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HomeMy WebLinkAboutBLD95-0219 Final SFR - BLD Permit / Conditions - 12/14/1995 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 F3 0 1 L_ D I N ci P EF m I -T` FOR ; NSPECTIONS CAL 1. 427-9610 BETWEEN 5pm AND Bam 427-7262 BLD95-0219 PARCEL tl23305200030 PLAT :BEPLO DIVs 8LKz LOT . 30 JOB ADDRESS : NE 260 SCHOONER LP BELFAIR OWNERi GFORGE HOLMGAFN 275--5337 CONTRACTOR : "OLMGREN CONSTRIOCTION 275--5337 LEGAL ! BEARDS COVE DIV 5 RLI(i 1.014 31 FS #4731 RK #57- CLASS OF WORK . :NEW BEVA 3 BATH : 2 Typf A10110T FY DAIF IIECHI'l lipf A1001 BY DATE RFcF I P TYPE OF USE . :SF STORIES . . . . . . : 1 OCCUP . GROUP . . . :7 BLDG . HEIGHT . . : O .Oft PIC 11 42-111 Nip 44110195 7,8814 Ito t 39,00 Nip ellhgiS5 388M TYPE OF CONST , z :7 FIREPLACES . . . . : 0 PRIT 354.40 Nip 0411819S 38814 Sift 1 4.50 Rip 0017811945 38814 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . t 0 RAON 11 8.00 Nip 04118195 $8814 DWELL—UNITS . . . . .. 0 PARKING SPACES : 0 PICK S 177.08 I1JP 04/1019N 38814 INSPECT ION AREA : I SHORELINE? . . . . :N PIIi 1 42.110 Nip 04118195 3491@ 1191AIt 665.511 VALUtATIONt 60984 TOILETS , . . . . . . . , . : 2 FUEL MOBILE HOME-- FRONT . . .S 62 .Oft PATH 2 0­3 HP . : 0 RE'AIR . . . .N 10 .0ft BATH TUBS . . . . . . . . : 2 3-15 HP . - 0 MODEL. i SIDF ( i ) .E 10 .0-rt SHOWERS . . . . . . . . . r 0 FURN < 100K BTU ! 0 15-30 HP . : 0 MAKF- SIDE (2 ) rW 1010ft WATER HEATERS . — i I FURN ---100K BTUi 0 30-50 HP . i 0 SHRLINE . 0 .0ft CI-OTHES WASHERS . . : 0 FURN - FLOOR . . . r 0 Flo+ HP . - 0 ...YEAR-- AREA KITCHEN SINKS . . . . t I HEAT PUMP . . . . . . t 0 LOT SIZE — FLOOR DRA INS . 0 VENT SYSTEMS . 0 EVAP COOLERS 0 1 FNGTH : 0 BUILDING — : 1444st DRINKING FOUNT . . . z 0 VENT FANS _ . . . 0 HOODS , _ . . . . ; 0 VVIDTH . - 0 BASEMENT . . . : osf LAUNDRY fRAYS . . , . ., 0 DOMES , INCIN :O nECKS . . . . . . Osf DISHWASHERS . . . . . . v I AIR HANDLING UNITS— COMML . INCIN .-O GAR/CAPP :G 528- f GARB DISPOSALS . . . : 0 ctm . ; 0 RELOCIREPA111i 0 A*r/DT . tA URINALS . . . . . . . . . . i 0 > 10000 cfm ' 1 0 OTHER UNII`S . .i 0 MISC PIM FIXTURES : 0 GAS OUTLETS . : 0 PROJFCT PROJECT iQCA1IQk!N0R1H SHORF, R160T ON SAND Hill, LFF1 00 LARS04 BiVO, RIGHT 01 SCHOONER LOOP THIS PEWIT BECONfS $011 AND VOID If 1009 Of CONSTIPCHON AUTPOIIZEI IS NOT CONVENCED W!IIIIII lot OAYS�TOII If CON8111ICTIO1 OR 10041f 13 SUS?f#DfB FOR A PERIOD Of 166 DAYS Al ANY TIME AFTER WORK IS rOkV[#CFD. EVIDENCE Of CONTINUATION Of WORK IS A PR06111SS INSPECTION 111111111 THE 160 DAY PFRI09, fINAl IIISPECTION MUST BE APPA006 SEFORE 0011.0116 CAN BE OCCQPIFD, OWNER 01 AGENIt DATE: OLD-11111T, rev: 03131191 COMM Ir TO ATTACHED CONDITIONS IS REO"" CONCRETE MECHAN A MOBILE HOME Footings-Setback date �� �� by Ribbons date --6 r-e Jc Ipx-J by Gas Pip"Ind, date b Foundation Walls date ' by Set Up date by INSULATION date by BG/SLAB Insulation Final Floors � v� date �I- 2`I- J by date Z' S S by % date by FRAMING'I / Walls r'� �_ _� FIRE DEPT. date 6 by date G t� date by PLUMBING OTHER Groundwork Attic date �/`- - 5 5-byt .% date by -P LA WALLgOARpp NAILING �s S D.W.V. date�7rec�cJ� ,. _, j c b t date ^ y - Water Line FINAL INSPECTION date by date r 4_ [� by L� date by 4-L-,- 4 yc i' c MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location ?