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HomeMy WebLinkAboutBLD94-1646 SFR, Garage - BLD Permit / Conditions - 1/24/1995 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 BLO94-1646 PARCEL :3202155020 FOP INSPFCTIONS CAIA. 427-967o 38 BETWEEN SPIn AND Sam 427-7262 JOB ADDRESSt F `10 VIEW PLAT :SHPL0 2 ER PL S"EL*I,ON Div : B L K : 2 L OT ,OWNt ED AND 87j-1551 CONTRACTOR , ED ANDEnSoN CON�TRUGTION LEGAL. - SRORFCOEST IU#RACE 200 ADP ILIt 2 Lot, 38 ' CLASS OF WORK , . :NEW BEDR ; o TYPE OF USE . . . . :SF -BATH : STORIES . . . . . . . ..0 VPF DATE RECEIPT Pik 1 45�00 Nip 0 TYPE OF CONST. . 0 AMOUNT By CCUP . GROUP . . . 17 BLDG . HEIGHT . . : o .oft DATE RE EIPT I OCCUP . LOAD . . , . , FIREPLACES. . . . 1 0 OCR S 33.00 Nip of 193 38235 Ip"k 10"0 911? 0112410 392315 0 WOODSTOVES . . . . , 12419,5 18235 DWELL -UN IT S . . . 0 0 4-50 NJ? 0112405 38235 PARKING SPACES 0 RADN 1 0.08 NJP 9112419& 38235 INSPECTION AREA : 0 SHORELINE? _ , PINT 259.50 Nip #1124195 38235 IT07AL, SETBACKS------_-...._____ 453-00 VAINATIOat 404041 FRONT . . .N TOILETS . . . . . . . . 2 FlIm)mE74ft TYPES------------- REAR . . . .S 30.Ott BATH BASINS . . . . . . 2 BOILERS/COMP---- "BILE HOME ­ SIDF( 1 ) .E 50.Oft BATH TUBS . . . . . . . . 1 0­3 HP . . 0 SIDE (2) .W 33 .Ott SHOWERS . . . . . . . . . . I FURN < 100K STUt 0 3- 15 HP . : 0 MODELe 33 .Oft WATER HEATERS . . . . , I !'URN >-100K BTU : 0 15-30 "P . r 0 SHRLINE , 0 >oft CLOTHES WASHERS . . , 30--50 HP . t 0 AREA ­­­----------- KITCHEN SINKS . . . I FURN - FLOOR _ : 0 Flo+ HP , .- 0 ------ LOT SIZE _ 1 ' : I HEAT PUMP . . . . . . 1 0 BUILDING . . . FUOOR DRAINS . . . . * 0 VENT SYSTEMS _ � j 0 BASEMENT . . . , '740sti/ DRINKING FOUNT . . * : 0 VENT FANS . . . . . . 2 EVAP COOLERS , 0 LIENGTHt 'o DECKS . . . . . 03- f LAUNDFJY TPAYS. . . t 0 HOODS . . . . . . . . 0 WIDTH . : 0 Oat' DISHWASHERS ,. .. .., ISHWASHERS . . .. . . AIR HANDLING UNITS— DOMES . INCINtO GAR/CARP :G 720if GARB DISPOSALS . COMML , INCIN „O AT/DT . iA URINALS . . . . 0 <-0 10000 ofmt 0 RFLOC/RFPAIRt o >MISC PLM FIXTURESe 0 10000 oft . , 0OTHER UNITS . , 0 GAS OUTLETS . : 0 PROJECT AND *Tr A AC,2EII G4RAGE m PROJFCT tOtAT104tA6ATE BD TO AGATE STORE RIGHT 00 CRESTVIEW DRIVE TO SHRECREST, Ifff PO PARYWAY WD To vIEW pLACE I pool, 01 00 SOVINEAST COINER ACROSS F441 togg ��I; � � �I��������t�►��" ��A� �I� ����1�"'���N���ir����������� ��T�������a��4���������N���A����� E���I� ��GT��f11�I������� T��� � CC gg s � qq . pp� �q 011011 09 AGE DAIEt COMPLIANCE TO ATTACIIED CONDITI CONCRETE MECHA I L / MOBILE HOME Footings-Setback date Z Z-IgO by Ribbons date I_ V-35 by Gas Piping date b Foundation Walls date by Set Up date 2-VD- by INSULATION date by BG/SLAB Insulation Floors Final Final date by date l� /� by date by FRAMIN ' Walls FIRE DEPT. dat by date vJ by date by PLUM ING OTHER Groundwork Attic I 4- date Z '3 by dat D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION Q�Y� date by date 2 _�b date by Z 7 " a—IpAro LEMU-J&M a ry�na�l4 k ,n o -wswe �tn 1Yru1 T CA e- V �P f-Ce ADe Gore en ro f MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Case No . o BLD94- 1646 For : ED ANDERSON Paget 1 i 1 ) The use, handling and storagge of hazardous materisis or flam►nable and c,oml,)ustible �q I asrina xcess of 10 gallons Is not allowed without the approval of the Mason County 2) Proposed structure or any portion thereof greater than 301, In height from grads line Suet maintain a minimum of 5 ' setback from all property lines , easements and right of ways . X L� 3) All approved plans are required to be on-.site for 1 nspect i on purposes . 1 f f r►Rpec t i rrn i C Relied for and plans are not on site Approval WILL NOT be granted . in addition, a Re- Inspe�;tion fee in the amount of :sA0 .,99 per hour (minimum 1 hour ) will be charged at►d must be collected by this department prior to any further Inspections being performed or approval granted , X 4 ) PURSUANT TO 1991 UNIFORM BUILDING CODE, SECTION 305(C ) AND SECTION 513 ALL SITES MUST HAVE APPROVF'D NUMBERS OR ADDRESSES PROVIDEn IN SUCH A POSITION AS TO Bt PLAINLY VISIBLE AND LEGIBLE FROM THEN STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SETS' INSPECTIONS , A RE 1 NSPECT I ON FEE BASED ON RATES IN TABLE :3A OF THE 1991 UN I FORtl BUILDING CODE W i 1_E BF ASSESSED IF OWNEA/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPEC3IONS . X No Occupancy . This struoture is limited to M�-1 use only , An other use will be In violation o the Uniform EauiIding Code and Maso County only,, y gu1atione unless a "Change of Use- permit i 9approved . X ��" 6) ALL CONSTRUCTION MUST MEET OR EXCFED ALL LOCAL, CODES AND 013C REQUIREMENTS X .`� 7 ) Changes to approved building plans that affect comppliance to the 1991 Washington State Energy Code, 1991 Ventilation and Indoor Air Qualiky 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 PLUMBING date by 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 MASON COUNTY Coax, the un i -rorm 13 Mason County Bldg. III 426 W. Cedar be approved by Mason poi P.O tox 186 Shelton, Washington 98584 - -- .8 3 CONSTRUrT I ON PROCEfiS TO f I F=I..D CnRP I AS RFMI I I PFr „,TY RU I I O t No r I a CONCRETE MECHANICAL - MOBILd 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 3-Z-�- qrG `mil by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by date 3 2-b �� b D.W.V. WALLBOARD NA ING date by dat q by Water Line FINAC INSPECTION date by date by date by ,,vrvl +dAw JAee me4 - ti R A?� U v ainj �. 12 z �z 0 ZZ A T-::04�y\ xx5o �- fin/ ttll MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location £ ro *NOW V ICw -Pt-- � Arr0 ,-s �,) 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 /Vy e02(L6G7tey'�J!� W L-"� �)oN C &p4s-r -Tim t q W-4S dcae- !:t FT &j o`Z-t c —�0 f 5 CIAJ►`t /`146T rd-b rJ a filv-4 FO L,-w N O NO'TC Fee 1S 7-(-0S �u use 1StYeL'Tor" OFFS 8-e�f o2e U'au CPIN Sc�EpuCE -- ��i�� You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK all for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OKto Department Q( r✓D��V Date S Inspector C ■ �� 0 NOT Mo *V THI TmL* M MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location CE 10 u l f--'W � 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 N b Ac-L_c,s s m2 L4e57R rz S� F ou.yo ,J b N C,6D ?-O Q �- (-f-t C'k-e 4 `7-o D 14 W�L L- z -ro r c'c—r 7`U Flo,tz P-oy ty� Acr t sS `m Lps-r,41 as- - -A-- i2E`-1�JS,pcc7f 3 cA 0 '�?b D -7-t:3 n:�R. c5 ,c N cy 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 ❑ OKto Department Date S- 2-(- QS Inspector (.AJ ■ 00, 10 No OT MOV TH1,41112k T` ,* w MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Location �9L /� Job •catn• 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 'QOUIC 11 Com 4,roy� S �•.� ��1� 1 � b�,�.��II G,vnc.�d�hClr p�15 ��I �ct�r��• Qe,�-I�,�-4 i�r,� �-� �,;�,x.( ( w�I I �v� c�el i►�•� i� ��,,�. '�5�i�w tie I rl I `� , I tp; V J'-� L��12 ,����i�QO Gc, �� On L C' L+e-, 4b-oltTt aAAvas cam, '-C u v 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 -- a-Make corrections, items will be checked on next inspection ❑ OKto Department�- Date 3D Inspector 0 100 0 * MOV , T • ,ORM No T _ MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRE TION NOTICE Job Location SL o ?y— /'�Z-1"6 i=. IC) y Cam( . This structure has been inspected by Mason County Building Department and the fo lowing VIOLATION of County Laws and Ordinances has been found: 3 r--� - Items listed below must be corrected to gain code compliance � cr— �� p 44 1- TA J 'n 4 1)Z) C=Z=0 Z - JJIAZZV'T—)� You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK *all for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to Department Date S Inspector ■ 04 nT MnV THI, Tj 'RL* = 19 y ' '' � i MASON COUNTY/ BUILDING III 426 W. CEDAR �GLv�S �r sPzb ( SHELTON WASHINGTON 98584 ©� o►ti s-f���S , 3�� rc3�'�' (360) 427-9670 , 6'-�j CORRECT116k NOTICE Job Location 3r— This structure has been inspected by Mason County uildingl paArtment and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain code compliance O U C.d O AD You are hereby notified thattie above corrections shall be made BEFORE P �qqFEDING WITH ANY FURTHER WORK I D Ir�j � ❑ Call for re-inspection when corrections are made before continuin C 44) ❑ Make corrections, items will be checked on next inspection 0—+ ou ,p,rko-t ❑ OKto Department I1 - )ate S 1 Inspector 01044NOOT MOOV TH1 , T"' ,* ffAi MASON COUNTY t BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location `cam 4 [l 4( 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 c. m - 2A onr e5toC 4- fj U O lr2 n uk+ 14,D 1' CtALL-a4al"4 U'p114 tati 'g `1 D1r—GJ �u-}'���►s b You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK all for re-inspection when corrections are made before continuing Make corrections, items will be checked on next inspection ❑ OK to Department (�� Date ��- `�5 Inspector jlkv- IALVIV-a� ■ oo s NnT MuV THIV-- Tmk* M i MASON COUNTY r Z BUILDING III 426 W. CEDAR SHELTON, WASHINGTON.98584 (360) 427-9670 CORRECTION NOTICE Job Location ('�q-16 q L 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 ik:�r. C Q 1d U MMXW\kiw\. LA)) 1 -b -'Ea, i YQA atr &S� Tr v\ J��wri + M 8�� 4n, tg&i6y 4-b Dctt/ QV6 �Jj') Le Y J�� JC&2L3:jf"k3 A69 _ Ik --r i D �,� , —� 1 l Ccw( You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK t.Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ��rr\\ Department L-b 46 Date �0- Inspector )GAn—X,- ��YVN. moos NOT MOV THF TA& L* M' MASON.COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location C- / 0 0 i Ec,�� P L (3LD ?q- 16zl� 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 13 cc3- 2 1/ ` ' �. C. C S r C. You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK all for re-inspection when corrections are made before continuing • Make corrections, items will be checked on next inspection ❑ OKto Department Date '� 7 S Inspector -P ■ �� �T MOOV THI,Ruh T, " ,� c � S WASHINt�II�V Attachment B Building Record WSEUConh'act# ,_, _ RMW For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps <« <:. ;:............................ FIWII (please check one) (pl se check one) )(New Building ❑Addition over 500 sq.ft. Single Family ❑ Duplex Jurisdiction: ❑Multifamily ❑Zero Lot Line Home ❑ Planned Unit Development + please check one: ❑ City ounty Permit# Q q-- /(a 4(P ��Fii{{l��e ID# (if different from Permit + `'`?'°i ii> Ft�F ?' ? i 'ii=?i< si ` i$i� i'isi' isisi�?i�'` ` ':E`-�'`` :`??< ��..... ' A. Site Information B. Owner Information Address /0 / e!u2 Owner owner at time of construction receives Lgifify payment) City Zip ���c,G Company Assessor's Property Tax or attach legal descri tion Addr ss 5 ezo Ck. Cit O /r r;(State Zi Servicing Electric Utility 1—,36 Phone C. If Single Family, Zero Lot Line or D. Duplex E.If Multifamily(R-1) Planned Unit Development First Duplex Unit s .ft. Total #/Bld s. Total Conditioned Floor Area 7 56c2 s . ft. Second Duplex Unit s . ft. JTotal #/Units ::;.::::<::<:<::::.::.::::::::::.::.............. ::::::._: < �Jk . .......... .::....... A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat Type (check one) (check all that apply) (check one) ❑ Electric Baseboard None Electric XElectric Wall Heater Wood Gas ❑ Electric Furnace ❑ Electric Baseboard ❑ Other (specifybelow) ❑ Electric Heat Pump ❑ Other (specify below) ❑ Other ; :: .,.h,w...........: : :: W EC Compliance Method For Heat Pump Only: Prescriptive Path Built to the Electric Date of Permit Application ��—� —�f Component Performance Requirements of WSEC? Date of Building Permit Issued a — If es, Date of Insulation Inspection ❑ System Analysis ❑ Yes ❑ No Y Date of Final Inspection —.;7- —Gf _ utility may offer incentive.) I hereby certify that this building or addition has been inspected for the measures required by the 1991 Washington State Energy Code(WSEC), that it is in substantial compliance with the WSEC, and that th WSEC checklist for this building is on file. — 1 S— Signatu o Building Official or Authorized Representative Date ■ Building Department:Return white copy to Gail Burris,Washington State Energy Office, P.O.Box 43165,Olympia,WA 98504-3165. ■ Owner or Building Deparment: Forward canary copy to the servicing electric utility to trigger WSEC compliance payment. ■ Building Department: Retain pink copy for jurisdiction's building file. WSEOA94-015 5-95 kL6 ( a Permit No. M SON COUNTY 0 BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 ,Oi n City Directions to Job Site .4CrArs- &,gp rl 46-A7-,e J'i ol?x Ricm-r DAI rAI,9 Rtr c — L ON .a Czj19 ' ��c=rr =tor, ��H, ,a•, pooh Owner Mailing Address City ,D 19T DMc�#�Irt'o St 4./4' Zip 5�, e-C Lien/Title Holder Address Clty St Zip #2 Contractor Name �fla A Contractor Reg #,EDANyc /P.7 mc— Address .re, s'for w,c a ,q�. Expiration Date K/ :V/_/ ?-r City Pn2 r St ey,4, Zip %P&Z Phone # dDG -J--&- /_ 1'/ #3 If septic is located on project site, include records. Connect to Septic? 9.-' Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) � 3�0� 1 -� s� - Oao 8 #4 �ro. 3aOd� -�- 0.70 3,�scription 407-3F Lv,-lt� lffDn>r c p ,acf #5 Building Square Footage: (existing roposed 1 st FI / 2nd FIB_/ 3rd FI / Loft / Basement / Deck # bedrooms / #bathrooms / Garage 7_,)o / Carport / (Circle Attached or Detached?) Other ­­1 sq. ft. / #6 Use of building AAA rcc. /?X1iagKcle- -tr�x�2. _Describe work T #7 Type of Job: New i-� Add Alt Repair Other #8 MOBILE/ UFACTURED HOME INFORMATION Model Year Make Model Length Width,-, No. # Bedrooms # Bathrooms Type of Heat Purchase Price $ 1 #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 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 Directional by N, S, E, W) Name of Flanking Street Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW (13 dye � Q APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW c t?ti Plumbing Fixtures ($3 each) F�,g Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, lectric, Bath Basins _ Heatpump, Other Bath Tubs 3 No. Units Fees Showers 3 _ Furn BTU Hot Water Htr _ Heatpumps Laundry Washer _ Vent Systems Sinks )�a Spot Vent Fans Floor Drains No. Boilers/Compressors _Laundry Basins HP / Dishwasher _ No. Air Handling Units _Disposal cfm# Urinals No. Fire Protection Systems Other Auto. Fire Alarm Sys 50,00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ l . 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 off' 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 OWN ER _ �w X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Ofts Environmental Health: Building Plan Review Occupancy Group: - = Type of Const: — Fire Marshal: Other: Special Conditions: FEES Building Permit 0 Plan Check 00 Plumbing Fee Mechanical Fee - 02 Wood/Gas/Pellet Stove Radon Monitor / Violation Fee ---- Site Inspection 5�0�( Building State Fee T Other Other Building Valuation: `3 72 TOTAL FEE �S3 • PERMIT Mason County Road Department Permit Number: 5057 411 North Fifth Road Name : view Place P.O. BOX 1850 Road Number : 22420 Shelton, WA 98584 Road Location: Subject to all terms, conditions and provisions written or printed below or on any part of this form, Permission Is Douglas Anderson Hereby Granted To: 5650 SE Sedgewick Port Orchard, WA98366 871-7409 To Install : single family access Location: On right hand side - corner lot . Parcel Number: 32021-55-02038- Legal Description: Block 2, Lot 38 , Shorecrest Terrace 2nd Addition A bond in the amount of $ 25 . 00 accompanies this permit . Receipt Number: 14329 Check Number: Contractor Address City/St/Zip: Phone : 426- Lic. Number: Expires: Specifications : Access to be graveled to property line with 3" depth of clean gravel. Culvert to be aluminum, concrete or polyethylene. Access will be staked and flagged by Permittee for pre-inspection. Culvert will lay in line of ditch. Access will be pre-inspected by this office prior to installation. Culvert to be minimum of 12" diameter by 20' length. Access installation shall be in accordance with county specifications. Commercial/Multi use access shall require STOP Signs, installed in conformance to the MUTCD manual, at intersection with county road. No work shall be done under this permit until the party to whom it is granted has communicated with and received instructions from the road supervisor at : 427 -9670 ext . 450 or at 1-800-562 -5628 ext . 450 . RESULTS OF SITE INSPECTION: See Attachment "A" This permit shall be void and bond forfeited to Mason County unless the work herein contemplated shall have been completed on or before: 19 Dated at Shelton, Washington, this day of 19 Issued by: Title :