The URL can be used to link to this page

Home My WebLink AboutBLD95-1508 Cancelled Convert Mobile to Workshop - BLD Permit / Conditions - 3/15/1999 MASON COUNTY Mason County Bldg. III 426 W. Cedar r P.O. Box 186 Shelton, Washington 98584 .r E3 U I L_ L7 I N C3 P E R M I T FOR INSPECTIONS CALL 427-9670 BETWEEN 5pm AND 8am 427-7262 BLD95-1508 PARCEL : 123171400010 PLAT : DIV : BLK : LOT : JOB ADDRESS : NE 2481 OLD BELFAIR HWY BELFAIR OWNER : RICHARD MEDEIROS 275-2110 CONTRACTOR : LEGAL : TR 1 OF SE NE I SI NI SEC 16 CLASS OF WORK . . :OTH BEDR : 0 BATH : 0 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT TYPE OF USE . . . . :MH STORIES . . . . . . . :0 OCCUP . GROUP . . . :? BLDG . HE I GHT . . : 0 .Oft CHOU $ 25.00 CPH 10/18/95 0000 TYPE OF CONST . . :7 FIREPLACES . . . . : 0 S T F E 9 4.50 CPH 10118/95 0000 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 EHCP $ 10.00 CPH 10118/95 0000 DWELL .UNITS . . . . : 0 PARKING SPACES : 0 ! INSPECTION AREA : 1 SHORELINE? . . . . :N I ITOTAL: 39.50 VALULATION: 0 SETBACKS-------------- TOILETS . . . . . . . . . . : 0 FUEL TYPES---------- BOILERS/COMP---- MOBILE HOME-- FRONT . . .E 5 .Oft BATH BASINS . . . . . . : 0 0-3 HP . : 0 REAR . . . .W 5 .Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL : SIDE ( 1 ) .N 5 .Oft SHOWERS . . . . . . . . . . : 0 FURN < 100K BTU : 0 15-30 HP . : 0 -MAKE------ SIDE (2 ) .S 5 .Oft WATER HEATERS . . . . : 0 FURN >=100K BTU : 0 30-50 HP . : 0 SHRLINE . O .Oft CLOTHES WASHERS . . : 0 FURN - FLOOR . . . : 0 50+ HP . : 0 -YEAR------ AREA ---------------- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 LOT SIZE . . : FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH : 0 BUILDING . . . : Osf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0 BASEMENT . . . : Osf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN :O -SERIAL#---- DECKS . . . . . . : Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS-- COMML . INCIN :O GAR/CARP :? Osf GARB DISPOSALS . . . : 0 <= 10000 cfm . : 0 RELOC/ REPAIR : 0 AT/DT . :? URINALS . . . . . . . . . . : 0 > 10000 cfm . : 0 OTHER UNITS . : 0 MISC PLM FIXTURES : 0 GAS OUTLETS . : 0 PROJECT OESCRIPTION:CONVERT MOBILE TO WORKSHOP PROJECT LOCATION:NEXT TO BELFAIR SAND AND GRAVEL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD OF 100 DAYS AT AN TER WORK IS COMMENCED. IDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 180 DAY PERIOD. FINAL INSPECTION MUST BE APPROVED BEFOR UILDING A E OCCUPIED. OWNER OR AGENT. DATE: ZS / BLD PRNT, rev. 03131191 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED N'Vi34:� -NSA, J J A.) RVO ! I 034kW ! RO 1 P/1 P j r-1 'D tl I (--j I I 1.1 cl(3 R N- V CA MFP, OTA map— 0.39W r 171 .1 1 e3 V 1 (5 CJit4 r r 2 .3111- 1 Ec14 ilp(1 .18 it A 138 YWH H I Vi 138 It JCS t (44S 11A -'A 30o t t (YT 2V R I J Q A M d$1 A H 0 i 4 P i W. q TV I 74j-)VA ;cy— r, PTA d ,1 :4 33 HTO; '1')W 90 P-:3A.; . . . . . . jaU 10 3qy- -9, 55. f t G U TH6 f-I 3 quoJo -11 0 A V-; T-:11 I I Y I Isle G P, I V 0 T 0 0 V-11 A(1 0 A q A9 N I (A 3V411 0 T 301 Clf�"JHC t A 3 A V T 4 0 H J cl C M C!m 0 ls. 9. --F3q)(,7 -13119 r4 T 3-l' 0 T 9 r I F, r le qH 7 V. i 2 A A rj I t9. a q H a r 23' T HTAq �'tr; e �400V q� A I H U 1 1")0 t 0 P Uq N P IWO V - 3Q 3AAV N ql� 0 F,-�'. I q H Ga -NL 0 li-rd ANQ 0 q U A:3 P P-i' Atm I i ? r�4-KI( 2-1. -rM` I') t I*' - . , . P:)(" ! A R U . ry IWO TA 3 ?AO I ;? 03HjT -09V �7j .21A : AHO J100 11 i 0 �:AA.1003 CIAV N Y;� 1 i u . . . . - -,,G r)r," N -1 1 . . I I I.r)A DO IAM ; q G A . T1,4 I V -A 0 j 1 0'-1 OM -'VA IT V :l;1WJA � 1 21�, V1'-3*M I P A ---PTlt4;j OA , 1! 