&0 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: P Items listed below must be corrected to gain code compliance �s-f Z- / c4- c. sti LA s h e-- e l ct In CA 2 0 en (Oc) d';2c) / lr 2- r L' CYX �S You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK 4 Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OKto Department Date Inspector G�✓ � ■ �K � NnT MnV THI, T " ,� � MASON COUNTY BUILDING III 426 W.`CEDAR SHELTON, WASHINGTON Sr8584 (360) 427-9670 CORRECTION NOTICE Job Location 2Z� 0 -."c /0. 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 i L�C t,J4 cniAw [ , �v S �. �. C 1 7 Cr LWahe- hereby notified that the above corrections shall be made BEFORE P CEDING WITH ANY FURTHER WORK �- �o v v J 1� b,, y l..J 1 ��✓; �s roo,,, ri e<<P c .� b e e— w. ❑ I f�inspection when corrections are made before continuing p��.� s *fii x)e_ Plea.,C—v=f �e corrections, items will be checked on next inspection +ru s s e ny �,�;„y bo 'WOK to e ! ia e-z,•-. c r•c e—k e %r v v cf- Department Date l v - '3y 5 T- Inspecto Do * NOT MOV TH10, TRAji MASON COUNTY BUILDING III 426,,W.`CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location Z (c�o Go This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: A 0 e� JX X, 4-- C- Items listed below must be corrected to gain code compliance r �v✓ j n Cr Yoga are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK *all for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to Department Date Inspector ■ oo s NET Mk *V THIV-- Tmkoqi e ,�_� �--_ a� __� ./ \� � V� ''� �_' E MASON COUNTY Mason County Bldg, III 426 W. Cedar RO, Box 186 Shelton, Washington 98584 I iF F—R M I "V 0C3N0 1 T 1 C7NS Case No . t BL D95-0,219 For : GEORGE Hat.MGRFN Page , 1 1 ) 1he use, hand) ing and Storage of hazardous matearials or f lrammable and c,ombustibie liquids In excess of 10 gallons Is not allowed without the approval of than Mason County Fire Marshal . <17 2) Structures ust be setback- from all utillty and drainage easements , a total of 10' f a ! i pet errty. 1 f Hers ,or a variance must be obtained from the Su i I d i nq Department . 3 ). Propos©d truc tur°e or anV palm ion thereof greater than 30" In height rrom grade tine, must maintain a minimum o1` 5 ' setback from all property lines , easements and right of 4 ) THIS PROJECT WILL. MEET THE L NG TERM SUPER GOOD CENTS RFOU1REMENTS AS AGREED UPON WI-TN T14E ELECTRIC UTILITY SERVICING THE PROPERTY . INSPECTIONS FOR ENERGY CODE COMPLIANCE ( INSULATION & iNDOOR VENTILATION) WILL RE PERFORMED BY A UTILITY REPRESENTATIVE AND THE FINAL. INSPECTION PERFORMED BY UTILITY STAFF MUST BE SIGNED OFF PRIOR TO THE FINAL INSPECTION PERFORMED BY THE MASON COUNTY BUILDING DEPARTMENT . If rhanges occur and you decile not to meet with the LTSGC program, contact the MCBD at extension 284 to arrange e t2*'r qy code gomp.l- oe Y. 5) PURSUANT T 1991 UNIFORM BU14D ING CODE , SECTION 305(C ) AND SECTION 51:3 , ALL. SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND L FG I BL E FROM THE STREET OR ROAD FP.ONT I NG -THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNEi/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . CiA r4 F) All approved p 1 ar►s are recta i red to be on-site far Inspection purposes . It I nspect I can 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 