HomeMy WebLinkAboutCOM2006-00051 Cancelled Composting Structure - COM Permit / Conditions - 4/27/2006 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)427-7262
Mason County Bldg. 3 426 W. Cedar P.O. Eiox 186 Phone: (360)427-9670,ext.352
Shelton, WA 98584
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COMMERCIAL BUILDING PERMIT
COM2006-00051
OWNER: NORTH MASON FIBER CC RECEIVED: 4l2712006
CONTRACTOR: WRS 360-366-3303 LICENSE:WESTERS101JS EXP: 102007 ISSUED:
SITE ADDRESS: 431 NE LOG YARD RD BELFAIR EXPIRES:
PARCEL NUMBER: 123211001070
LEGAL DESCRIPTION: TR 7 OF N 112 NE
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Corn posting structure -TYPE 3 FEED STOCKS E OF BELFAIR OFF HWY 3 WE SHARE THE PROPERTY LEASE FROM,
NORTH MASON FIBER
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General Information Construction&Occupancy Informatlon
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`~ No. of Units: Type of Constr.: IIB
�a Type of Use: Insp.Area:
a T No. of Bathrooms: Occ.Group: S2
Type of Work: NEW Fire Dist,: 2
No. of Stories: 1 Occ, Load: 3
o Valuation: $ 57,840.48 Building Height: 12
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Pro-Manufactured Unit Information Square Footage Information
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Make: Length: Lot Size:
_ Model: Width: Building: 1,296
Year: Serial No.: Basement: Parking Spaces:
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Setback Information
Shoreline& Planning Information
Front: S 700.00 Ft. Shoreline: Ft.
o Rear: N 400.00 Ft. Slope: Ft, Water Body: Shoreline Desig.:
n Side 1: W 425,00 Ft. SEPA?: Cornp.Plan Desig.:
Side 2: E 200.00 Ft.
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�— Fire Protection System Information
Auto Fire Alarm System?: Emergency Key Box?: Standpipe?:
m Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?:
o Fixed Fin:Suppression System?: Fire Hydrants?: Fire Lanes?:
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o Please refer to the following pages for conditions of this permit.
COM2006-00051 1 of 5
Plumbing Fixtures Mechanical Fixtures FEES
Typg Oly. Typo Qty. Type By Date Amount Recelpt
Plan Check Fee Ks dr?7Mnnw,, gdRR Fq S1Mnann
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o Planning Review Fee Its sr»l7nr g955 nn
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Total $741.69
CASE NOTES FOR
COV2006-00051
CONDITIONS FOR
COM2006-00051
x 1) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND THE INTERNATIONAL CODE R UI ENT D
U OCCUPANCY IS LIM TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF U OCCU Y WOULD
F, RESULT REV CA ION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x
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a 2) Chang to a ved di ans that affect compliance to the current Washington State Energy Code (WSEC), ventila n nd Indoor Air
a Quail t binglMechanlcal Codes andlor Mason County Regulations shall be approved prior to ructlon.
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z 3) Any chang m anst c all be reviewed by engineer of record and submitted in writing to the Mason County Building Department prior to
constructs en n r n documents are a part of the approved set of plans and must remain attached thereto. If engineering documents are
remove ap r al ' no be granted. In addition, a rein spection fee, based on the current fee schedule, minimum one-hour will be charged and
collect M o unty Building Department prior to any further inspections being performed or approvals granted.
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4) Prior to final approv , all upland areas disturbed or nQyeaD79uction activities shall be seeded, vegetated or given an equivalent type
of erosion protection (silt fencing or straw matting),
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5) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE
ADOPTED BUILDING CODE.
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The const the perm' project is subject to Inspections by the Mason County Building Department. Ail construction must be in
m confor ne with the'nter do al codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a
Maso C my Buil ' g In or shall be made prior to requesting additional inspections.
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w 6) All buildin erm sh have a f' I inspection performed and approved by the Mason County Building Department prior to permit expiration.The
failure to equ t a final specf or to obtain approval will be documented in the legal property records on file with Mason County as being
non-co with o my ordinances and building regulations.