1 V, 0 3 f.1 rj j j I i !WY I 00(Y) iill-)A I P 01 .1:.)VA I YOV"I MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 hereby assume all responsibility for the scheduling of these required inspections . If these required inspections are not requested , inspected and signed off ( approved ) by the inspector in the prescribed order , I understand that reinsppection fees and an hour ) investigation fee pursuant to the 1991 UBC , Ta s will be assessed in addition to my original permit fees to resolve any question le practices or problems that have been discovered . I further understand that th1 investig n will be . acheduled as time allows . Until resolution of any/all prob ems no oc pa cy ( Fin " Inspection ) will be granted for the residence . OWNER/CONTRACTOR ( indicate which ) Signatu e X ! / 8 ) All mobile/manufactured home landings or decks must be freestanding ( self supporting ) . The largest landing or deck permitted without drawings or a building permit is 36" x 36" . Any landing or deck that is 30" or more in height from walking surface to finish grade requires—a—guardrail . Any landing or deck that has 4 or more risers requires a handrail . Any ! ending or deck larger than 36" x 36 " must be permitted which requires structural drawings and a building per application . This Installation Permit does NOT include any landin or ck lar han the 36 " x 36" size . 9 ) Changes to approved building plans that effect comp ance to 1991 Was gton State Energy Code , 1991 Ventilation and Indoor Air li y Code , the Uniform Building Code and/or M on Co n y R ul i s m be approved by Mason County prior to con ructio X 10 ) CONSTRUCTION PROCESS TO BE FIELD CORREC_ E IRE P 0 OU.I;VTY BUILDING DEPART AND UNIFORM BUILDING CODE .x 11 ) Ow er/ buil r assumes al r sponsibility if drainfield area is e cumbere . X G 12 ) S or age us y . Remov all lumbing , plumbing fixtures and cooking Pi X MASON COUNTY NL Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 P E R M I T C O N D I T I O N S Case No . : BLD95-1508 For : RICHARD MEDEIROS Page : 1 1 ) Th se, handling and storage of hazardous materials or flammable and combustible I quids xcess of 10 gallons is not allowed without the approval of the Mason County ire Ma s a I 2 ) P posed str cture or a y portion thereof greater than 30" in height from grade line ust ma ' t a ini of 5 ' setback from all property lines , easements and right ofi X 3 ) All a d plans are required to be on-site for inspection purposes . If inspection is cal for nd plans are not on site Approval WILL NOT be granted . In addition , a Re Inspecti n fee in the amount of $�0 .00 per hour (minimum 1 hour ) will be charged and st be c I ted by th pp I r ted ' epartment prior to any further inspections being performed or .r g 5�'; Z�� 4 ) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305 (C ) AND SECTION 513 , ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND L BLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEP ME T REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A R INSPEC N FEE , BAS D ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE SSESSED IF OWNER/CQTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSIDE NS X 5 ) No 0 an This structure is limited to M- 4ny Any o 'h r s w ' Il be in vi ation o the Uniform Building Code and Ma n gula n less a ge of Use" ermit is approved . X 6) R C ION M T EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS . 7 ) REQUIRED INSPECTIONS ( Footing Inspection-prior to pour , Set-up Inspection-prior to skirting , Final Inspection-prior to occupancy ) . I have received a copy of the General Information and Guidelines-Mobile/Manufactured Housing Installations Handout for detailed descriptions of all required inspections on my mobilegmanufactured home installation . I —T MASON COUNTY Mason County Bldg. III 426 W, Cedar P.O, Box 186 Shelton, Washington 98584 E3- U I L_ C7 i N C-x PE R M 1 -r �! FOR I NSPECT I.ONS CALL 427--9670 BETWEEN 5pm AND Sam 427-72EiM�'( RAS��N BI_D95-1508 PARCEL- : 123171400010 PLAT : D I V , BL. ,p11 ,)OB ADT)RF ,St NE 2481 OLD BEL FA I R HWY BELFA I R ��'! �►� OWNERS RICHARD MEDFIROS 275-2110 NV`` & k CONTRACTOR : �2 LEGAL : TR 1 OF SE NE 1 $11 Of SEC 16 CLASS OF WORK , . :O'r11 BEDR : 0 BATH : 0 TYPE A00901 BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT TYPE OF U S F , . .. . :M Ei STORIES . . . . . . . .0 _:�_� _ �•� OCCUP . GROUP . . . -7 BLDG . HEIGHT . . ; 0 .OTC CHOU 1 25.60 CFO 1#118195 001111 TYPE OF CONST . . :7 FIREPLACES . . . . . 0 Siff f 4.50 CPR 1#118195 00#0 OCC.UP . LOAD . . . . s 0 WOODSTOVFS . . . . : 0 EHCP 3 iA.00 CPR 1ff118195 00i1ff DWEL-! .UNITS . . . . . 0 PARKING SPACES : 0 INSPECTION AREA : 1 SHORELINE? . . . . :N ;TOTA1 : 3b.50 VALULATIONs a _.T.e'X�.��:'.::^3"-: k'•S»i-4A`.`:" T.:�L:SG?T ,. '�19�Wii&�.'CC:tFS4S6'i6aR. TOILETS . . . . . . . . . . : 0 rUEC TYPES---- .---.---- BOIL_FRSICOMP-- MOBILE HOME -- FRON'T _ . .E 5 .01t BATH BASINS . . . . . . i 0 s ' a 0-•3 HP . : 0 REAR . . . .W 5 .Oft BATH TUBS . . . . . . . . : 0 3-- 15 HP . : 0 MODEL; SfDE ( 1 ) . 5 .0'Ft SHOWERS . . . . . . . . . . : 0 FURN 4 100K BTU : 0 1 5--30 FIP 0 MAK.F S I DE ( 2 ) .S 5 .Oft WATER HEATERS . . . .. a 0 FURN >-100K. BTU : 0 30--50 HP . : 0 SHRLINE . 0 .0Tt CLOTHES WASHERS . . : O FURN - FL.00R . . . : 0 50+ HP . : 0 _. YEAR AREA --------_.__.____... KITCHEN SINKS . . . . s 0 HEAT PUMP . . . . , . : 0 LOT SIZE . . a FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . r 0 EVAP COOLERS : 0 LENGTH : 0 BUILDING . - . : Osf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0 BASEMENT . . . -. . . : Os F LAUNDRY TRAYS. O DOMES . I NC I N tO .-SERIAL_#---- DECKS . . . , . Ost DISHWASHERS . . . . . , : 0 AIR HANDLING UNITS- -- COMML . INCIN40 GAR/CARP :? Osf GARB DISPOSALS . . . a 0 <— 10000 cfm . : 0 REt.00/REPAIR : 0 AT/I?T . a? URINALS . . . . . . . . , . 0 10000 cfm . : 0 OTHER UNITS . : 0 MISC PLM FIXTURES : 0 GAS OUTL.ETS , : 1 PROJECT DF3CIIPTIO1sC41V(1 T NOSILE TO WORKSHOP PROJECT 1.00A4ION:NEx7 TO SELFAIR SAND AND GRAVEL ,HIS PfINIT 6ECONIS NUIL AND VOID If WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMfNCED 01IHIN i90 DAYS. OR IF CONSIROCTION OR 1049 IS SOSPENDfB FOR A PERIOD OF 181 DAYS AT AN 1fE-l"i ER 1011( IS CONMENCE9.y IQENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 180 DAY PERIOD, fINAI INSPEC.IION MUSE OF APPROVE3 BEFORE ILDING �AN,_B,f OCCUPIED. 910IR OR ACENT: " r-x DAIS: B10 ?IV'., rev i 13131191 COMPLIANCE TO ATTACHED COND I Ti ONS IS REQUIRED CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping, date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 PE RM I T C, (7)Nf I _r I c) N Case No . : BLD95-1508 For : RICHARD MEDEIROS Page : 1 1 ) Th¢--Tfsc,` handling and storage of hazardous matar i a 1 s or f i ammab 1 e and combustible 1 1qu i ds -oxcess of 10 gallons Is not allowed without the approval of the Mason County Fire Ma.