i hour ) will be. charged and must be collected by this department prior to any further- Inspections being perforated or approval granted . I I 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 I J MASON COUNTY i Mason County Bldg. III 426 W. Cedar RO. Box 186 Shelton, Washington 98584 7 ) ALL. CONSTRt1LUTlC�N 11:if MEET R�EXCEED ALL LOCAL CODES AND tJRC R �11�!REMENT4 8 ) Changes to s roved bulldin ` Tans that ef1"ect compliance a e s S 9 Pp c1, � t the 1 91 Washington ngton State Energy Code 1991 Ventilation and Indoor Air Quality Cade, the Un i form Building Code and/or Mason Count' � eclu i dt+on :s be approved by Mason County prior to construct i onX 9) AL CONSTRUCTION MUST ME'ED OR EXCEED LOCAL CODES . IF ANY 4ESTIDNS, PLEASE ( . THIS QFi= I CE BEFORE CONSTRUCTION . 10) CONSTRUCT-NIPid PROCESS TO F3E FIELD CORRI R'D AS REQU I RED. R. MASON COUNTY BUILDING DE PAR TMFNT AND UNIFORM BUILDING CODE ,x ` i CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons , date by Gas Piping date b Foundation Walls dat: 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 b date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by L WASHINGTON sTA!"E Record Attachment B CODEBuilding WSEOContract# 91-19- 1 PROGRAM For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps CLASSIFICATION (please check one) (please check one) New Building El Addition over 500 sq. ft. ingle Family ❑ Duplex Jurisdiction: MA;S� ❑Multifamily ❑Zero Lot Line Home ❑Planned Unit Development please check one: ❑ City County Permit# 9,5 —0,0/9 File ID # (if different from Permit4) _- CONSTRUCTION A. Site Information B. Owner Information Address MeF o?w0 6,c vn.? Owner owner at time of construction receives util' ment Zip flSa�' Company Assessor's roperty Tax# or attach legal description): Address OOX 7 ea_, Z) L C) City r State It Zip kS� ff Servicing Electric Utility P U!_X3 Phone ( 6 ) C. If Single Family, Zero Lot Line or D. Duplex E.If Multifamily(R-1) Planned Unit Development First Duplex Unit s .ft. Total#/Bld s. Total Conditioned Floor Area / s . ft. Second Duplex Unit s .ft. Total#/Units T HEAT SOURCE, A. Primary Space Heat Type B. Secondary Space Heat Type CVGas Wtr Heat Type (check one) (check all that apply) one) ❑ Electric Baseboard None ic Electric Wall Heater ❑ Wood ❑ Electric Furnace ❑ Electric Baseboard ❑ Other(specifybelow) ❑ Electric Heat Pump ❑ Other (specify below) ❑ Other _ COMPLIANCE --- -- - INSPECTIONIENFORCEMENT WSEC Compliance Method For Heat Pump Only: El Prescriptive Path Built to the Electric Date of Permit Application Component Performance Requirements of WSEC? Date Building Permit Issued Date of Insulation Inspection El System Analysis ❑ Yes El No (If yes, Date of Final Inspection utility may offer incentive.) I hereby certify that this building or addition has been inspected for the measures required by the 1991 Washington State Energy Code(WSEC), that it is in substantial compliance with the WSEC, and that the =ecklist for this building is on file. Si re of Building Official or Authorized Representative Date ■ Building Department:Return white copy to Kathleen Skaar,Washington State Energy Office,P.O.Box 43165,Olympia,WA 98504-3165. ■ Owner or Building Deparment: Forward canary copy to the servicing electric utility to trigger WSEC compliance payment. ■ Building Department: Retain pink copy for jurisdiction's building file. WSE0894-015 2-94 BUILDER/HOMEOWNER AGREEMENT LTSGC FILE NO. '? d 70 V HOMEOWNER: (_: i;e I►+yigyt� PHONE: e� 75- 513 7 SITE ADDRESS: Le ACCT: MAILING ADDRESS: _ P �• 6 oX 74 e Re 1(�&ky- e BUILDER: _ 4 � PHONE: MAILING ADDRESS: fq' z I understand that in order for the electrially heated home located at the above address to be certified as Long Term Super Good Cents, the home must be constructed in compliance with the attached Wattsun heat loss and Long Term Super Good Cents addendum/ specifications. I understand that inspection by District staff is required at each of the following stages: Prior to pouring of concrete slab, if required. Prior to installing exterior insulation and damp proofing the below grade basement walls, if required. �_Prior to installing insulation (structure is framed, roof is on, roughed-in plumbing, heating, wiring, telephone and TV cable are installed and all penetrations are sealed.) ,Following installation of insulation and vapor retarder prior to coven . R X _Final inspection - all components installed. R MAR 2 1995 XOther As deeded _]ENERALSERVICES NOTE: Failure to have inspections performed by the PUD at the required times may result in the reduction or elimination of incentive pavments. It is understood that the Super Good Cents Department is to be notified at 426-07/77 or 426-82 ,5 Ext. 77 7, not less than 48 hours prior to required inspections. I I understand the Long Term Super Good Cents certification by Mason County Public Utility District No. 3 only verities compliance with the Long Term Super Good Cents program standards and only in respect to energy efficiency. Neither the District nor any employees make any warranty, expressed or implied, in regard to the general workmanship and structural integrity of the residence or the future electrical consumption. I, the undersigned, understand that if the home is built according to this agreement, the attached specifications and heat loss detailed checklists and addendum, and is certified by the District representative that I will be eligible to receive Long Term Super Good Cents incentive payment(s) in the amount shown on the attached worksheet. Homes started by September of a given year will have untill June 30th of the following year to pass a final inspection to receive the stated incentive(s). Homes completed after June 30th of the following year will receive the incentive(s) in effect at the time of completion of the home. I further understand that it is my responsibility to be aware and adhere to the Long Term Super Good Cents specifications. Only verified completion by the on-site inspections listed in the agreement of all the attached criteria by the Mason County Public Uility District No. 3 Long Term Super Good Cents respresentative, will the house be certified as a Super Good Cents home, and the stated incentives paid Signed: - - Q J\ Homeowner Builder -7 -Qj S Date Date '2471 Utility Representative Ron Tewalt Date Homeower conservation incentives may be paid directly to homeowner, or applied as a _ credit on your utility account. *Homes which have not started construction within 60 days of signing this agreement will receive the I in effect at the time constrution begun. WATTOUN 5. 40 �ONG TERM SUPER GOOD CENTS/1991 MC3 COMPLIANCE REPORT 03/21/95 Bite: ME 160 SCHOONER LOOP Analyst: RON TEWALT BEL7A1R, WA Jurisdiction: MASON COUNTY 11 P.O . BOX 74:3 Floor Area: 1435 f* 71 ( 36n =75-533`7 )-- Builders HOLMOREN CONSTRUCTION Weather Data: Olymnia, WA P.O . BOX 740 Climate Zone: , 1 The PROPOSED design QUALIFIES for SGC( 91 MCC ) Tier 1. REFERENCE PROPOSED PcFERENCE DESIGN I - Reference -------------------------------------------------------------------------------- Ceiling , Attic R49 blown Attic ADV U-0. 020 1400 28.0 Infiltration Standard air sealing ACH-0.350 11622fts 74.4 ----------------------------- PROPOSED DESIGN COMPONENTS Component ` Description Value X Area - UA -------------------------------------------------______________________________ On Grade 3Iat R5 Folly insulated F-U' ��� 184ft 84.6 GlaminQ @15% ""INSULATE INTERCEPT LOW-E ARGON YO U-0. 350 125'0 42,5� xwINSULATE INTERCEPT SH LOW-E ARGON i/-0'150 20.0 6.8� :NIN3ULATE INTERCEPT PIC LOW-E ARGON U-0. 320 25.0 7.8:*: *NAVANTI FULL LITE LOWE/AR U-0.300 40.0 Donra x=INSULATED DOO� _ U-0' 14') 17. 0 ____________ --------------------- � items in parentheses not inc1ude6 in COMPONENT PERFORMANCE totals. �x Denotes non -standard values - chock calculation of thermal value. � Denotes adJuited UA 7o rerlect 7- L/2 mph w ! nn ooe*d � ` � pale 1 -~~-~----~- | -s"010el MMO Pue e I A%Say ! %uednoo luov I fr no:::) aeqjeem U0 BUIPUedep Auen ll !m buj %eaq U04 : Soo lenjov . , jun sysownd 0AMISM00 101 POUNSeP Me sajew ! 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' ME wn Pesodow., - ------------------------------- V'VL EMM9TT 0GUO-HOV UIV 1;:?USPq0%S 078Z OOVT 070"04*i AIV wizov UM010 6vw bu ; 1 L'89 =7T 9GO, TI-T! 1NI SSIE 77U To M Q--i N3HOW10H 308030 wi mnm !F", -! GG/TE/60 lUDd3U 30NVT72400 SOW 166T/SIN30 0009 H3dns wmi •ONOA -U - S Nnll, lk Permit No. &J'915-- MASON COUNTY \o" BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 ���,OA PLEASE PRINT #1 Ow r Cie Address \V� "ZOO �c�oohe� \..oc p Fire District# �- City Directions to Job Site V36 t-�t1-, Sao\-t-. �,-a�soY. `CS\v a 'EZti��JC o�. Sc�, oov`ey- �-o o Owner Mailing Address o>c —748 City St W a ZipgaSZS Lien/Title Holder O Address Clty St Zip #2 Contractor Name \�o\w.c�� eu. Co�.s'Ctvc \bye ,�-�"c Contra (?b e # �cA� —SS1 —004 Address "'P- O "Sox —7�\8 Expi S City "$-e�ca� •- St W a.• Zip �f3'SZg Phone -533'7 #3 If septic is located on project site, include records. I 2 Connect to Septic? Public JVater Supply X Well e Connect to Sewer System? _Name of System v (If residential, proof of potable water is required) #4 $a �is �gal cZ S 0 Des_ Cov � �• 3�r\ption3c.� 3 S #5 Building Square Footage: (existing/proposed) 1 st FI \4^ / 2nd FI_ / 3rd FI / Loft / Basement / Deck / # bedrooms / #bathrooms / Garage 572-8/ Carport (Circle: ttache r Detached?) Other sq. ft. / #6 Use of building y �Zcs Describe work #7 Type of Job: New X Add_ Alt Repair Other #8 MOBILE/MANUFACTURED HOME: INFORMATION Model Year M ke Model Length Wi�h Serial No. # Bedrooms # Bathroom:; Type of Heat Purchase Price $ #9 Indicate by circl g` e le source if any water is on or adjacent to subject property: River Pond C% rem 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 SSE P 1._O� Q L`F1'N APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW S