HomeMy WebLinkAboutBLD93-1035 Addition, Roof, Remodel Final - BLD Permit / Conditions - 6/17/1998 MASON COUNTY
—� Mason County Bldg. III 426 W. Cedar
RO. Box 186 Shelton, Washington 98584
El U11 I t_ 0 1 N t i Ems' E; t I IN1E I POR 1 MSPFC;r I ONS CALL 427-9670
BETWEEN 5pm AND Sam 427-7262
OLD93-1035 PAP EL :123094300130 PLAT : DIVI BL.K : L-U t
JOB AVDRESS : NF 110 PEDE RSON 014 BELPA I R
OWNER : ,IAA 275-3051
CONTRACTOR :
LEGAL s TV t3 Of SV SE
'cnsa.-,:smc>.rw�aszcsmm'*tce.+es�m^•-,..—._••.•��•,•r ...'sc-x^�.a,r.� _»,.aem:z�-aas r?amx:.x�aeesaxmexc:
CLASS OF' WORK . sADD BEDR : 0 BATH - 0 TYPE AMOUNT BY #Alf RECEIPT FYPF. AMOUNT Ef DA!F RECEIPT
TYPE OF USE' . . . . :SF STORIES . . . . . . . :O
OCCUP . OROJP . . . t? BLDG . HE I GHT . . : 0 .Oft PINT $ 211.50 KS 1#125193 33722 Siff 8 4.S# KS 09125193 33722
TYPE OF CONST . . :? F I REPLACES . . . . : 0 IPLCK 8 84.00 K& 04125193 33722 [OFF $ 1.40 KS #8125103 33722
OCCUP . LOAD . . . , t 0 WOODSTOVES . . . . : 0 PLN 1 21.I0 KS 80125193 33722
LIWELL. .UN I TS . . . . : 0 PARKING SPACESi 0 i4cm t s 1.to KS 08125i93 33722 !
INSPECTION AREA; '1 SHORELINE? — , , sN IWOST 1 75.to f.S 08125193 33722 TOTAL: 379.00 YOUTATIONs 30090�
�,�. �'>'.-a,
SETBACKS-- .--____.__.__-._ TOILETS . . . . . . . . . . : 0 FUEL TYPES---- - _ BOILERS/COMP---- MOBILE HOME---
'. FRONT . . .N O .Oft BATH BASINS . . . . . . t 0 :? 0-3 HP . : 0
HEAR . . . .e; 5 .Ott BATH TUBS . . . . . . . . : 0 3--15 HP . t 0 M0DE L :?
S 1 DE ( 1 ) .V11 5 .Ott SHOWERS . . . . . . . . . . : 0 FURN -z 'I OOK BTU a 0 15--330 HP . e 0 -MAKF - -- -
SIDE(7 ) .E 5 .Oft WATER HEATERS . . . . , 0 FURN >-100K RTUt 0 30-60 HP . : 0 ?
SHINE.. I NE . 0 .Ott CLOTHES WASHERS . . r. 0 FURN - FL.00R . . . i 0 504 HP . - 0 --YEAR---
AREA ---_-- - --------- KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . . 0 ?
LOT S1ZF . . :? FLOOR VIRAINS . . . . . . 0 VENT SYSTEMS . . . . 0 FVAP COOLERS : 0 LENGTH: 0
BUILDING . . . : Osf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTIi . : 0
BASEMEN!' . _ . : 03f LAUNDRY TRAYS . . . . : 0 DOMES . INCIN :0 SER 1AL.V-. --
DECKS . . . . . . Osf DISHWASHERS . . . . . . : 0 AIR NANDLING UNITS-- COMML . INCINtO ?
GAP/CARPc'7 0-- f GARB DISPbSALS . . . s 0 <- 10000 ofm . t 0 RE:LOC/REPAIRt 0
AT/DT . :? URINALS . . . . . . . . . . : 0 > 10000 otm . : 0 OTHER UNITS . : 0
MI SC PL.M F I XTURES s 0 GAS OUTLETS . : 0
O"111�C i1m:�G".'T..E'3fn.V"C'L" .'Let4':.:.ZJ.'CC•�f."SLiL:- Y41:R'L.'T6C"9�4_'19�.Cm.SS:.S'?.'i".!cS�.B.��5:'-
P11041c; OESC11PT18MrAINITICN, ROOF OVE1 FLAT TIP /0 CREATE NEW VASTER BEO000N AND STOPAOE AREA AND MASTER OATH
PROJECT LOCATION:OI.D BEIFAIR V41AFY RD 3 112 MILES FP00 BELFAIR TO PE DERSON DRIVE, TURN RIGHT AT FORK STAY TO kICHT A604.
THIS PERMIT BECOMES 49L1 AND VOID IF NOR; 01 CONSTNDCTFON AITNORIZED IS NOT CO11ENCE0 WITHIN 186 DAYS 01 If CONSTROCTION OR MORK IS SUSPENDED ;of A �ER100
OF T80 BARS AT ANY TIME AfTFR MURK IS CONNENCF9. EVIDENCE Of CONTINUATION Of WORK IS A PA04R[%$ INSPE11I11 WITHIN ThE 18A DAY PERIOD. FINAL INSPECTION NUST 8
AP?ROVER BEFORE BUILDING CAN BF OC+`"'�FD,
'4�NER OR
BLIgP�lMT, ;ev: I313i'Q' faf►MPL I ANCE TO ATTACHED CONDITIONS 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 l t by date " —.Z./ �'g by
Water Line FINAL INSPECTION
date by date /_�7_G�� by 77/�, date by
L JG - -bOc✓c 11 Po Cm �e—
i�� (l �Dcry-� ��-- /S—I� z.� 7� fi s�.�ralc�c�U � . .%tc✓�a L ,
L
MASON COUNTY
Mason County Bldg, III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
P1 HM 1 `t' C; 01NI:J 1 -1" 1 ci0ti4 :3
Case No . : BLD93-1036
For j %JACK fi P I DGF
Pages 1
1 ) PURSUANT TO 1991 ONIFORM BUIi,DING CODE SECTION 305(C ) AND SECTION 513 ALI. SITES MUST Y
HAVE APPROVED PUMPERS OR ADDRESSES PA6VIDED IN SUCH A POSITION A3 TO St PLAINLY VISIBLE
AND LEGIBLE FROM THE STREET OR ROAD FRONTING TI-fE PPOPE RTY . MASON COUNTY BU I I,D I Nib
DEPARTMENY REQUIRES THAT T141S BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
REINSPECTION FFF BASED ON RATES IN TABLE .3A OF THE 1991 UNIFORM BUILDING CODE WILL BE
ASSESSED IF OWNEI?I/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
INSPECTIONS .:
X
2 ) A1.1.. CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES A'ND URC
REQUIREMENTS
X
3 ) AREA OVER GARAQE M1 STORAGE ONLY Mfl HABITIAL AREA .
ALSO SE:'F REVISED ADD TO PLAN FOR OVER SPAN ..JOISTS FLOOR*CEILING
1
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
114 I'I t. I I Ilpla, i A1. 1 4: 7 '9670
A W I l >i;vfit 417 u 1 Z6
!I I •,.1, fi1 1, 1
.l08 AI)Iii;i MIF I f fA V+I)FKRQN DR ttt• t
.JACK RIDGE :'. 7f�—'ittlht
(11)NIRAV101'
( 1 1ila( IQ 13 Of Sit St IS 0031 it •67
1
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#18�1411", rev. 63; i�)4 i.IIM!°i .tflWl.f: 10 Al lA1:141_0 CON1►111.UN , .1;-; 1411I:.QUIRI D
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
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 date by
PLUMBING Attic 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
MASON COUNTY
Mason County Bldg. 111 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
IJI 1 14 m I I r4 1 Jt it 1 6, t j W4 I
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f �
Date Checklist Prepared C7
MASON COUNTY BUILDING DEPARTMENT
PLAN REVIEWER AND INSPECTOR CHECKLIST
1991 WSEC AND V&IAQ CODE COMPLIANCE
Uhl. idd4ion
Permit Number Address sF IA6 ea[pCSDlt l% VG Sq. Ft._,
Name on Permit W:KJ)C., . -: CGk H . Contractor/Phone# 7
Compliance Method: ( Prescriptive (Option) ( ) Component ( ) Systems Analysis
Date FOUNDATION
Insp. Rev.
( ) ( ) Slab: R- (Ext.foundation down to frostline/slab bottom;or interior 24"top of slab&horizontal. Radiant under entire.)
( ) ( ) Below grade exterior wall insulation: R-
( ) ( ) Crawlspace ventilation: (1 sq.ft.NEA1150 sq.ft.floor area-cross vented)
FRAMING
Standard ( ) Intermediate ( ) Advanced
( ) ( ) Woodstoves and/or fireplaces: (6 sq.inches combustion air supply duct with damper direct to firebox.)
( ) ( -r —Standard air seal: (Bottom plate/subfloor,rim joist/mudsill,window/door frames,penetrations condition to non-condition.)
( ) (—)---Attic ventilation (1 sq.ft. IIA/150 sq.ft.ceiling area)
( ) ( ) Spot exhaust fans: (4"exhaust-bath/laundry 50 cfm @.25 WG;kitchen 100 cfm @.25 WG. Vented out with dampers.)
air ventilation: Available to all habitable roo . Installed and operational. (Integrated forced air,windows,wall ports.)
�.?f « Spec " R�4A
Whole house exhaust fant3 cfm IntermRtent system manual auto controls/sone7ess than or=to 1.5 at.I WG)
INSULATION
( ) ('Attic baffles installed to deflect incoming air(Rigid material resistant to wind-driven moisture,extend 12"above loose fill or 6"
above batt insulation)
( ) ( ) Mechanical ventilation ducts R-4(Exhaust in unconditioned space&supply in conditioned space.)
( ) ( all insulation(above grade) R- J 5 _(Batts face stapled)
( ) ( ) Wall insulation(below grade-interior) R- (Batts face stapled)
( ) ( —Vapor retarders on walls (Faced batt,or 4 mil poly or perm.paint.-circle one)
( ) ( ) irn joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.)
( ) ( Vaulted ceiling insulation R- -3� (Vapor retarder& V airspace)
FINAL
( ) ( ) Floor insulation R- (Substantial contact w/surface,supports less than or=to 24"OC,not blocking vents.)
( ) ( ) Ventilation system is operational (spot,whole house,fresh air to all habitable rooms. If integrated system,certification by installer is
required.)
( ) ( ) HVAC ducts in unconditioned areas R-g (Joints sealed;mechanically fastened with a minimum of 3 fasteners.)
( ) ( ) Pipe insulation R-3 (Hot and cold lines in unconditioned areas-service or recirc.see Table 5-12).
( ) ( ) SHW heaters: (NAECA label,separate power or gas.shut-off,on R-[11_pad'f electric in unconditioned or on concrete.)
Heating system type: �AQr�etC a I
( ) ( <� Radon monitor on site with instructions.No. Supplied by MCBD
( ) ( ) Thermostat: (Heat range§5-75;AC 70-85;both 55-85. Backup heat controls(lockout)prevent simultaneous operation of primary system.)
( ) ( ) Solid fuel appls.: (Glass/metal tight-fitting doors;dir.comb.air source,or 4"dia.dampered,indir.source for existing const.)
( ) ( ) Ground cover: (6 mil black polyethylene or approved equal lapped 12"at joints,extending to foundation wall.)
( ) ( -1-�Penetrations(All exterior wall and ceiling penetrations sealed to drywall-plumbing,exposed beams,wall receptacles,fans,recessed lights.)
Ceiling Insulation R-3Y (Insulate&weatherstrip access,baffle to prevent spillover-no cardboard)
( ) ( ) Vapor retarder paint if a vapor retarder was not installed when insulation was installed.