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COM2006-00051 2 of 5
7) Provisions for surfacetsubsurface 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 egarding this Ord 7-scelCocated
and the REQUIREMENT to obtain an ACCESS PERMIT for the Instal latlonlconstruction of a
G driveway or access nn i rom a ounty Road, Contact the Mason County Public Works Department prior to construction at Ext 450.
For any construct) wh 'h is pr pose t within 25'of a Mason County road right of way, it is suggested to contact that office to review
future planned w w i our project.
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8) Water quali s to be d to the detriment of the aquatic environment as a result of this project.
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9) All approved plans are required to be on-site for inspection purposes. If inspection is called for and ans a not o site,Ap val WILL NOT be
granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour wi c rged a coil by the Mason County
Building Department prior to any further inspections being performed or approvals granted. X
10) PURSUANT TO INTERNATIONAL CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A
POSITION AS TO PLAINLY' SIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY
BUILDI D TMI OFTO
ES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION
FEE, ASED N RATESPTED BY THE JURISDICTION AND THE INTERNATIONAL WILL BE SSESSED IF
a OW E TRAC POST ADDRESS ON SITE PRIOR TO REQUEST PEG ONS.
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H 11) All property lines shall be clearly Identified at the time of foundation inspection. X
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aW 12) Contractor registration la g n der R 18. and enforced by the WA State Dept of Labor and Industries, Contractor Compliance
o Division, There are po ntial ris and mon tary abilitie o the homeowner for using an unregistered contractor. Further information can be
obtained at 1-8 - - 82. a perso ignln thi ndition is either the homeowner, agent for the owner or a registered contractor according to
CDWA s e la X
13) Alp rot r dime ns an etbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
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14) The aXui �ted7epart
is r aired t e on-site for Inspection purposes. If inspection is called for and the site plan is not on site, Approval WILL
NOT b addition a r ' section fee, based on the current fee schedule, minimum one-hour will be charged and collected by the Mason
Count rl any further inspections being performed or approvals granted.
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15) Recyclable ma �Is olid Was a age: Space shall be provided for the storage of recycled materials and solid waste. The storage area
shall be deli deet th the occupancy, efficiency of pick-up, and shall be available to occupants and
haulers.X
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"> 16) Internationa de CHAPTER 17: IN ADDITION TO THE INSPECTION REQUIRED IN IBC, SECTION 109, THE OWNER OR THE
ENGINE OR RCHI CT O ECORD ACTING AS THE OWNER'S AGENT SHALL EMPLOY ONE OR MORE SPECIAL INSPECTORS
w WHO ALL OVID NSP T DURING CONSTRUCTION ON THE TYPES OF WORK LISTED UNDER CHAPTER 17. THE SPECIAL
°� INSP D SI ILITIES SHALL BE AS SPECIFIED IN CHAPTER 17,
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m 17) This structur app ed as a space as identified by by the Mason County Semi-heated Building Exemption Guidelines.
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COM2006-00051 3 of 5
18) Min 3AW
d not more than 50 feet travQl distance in an approved location and mounted not more than 48-inches from the
finish lsher.
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19) This nagement zone. Please contact a fire warden at(360)427-9670 ext, 459 for further information.
