument, and acknowledged that he/she executed it. WITNESS my hand and official seal. -For County use only- Reviewed ap li r n (Q te) Notary's signature Staff Initial: My Commission Expires: 1