GLAZIN 7� C( be-ffer dr AWA,G
Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. Impector- Verify window
information during field inspections. Include skylights, glass doors and all other glazing on this form. Use rough opening
area for calculations.
Date
Size Quantity Area S . Ft. U-Value Manufacturer Rev. Ins .
)PST 4 O 1Z� )q Pcc� ✓
q,3(c>
I Z S — LYs�—
1 y. 76
Total glazing area: 3�
Total conditioned area:
Percentage glazing: Verified:
DOORS
Plan Reviewer-List opaque doors by type(solid core, insulated,etc.)quantity,U-value,and manufacturer. Imo,pector-
Verify door information during field inspection.
Date
Type/Quantity U-Value Manufacturer Rev. Insp.
,boo -N,1'
o/ c
Signature of Building Inspector: Date of Final Inspection:
Building Permit # `/cn� MASON COUNTY
BUILDING 111 426 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
fo nd: Items Listed below must be corrected to gain code compliance
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
�3 Make corrections, items will be checked on next inspection
❑ OK to
❑ This is not a complete inspection Department '—�
Date _j � Inspector
■ *0 NnT MOV THINIV& T A ,k
1
Building Permit # 6;0 7? MASON BOUNTY
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
�> %U/GAT WiR�TiF ��-52zx Td EiYi 00 V e Wi Th' �
��S hlacdE�i' rt � 7C2 Fy�-r"r? ,n W AI d- ,o �` TO Tft/_ h'c>'?i zyi✓i?9�_
y) L ►vim%t= T/,P!te ff"4-/27 Td LorG G.4rY ,13,Lr
/3 Y T,97 11
a- Cow-yECTi•Y� i To ✓�.yT�9 ��.
You are hereby notified that the above corrections shall be made BEFORE
PROCEEDING WITH ANY FURTHER WORK
�r Call for re-inspection when corrections are made before continuing
❑ Make corrections, items will be checked on next inspection
❑ OK to
Department /5 e o
Date Inspector
■ oo s NnT MOOV THII
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason County Bldg.III 426 W.Cedar
P.O.Box 186 Shelton,Washington 98584
(360)427-9670
BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
Date
TO:
RE: Permit NumbeA&&-S��D���j
Parcel No. or legal description:1"9_1*-10/50
As per your recent request, this office has granted a 180 day
extension to the above permit . In r to keep the permit valid
beyond the extension date of � V , you must call for a
progress inspection prior to the new expiration date .
In the event that you do not call for the required inspection,
this office will mark the permit null and void by expiration.
Once the permit has been noted as expired, it will be
necessary to renew the permit by paying the applicable renewal fees
and/or applying for and completing the permit process again prior
to further construction or inspections being granted.
Sincerely, .
�/y
Mason Coun y uilding Department
CC : Property File
11
10.
dvv D O
W� ��L (��iY4 C�lOSG �(ZLleL! �•«
f _
2 Q e i-eQ . , ------
MAY 1
AL SERI I CEk
T
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Page No. 1 CASE HISTORY FOR CASE NO.: BLD93-1035
JACK H RIDGE
NE110 PEDERSON DR BELFAIR
04/23/96
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
BLDA010 Application received / / / / 07/07/93 07/07/93 KW
BLDA100 Approved For Issuance / / / / 08/25/93 DONE KS O8/25/93 KS
BLDA500 (F) Issue building permit / / / / 08/25/93 DONE KS 08/25/93 KS
BLDA510 (F) Reprint building permit / / / / 04/18/96 LOST HARD CARD NEED NEW ONE TO SCHEDULE CS 04/18/96 CPH
INSPECTIONS.
BLDB110 Structural Plan Review 07/16/93 / / 07/27/93 DONE WLC 07/27/93 DLC
BLDB120 WSEC Compliance Review 08/20/93 / / 08/25/93 FINI DLF O8/25/93 DF
BLDB129 Sent to Planning / / / / 07/15/93 SENT MMT 07/15/93 MMT
BLDB130 Planning Review 07/15/93 / / 07/16/93 DONE DB 07/16/93 DMB
BLDB135 Addressing 07/09/93 / / 07/09/93 DONE GMP 07/09/93 GMP
BLDB200 Environmental Health Review 07/27/93 / / 08/20/93 There is adequate reserve area... Septic DONE CAJ 08/20/93 CAJ
system does not appear to be failing
Sent letter with requirements;
non-failing system and verify reserve.
BLDC140 Fr/P1/Mc/Pen Inspection 03/06/95 03/07/95 03/07/95 CORRECTIONS: NO PLUMBING OR FANS IN AT FAIL LW 03/07/95 LAW
THIS TIME.
1. NEEDS ELECTRICAL SIGN OFF FROM L&I.
2. SEAL EXTERIOR PENETRATIONS.
3. BLOCK AT RIDGE.
4. STRAP AT CORNERS WHERE CORNERS DO NOT
LAP.
5. PROVIDE FRESH AIR OPENINGS INTO EACH
ROOM AS PER PLANS.
OK TO INSULATE EXCEPT OVER PLUMBING.
BLDC140 Fr/P1/Mc/Pen Inspection 07/12/95 07/13/95 07/13/95 DONE LW 07/14/95 LAW
BLDC145 Insulation inspection 07/12/95 07/13/95 07/13/95 DONE LW 07/14/95 LAW
BLDC150 Wallboard inspection 04/18/96 04/19/96 04/19/96 NO ONE HOME. DOOR LOCKED. FAIL LW 04/23/96 LAW
BLDC250 Permit Extension 12/20/95 06/20/96 12/20/95 extended per owners request. In process EXTD TL] 12/20/95 TLG
of sheetrocking and has had 2 surgeries
and had to buy braces.
141�)o
��
Z
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION a�
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 �L0 l0
PLEASE PRINT
T _
#1 Owner j a Phone #
Site Address A 1 QQ e-de r son DK Fire District#
City i St L✓id Zip
Directions to Job Site f
s �
Owner Mailing Address L
City 1L ej. ja' L St Zip ;24
Lien/Title Holder IP_P -, C")-1 rn Lk-n 4 1 Fe-,l �rP c�a 1 2�'rn1--i
Address
City St Zip
#2 Contractor Name "Tel t Contractor Reg #
Address Expiration Date
City St Zip Phone #
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. Ia�(-)7 - 0
Legal Description 0?3 Al- 12a, je, /L�-
#5 Building Square Footage: (existing/proposed)
1st FI /915 / y 2nd Fl&yam//r)& Y 3rd FI / Loft /
Basement / Deck / _ #bedrooms / # bathrooms - l 07, 7S
Garage /5-(D / Carport / (Circle: Attached or Detached?)
Other 0ML-e— sq. ft. l F r i`s gedruor.�✓
#6 Use of building re/�-� .�.���. Describe work 0 /er
�, h- 2 Is, 6-4-EL k-a lte 4/er'3 )-3102,RfC� &d106XK- 0-.14 sidri'4 el at
#7 Type of Job: New Add c/ Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
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
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW
/SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets 3 `'" CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins 3 co Heatpump, Other f-Lr-c i l=oRol r=a4 VAAr
Bath Tubs No. Units Fees
i Showers 3 c-) Furn BTU
_Hot Water Htr _ Heatpumps
_Laundry Washer f Vent System/14M4/tZ''i; In OU
_Sinks 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 $ ',7 y °`' 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
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 OWNER "�L
S X BY
DATE �:� DATE
FOR OFFICIAL USE ONLY: Accepted by: c'�� ' � Date: l ���
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: J 13
-7 16 43
Environmental Health:
Building Plan Review
Occupancy Group: 0-:: ype of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit 6
Plan Check E5 00
Plumbing Fee IL(, 00
Mechanical Fee �(.01b
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other
Other
a
Building Valuation: 30,U j o • v TOTAL FEE 3 0.Gcs