Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
BLD94-1605 Final Add Dining Room - BLD Permit / Conditions - 5/11/1995
MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 I 1 .0 F 1'-4 4: it I I Ile 1" 11 1 1 1 4 4 6/9 lit- I W I J N 111 4 7 1 6 lnti ifUltio "'." NU' ."S-t HIVERSiDL PI FAIR (lIJNl R - JOHN CHAt I MAN "—,271,-344!!, I i- I If 14 «f Ill? of k 14111 All 111011f kfillpi filit'l 41111,101 liv 11411 k1kill'i Ill I Ill' sjt'Wjt' Ill lit$ Ill I fill I 1,1ill0l'114 I Y P v f I 1 1 4,1,1" 1 t tii 1 1 {tl I c9 JPI 1 14 00 1 1,'11#804 4-0� lit,0,111, 1, 1 AI fill)0'' 1 ti"?l 4 0 t I ljI4 1 11 tj A 1 1 A 1 VAi ill fit loo, Yi t I I i I Jill I I 1 1, m I (I N I fit Hill I it I lit, 1 If;'( 1 0 0 f 11 1 it Ill, 4j flfit I I JA 1 f 1" lit 11 111 c1 0 lit, 0 I I 'I I lit " I!I i'l lit. All'I i 1-1 f 0 1 t 11it,?11 t 1, 1 llj�tj liiij� 0 k" API h I' I I I Ht 14 1. 1 ult I l,ljptl 1 1 t 111d... fli ii I N N I I I m I itot i I. ay I f 1.41. 114 (1 fill Ill If 1 N(1 0'. 1 k 1 141 , N1 i filit4 I Vt-H 1 1 1%14'. Ij I It 1 11 HA J= 111 N I A.-,I I I R (N 114 11(%P4 I I 1 1 14 14 1 t 1 IfJHf11 1 tdf 1 H 6 A P? It k P I I"h I I I l"I I is, A 1 111 c Ilk I NA I o I I 1J 1 11, IIN I 1 0 m PR 0 3 f 111 1111CAI[ON, I. Illul". OuRl" !10 to 0 911 IAIR VAI Mi RN, R16111 IIIRK 00 PIRI 1111, ift',l ill I OPI A RlIS';I04 110100 1110 P 1 1.4 Mill filt!'11JAI IIIRN 014MI At A',I'Ilhl I litIff 19 VI'I'm Rut; 10 t 0 11 p IN]', Pf RNJI h1`11141 , Pit AND VOID if willit OR 1,1111SIP11ilillil 41110op(.10 1,. NOT (OWNIfft Illm" 1110 hAvs. Ilk It iflosift"411"A 44 wiikt 1', "N"PtOpHt fa( A Mill1i 180 047" Al f'0' I Al I F ORI ONAI-01-F[I I vlaflif f Ill (0111[OvAl Illil o PORt IS A PR AM!�', 1111SPI f I lell UTININ 101 100 PAY VW614 f TNAI (11SPI I I"A "ll"Ji go 81,110146 1 1 ? IN lit /,7 Ailotil, OR Will] : 4 A I i 'to 0 t 0-P p N I 11-01111PI. I AN(J- 10 Ai I All.fit 1) C Glitill I I I li)Wi I t.o k 11- Q If T H It-11 r CONCRETE MECHANICA �V4 MOBILE HOME Footings-Setback date by Ribbons date 6Z 1 Z —3b—f by e Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date — / — i S by (f� date by FRAMING Walls FIRE DEPT. date — `7 5 by date date by � � J �by PLUMBING OTHER Groundwork Attic date b date Z — 5 — S) by D.W.V. WALLBOARD NAILING date n by date --f f) by Water Line FINAL INSPECTION date << by date S_ _ by date by II I 1 MASON COUNTY BUILDING III 426 W. CEDAR SkELTON, 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 cc j t' l e 7 C-V 1, pi e ��, 1 �G I�� � G� D�I� r� � r✓DY1 YJ ci _� C}� �t.,J G �� e X,r -I, ►♦ I�I�Ls S� JO n J1 0✓ C J?r f? D4i I C c. 9 4� r' �c colc.m You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK J Call for re-inspection when corrections are made before continuing /❑ Make corrections, items will be checked on next inspection ❑ OK to Department r„ Date Z_- J;; Inspector ' ■ joo s NuT Mo *V 1 , TA ,� dw _ Date Checklist Prepared MASON COUNTY BUILDING DEPARTMENT PLAN REVIEWER AND INSPECTOR CHECKLIST 1991 WSEC AND V&IAQ CODE COMPLIANCE Permit Number 94— I eOAddress ►1 E -as/ A Sq. Ft. ar(� Name on Permit Cha,lI ma n Contractor/Phone# a-7,5 - 3 � 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- ( ) ( 0*4do"—Crawlspace ventilation: (1 sq.ft.hTA/150 sq.ft.floor area-cross vented) FRAMING ( ) ( 1K (1,KStandard ( ) Intermediate ( ) Advanced ( ) ( ) Woodstoves and/or fireplaces: (6 sq.inches combustion air supply duct with damper direct to firebox.) Standard air seal: (Bottom plate/subfloor,rim joist/mudsill,window/door frames,penetrations edition to non-condition.) Attic ventilation (1 sq.ft. TA/150 sq.ft.ceiling area) ( ) ( ) Spot exhaust fans: (4"exhaust-bath/laundry 50 cfm C@.25 WG;kitchen 100 cfm @.25 WG. Vented out with dampers.) ( ) ( ) Fresh air ventilation: Available to all habitable rooms. Installed and operational. (Integrated forced air,windows,wall ports.) ( ) ( ) Whole house exhaust fan: cfm(Intermittent system manual&auto controls/sone less 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 R4(Exhaust in unconditioned space&supply in conditioned space.) ( ) ( Wall insulation(above grade) R-0_(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) ( ) ( ) Rim joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.) ( ) ( ) Vaulted ceiling insulation R- (Vapor retarder&I"air space) FINAL ( ) ( Floor insulation R- %3 D(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-8 (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-10paad if electric�iin unconditioned or on concrete.) Heating system type: �l-l.G. (,�.JA t I l �.c�� - Radon monitor on site with instructions.No. - Supplied by MCBD ( ) ( ) Thermostat: (Heat range 55-75;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.) Penetrations(All exterior wall an4 feiling� pen trations sealed to drywall-plumbing,exposed beams,wall receptacles,fans,recessed lights.) ml : ( ) ( LY Ceiling Insulation R- n ulate&weatherstrip access,baffle to prevent spillover-no cardboard) ( ) ( t4-" Vapor retarder paint if a vapor retarder was not installed when insulation was installed. GLAZING Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. jmpector- 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. Insp. L to 41 PD 0 I� ►� (-PSo 11r1 ' r 1 i � t,J acwn Total glazing area: Total conditioned area: oZ � Percentage glazing: c Zp k) I Verified: DOORS Plan Reviewer-List opaque doors by type(solid core,insulated,etc.)quantity,U-value,and manufacturer. jwpector- Verify door information during field inspection. Date Type/Quantity U-Value Manufacturer Rev. Insp. Signature of Building Inspector: Date of Final Inspection: MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 rf 1 f'tl ,I!/IfV I I !! ( •,�, i Ilri ! #fi`•'I Ptl'f lslt','� It �i+IRflii !;', 1i•: 1it11!tf 1 1'IiU`�' 11!I 11 I IV I11 11 1 1'!!'• I 1 11114 L.r1aRi1 I 1=!irV I 1 hlr; 1 I11 111 ( 11i F !li PJ 1 Ic! I1111 I;1 !iH f } H I ', HI t lll11'I I { I ti I'{i 1111< 1 u 1 r11 I ! -� i=I� I hd •{" 1 I 111P1 I F I Ffli'�1 !1 1!Fii l:�1 ! '- ! i��l t (iFil f '('t U! I ilF i 't'e 1 li{.f f I r�t:(9 !t!i 1 { Ir i fd1, + !IIrF I I I I I 1i! t1:�',f I! ! ui-Itl•. 1: (1 !1ia I I:f'.+ I UI< 1 11 f I 1 !1 I'!!' I tillilf i t11 d I t ! I'k i u;. I sl F1 11iI1 '. ! I I41, ! l r11 !' 1 11N'. 11i111 ! I till Pill'. 1 F11 I 1 !I' 1 <i 1 ! {1 f11 ► 1111 fJI 1 1111( t1rIII !1111 r. 1 t. {l.fl'i�l•. ! rf� r;!�I,I ., .I f•I� • I.rf i tiit 1, 1 :!;t•-. i ft,t 1 { 1 .. ,... F- , :�!nf, ( 1 .��!� ! .. 1 h,. 1 ,! t i 1.1,,..11 i !rfl I r�!t .r ! ., 1 !1�.•r f{\r t t�c�.• .. 1 '1" 1 `�i'•�I! 1 1 1 ;t i t utl ,311•f I lic{r�rl I fi 1 t' 111t.. 1 1 1 V I >>I lit t{I i 111 i II i n�{ � �vllrllcrl (�1;t'..nr1 ! r�lrPlt.�' !;;'F411 l•. f i 1,,. .r 1.1; 1 r �,�f (>',r ��1 A'�•!tl � c�i!ti1 y f1F ! c.I 1 ct rj�� 1 ! 1!+' I I gill ' �� Ir1114 1 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 b 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 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 Mason County Bldg. III 426 W. Cedar P,O, Box 186 Shelton, Washington 98584 N:::i6 N,.J ::N:_ N.... C11 :1 0,14 C li F=w IF: N 4!' 11-11 ::II:: ..H... F O R INSPECTIONS CAL L 4 2 7—9 6 7 0 BETWEEN 5pm AND Barn 427-7262 BL094-1605 PARCEL : 1232O1O93342 PLAT : DIV: ? BLK : ? LOT: ? JOB ADDRESS : NE 251 RIVERSIDE PL BELFAIR OWNER : JOHN CHALLMAN 275-3445 CONTRACTOR : LEGAL : Tr 34 of E1/2 NE i W111 IN. I CLASS OF WORK ADD BEOR : 0 BATH : 0 ITYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY GATE RECEIPT TYPE OF USE . . . . : SF STORIES . . . . . . . : 0 OCCUP . GROUP . . . : ? BLDG . HEIGHT . . : 0 . Ott IPRMT t 86.01 KS 12/08/94 37936 TYPE OF CONST . . : ? FIREPLACES . . . . : 0 PLCK ; 34.01 KS 12/18/94 37936 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 STFE Z 4.51 KS 12/18/94 37936 DWELL . UNITS . . . . : 0 PARKING SPACES : 0 INSPECTION AREA : 1 SHORELINE ? . . . . : N TOTAL: 124.50 VALULATI0N; 0 SETBACKS-------------- TOILETS . . . . . . . . . . : 0 FUEL TYPES---------- BOILERS/COMP---- MOBILE HOME-- FRONT . . . N 5 . Oft BATH BASINS . . . . . . : 0 0-3 HP . : 0 REAR . . . . S 5 . Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL : SIDE ( 1 ) . E 5 . Oft SHOWERS . . . . . . . . . . : 0 FURN < 1O0K BTU : 0 15-30 HP . : 0 —MAKE------ SIDE ( 2 ) .W 5 . Oft WATER HEATERS . . . . : 0 FURN >=1O0K 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 (= J.00OO cfm. : 0 RELOC /REPAIR : 0 AT/DT . : ? URINALS . . . . . . . . . . : 0 10000 cfm . : 0 OTHER UNITS . : 0 MISC PLM FIXTURES : 0 GAS OUTLETS . : 0 JECT DESCRIPTION:ADD OININ6 ROOM PROJECT LOCATION:1.2 MILES NORTH ON 0 L 0 BELFAIR VALLEY R0, RIGHT TURN ON DIRT R0, JUST BEFORE C R 0 S S I N 6 UNION RIVER, 1/4 MILE DRIVEWAY TURN RIGHT AT ASPHALT HOME IN VIEW RED IN COLOR. TOoHFFIS11BgPAAERMIIyTgg 88pETTC00EyySTTNIIUMMLLfL AFFNTTDEE VOWWID IFISW0RK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD RPPROVE�ABEfOREABUILOINfiACRNR8EI KCI 1Cj�9NENCE0. EVIDENCE OF CONTINUATION OF WORK IS A P R 0 6 R E S S INSPECTION WITHIN THE 180 DAY PERIOD. F I M A L INSPECTION MUST BE OWNER OR AGENT: DATE: 8L0_PRMT, rev: 13/31/91 COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED I MASON� � � ����� COUNTY ���U U ��l�� K -K �K � U^� U 1y " " "" ~~~ ~�- " " ,�~ ,�~ ~~ " " " " M[]So[l CC>iJrty Bldg. U| 426 W. Cedar � P.0. Box 186 Shelton, Washington 98584 u]: K:11 U� 1L) V l[ ][ 0 P4 lz::� � Case No . : BLO94-1005 For : JUHN CH8LLMHN � Pnge ; 1 � � 1 ) The use , handling and storage of hazardous materials or flammable and combustible � liquids in ax000e of 10 gallons is not allowed without the approval of the Mason County � i l � � � ^ | 2 ) Proposed structure or any portion thereof greater than 30" in height from grad* line , ' must maintain a minimum of 5 ' setback from all property linee � ". , easements and right of � ways | K / 3 ) A1,10'approved plans are required to be on—site for inspection purposes . If inspection is | called for and plans are not on site , Approval WILL NOT be granted . In addition , a | Re—Inspection fee in the amount of *30 . 00 per hour (minimum 1 hour ) will be charged and must be collected by this department prior to any further inspections being performed or approval granted . | X | � / 4 ) PUp""^""ANT TO 1991 UNIFORM BUILDING CODE , SECTION 305 ( C ) AND SECTION 513 , ALL SITES MUST | HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH 4 POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROP[RTY , MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A � REINSPECTIUN FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE � ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING ZNSPECTIO X � 5) ALL""'CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC � REQUIREMENTS � X � | h) Changes tv�'approved buildin plann that effect compliance to the 1991 Washington state � | Energy Coda , 1991 Ventilatiug n and Indoor Air Quality � | Code , the Uniform Building Code and /or Mayon County R be approved by Mason County prior to oonotructiunX | 7 ) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIIR�D PER MASON COUNTY BUILDING | / | / MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 DEPARTMENT AND UNIFORM BUILDING CODE . x 8 ) owner builder assumes all responsibil ' y if drainfield area is encumbered . X k'lI I//� Y K!/J f� Permit No. • MASON COUNTY < BUILDING PERMIT APPLICATION PLEASE PRINT 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 ((yyV, v 1\P V #1 r ��� ��ti ` A11 i'+� IA✓ Phone#�dOG) -K22 lclf� eAddress1l� _�,'yrr s,'� ,/z/ Fire District# iity ,'t- St Zip Directions to Job Site V i C s&/ dlo 46 CJ/ i n/ e'U 10 Owner Mailing Address City St Zip Lien/Title Holder Address City D r' © rc r St Zip #2 Contractor Name fr✓i/� /< sTo�.c 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 resi ntial, proof of potable water is required) #4 rcel No. - D =/3 3 �Y Legal Description r/� -3'`1( -� o� % Nr r� 4 o��`,o ,,Z 3 #5 Building Square Footage: (existing/proposed) 1st FI .7dCJ/ 2nd FI / 3rd FI / Loft�Qt�/ S Basements DOI�,Deck / #bedrooms / #bathrooms / Garage / / Carport h 04 / S (Circle:Attached or Detached?) Other sq. #6 Use of building ho"V e Describe wo #7 Type of Job: New Add t Repair Other #8 MOBILE/MANUFAQT ED HOME INFO ATION Model Year _ a odel Length idth 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 Dlrgotlonal by (N, S, E, W) IL Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW ,1 l� Q) i � Pa l � Z, G!7 /VC'w-- 0-0—Q— G✓41cv- A^�t� APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbina Fixtures ($3 each) F& Mechanical Fixtures ($6 each) � No. Toilets( Noiv e be CIRCLE FUEL TYPE: Gas, Electric, ath Basins Heatpump, Other Bath Tubs No. Units Fees Showers Furn BTU Hot Water Htr _ Heatpumps aundry Washer Vent Systems Si ks _ Spot Vent Fans _Floor Drains No. Boilers/Compressors _Laundry Basins _ HP _Dishwasher No. Air Handling _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 $ 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- TOTAL MECHANICAL $ 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 OFTHE 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 OWNE X BY DATE �D T DATE XX IFOR OFFICIAL USE ONLY:Accepted by Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: r �m5 Environmental Health: Building Plan Review CT) Occupancy Group: ', Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee _4L—P— Other dD Other Building Valuation: qO 7Z TOTAL FEE zz `