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This Hermit beoornes null and void If wort orco n authorized n cwmmenced within 180 days,or if�nstructian or work is suspended for a period of 180 days at any time after work is
commenced. Evidenceofcontinuatio Isapnog sirup Lion thinth, 80 day period. Flnal inspection must be approved before building can be occupied.Proof of cont.inuatho of
work Is by means of progress ins Lion. a owner the ag ton a owners behalf,represents that the informafion provided is accurate and grants employees of Mason County access to
the above described property a c for revie� nd ins ctl
OMERORAGENT: DATE:
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COM2006-00051 4 of 5
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N CONCRETE MECHANICAL MANUFACTURED HOME 0
rn Footings/Setbacks Date Es r Ribbons =
Gas Piping
o Interior Date By Interior-Date By Date P;
Cnn Exterior Date By Exterior-Date By Sot-upN
Point Load!Isolated Footings INSULATION Date s p
BG!SLAB INSULATION Z
Date By Data By FIRE DEPARTMENT TI
Foundation Walls Floors Date By W
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Date By Date By DECKS X
FRAMING Halls Date ey n
Date By Data By PROPANE TANKS 0
PLUMBING vault Date '3
Date By OTHER
Groundwork Attic
Date By Type:
Date By Date G y
D.w.v
DRYWALL Type. 0
Int Brace Wall Date g,, O
Dare ey Qate 8y - --- ----- N
FINAL INSPECTION o
Water Line Fire Seperation O
Late By Date By Date By o
Pass or Request Inspect. o
Type of Insp. Fail Date Date Done By Comments
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NP14Mason County Dept. of Community Development
Mason County Bldg. 3
426 W. Cedar
P.O. Box 186 (360) 427-9670 Local (360) 482-5269 Elma
Shelton, WA 98584 (360) 275-4467 Belfair
Notice to Obtain Final Inspection
December 11, 2007
NORTH MASON FIBER CO
PO BOX 275
BELFAIR WA 98528
Case No.: COM2006-00051
Parcel No.: 123211001070
Proiect Description: Composting structure - TYPE 3 FEED STOCKS
The Mason County Department of Community Development is currently reviewing all
permits that are expired and have not been approved for occupancy and use.
Pursuant to Mason County Code, Title 14 Building and Construction, a permit and
final inspection for this type of activity is required under the 2006 International
Building Code or the code your permit was issued and your property is currently in
violation status of occupancy and use.
Please contact our office to make the necessary arrangements 21 days from
the date of this letter. Failure to contact our office to make the necessary scheduled
inspections will result in enforcement actions.
To bring your site into compliance, you must schedule an inspection. One (1) $64.00
site investigation fee will need to be paid prior to inspection along with any
outstanding fees currently due on your building permit. For every inspection required
after that, you will be charged $64.00 again, per inspection until final inspection and
conditions are met.
To schedule an inspection, please call (360) 427-9670 ext. 262.
If you should have any questions regarding this notification, please contact me at
(360) 427-9670 ext 359.
Sincerely,
Terry Ryan
Mason County Department of Community Development
Cc: Property File
December 11, 2007 COM2006-00051
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MASON COUNTY DEPARTMENT OF /0
` r COMMUNITY DEVELOPMENT I/? , ,
426 West Cedar Street ♦ PO Box 186 ♦ Shelton, WA 98584 � /N' *'
(360)427-9670 EXT. 352 FAX (360)427-7798 HOME PAGE—www.co.mason.wA.Xq
Special Inspection Authorization
Project Owner: North Mason Fiber Co. Building Permit Number: COM2006-00051
Project Address: 431 NE Logyard Road Engineer/Architect of record: Scott E Jacobs #39730
In addition to the inspections required by International Building Code (IBC) Section 109, the owner or the engineer
or architect of record acting as the owner's agent shall employ one or more special inspectors who shall provide
special inspections during construction on the types of work listed under IBC Section 1704.
This form must be completed by the owner or the engineer or architect of record, prior to permit issuance, indicating
who will perform the required special inspections for this particular project. The specified special inspector(s) shall
perform the required special inspections during construction of the project, submit all inspection reports to the
Building Department and provide a final signed report stating whether the work requiring special inspection was, to
the best of the inspector's knowledge, in conformance to the approved plans and specifications and the applicable
workmanship provisions of the IBC_ The following checked items require special inspection:
1. Concrete. During the taking of test specimens and placing of reinforced concrete. (IBC 1704.4)
2. Bolts installed in concrete. Prior to and during the placement of concrete around bolts when stress
increases permitted by Table 1912.2 and section 1912.5 are utilized. (IBC 1704.4)
3. Erection of precast concrete members. Periodic inspection per ACI 318. Ch 16. (IBC 1704.4)
4. Shotcrete. Continuous inspection per ACI 318: 5.9, 5.10 and IBC Chapter 19. (IBC 1704.4)
5. Reinforcing steel and prestressing steel tendons. Inspection of reinforcing steel including prestressing
tendons. (IBC 1704.4)
i;6. Welding of reinforcing steel. Inspection of the welding of reinforcing steel according to AWS D1.4, ACI
318: 3.5.2, and IBC 1903.5.2. (IBC 1704.4)
X 7. St uctural welding. Idin inspection shall be in compliance with AWS D1.1. (IBC 1704.3.1)
/YeZe— i/2 f At. i e/� —
X 8. High-strength Bolting. The installation of high-strength bolts shall be periodically inspected in accordance
with AISC LRFD Section M2.5. (IBC 1704.3.3)
❑ 9. Structural Masonry. Masonry construction shall be inspected and evaluated with the requirements of IBC
section 1704.5.
Li 10. Soils. Inspections for fills 12 inches or greater to be performed in accordance with IBC Section 1704.7.
11. Pile foundations. Inspector to be present when pile foundations are being installed and during tests. (IBC
1704.8)
12. Pier foundations. Special inspection of pier foundations for buildings are required in seismic Zone D. (IBC
1704.9)
l 13. Spray-applied fire resistant materials. Inspections shall be in accordance with sections 1704.11.1
through 1704.11.5.
=1 14. Exterior insulation finish system (EIFS). Special inspection shall be required for all EIFS systems. (IBC
1704.12)
Continued on reverse side
0 15. Smoke-control system. Smoke control systems shall be tested by a special inspector per IBC Section
1704.14.
0 16. Special cases. Special Inspection shall be required for proposed work that is, in the option of the building
official, unusual in its nature such as alternative methods and material of construction, unusual design applications,
and materials and systems required to be installed in accordance with additional manufacturer's instructions that
prescribe requirements not contained in the IBC or referenced standards.
X Installation of structural epoxies ❑ Installation of'high-load shear panels'
D Structural Observation (IBC1709) ❑Other:
Special Inspector Selection:
The special inspection agency and special inspector shall be registered by the Washington Association of Building
Officials(WABO)for the particular type of construction or operation requiring special inspection. Such inspector(s)
shall be selected by the owner or the owner's agent and approved by the Building Official prior to issuance of the
building permit. The owner's agent shall not be acting as, or employed by the special inspection agency or the
contractor for this project.
Name of Special Inspector or Agency: Type of Inspection: Registration Number:
Construction Testing Laboratories High Strenath Bolt Testing 601580376
Construction Testing Laboratories Installation of structural epoxies %1580376
Au I hereby state that i am the legal owner of the project property,or that I am the legal owner's agent
w is n t em oyed by a al inspection agency or contractor associated with this project. In addition, i agree
t compl with t e specs Inspection requirements established by Chapter 17 of the International Building Code as
dopt by Ma on Cou y.
else
nature Printed Name Owner 0 Agent Date
PURPOSE OF SPECIAL INSPECTION
Special inspection is the monitoring of materials and workmanship which are critical to the integrity of the building
structure to assure that the approved plans and specifications are being followed and that relevant codes are being
observed. Special inspections are in addition to those conducted by the county building inspector and by the
engineer or architect of record. Special inspectors furnish inspection at all times that their presence is required by
the code,the plans and specifications,and the enforcing jurisdiction. Good communication between the special
inspector and the designer,contractor,and building department Is essential.
DUTIES AND RESPONSIBILITIES OF THE SPECIAL INSPECTOR: 1
Special inspectors are individuals with highly developed, specialized skills who observe those critical building or
structural features which they are qualified to inspect. Duties of special inspectors and/or inspection agencies
include the following:
1. General Requirements j
Special inspectors shall review approved plans and specifications for special inspection requirements.