- s aJ { . / 2 ) Propose ci, str oture or v portion thereof greater than 30" In height from grade line i P 9 q g , musjt malint n a 71nimu of 5 setback from all property lines , easements and right of ways 3 ) All approved plans are required to be can--site for. inspection purposes . It inspection is calle-d for and plans are not on site Approval WILL NOT be granted . In addition , a Re- inspection fee in the amount of tiO . 0 per hour (minimum 1 hour ) will be charged and crust be collected by this epartment prior to anNj further, inspections being performed or approval ir.antedAl 4 ) , PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305(C ) AND SECTION 513, ALI_ SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SOCH A POSITION AS TO BE PLAINLY VISIBLE AND LED_l-BLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DE, RTME14T REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A RE'INSPEC , ION FEE , RAS D ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL. BE ASSESSED' IF OWNER/CO RACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING 1 NSPECT-JtbNS . X r. -t 5 ) No Oe cupa—'o This structure is limited to M.- i u ag o�yr . Any o her u� w,i'11 •be In vioiatian o the Uniform Building Cade and Mason Co my Regula�on unless a "Change of Use". erm i t is approved . X� GA L, 6 ) ALL CONaT*R�1C,T 1 ON US M T E"EED ALL LOCAL_ CODES AND UBC REQUIREMENTS , 7 ) REQUIRED INSPECTIONS ( Footing Inspection--prior to pour , Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy) . I have received a copy of the General Information and Guidellnes3obile/Manufactured Housing Installations Handout for detailed descriptions of all required inspections on my mobile/manufactured home Installation . 1 CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date by 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 teV b WALLBOARD NAILING D.date by date by Water Line FINAL INSPECTION date by date by date by I I �i I J MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 herebv assume all responsibility for the scheduling of these required Inspections . If these required inspo ions are not requested, inspeoted and signed off ( approved) by the Inspector in the prescribed order , I understand that reI "spp�ction fees rind an hourly investlyation fee pursuant to the 1991 UBC, Tah4e"-3A-. will be assessed In addition to my or i o i na permit feces to resolve any quest i on.ab I e pradt i ces or problems that have beerre discovered . I further understand that this" Inve:stig 'tion will le educed as time allows . Unt i i resolution of any/all probl'e�ms no oco panty (Fin na#` i n pent i ten ) will t,e - granted for, the residence . OWNERICONTRACTOR ( indicate? which ) Slgnatune X 8 ) All mobile/manufactured home landings or decks must be freestanding ( self supporting) . The largest I and i nc� or deck permitted without drawings or a brr i I d i ng permit, is 36" x 36" . Any landing or deck that Is 30" or more in height from walking surface to finish grade requires a- guardrail . Any landing or deck that has 4 or• more risers requires a handrail . Any landing or deck larger tha �'"� x 36" must be permitted which requires structural drawings and./a building permit-Ray lication . This Installation Permit does NOT include any landing 'or eok tar er than he 36" x 36" size . 9) Changes to approved building plans that effect compliance to "he 1991 Was gton State Energy Code, 1991 Ventilation and Indoor Air.-Q-ua11ty Meson Code, the Uniform Building Code and/or Men County Rggu m i i s be approved by Mason County prior to oon%tr�uct l onX ,, cv � Z—.,.r. 1 D) CONSTRUCT I ON PROCESS TO BE FIELD CORRECTED- �A,E /1 REO}�PE OtW GOLLITY BUILDING DE PARTMEAtT AND UNIFORM BUILDING CODE .x ,..! r 11 ) Owne r ' bui lder-- assumes al.!