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Home My WebLink AboutBLD2015-00113 Remodel, Reroof - BLD Permit / Conditions - 3/16/2015 Request To Revise An Approved Plan Permit Number: BLD ^9015 _ CAD 113 Name Parcel Number ) ;aZO- _- _ Phone Number daytime (13 2cbOr 70'ZS Project Address 1 Q?2 6 IF, SR- 3 Mailing Address ..- �v vA- Please provide a complete, detailed description of the proposed revisions to the approved plans: 1 f �> L0 4- ,o -Qf-CJC- A.rt two sets of the revised plans or addendum indicating the changes included? P'ye:s ❑ 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"elan will be approved witoout the written consent of the engineer and/or architect of record) Does the proposed revision modify the footprint or location of the struct�, t? \Yes If Yes, Is a revised site plan,with all new setback dimensions included Rath this request? n _ J❑ Yes ❑ No Additional Infonnatio rly-) n F 14 11 n� 3-19-l� Appl_icant's signature Date: -. Once Use Onty Received by. Date Sent Assigned To Approved By Bate Original Valuation: $ B. 313 IC�� Additional Valuation: $ Sq.Ft x$ $ j4i4e) Sq. Ft x$ $ Total New Valuation S Additional Fees: Additional Planning Dept $ Additional Plan Review $ tonal Condtonst/ Co,�tmeen::: Additional Building Permit $ �,( Additional Plumbing $ hi nAdditional Mechanical $ Additional E.H. Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ Inspection Line (360)427-7262 N carN�f MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County Bldg. III 426 W. Cedar Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2015-00113 OWNER: DEAN BURNETT RECEIVED: 2/18/2015 CONTRACTOR: KETTELAND CO LICENSE: KETTECL861ON EXP: 9/15/2016 ISSUED: 3/16/2015 SITE ADDRESS: 18220 E STATE ROUTE 3 ALLYN EXPIRES: 9/16/2015 PARCEL NUMBER: 122205002001 LEGAL DESCRIPTION: ALLYN BLK: 2 TR 1 (SWLY 100'OF BLK: 2 & ELY 10'OF VAC SHERWOOD ADJ &VAC PTN ASHTON) PROJECT DESCRIPTION: DIRECTIONS TO SITE: INTERERIOR REMODEL AND RE-ROOF OF SRF ST RT 3 N TO ADDRESS IN ALLYN General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 2 Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. Group: R-3 Lot Size: Deck: Type of Work: REM Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:1,347 Valuation: $ 100,000.00 Building Height: Occ. Status: Primary Basement: Manufactured Home Information Setback Information Shoreline & Planning Information Make: Length: Ft. Front: Ft. Shoreline: Ft. Water Body: CASE INLET Rear: Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: Ft. Comp. Plan Desig.: Urban Growth Area Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Bath Tubs 1 Dryer Vent 1 Plan Check Fee JBN 2/18/2015 $645.94 S220150000000t Clothes Washer 1 Exhaust Hood 1 Building State Fee MAU 3/12/2015 $4.50 S120150000000i Dishwasher 1 Ventilation Fan 3 Building Permit Fee MAU 3/12/2015 $993.75 S120150000000i Kitchen Sink 1 Mechanical Base Fee MAU 3/12/2015 $28.50 S120150000000( Lavatories 3 Mechanical Permit Fee MAU 3/12/2015 $49.20 S120150000000i Showers 1 Plumbing Base Fee MAU 3/12/2015 $24.70 S120150000000i Water Closets (Toilets) 2 Plumbing Permit Fee MAU 3/12/2015 $95.70 S1201500000001 Water Heaters 1 Total $ 1,842.29 BLD2015-00113 Please refer to the following pages for conditions of this permit. Page 1 of 4 CASE NOTES FOR BLD2015-00113 CONDITIONS FOR BLD2015-00113 1) 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 �3 1-800-647Q� The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) 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 Departm L pr to any further inspections being performed or approvals granted. X 3) Owner ZK is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X 4) All replacement windows shall be installed per manufacturer's specifications and be flashed per IRC section R703.8. All installations shall meet requirements for guards per R613 and safety glazing per R308.4. WSEC requires a U-factor of .30 or less in all heated spaces. Existing, non-conforming, egress window openings are not required