Special inspectors shall comply with the special inspection requirements of the enforcing jurisdiction. i
2.Signify Presence at Job Site l
Special inspectors should notify contractor personnel and the enforcing jurisdiction of their presence and j
responsibilities at the job site. i
3. Observe All Work for Which They Are Responsible f
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Special inspectors shall inspect all work and perform or observe all tests requiring inspection and testing for
conformance with the building-department-approved (stamped)drawings, specifications and applicable
provisions of the code.
4. Notification of Discrepancies
Special inspectors shall bring all nonconforming items to the immediate attention of the contractor. If any
such item is not resolved in a timely manner or is about to be incorporated in the work, the engineer or
architect of record and the building official should be notified immediately by telephone or in person, and
the item noted in the special inspector's written report. The special inspector shall write a separate report
to be posted at the job site regarding noted discrepancies which should contain, as a minimum, the
following information about each nonconforming item:
• Description and exact location,
• Reference to applicable detail of approved plans/specifications,
• Name and title of each individual notified and method of notification, and
• Resolution or corrective action.
5. Reports
A. Inspection reports
The special inspector should complete written inspection reports for each inspection visit and provide the
reports on a timely basis determined by the building official. The special inspector or inspection agency
shall furnish these reports directly to the building official, engineer or architect of record, and others as
designated. These reports should be organized on a daily format and may be submitted weekly at the
option of the building official. In these reports, special inspectors should:
•Describe inspections and tests made with applicable locations;
•List all nonconforming items;
• Indicate how nonconforming items were resolved;
• List unresolved items, parties notified, and time and method of notification; and
• Itemize changes authorized by the architect/engineer of record and approved by the building department,
if not included in the nonconformance items.
B. Final reports
Special inspectors or inspection agencies shall submit a final, signed report to the building department
stating that all items requiring special inspection and testing were fulfilled and reported and, to the best of
their knowledge, in conformance with the approved design drawings, specifications, approved change
orders and the applicable provisions of the code. Items not in conformance, unresolved items or any
discrepancies in inspection coverage(i.e., missed inspections, periodic inspections when continuous was
required, etc.)should be specifically itemized in this report.
DUTIES AND RESPONSIBILITIES OF THE CONTRACTOR:
The contractor's duties include responsibility for notifying the special inspector or agency regarding individual
inspections required by the Building Department, or required by the International Building Code, Chapter 17.
Adequate notice shall be provided so that the special inspector shall have appropriate access to the approved
plans at the job site prior to the required inspection. The contractor shall not perform any work that requires special
inspection without the special inspector present. Completion of this form, and the performance of special
inspections does not relieve the contractor's responsibility to schedule required inspections by the Mason County
Building Department prior to concealing any work.
DUTIES AND RESPONSIBILITIES OF THE ENGINEER OR ARCHITECT OF RECORD:
The engineer or architect of record is responsible for identifying which special inspections are necessary,
developing a schedule of required special inspections, and assisting the owner in the selection of the special
inspector. The engineer or architect or record shall review the special inspection reports to determine that all
required special inspections have been performed and that all discrepancies (if any) have been resolved.
DUTIES AND RESPONSIBILITIES OF THE PROJECT OWNER:
The project owner, or the engineer or architect of record acting as the owner's agent, is responsible for the funding
of all required special inspection activities in accordance with International Building Code Section 1704. j
II
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FIN FISH,CHICKEN MANURE,POST-CONSUMER FOODVASTE
FEEDSTOCKS TRUCK ROUTE THROUGH SITE
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+?� . CATCH BASIN Math submersible pum COLLECTION POND
1A r Copec ion tank systaneq Jk : \. i �1r z4 A ff p i i FNISHED Fi2000CF,/ j �L: 1 - EXIST SOUTIEAST
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SYSTEMSURROUNDING AERATED
COMPOST ZONES AND FEEDSTOCK
NOTE COMPOST AREA LIMIT LINE IS BEEN. ��\ /I \ STORAGE AREAS
SIZE 01 AUXILIARY AERATED COMPOSTING/ l
-- - �T ------- -- CURING
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ETMSPLANISINTENDEDTOILLUSTRATEAPOTENTIALLAYOUTOFAFLEXIBLEDESIGN.
THE SPECIFIC PROCESS AREAS WITHIN THE OUTER COMPOSTING AREA LIMITS ARE SHOWN
FOR EXAMPLE PURPOSESAND FOR GENERALAREA SIZE CALCULATIONS.
- EQUIPMENTANDPROCESSE3'ARE-DESIGNEDTOBEAAWLE40FACILITATE APPROPRIATE----
PROCESSING OF THE TYPE AND QUANTITY OF FEEDSTOCK SEASONALLY PRESENT I
THE SPECIFIC PROCESSES MAY BE MOVEDAND SHAPES CONFIGURED DIFFERENTLY SO LONG
AS THE TOTALAREA WITHIN LEACHATE COLLECTION BERMS DOES NOT EXCEED LEACHATE }
C'3 COLLECTION CAPABLITIES.LEACHATE WILL BE COLLECTED FROM ALL COMPOST FEEDSTOCK I
--PROCESSING;ACTNEAND CURING AREAS.-LEACHATE WALL NOT BE-REQUIREDITO BE COL-- - -- _EXIS�Seu7li '.-
7 LECTED FROM FINISHED COMPOST AREAS.
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----------North--Mason--Fiber-Company-Eomposti ng-Facility ---
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MASON COUNTY PERMIT NO. r /
BUILDING PERMIT APPLICATION /�
426 W. Cedar - P.O. Box 186, Shelton, WA 98584 oco�'3 1
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 North Mason Fiber Co. Company Name VRS
Mailing Address PO Box 275 Mailing Address?180 rrnnrlxTi Pw Rnnd
City RP1 fair State WA _Zip Code �8428-- City RG"d a Q State WA Zip Code 9R9148
Phone 360-975-w9 i Other Ph. Phone3h0-166-3303 Other Ph.
Lien/Title Holder Blue Star Propgrties L.L.C. Contractor Reg. # Western 0 12 Exp.1/2/2007
E mail address rA r e_^o e- /9-it -nelt E Mail Address 1 nm
Drivers Lic.# DOB T Drivers Lic.# DOB
SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic N/A Existing Septic N/A
Connect to Water System Name of Water System N/A
Well Water System Name of Water System N/A
PARCEL INFORMATION - 12 Digit Parcel No, 123211001070 Fire District
Legal Description TR7 of N 1 / . NE
Site Address (Please include street name,street number and city)431 NE Logvard Road, R 1 fair
Directions to site TnkP WA-1 6 towards RP1 fair, turn 1 Pft on WA-3/WA3W1continue aDprox 7 miles
Will timber be cut and sorcr in parcel preparation? Yes/N(K
Is property within 200'of Saltwater No Lake No River/Creek_ No Pond No
Wetland No Seasonal Runoff No _Stream No Slopes or Bluffs > 15%_No
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Ye
TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building Composting Describe Work e 3 Feed Stocks
No. of Bedrooms TIA_No. of Bathrooms N/A Square Footage- 1st Floor 1 296 2nd Floor N/A
3rd Floor Nf A Basement N/A Deck N/A Covered Deck MIA Other-N/A Sq. ft.
Garage N/A Attached Detached Carport N/A Attached Detached
MANUFACTURED HOME INFORMATION - Make N/A Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit? Yes/No
Installer Name 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 information
provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION.
X . �L-,-- C'�C'� , C-,,s :A r-N(( Date:
Owner/Owners Re resentative/Contractor indicate which one
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal C�ir
BG e
FEES
Building Permit Fee Site Inspection
Plan Review Fee _'� Ir a — EH Review Fee
Plumbing& Base e Planning Review Fee
Mechanical & Base fee Other L)YG ,
Wood/Gas/Pellet Stove Fee State Fee
Violation Fee A; ,�L; Pre-Paid at Submittal
Valuation$ /2L 2 TOTAL FEES
6A/V8