HomeMy WebLinkAboutBLD2008-01289 Replace MFG Home Final - BLD Permit / Conditions - 4/23/2009 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext. 352
Mason County Bldg. III 426 W. Cedar P.O. Box 186
Ig Shelton,WA 98584
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RESIDENTIAL BUILDING PERMIT BLD2008-01289
OWNER: JACK DEAN RECEIVED: 10/16/2008
CONTRACTOR: MODERN LIVING LICENSE: MODERLL972DO EXP: 4/14/2009 ISSUED: 10/30/2008
SITE ADDRESS: 731 NE BEAR CREEK-DEWATTO RD BELFAIR EXPIRES: 4/30/2009
PARCEL NUMBER: 123093304010
LEGAL DESCRIPTION: TR 1 OF W1/2 SW SW
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
REPLACEMENT MANUFACTURED HOME
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.:
Type of Use: MH Insp.Area: No. of Bathrooms: Occ. Group: Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: Occ. Load: Building:
Valuation: Building Height: Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline& Planning Information
Make:LIBERTY Length: 71 Ft. Front: N 265.0 Ft. Shoreline: Ft. Water Body: Man Made Lake
9 SEPA?: No
Rear: S 300.0 Ft. Slope: Ft. Shoreline Desi
Model:ANNIVERS/ Width: 29 Ft. Side 1: E 215.0 Ft. g.". Not Applicable
licable
Year:2009 Serial No.: Side 2: W 90.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Mobile Home Submittal Fee TW 10/16/200 $247.00 B12008000
EH Plan Review TW 10/16/200 $40.00 612008000
Planning Review Fee TW 10/16/200 $190.00 612008000
Fire Warden Review TW 10/16/200 $68.00 612008000
Mobile Home Issuance Fee MAL 10/20/200 $247.00 B12008000
EH Plan Review CEW 10/23/200 $60.00 B12008000
Water Adequacy Plan Review CEW 10/23/200 $40.00 b12008000
Total $892.00
BLD2008-01289 Please refer to the following pages for conditions of this permit. 1 of 6
CASE NOTES FOR
BLD2008-01289
CONDITIONS FOR
BLD20 0 8-01 2 89
1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division.
There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at
1-800-647-0982 ,he.,person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law.
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2) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will
not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building
Depart for to any further inspections being performed or approvals granted.
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3) OwneJ� et,is-responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28.
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4) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the
corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building
Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or
remoy�/aproved documents will result in failure of required building inspections.
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5 THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X
6) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" site plan is not on site, then
approval pql not-be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and shall be collected by the
BuildilDeplrtrpl nt prior to any further inspections being performed or approvals granted.
7) Any retailer, manufacturer or contractor who installs a manufactured home warrants that the manufactured home is installed in accordance with the State
Installation code, chapter 296-150M WAC. All installers hired to do installation work shall be certified manufactured home installers and shall be present
to supervise the installation of all on-site work. An Installer Tag shall be posted on site giving the certification number and signature of the certified
installer responsible for each major part of the installation. RCW43-63B.090
An approved Installer cerification tag shall be placed on the end of the manufactured home directly above or below the HUD certification tag or temporarily
located in plain site within three of the home's front entry. There shall be one certification tag for each certified installer accounting for the work that each
installer performed or.inst I , certification number and signature of the certified installer responsible for each major part of the installation.
WAC365-210 X
BLD2008-01289 Please refer to the following pages for conditions of this permit. 2 of 6
s 8) If you are installing a manufacturing home and no longer have the installation manual for the home, you must use the instructions of the American
National Standards Institute (ANSI). To order the ANSI instructions you may either get an order form from the Mason County Building Department or you
can coRtac(th_e-Offfice of Manufacturing Housing (360) 725-2800.
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9) Per 2003 IRC - SECTION 1609-WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the
minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609
BASIC WWQ,SPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH.
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10) Per IRC - SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in
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accord 5 .with the applicable provisions of this section and the manufacturer's installation instructions.
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11) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement,
inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the
owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel
prior to the commencement of any development activities. "NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater
Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes
an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are
responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system
of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of
the building permit the owner/agent/contractor is p4,, wl6dging that all components of the stormwater management system have been installed as
approved on the stormwater site plan. X
12) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the
State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in
permjt-r6vAcbtion.
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13) Lake Cushman area is designated with a 551b snow load rating. The owner/agent of this permit acknowledges that if the unit permitted under this permit
does npt`rrit'the recommended snow load rating, there is a potential for failure due to weight accumulation beyond that of the design criteria.
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14) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I hereby assume all
responsibility for the scheduling of my required inspections. If the required inspections are not requested, inspected and signed off(approved) by the
inspector in the prescribed order, I understand that reinspection fees and an hourly investigation fee pursuant to the current fees adopted by the Mason
County Building Dept., and will be assessed in addition to my original per .'t fees to resolve any questionable practices or problems that have been
discovered. I further understand that this investigation will be sched a allows. Until resolution of any/all problems no occupancy (Final
Inspecti?r -wi" ranted for the residence. �✓
OWNER/CONTRACTOR(indicate which) Signatur
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15) Applicant has indicated this is a replacement unit. Prior to Mason County allov, g.any occupnacy of the new proposed unit, the existing unit which is
on-site and is being replaced MUST be removed from the parcel. X
BLD2008-01289 Please referto the following pages for conditions of this permit. 3 of 6
16) This permit is for Ikcbrhent and installation of the manufactured home only and does not imply approval or review for any other items indicated on the
plot plan. X
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17) Permanent Address must be posted and visible from the road
Deck must be safe and meet code for year building permit was issued. Rebuilt decks are required to meet current code. All guardrails and handrails
must be in good condition and meet code for year built or current code if replaced.
Skirting must be vented 1:150 and backfill sloped away from unit 2% for a minimum of 5' around the perimeter of the unit
Gutters and downspouts must be installed with splash blocks provided
All exterior penetrations must be sealed
HWT Pressure relief line and dryer vent must exit skirting a minimum of 6"with a maximum of 24" above grade.
The unit shall have a minimum of 16"x24" crawl space access provided HOWEVER, if the unit has not received a set up inspection and is skirted, 4
panels centrally located (one on each side of unit) shall be removed by the owner/applicant prior to requesting the inspection.
All conditions on the original or issued permit must be met
If the unit was installed by a WAINS certified installer/contractor since July 1, 2003, CTED Installer Tags must be available
It shall be the responsibility of the person requesting the inspection to provide the
manufacturer specifications, ANSI Standards or approved engineered design for the installation of the unit and have them available on site for inspection.
Each inspection required will be assessed a fee as adopted under Mason County current fee schedule. Re-Inspection fees will be assessed each time an
inspection is requested and required items are not completed prior to the inspection being performed
ENFORCEMENT PROVISION:
Any manufactured/mobile home and/or appurtenant structures found non-compliant with any county or state regulation are subject to enforcement action
and subsequr,t violation and penalties pursuant to the Mason County Code.
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18) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely impact
adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements of the
stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose. For further
information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a driveway or access
connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450. For any construction which
is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may
affect your project,-r_
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19) PlaceJic `str ture must comply with standards set forth per the international codes regarding descending and/or ascending slopes.
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BLD2008-01289 Please refer to the following pages for conditions of this permit. 4 of 6
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20) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County
ordina �crregulation, must be reviewed and approved by Mason County prior to construction.
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21) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED
BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspectof;i�all be made prior to requesting additional inspections.
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22) The installation permit shall be displayed in clear view of the site access road. The approved site plan and other applicable instructions, including
installation instructions, shall be available in this location OR placed in the location specified by WAC 296-150M-655. Support configuration shall be
clearly (kd(fin,the installation instructions.
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23) All property lines shall be clearly identified at the time of foundation inspection. X ->
24) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure
to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with
Mason GodVy c rdinances and building regulations.
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25) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for
action for period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holdefr ha"vq )r-evented action from being taken. No more than one extension may be granted.
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26) Pressure ri(�jated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners,
conne ors;26 flashing. Install metal connectors approved for contact with the new types of pressure treated material.
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27) Retaining walls needed to support a surchArq� uch as structures, roads, or to support slopes, shall require a separate building permit and approval prior
to construction of the retaining wall. X
28) Prior to final approval, all upland areas isturbed or newly- raeked by construction activities shall be seeded, vegetated or given an equivalent type of
erosion protection (silt fencing or straw matting). X
29) Temporary erosion control measures must be implemented to prevent water g4akq/. 6gradation of adjacent waters or wetlands. Silt fencing must be
installed and maintained until upland vegetation has become established.
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30) Approved p*tydimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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BLD2008-01289 Please referto the following pages for conditions of this permit. 5 of 6
31) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are-rid for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
32 All Best Management Practices must be strict) adhered to throughout the proposed devleo men
9 strictly 9 P P P nt. l •-
33) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your
"AApr6u If Site Plan"to ensure these structures are shown and meet the setback conditions listed.
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 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described propert structure ff r re v+e d ii'pection.
OWNER ORAGEN 1 / F / �.�` --_ DATE:
BLD2008-01289 Please referto the following pages for conditions of this permit. 6 of 6
o CONCRETE MECHANICAL MANUFACTURED HOME M
N
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o Data By n
C) Footings!Setbacks Gas Piping Ribbons Z
o Interior Date By Interior-Date By Date S, ar By D
00 Exterior Date By Exterior-Date By Set-up 0
C° INSULATION
Point Load I Isolated Footings Date By
BG 1 SLAB INSULATION
Date By Data By FIRE DEPARTMENT
Foundation Walls Floors Date By
Date By Date By DECKS
FRAMING walls Date By
Date By Data By PROPANE TANKS
PLUMBING vault Date By
Date By OTHER
Groundwork Attic —...__.
Type:
Date By Date By Date By
D.W.v DRYWALL Type:
Int Brace Wall
Date By W
Date By Date By FINAL INSPECTION
m Water Line Fire Separation 110
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PRIOR TO PERFORMING WORK
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General/Specialty Contractor
A business registered as a construction contractor with LEtl to perform construction work
within the scope of its specialty. A General or Specialty construction Contractor must
maintain a surety bond or assignment of account and carry general liability insurance.
Business and Licensing Information
Verify Workers' Comp Premium Status Check for Dept. of Revenue Account
Name MODERN LIVING LIMITED UBI No. -14 601957031
Phone No. (253) 926-0455 Status ACTIVE
Address 6119 PACIFIC HIGHWAY License No. MODERLL972DO
EAST
Suite/Apt. License Type CONSTRUCTION
CONTRACTOR
City FIFE Effective Date 3/20/2003
State WA Expiration Date 4/14/2009
Zip 98424 Suspend Date fs,<
County PIERCE Previous
License
Business Type CORPORATION Next License
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Company License
Specialty 1 b GENERAL
Specialty 2 UNUSED
Business Owner Information = Hide All
Name Role Effective Date Expiration Date
HENNING, DWANE PRESIDENT 03/20/2003
HENNING, ELIZABETH SECRETARY 03/20/2003
HENNING, ELIZABETH TREASURER 03/20/2003
https://fortress.wa.gov/1ni/bbip/Detail.aspx9License=MODER,LL972DO 10/24/2008
Name J'�- Parcel# ����� - ��-C 4(:3VQ BLDJ"
Mason County PA
Department of Community Development Rc
�r:Il.
�
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity.
Title 14,Chapter 14.48 of the Mason County Code(MCC) regulates compliance requirements for Stormwater
Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website:
http//www.co.mason.wa—us/code/commissioners/index.htm
Please follow the links to "Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you
in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public
Works this document will constitute an approved plan if all of the relevant details* are to be installed in their
entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A)_X_The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at:
Phone: (360)-427-9670 EXT.450
Mail: P 0 Box 1850, Shelton WA 98584
Physical: 415 N 6th St, Shelton WA 98584
If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other,parcel.You may also wish to consult with the septic design professional involved with the project.Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT. 352
Mail: P 0 Box 1666, Shelton WA 98584
Physical: 426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Ackno ement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further
ac owled a that the informati provided is accurate and employees of Mason County are granted access to the above-described
/roperty f r revie an do as may be required.
X Owner/Agent/Contractor(circle one)Date:
P e2of2
NameJ64-�-- Parcel# �2��•_�� G 4cliQ BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development, or redevelopment',with more than 2,000 square feet of impervious surface'.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity, and land disturbing activities associated with structural or impervious redevelopment.
'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area ` All dimensions in feet
Buildin s '\ \ X U.(-- = I �
� X �� _ �� Measurements for buildings are taken at the
`'''•�� perimeter of the farthest projections (example:
X I4 = Imo. eaves/gutters)
X =
Drivewa s '.L X 2
X = Length of drive begins at the right of way
X =
Parking Areas X (d: = Z` `x
X = Any paved, gravel or packed area per definition
above table
X =
Patios/Walks X =
X = Any paved, gravel or packed area per definition
above table
X =
Others X =
X = If the total impervious area of the proposed site
X = development is greater than 2000 square feet a
Small Parcel Stormwater Site Plan is Required
Total Impervious Surface Area (sum of all areas) Pj�3
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity.
Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.
Acknowled ement of such is by signature below. I declare that I am the owner,owner's legal representative,or the contractor.I further
ackn ed that the information provided is accurate and employees of Mason County are granted access to the above-described
p erty fo review nd ' io as may be required.
}t Owner/Agent/Contractor(circle one)Date:
e Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
SITE DIAGRAM
po
DYE PACKET RESULTS
B-&Z—ad Series 1 Retrieval Series 2 Retrieval Series 3 Retrieval
Site
Number Date Date Results Date Date Results Date Date Result: Date Dale Results
Placed Retrieve Placed Retrieve Placed Retrieve Placed Retrieve
BACTERIOLOGICAL RESULTS
Site Date Results
Number
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C• .r 4
MASON COUNTY PERMIT NO.
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
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name +' -%
r Mailing Address Mailing Address nd2C
City State Zip Code City State Zip Code
Phone Other Ph.
Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District
Legal Description
Site Address(Please include street name, street number and city)
Directions to site
Will timber be cut and sold in parcel preparation?Yes/No
Is property within 200' of Saltwater Lake River/ Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluff/o
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Describe Work
No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq. ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION,:: Make Model Year
'
Length_�Width-- Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/ No
Installer Name IN`r u IV —,'_' Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.
Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative, or the contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all
the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work
proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or
agent on owners behalf, represents that the informaticn provided is accurate and grants employees of Mason County access to the above
described property and structure for review and inspection. This permit/application becomes null & void if work or authorized construction is
not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY
MEANS OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION.
X Date
Owner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVIEP DENIED NOTES
Building Department Iti (�
Planning Department
Environmental Health Department
Fire Marshal
FEES
BuildingPermit e i' Site Inspection
Plan Review F EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
a
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1'
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APPROVED
MASON COUNTY DCD PLANNINC
SITE PLAN REQUIRED TO BE ON SITE
CH N E IIJECT TO APPROVAL
\ — — Date
33 