-fir sponsibi 1 ity if draiof ield area is encumhered 12) Storage use i y . Rem all I umb i ng, plumbing fixtures and cook I ng app I i a n.pels'. 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 date by PLUMBING Attic by OTHER Groundwork date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Building Permit # MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 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 !�.rv►.,�✓r� CJ/GYM _S/� c /S S K 8 �L _ I'�1.rl r✓l c.�M Qld 5/Z C z" � -& 01� e- t le- .ht04-kS ,S %.'2 & ��• oc>; Gi019roj c.�0 'Al' QDL-Y-n Cr oU t d<- 4- g L/` O 2 G rD�J Ae-J C c.l l ?ew"v-- y �5 4-cPs L err�,�p/� �Gc%� c--S P r r e-ss tir C You are�iereby riot fied that tie a �ove corrections s ade BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing �,s �' s�� f °� v Y!5-c' ❑ Make corrections, items will be checked on next inspection ❑ OK to Department �1�5 Date ( - r st Inspector �✓ ■ loos NnT Mk *V THI TmLow "0 � Permit No. MASON COUNTY BUILDING PERMIT APPLICATION Q kyp 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 v PLEASE PRINT #1 er Phone#� � ite Address AIE 2481 6,( D ZL--LF/�j;- 14WY Fire District# city St Ui A. Zip Q8S 2& Directions to Job Site ,(/rXT Ta aeiLsitie siyp C,eAt/E"G Owner Mailing Address :514ME 143 /��✓E City St Zip Lien/Title Holder Address Clty St Zip #2 Contractor Name_ GF' Contractor Reg# Address Expiration Date City St Zip Phone# #3 1 c is located on project site, include records. Connect to Se Public Water Supply Well Connect to Sewer System. Name of System (If residential, proof of potable wat required) # rcel No. I J/ - I - d�� ,t/�� 5�G Legal Description lt #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle: Attached or Detached?) Other sq. ft. / #6 Use ildin� Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year — Make Model 2 Length Width Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price$ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other 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 in relation to plot plan Name of Fronting Street --?IWLICANT TO DRAW SITE PLAN BELOW o J� ,� t p+��0s0 � 0! Z S � Nac�sE C31j Lo APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW PSI imbing Fixtures ($3 eac bj Fee Mechanical Fixtures ($6 each No. Toilets CIRCLE FUEL TYPE: Gas, Electri , Ba Basins Heatpump, Other Bath Tub No. Units Fees Showers Furn BTU _Hot Water Htr Heat mps Laundry Washer _ ent Systems Sinks Spot Vent Fans _Floor Drains No. Boilers/Comlressors Laundry Basins HP Dishwasher No. Air Handling Units Disposal _ cfm# Urinals Fire Protection Systems Other _ Auto. Fire Alarm Sys 50.00 Fi d Fire Supp. Sys 50.00 Permit is Fee 15.00 Auto Fir prink Sys 25.00 tOTAL PLUMBING $ No. Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COM- MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. WNERS 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 CONFORMAN HEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WI OUT FI ST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BU DING DE A TMENT. DEPARTMENT. X OWN X BY DATE /D —4 - 5j'5 DATE - - FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR U SE ONLY OFFICE Approved Cond. Hold Approval Planning: � Environmental Health: q Building Plan Review S A V&4.r 2d 1c.4 /'CWcwe a// 1,2140 A.6,•4, D � /D�iti�Gs Occupancy Group: Type of Const: S- Fire Marshal: Other: Special Conditions: FEES Building Permit C 2- 5- 0-0 Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE