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Home My WebLink AboutbLD99-0121 Shop - BLD Permit / Conditions - 3/10/1999 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Lj 1 1- U3 I N 03 F-1 F- 1*1 m 1 -1* VOR I NSPFC f I()NS CAC 1. 421-9670 BETWEEN pm AND dram 42T-7262 BLD99-0121 PARCEI- i320215502018 PLAT tSHPLO 2 DIVI BI-K - ' ' 7'--T' - I f! JOS ADDRFSS2 191 U WOOD LN SHELTON PERMIT OWNER : ELAINE DAVENPORT 425---337--1566 NULL $ YOID SY EXPIRATION CONIRACTOR : HEARTLAND 2.53- 941-9176 LEGAL. : $1101ECIFST TFIRACE 200 ADD ILK: 2 tOTi 19 DATE in BYBY CLASS OF WORK NEW BFDAt 0 .BATH 0 TYPE ANOUNI EY DATE RECEIPT TYPE A40941 PY DATE RfcF1?T rYPF OF USE . . . AC(' STORIES . . . . .. . . :0 - . �, =-'� .-M OCCUP . GROUP . " U1 B I-DG , IIE I GHT . - 0 . 0'r t PICK t 162.34 I(W 0301199 4955I 'TYPE OF CONST . :5N FIREPI-ACES . — , 0 ADOR t 5.00 TIP 03/10199 49658 OCCUP LOAD , 0 WOOD Cs'I OVE S 0 PRMT 4 24.4. 15 TOP 03110109 49659 DWELL UN I TS 0 PARKING SPACUS : 0 STfE 1 4.50 TIP 03118199 49658 INSPECTION AREA : 2 SHORF1, INE? . . . . .N fNCP t hf,Of TIP 03110109 49654 TOTALS 471,59 VAIULATION: 16755, SE TBACKS---- TO I LETS . . . . . . . t 0 F1JF L. l'YPFS--. BOILERS/COMP,----- MOBILE HOME--- I'RONT . —F 20 .01t BATH BASINS . . . . . . t 0 0-3 lip . - 0 REAR . . . .IN 70 .Oft BATH TUBS . . . . . . . . . 0 3-15 HP . : 0 MODELv tIDE ( 1 ) ,N 20 .Oft SHOWERS . . . . . . t — , : 0 f 0PN - 10011 BID : 0 115-30 tip . : 0 MAKE SIL)E (2 ) .S 20 Oft WATER HEATERS . . . . v 0 FURN >-100K BTU : 0 30-50 HP . : 0 SHRLINE .N 0 .0ft C1.0THE1 WASHERS . % 0 F OR N FLOOR . . . 0 50+ HP 0 --YEAR- AREA KITCHEN SINKS . , a 0 HEAT POMP . . . . - - 0 LOT SIZE — : FtOOR DRAINS . . . 0 VENT GYS'TFMS — t 0 EVAP COOLERS - 0 I-ENGTHr 0 BOIC-DING . . . 1120st DRINKING FOUNT — : 0 VENT FANS — . . . . 0 HOODS . . . . . . . . 0 WIDTH . : 0 BASEMENT . . 0 st tAUNI)PY TRAYS . i - 0 DOMES . INCIN :O -SER I AL# - - DECKS - - r 09,f DISHWASHERS . . . . . . 0 AIR 14ANDLING UNITS--- COMML . INCIN :O GAR/CARP :? Ost GARB DISPOSAI- IS — . - 0 10000 ctm . 1 0 RELOC/RFPAIRi 0 AT/DT . g? URINALS . . . . . . . - - 0 10000 ctm . : .0 OTHER UNITS . : 0 misc PI-M FIXIORES , 0 (31Ac�, OUTI ETS . 0 018ifeT PROJECI tOCA1109:811Y 3 TO ASAIF RD CtO TO STORE '.1190 Al ACiAlk TURN 41901 60 10 TURN LEFT DOWN PARKWAY 3fP tffl. CED 1111111 1#4 DAYS, 09 IF CONSTRUCTION OR 1011� 13 SUSPER08 F09 A PERIOD .THIS P11411 BEC105 NUH. APO VOID IF 1009 01 C011iflUCTIOA AUfHO#iZ(8 IS NOT CQVNiA Of 188 DAYS AT ANY TIME AFTER WORK IS CONOFICED. fVIPENCF Of f0#1100411011 Of 1011( IS A PIOAKIISS INSPECTION WITHIN THE 100 DAY PERIOD. HNAI INSPECTION IIIIISI !F APPROVED SEFORF RURGISG CAN 8F OCCUPIED. OV#fR (JR A.0411) DATE: 81,61-118mil revc 4-3c,1191 (,0MP1IANCF TO ATTACHED CONDITIONS IS REOUIRED CONCRETE }✓R MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date 3 . by 7/7 Gas Piping data b Foundation Wails date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEFT. date by date by date by PLUMBING roundd�rork �'e� 98 _n/ Attic OTHER date �/ qt� J / date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Aww— MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 P. t F1 1�4 1 "T, C.", U)N 14 V I t-k r1j *_I rase No , BLD99-0121 F(,,ir s FLAI NE: DAVENPORT Page I i I Tho u,-;Ae, handl inn and story e of hazardous materials or f I attima b I e a nd combust I b I e liqUicis In excess of 10 galyams is not allowed without the approval of the Mason County Fire Mar h I 2 Pr opo s e(I tructisre or arty porticon thereof greater than 30" In he I q bt from. grade fine, must maintain a minimum of 5 ' setback from all property lines , easements and 10' from all County and State Road right of ways , X 3. Al I approvet'l plans tare required to be canes Ito for ) tts e n s 0t io purpose IT inspection Is called for and plans are not ori site, Approval WIN. NOT be ranted . In addition , a Re-- inspeotion fee irt the amount cote m t *42 .00 peer hour (minium I ?4our ) will be charged and must be collected by thIs department prior to any further Inspections being performed or approva I qranted . X 4 ) PURSUANT 'TO 1994 UNIFORM BIJ11DING C(3PE , ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBL,E AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY ,, MASON COUNTY BUILDING DFPARTMFNT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES IN TABLE SA OF THE 19194 UNIFORM BUILDING CODE W11A BE ASSESSED IF OWNER/1CONTRACTOR FAILS TO POST ADDRFSS ON SITE PRIOR TO REQUESTING INSPECTIONS . X 5 ) THIS STRUCTURF IS, CONSIDERED UNHEATED SPACE (NOT TO EXCEF0 I WATT/SQUARF FOOT OR 3 . 4 BTU 1HR/SQUARE FOOT ) . AT SUCH TIME THIS CONDITION CHANGES, A CHANGE OF USE PERMIT AND A MEC'NANICAL PFPMI1 SHALL BE APP( fFD FOR AND APPROVED PRIOR TO THE CHANGE . X 6) Tlie ap - roved plot plan is required to be on-site for inspection purposes . if �I on I s ca I I ed for and p I of p lan I s not on site, Approva W I L NOT be granted In I rispec I addition , a Re- inspection fee In the amount of $42 .00 per hour (minimum I hour ) wil .1 be oharged and mti-qt be no lected bv this department prior to any fituther inspeotions beinq CONCRETE ,MECHANICAL MOBILE HOME Footings-Setback date Iby 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 FRAMINGWalls 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 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 papf-01:wed Or a64140 ;-'Ov X. 7 ) No Ocoopanc. This structure is I invited 'to U-1 use only . Any other use will he In violation ol ' they Uniform Aiiii(jinq Code and Mason founty Regulations unless a "Change of Use" permit Is approved X 8 ) AI. L CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES ANO UBC REQUIREMENTS AND OCCUPANCY UPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION , ANY CHANGE OF USE OR OCCUPANCY WOULD RESULT IN PERMIT RFVOCATION . CHANGE OF USE MUST BE APPROVFD PRIOR TO CHANGE . X 9 ) Proposed tr not ure or ortions thereof with an projection over 30" In height from grade line , must maintain a .91 separation distance between adjacent structures and that furthest projection . X _ 10) Chancles to approved building plans that effect compliance to the 1991 Washington Statf.. Energy Code 1991 Vent ilatin and Irsdoor Air Qualit Code , th ; o fform Eau Code and/ Mason County 4 e U B 8gulations must be approved by Mason County prior to const ritot I It) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDtN(11 DEPARTMENT AND UNIFORM BUILDING CODE Case No . : BLD99-0121 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. d PLUMBING by date by date by Groundwork Attic OTHER date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by I date by Building Permit#AL!f / MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 ORRECTION NOTI E Job Location Ze'/ w e--� 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 l -_ /�� •,—s — va _�ri��-i�.J' /�" �-T��rr. '� Co,✓ v.��rro�-- 7� �,��S'D�ivc�= c.�r cc_ You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to /11 This is not a complete inspection Department RcvO Date Inspector / ■ *O NOT MOOV THI T ALow Building Permit # 0�� -C�l MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location / / C-c�l��:- l�✓ hA vex i - �`' 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 14 1CC' 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 ❑ This is not a complete inspection Department 3111/11-% Date T": Inspector 01044 NOOT ► MUV THUM& T 'ak* m I Building Permit # MASON COUNTY BUILQfiNG 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 ORRECTION NOTI E Job Location ,14i raarT11 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 i pe-,�i / ✓c•- —�� zc=- �t .E/LT 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 4T- ❑ This is not a complete inspection Department' Date 3 Inspector -77; ✓,/-- ■ oo s NosT Mo *V THI = T " ,�' Mar-25-99•—UT-24A 021SEA 2537357820 P - 02. F � iKEiL¢TGdIiD JOHN K. 13ASTIAN P.E. Structural EnQlnear 2'F~,,4/2 AN ESTiITE !1Fxie,44r I P.O. Box 284 SUMNER. WASHINGTON 9839C /.v f�C.o�/ 2" 7 SG 19 G G (253) 862.0197 24' C0"CRF7,9 cows FoR �F$-'ATE GA R4G E >?4 cue A - 45 33,"l5'-� j 33.75r .56' = 16•8751-� • 1' • /36.az5 1- 4. �o 72� oe 2 ./'FN.N`�FrA4 ClG °c two Aksx ma-UT41 f LAN 24 2 8� �, bAI.A-C-� �4= 7-5xl,� Z = 37.5 47 S' i go C°aC = 5 750'.r)r 5 /3/.r5~� a�I r✓s� r�A•/� a 15,25), R 15 F 5 s G! '^ SOIL ! (Z'r+ 1000L. Z rt i53 a Qi 5 HQns �w OT 233.7SI �! � SIB. Q• r_ =2 S;•��i•JG.�rS /,71 .� !be,e AS t(3.sx .5)_/#f . GOZ a 504l�.3)04' .4o,.v'- 41 kF xG r 2SB r4 ?� 4, Ca r, 40 •C AlYJ tTC — 5 r. A,AidQG SEc't� oN q . , C N E-Cde SO 14 PX S Sr)t E v�o Est a'S��sT a /S F.Gd iA,G Fl Q l'Lv50= �G+oaF eau s. + RFC II kip= 4+0 4 5 w 1. 7AS'■ ' 1-,6 DE74 WIMP o 13.1�Y (3i.25)= 42,8) come- 24j liJ+4 T0,p bALUX-f Pt 4.5 Uv Lo JO ' . A l P 1 ,-V—.. 9 s MASON BUILDING INSPECTOR CHANGES SUBJECT TO APPRO'vAl ATE Z yc, 1t XP/R F5,/ 7�2000 D -�=_- Mar-04-99 11 : 30A 021SEA 2537357820 P _ 03 ,JOHN K. BASTIAN P.E. A1ff.1,L7L.4AVp rQi, y�sa,� CovNTr CeWMEAJT Structural Englneor y, P.O. Box 284 SUMNER. WASHINGTON 98390 2S3 756 18f.0 (25 3) 862-0197 kE��2Tc�,lD 6/iM B R EL Qom F urr�i t 4 c U� 2C� Zvi Qo I AMI S i I FE HEART11101KJ 04/6 OD F L. TNf y Es rJOAJ PpSED ro M E /S "/irNK`N f C�AJ s/{a kl�u A 00 rF sTi2eN�!'R /�'S 6T vrrF e,$I,IovS rS A 6,ff77RE S-014,01^J& rko'A! PtAov A FIFA A SrRvcr4-A14 ✓/EfvPD/N� �dE�! TNOrts'N �SoTN �E,dµS dv/b 0w6: cope GR I TfRrA . Jyg,F6-fQiQE., l wo6rc p rIOs�C THE GWL Y gwrs .,or) /5 TY4 7- PZ,4v A ku 5 I S O Meb A &W 4 0iAIG PERM 17 IV ANY CA 5 9 � kvovy DOES A S772 u;:,M�44 L FN�rNQ�fz IYA vG To jvAZrTE Le7rEg L//,'E TfY/S ? C.74/d D N 7- 77Y,6 l;a' - A!/�,tlY6 �vrmom�rr soot Y zlrae rroAj 6y 4sA,,o,v6 rV4RI6RkIr APPE 1ca roo- ro A VAmrS w A p4AW A5 ? OR AlAiaK rHa sueo-417TEb P1A Al it J0 p furTK A 'e- IAre aR 1100 ovE+cK+�aa DooR 7#1f is saRecY APrR&WCH-N6 7WE L Ev ITN OF NIT-RICAWd: OV o 06TR/rti Erv7A L coAJsl cpMEA/C c CaN A16 40 0&J s r•.eAr5jj l —MOT To -IfdVT)OP4 auTL TN I "e-FD G 6�$S c 05 r ,t^r 0 t WILL f d•!G�l++D EJa A c- riO/V$ 3-40CH AS T///S AAID 7NC "Afr4.4F M`lTfHE Ajj,0 Yo va J, SaM rNIuG s-raA vG C / S 661AJ& vAu 'Ar NaSo�1t GouAITY, 'FXp/Rg:5;/ 7f2000 j 1 4�1 - _ - -70 rE---� —� aa' (7TSAVf( 6¢.�,dh r i � n I m v � m I m A SHOP CHANGES ' SUBMIT CHANGES FOR APPROVAL THESE PLANS MUST BE PRIOR TO PERFORMING WORK ON THE JOB S' - FOR INSPECTIO: j• T 3 / M E9MASON COUNTY PERMIT ASSISTANCE CENTER Mason County Bldg.III 426 W.Cedar P.O.Box 186 Shelton,WA 985M (360) 427-9670 Belfair (360) 275-4467 Elma (360) 482-5269 Seattle (206) 464-6968 March 4, 1999 Mr. Russ McRee Mr. John K. Bastian Re: Heartland plan submittal . Dear Heartland Industries: This note is in reference to your fax received regarding the garage with either living or storage area above. 1. The plan that was submitted did not option "A" or option "B" as you stated , the plan shows a single design . 2 . Your statement of which is stronger is , yes, "QUITE OBVIOUS" , but due to the Washington State RCW this jurisdiction is prohibited from accepting any plans that have been stamped by a Washington State Design Professional that have been altered by any person except the engineer of record, please see item #4 attached to this fax from the Washington State Board of Engineer Guidelines . If in the future if would like to have options A and B please include these items in your stamped plans and there will be no further questions. If this is not acceptable to you I would suggest you contact the Washington State Board of Engineers and have them revise their laws. Unfortunately, this is required by state LAW. If in the future engineered stamped construction plans are changed in ANY way, the same procedure will be followed. This is to protect both sides and is not considered, "NIT-PICKING" , but Washington State Law. . . . . Sincerely, Kelly Mayo Mason County Building Dept Plans Examining Division cc: Dana Herron Betty Wing Guidelines for Washington State Building Officials and Design Professionals Prepared by: Washington State Board of Registration for Architects �Vashington State Board of Professional Engineers and Land Surveyors Washington State Soard of Registration for Landscape Architects In cooperation�ti ith: Washington State Association of Building Officials L��lh•�rbNi pit r( - HAP/ 5 �� October 1998 20 Guidelines for Washington State Building Officials and Design Professionals 3. Can a Washington State-registered architect or landscape architect "overseal"plans prepared and sealed by such out-of-state registered professionals for submittal in Washington? Yes. A Washington State-registered architect or land- scape architect can seal drawings prepared by or under the direct supervision of such out-of-state professionals. However, that Washington State-registered professional is thereby responsible to the same extent as if the documents were prepared or originally reviewed by him or her. �-� 4. Can an owner/builder/contractor make changes to an architect's, engineer's, or landscape architect's sealed documents? No. When plans are sealed by a Washington State- registered professional, no changes may be made to those plans except by that professional or another professional who thereby assumes responsibility for the plans as in the answer to question 2 above. 5. May Washington State-registered engineers and landscape architects practice architecture in Washington? No. The Architects' Registration Act, chapter 18.08 RCW, requires, in part, that individuals offering or intending to offer "architecture" must be registered in accordance with the provisions in that chapter. Profes- sional engineers acting in accordance with their authority in chapter 18.43 RCW, and landscape architects acting within their authority in chapter 18,96 RCW, while exempted from the conditions of chapter 18.08 RCW, I Mar-04-99 11 : 29A 021SEA 2537357820 P _ 01 tg OIL" Y ,. ,w.. :. HEARTLAND 3411 C ST NE #16 AUBURN, WA 98002 FAX COVER To: Plans Examiner Company: Mason County Phone: Fax: 360-427-7798 From: Russ McRee Company: Heartland Industries, 021 SEA Phone: 253-931-8082 Fax: 253-735-7820 Date: 3-4-99 Pages including this cover page: 3 Comments: See attached PERMIT , � Mason County Road Department Permit Number: 411 North Fifth Road Name : &U f1d V I2ILJ P.O. BOX 1850 Road Number : ail rl7b 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 Hereby Granted To: r-n / -e J n -S a n 4s'10 a )1? t?d S 4 L_ a c e/' W q p85'13 77-e-1 .5�Lj - S39gz To Install: EGG g fs u /1/e rZ` Location: -L%w <,zft ��<c £� A'd - i,,.7�5 ly s,�� fe z`vti C-resCv« L e,A, vt x ,re e-cY, es16, '7ur.� s ��t r,tric S�O�c �?dti'te..v P'?. -r-7 t a /Vo./''�r de 51 Xo it .i- d ✓j w fi,2 c r� Parcel Number: 32 0 2 / ..y 9 0 2 01<T Legal Description: ,§`4 a rc G re,S t ,6-e c c h aSta_t e S z 9 1 X 1-0-6 /8 A bond in the amount of $ .. °b accompanies this permit . Receipt Number: Check Number: -93 Y' ' Contractor : Address : 0 u)rt 2 r City/St/Zips Phone Lic. Number: Expires: Specifications: Access to be graveled to property line with 3"depth of dean 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: 360-427-9670 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: Dated at Shelton, Washington, this day of Issued by: Title. PERMIT NO.: BLD l'a MASON COUNTY BUILDING 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 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Ej;jty, IDAyu,l2or+ Contractor Name k8ailllf%a :rNcf- Mailing Address II st S Mailing Address 3H 11 C 1' A L / City IA3k CAW,, State Wei_ Zip Code 9 01X City ALAjLArv) State R ZipCode 400.1 y Phone( al ) 33"7- 15(e� they Ph.( Ph.(/-�h),) `7 q - 19Wther Ph. d( 5 Lien/Title Holder Contractor Reg. # EAat'14,101 T Address Expiration SEPTIC/�te TER SYSTEM INFORMATION-jonnect to New Septic Existing Septic Conne ' Sew SystE Name of Se er System�/A Well Water System Name of Water Sym JJ PARCEL INFORMA ION-12 digit Tax Parcel No. Eirp District Legal Description M Site Address(Plea include stree name stree numbe an city) S I h i s to ct sit Will timbe e cut and sold in parcel preparation? (Yes/No) O —t I Is your property within 200' of the following: Body of Water (Name) AMM Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Buildingo,o Describe Work .S No. of Bedroo s No. f Bathrooms SQUARE FOO AGE-1st Floor 0 2nd Floor�Q 3rd FloorLoft Basemen��Lr Deck Other sq. ft. Garage Attache Detached Caport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length LWdt y Serial N .Zrice "� No. of Bedroo s No. of Bathrooms Type of Heat Ptt � se $ �� —Replaeement Unit ?(Yes/No) Installer Name Certification Na. 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 approval. first obtaining approval. X Date �'AS' X Date FOR OFFICIAL USEBEYO D THIS POINT Accepted D lSgi bmittal Amount Due Receipt N DEPARTMENTAL REVIEW APPROVED DENIED;> CONDITION CODES Building Department Occ Group L.(- / Type Constr. Planning Department Environmental Health Department Public Works Department I Fire Marshal Valuation $ FEES Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Revie�ee (� Mechanical & Base Fee Other � l2v�S S Wood/Gas/Pellet Stove Fee Other 4 Violation Fee Pre-Paid at Submittal T L OTA FEES PERMIT NO.: 1 r1,�,5 qq_o 19 MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION Y'6 426 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 APPLICANT INFORMA ON CONTRACTOR INFORMATI N Owner 1E(m\%,\4- u a,j2p Contractor Name '�h�Or �i+ P(� Mailing Address 11 o 1 1 utL+�. +. E. %rl 3 Mailing Address P.O- to c CityoLkk State Wc- Zip Code q do 12 City 51,.,E l6- State Wk Zip Code 7 P-5/i Y Phone 'Z'S- 337- IS66 Other Ph.( Ph. Co 42L.-6 061 Other Ph.(_ Lien/Title Holder Contractor Reg. # U N 10 N C-P Address Expiration SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parce No. / / Fire Dis act Legal Description 64 16 t c ( r` �c > 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 1 st Floor �2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets �_ �� Type of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers = '7 O0 Vent Fans Water Heater _j_ '1 0U Propane Tank Laundry Wsher Gas Outlets Sinks �_ oo Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other Other Other Other Base Fee 2�� ° Base Fee zz °c.� TOTAL PLUMBING yg.�a TOTAL MECHANICAL-25s 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-1 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 approval. first obtaining approval. X Date X �Y `^( Date �69 FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. L EPART:M AtT1�:FtIwVfEW :.APFRt7V.ED DENIED GONDITICTN COR7w5. Building Department y?( Occ Grou - Typeconstr. (/- Planning Department Other Other twES 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 FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name RtA4iginA 'T,� PARCEL NUMBER 22C)C) �-- 0006-Dalrte d -o4S-92 SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements 11 Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line- I I E-adjacent property line I I I I I I I I I I I I I � I I v I I I i I I I I I I I I I I I I I I I I I I I I I ( I I I I I I I I I adjacent property line-> I ' <—adjacent property line SAMPLE SITE PLAN adja t property lined _ _ E-adjacent property line D 30" rRE r;,vE gel .SFALnr✓AL. I a _�PT1G._J �. C I Hom& I Gna.E�.l I j P(lOPO.SGD sap*.c. �I I 1 , I I VACAKiT I 7 c �rt�o cs I i I(C 31 aaofoscD ' i Ab2iCuLTU-MAL So I I 60' I � I I \ I c.—eLL I \ I adjacent property line- ; A�. \; f-adjacent propert� line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE f� p �( dtstar.cm to rl�-l�-l�^ ` s�rruLtwr� o q '� &s�ta r cc. to S►op¢ ta¢ 6INT dis+anL2 to t C—ao D e� - aL1+ - 99 Signat a Date