HomeMy WebLinkAboutBLD2015-00447 Garage, Bathroom - BLD Permit / Conditions - 9/25/2015 Inspection Line (360)427-7262
A 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
BLD2015-00447
OWNER: KEITH OHM RECEIVED: 6/8/2015
CONTRACTOR: LICENSE: EXP: ISSUED: 9/25/2015
SITE ADDRESS: 81 E ORCHARD LN SHELTON EXPIRES: 3/25/2016
PARCEL NUMBER: 320215701008
LEGAL DESCRIPTION: SHORECRESTADD 2ND REPLAT BLK: 1 LOT: 8 & TAX 235-C
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
NEW 2 STORY DETACHED GARAGE-ROUGH IN TOLIETAND SINK ST RT 3, R ON AGATE RD, R ON CRESTVIEW DR, FOLLOW TO
ONLY SHORECREST DR, R ON ORCHARD LN TO SITE ADDRESS ON THE RIGHT
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: VB
Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U Lot Size: Deck:
Type of Work: ACC Fire Dist.: 5 No. of Stories: 2 Occ. Load: Building: Garage-Detached 864
Valuation: $ 62,591.10 Building Height: 24 Occ. Status: Primary Basement: STORAGE 595
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 50.0 Ft. Shoreline: Ft. Water Body: HAMMERSLEY INLET
Rear: W Ft. Slope: Ft. SEPA?: No
Model: Width: Ft. Side 1: N 10.0 Ft. Shoreline Desig.: Urban
Year: Serial No.: Side 2: S 31.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Water Closets (Toilets) 1 Plan Check Fee GMM 6/8/2015 $ 477.59 S2201500000001
Lavatories 1 Planning Review Fee GMM 6/8/2015 $205.00 S2201500000001
EH Minor Plan Review GMM 6/8/2015 $ 100.00 S2201500000001
Building State Fee LDK 7/16/2015 $4.50 S2201500000001
Building Permit Fee LDK 7/16/2015 $ 734.75 S2201500000001
Plumbing Permit Fee LDK 7/16/2015 $ 17A0 S2201500000001
Plumbing Base Fee LDK 7/16/2015 $24.70 S2201500000001
Total $ 1,563.94
BLD2015-00447 Please refer to the following pages for conditions of this permit. Page 1 of 6
CASE NOTES FOR
BLD2015-00447
CONDITIONS FOR
BLD2015-00447
1) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X A!b
2) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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3) Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Rural Residential 5.
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4) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT
PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM
OR ROAD WAY.
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5) 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.
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6) 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 Site Plan"to ensure these structures are shown and meet the setback conditions listed.
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7) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered.
A. Drainfield/Reserve requires a 1 Oft setback from all footing/foundations.
B. Septic tank(s) requires 5ft setback from all footing/foundations.
C. No foundation drains within 30ft, down gradient of drainfield/reserve area.
D. Septic Transport Line requires a 2ft setback from all footing/foundations.
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8) 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.
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BLD2015-00447 Please refer to the following pages for conditions of this permit. Page 2 of 6
9) This,permit include rough in of water closet and lav sink only. A seperate permit will be required prior to completing bath room.
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10) 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.
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11) 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.
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12) 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.
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13) This structure is approved as unheated space.
To be considered unheated space the area may be provided with a heating system that does not exceed energy usage of 1 watt per sq. ft., or 3.4 Btu/h
per sq. ft. A permit and approval shall be required prior to installation of any heating system.
When a heating system exceeds 1 watt per sq. ft(or 3.4 btu/h per sq. ft)the heated space shall be insulated in accordance with the energy code in effect
at the time of permit application.
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14) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL.
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15) 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.
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16) WINDOWS IN HIGH EXPOSURE AREA
All windows and doors shall be installed and flashed in accordance with the manufacturers written installation instructions and shall be available during
inspections.
In addition to other inspection(s), an inspection of the flashing shall be required for projects located in an area with a wind exposure of C or D, reference
IRC R301.2.1.4 & IBC 1609.4. The design criteria for this project is established at 85 mph wind speed, exposure_C_.
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BLD2015-00447 Please refer to the following pages for conditions of this permit. Page 3 of 6
17) 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 shall be provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5)
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18) 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 acknowledging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X KL
19) This structure has NOT been reviewed or approved as an Accessory Dwelling Unit(ADU): A second dwelling unit detached from an existing single-family
dwelling for use as a completely independent or semi-independent unit with provisions for cooking, eating, sanitation and sleeping. ADUs are required to
meet the requirements under Mason County Development Regulations 17.03.029. X
20) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the
international codes and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved.
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21) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building
Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached
thereto. If documents are removed, 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.
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22) 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.
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23) 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.
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BLD2015-00447 Please refer to the following pages for conditions of this permit. Page 4 of 6
24) The placement of buildings and structures on or adjacent to slopes steeper than one unit vertical in three units horizontal (33.3% slopes) shall conform to
the International Residential Code Section R403.1.7 for descending or ascending slopes.
Alternate setbacks may be approved subject to approval of the building official based upon the investigation and recommendations of a qualified engineer
licensed in the State of Washington. Such an investigation shall include consideration of material, height of slope, slope gradient, load intensity, and
erosion characteristics of slope material.
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25) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
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26) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND 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.
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27) All property lines shall be clearly identified at the time of foundation inspection. X
28) 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.
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29) 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.
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30) 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.
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31) Retaining walls needed to support a surc arge such as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X
BLD2015-00447 Please refer to the following pages for conditions of this permit. Page 5 of 6
32) SHEAR WALL INSPECTION
A separate inspection in addition to the inspections required in IBC, Section 109 shall be required in accordance with the 2012 IBC, Section
1707.3. The additional inspection is required when shear wall fastener spacing is required to be less than 4-inches. The shear wall schedule
shown on sheet_S-2_designate walls_DETAIL 15 with fastener spacing less than 4-inches.
The required inspection may be performed by the Mason County Building Department, a WABO certified inspector, certified to inspect lateral
connections, the engineer of record(EOR), or an authorized representive of the EOR. The special inspectors duties & responsibilities shall be
as specified in Chapter 17. When a third party inspector is used to perform the inspection special inspection reports shall be submitted to
the Mason County Building Department, PO Box 279, Shelton WA 98584 and also available for inspection. Inspection reports shall be
completed and submitted to the dept. in a timely manner and shall be submitted prior to the framing inspections.
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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 APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
lgn ture Date
Krll" G f//I OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
BLD2015-00447 Please refer to the following pages for conditions of this permit. Page 6 of 6
MASON COUNTY Permit No:,-*I'
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE MARSHAL
(360) 427-9670 Shelton ext. 352
http://www.co.mason.wa.us/commune (360)275-4467 Belfair ext. 352
�as4 426 W Cedar-Street, Shelton WA 9858,. (360)482-5269 Elma ext. 352
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: NAME:
MAILIN ADDRESS MAILING ADDRESS: _
C TATE: Cc_ ZIP:Ilf5oQ3 CITY: STATE: ZIP:
PHONE - CELL: PHONE: CELL.
EMAIL: ; dh i � hok . A n m EMAIL :
L&I REG# EXP.
CONTACT : OWNER ❑ CONTRACTOR ❑ BELOW ❑
NAME: %-AA6Ju c _ -AS 44nnyF- MAILING ADDRESS:
CITY: STATE: ZIP: PHONE: CELL:
EMAIL:
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) a �I -S1-61oce;, FIRE DISTRICT 5
LEGAL DESCRIPTION(ABBREVIATED) :!Y e' `RyL.I'.• LO
SITE ADDRESSS E_ O1 C a - _CI Y
�IRI;�O���eS�E ADD�,ESS f G.�l 7Q � lr1 � I I
IS PROPERTY;�ALAKE
THIN 200 FT:
SALTWATER ❑ 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❑ REPAIR❑ OTHER ❑. ,
USE OF STRUCTURE(RESIDENCE,GARAGE ETC.)
IS USE: PRIMARY ❑ SEASONAL❑' NUMBER OF BEDROOIRS J NUMBER OF BATHROOMS
DESCRIBE WORK
SOUARE FOOTAGE:
IST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. ATTACHED ❑ DETACHED ❑ CARPORT sq.ft. ATTACHED ❑ DETACHED ❑
MANUFACTU + *4 COPIES OF THE FLOOR PLAN RE UIRE ID
MA MODEL LENGT
TH BEDROOMS BATHS SERIAL NUMBER
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)
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Signature of OW R Date
DEPARTMENTAL REVIEW AXPROVE DATE DENIED DATE TAGS/NOTE&CONDITIONS
BUILDING DEPARTMENT /s
PLANNING DEPARTMENT
FIRE MARSHAL
rFE I ,00�I'AL�VALUA�L10N: --
13UILDING 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
MASON COUNTY Permit No:'')Il�o�ll�J'r�'�`��
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•FIRE NARSHAL (360) 427-9670 Shelton ext. 352
http://www.co,mason.wa.us/coi-nmuniiy dev/ (360)275-4467 Belfair ext. 352
1854 426 W Cedar-Street, Shelton WA 98584 (360) 482-5269 Elora ext. 352
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: �1 Y NAME:
MA.ILIN ADDRESS _ MAILING ADDRESS:
CITY•{- TATE: O-- ZIP: �3 CITY: STATE: ZIP:
PHONE - CELL: • PHONE: CELL:
EMAIL: dhvr� hnEm , nor EMAIL :
L&I REG# EXP.
CONTACT : OWNER❑ CONTRACTOR ❑ BELOW ❑
NAME: !§t=� o _ 7:A A-I:)n►l�-- MAILING ADDRESS:
CITY: STATE: ZIP: PHONE: CELL:
EMAIL:
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) FIRE DISTRICT S
LEGAL DESCRipnON(ABBREVIATED):S r2a
SITE ADDRESS81 E_ onf J, '— CITY -
�lDIREqTIONS TOeS A.DJSs L Gil -
IS PROPERTY W TFHN 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 ❑ ALTERjATION❑ REPAIR❑ OTHER ❑..// �1111,079
J
USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) i C
IS USE: PRIMARY❑ SEASONAL❑J NUMBER OF BEDROOI41S of NUMBER OF BATHROOMS
DESCRIBE WORK
SQUARE FOOTAGE:
1ST FLOOR JGN sq.ft. 2ND FLOORL. 644' sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. ATTACHED ❑ DETACHED ❑ CARPORT sq.ft. ATTACHED ❑ DETACHED❑
MANCTFACT + *4 COPIES OF THE FLOOR PLAN RE UME ID
MODEL LENGTH
BEDROOMS BATHS SERIAL NUMBER wTI-If;-7—� R
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 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
APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42)
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Signature of OVOTER Date
DEPARTMENTAL REVIEW APPROVE DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
1=QTO ! UAsTIQ Gi;, erd ,.
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 J VIOLATION INVESTIGATION FEE
PLANNING REVIEW FEE _l VIOLATION FEE
zs"fix coa���. MASON COUNTY PERMIT NO? 161 Zb 4 VAA
w DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING•PLANNING•fTRE MARSHAL
WWW.CO.MASON.WAUS (360)427-9670 Shelton ext-352
_ Mason County Bldg. III,426 West Cedar Street (360)275- 467 Betfair ext.352
tau Shelton,WA 98584 (360)482-5269 Elma ext.352
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER ORMATION: CONTRACTOR INFORMATION:
NAME: NAME:
MAILING DRESS: MAILING ADDRESS:
CITY: STATE: ZIP: CTI'Y: STATE: ZIP:
PHONE: CELL: PHONE: CELL:
EMAIL: EMAIL :
L&I REG# EXP.
PARCEL INFORMATION: _
PARCEL NUMBER(12 DIGIT NUMBER): j2-4)2. 1 - e)i )OF)
LEGAL DESCRIPTION(ABB1tEV,54=):
SITE ADDRESS: P-,1 hr f rti CITY: J >y—
DIRECTIONS TO SITE ADDRESS:
TYPE OF JOB
NEW ADD ALT REPAIR OTHER USE OF BUILDING
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 Type of Unit No. of Units Fees
Bathroom Sink �- Furnace
Bath Tubs Heat Pump T
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
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 APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X
Signature of Applicant Gate
X Owner/Owners Representative/Contractor
Print Name (indicate which one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
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TOPOGRAPHY PROFILE: M:
Direction: Scale: /'' D� Approval: for offico use
Building Permit number: / Building:
_Owner/Applicant: e l 4 d�ir,-� n Date of Planning:
/ application: Env. Health:
Parcel Number. r 0/�I D 3 O �} 0 s"85"