to be enlarged, but it is highly recommended. Egress windows replaced in an existing opening shall be brought into compliance with current codes if a product is available for this application. Building plans/permit are required for windows in new, enlarged or relocated openings these installations must meet all current codes. Windows and doors shall be installed in accordance with the manufacturer's written installation instructions and shall be available during inspections. X 5) All wall cavities serving as exterior walls, exposed during construction or remodeling work shall be insulated to the full depth of the wall cavity and inspecte ty covering. Insulation R-values shall be as follows: 2x4 wall cavities min. R-15 and 2x6 wall cavities min. R-21. X 6) Single rafter joist roof NplgCRnnent shall be insulated to a minimum of R-38 allowing for a minimum of one-inch continuous vented airspace above the level of insulation. X BLD2015-00113 Please refer to the following pages for conditions of this permit. Page 2 of 4 7) 2012 IECC/Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric or other than electric, Compliance Method: Prescriptive option Marine-4C, Window(Max U-Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.30 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation min. R-49, Vault Insulation R-38, and Slab Insulation R-10. In addition thefollowing credits from R406.2 shall be completed as follows: NO CREDITS NEEDED FOR WORK BEING DONE X L}� 8) A minimum of 75 percent of all permanently installed lamps in lighting fixtures shall be high efficacy lamps in accordance with IECC/WSEC Section R404.1. X 9) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer's installation instructions. A drip edge sh be provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5) X 10) Carbon monoxide alarms, listed as complying with UL 2075 shall be installed in accordance with manufacturer specifications and in accordance with IRC Section R315. Alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on each level of the dwelling. EXISTING DWELLINGS shall be equipped with carbon monoxide alarms when alterations (including addition or alteration of fuel burning appliances), repairs, or additions requiring a permit occur, or when one or more sleeping rooms are added or created. X !Ll� 11) 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 oQatnn. X 12) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordin�regulation, must be reviewed and approved by Mason County prior to construction. X 13) 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 Inspe� F(all be made prior to requesting additional inspections. X �W BLD2015-00113 Please refer to the following pages for conditions of this permit. Page 3 of 4 14) 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 Co ty nances and building regulations. X 15) 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 ha�nted action from being taken. No more than one extension may be granted. X 16) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors-a f ing. Install metal connectors approved for contact with the new types of pressure treated material. X 17) Landings and stai ust meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Appro Ian" to ensure these structures are shown and meet the setback conditions listed. X 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s) for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PER LITAPPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. PC 03 Signature Date OW REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) BLD2015-00113 Please refer to the following pages for conditions of this permit. Page 4 of 4 LA PLOT RL-VISION PLANNING RaCEivc 7 PLANNING : RECEIVED MAR 15 2016 ALL SETBACKS ARE MEASURED DATE \j'15 cello FROM THE FURTHEST 615 W.A1der sbvet PRQIFr.TIQNQF- - - rSHEf vl00D AvE. RT. 3 /t�LLYN. 1 X3P. 0 No cn a l0 Q EXISTING N ul -- z 8,o„ A o �Idzors ..oa 113 w d a � u nit o Y,?,o APPROVED ASON COUNTY DCD PLANNING �- SITE PLAN REQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL By 7 Date vtG (��-{ NO SCALE Lf9SES INLET i�2DP�5ED GARAGE RLGERS P2C]P6RTY `30 Oi ALLYN MASON VfA. BLOC K 2. VOL. 1 PLAT 5 iROGE 17 ALLYN, WA. L +�P 3 �Ti ,n fS�S rvr N►ww, Jn w►� ► jL� �`� �ct /y1 i Kettel and Co. LLC Estimate General Contractors 2103 Summit Lake Shore Rd NW Olympia, WA 98502 Lic#KETTECL861 ON Name/Address Dean Burnett 24021 SE 238th Street Maple Valley, WA 98038 RECEIVED - - _ FEB 18 2015 Date Estimate No. Project 426 W. CEDAR S T. 02/18/15 434 Item Description Quantity Cost Total 07 Wall Frame Remodel 18220 State Rt 3 to specifications 1 100,000.00 100,000.00T provided by owner Unincorporated Mason County 8.50% 8,500.00 Total $108,500.00 cACT CJAJ FtI4 _O I irr ��c,� c,.�vS Txu t�1 o.J��-r�L 2�-� � 1/�!�CMo/� �j PKtJV 0 a t e o 07 Q L BUILDING SCOPE OF WORK RECEIVED 18220 E. STATE RT 3 FEB 18 2015 ALLYN, WA 426 W. CEDAR ST. 1. Tear off and reroof with 25 year composition roofing material 2. Repair cedar siding in damaged areas as needed. Approximately 40 square feet. 3. Demo non structural interior walls and replace as shown. 4. Move kitchen from north side of building to south side of building 5. Move bedroom from south side to north side. Remodel existing bathroom on north end of house. Move laundry from existing location to master bedroom closet/bath area 6. Move electric hot water tank from existing location to attic location. 7. Remodel existing middle bathroom. 8. Add 3'x5' low a window to middle bedroom. 9. Any exterior walls that are exposed will be insulated to R15 with fiberglass batt insulation 10. Ceiling insulation will be increased to R49. 11. Bath fans to be replaced in both bathrooms with minimum 80 CFM fans vented to the outside. 12. Install kitchen vent hood that vents to the outside. Wa- � . Uj U- to , L , Cry L 61_ v �P$aN c MASON COUNTY Permit No: 6LD DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL (360)427-9670 Shelton ext. 352 http://www.co.mason.wa,us/community dev/ (360)275-4467 Belfair ext. 352 Ru 426 W Cedar Street, Shelton WA 98584 (360)482-5269 Elma ext. 352 BUILDING BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:_l),,a,� ' �,2N=�rr NAME: P- -e,., L-L MAILING ADI?RESS:1..42oi Si 23`5" MAILING ADDRESS:Z.f tad ej,,moirr ZJ CITY:Jil(WL If fia i ti STATE: UM ZIP: '60',5 d CITY:01wm F STATE: j4 J& PHONE:ZOL,--3or!-113XELL: PHONE: CELL:3cy-Z-6�' EMAIL: t-4T Vyt`i�✓. �i�r� EMAIL : p/tVt e-,Te-L r�cc� , (_J..•-- L&I REG# Kr'+;'CCU-%1 iod EXP. / -571 6 `.. CONTACT : OWNER❑ CONTRACTOR[, BELOW ❑ NAME:� MAILING ADDRESS:2 i 05 CITY: STATE: t-1.1 I ZIP: ='� PHONE:3(0 -Ugy 70t,;CELL: 7/ _ EMAIL: 71�1v�—�%f (=�e 77t, iAoP". c PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) ( Z2, ,a - `�Q - O.7.G0 if FIRE DISTRICT LEGAL DESCRIPTION(ABBREVIATED): 1 r� 1. -,X, -rw- l SITE ADDRESS Z C) 1;. , , 32 CITY fl LA.�o DIRECTIONS TO SITE ADDRESS p 5*-e`7S IS PROPERTY WITHIN 200 FT: SALTWATER®. LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES[] NO TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION 0 REPAIR❑ OTHER ❑ USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) Z.19-17 J 1>WCL' IS USE: PRIMARY(g SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS_ DESCRIBE WORK /II�rt1� 1�-f'TCfif?ti 1 �i�a;�r� ,1'liT`irt � -3i1'�1 . 1�-F - 12-Jor. IZCr�tri�_. SOUARE FOOTAGE: 1ST FLOOR 134 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK 3I.Z-sq.ft. COVERED DECK sq.ft.STORAGE sq.ft. OTHER sq.ft. GARAGE�C6 sq.ft. ATTACHED❑ DETACHED% CARPORT sq.ft. ATTACHED ❑ DETACHED ❑ MANUFACTURED HOME MORMATIO �*4 COPIES OF THE FLOOR PLAN REOUIRED MAKE 100DEL YEAR ENGTH WIQJ, S BATHS SERI ER OWNER 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 or owner's legal representative. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or legal representative, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permittapplication becomes null &void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) x Signature of OWNER Date DEPARTMENTAL REVIEW APPROVE DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL FEE'S TOTAL VALUATION: BUILDING PERMIT FEE FIRE ACCESS AND GRADE PLAN REVIEW GEO-TECH REVIEW PLUMBING&BASE FEE STORMWATER REVIEW MECHANICAL&BASE FEE TOTAL FEES WOOD/GAS/PELLET STOVE VIOLATION INVESTIGATION FEE PLANNING REVIEW FEE VIOLATION FEE FEB 18 2015 426 W. CEDAR ST. ILDING ♦ ~�',• MASON COUNTY PERMIT NO. �Gf 0�01%-1�113 _ DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL _ WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 _ Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext.352 PO Box 279,Shelton,WA 98584 (360)482-5269 Elma ext.352 PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Of--:AIL) &i Il0 e i-r NAME: i t t i i wl) C, 7. l.-t-C. MAILING ADDRESS:2y 5,tg - 5"s" MAILING ADDRESS: iC�5�w�-14i CITY:&Pa STATE:ZIP:`)43031s CITY:, r, STATE: �- PHONE:,xd. . 3Lir,, .-7s3 z CELL: PHONE: CELL:3G0-146D--7 EMAIL: EMAIL : L&I REG#ICI;T7-a-e,i._!64J U f11 EXP.9/j5:/1, PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER): I k-kzL 0 LEGAL DESCRIPTION(ABBREn4TED): L}i,J-V IiI IlirL K : i2. TiL -t SITE ADDRESS: i e? %% `7.A-rt T2-4- 22 CITY: L.L_7w DIRECTIONS TO,�ITEADDRESS: '-rLfjVt t- TYPE OF JOB NEW ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS—IST FLOOR 2NDFLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric_LPG Natural Gas Ductless_ Toilets :2-1 Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs 1 Heat Pump Showers 1 Spot Vent Fan I Water Heater 1 Propane Tank Clothes Washer I Gas Outlets Kitchen Sinks I Wood/Gas/Pellet Stove Dishwasher I Kitchen Exhaust Hood Hose bibs Dryer Vent Other Solar Panel Other Base Fee 7D Base Fee TOTAL PLUMBING _l:?� I TOTAL MECHANICAL j,?p OWNER I 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permittapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended fora period of,180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT�'"t: AT 480 AYS WILL INVALIDATE THE APPLICATION. X 1� I� ignatur of Applicant Date X D- fl _ K(7 Owner/Owners Representative/ ntractori Print Name (indicate which one)—�- DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT ./ G DEPARTMENT �f 1 D I,► Gt.✓t FIRE MARSHAL .REC'EIVED FEB 18 2015 426 V/V• CEDAR ST. MASON COUNTY PERMIT NO. �Gf DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg. 111,426 West Cedar Street (360)275-4467 Belfair ext. 352 rasa PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext.352 PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: 17j��fi10 e TT NAME: ._ i 7-ii#_ jbt-D (:A). C-L--C— MAILING ADDRESS:Z4,Zcg 59 Z3-6-"— 51- MAILINGADDRESS:.;ZJD';5 zAf07,11j Pp CITY: Le ��+"e.. STATE:ZIP: - n' % CITY: J '1 STATE: iti/,4 ZIP:c '_ "- PHONE:;�C6.. 3,iz .7,4 Z CELL: PHONE: CELL: EMAIL: EMAIL : DW(_ Q 14-eTTZL.-Ati3O :J - L&I REG# D N EXP. PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER): ( Z27.V--- 5U - O't_.c)a I LEGAL DESCRIPTION(ABBREVL4TED): 4i..t, V 6 SITE ADDRESS: I d_,�;J.-C? �, 2-4- ?> CITY: /-ALL-Y>✓ DIRECTIONS TO., IITE ADDRESS: t%Itr7�v► 5Ht��ii��t./ T�Z-(�►/Cc- 1�1 rti I-IwJu �i f"t� la-►7JrC�`7`i . � >� TYPE OF JOB 7 NEW ADD ALT REPAIR OTHER USE OF BUILDING ]4t `J� Dr'Nt LOCATION OF FIXTURES/UNITS—1 ST FLOOR ,/ 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric_LPG Natural Gas—Ductless— Toilets iZ Type of Unit No.of Units Fees Bathroom Sink -5 Furnace Bath Tubs I Heat Pump Showers 1 Spot Vent Fan —1— Water Heater I Propane Tank Clothes Washer I Gas Outlets Kitchen Sinks �— Wood/Gas/Pellet Stove Dishwasher I Kitchen Exhaust Hood I Hose bibs Dryer Vent Other Solar Panel 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. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT L A AYS WILL INVALIDATE THE APPLICATION. X l - 1�6 _-SignatW of kpiplicant Date X ; , ;TrL Owner/Owners Representative/ ntractor Print Name (indicate which one —— DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT ING DEPARTMENT V1 D Y t CLL.✓\. FIRE MARSHAL �InotE -4 EJ �� - 110� �l5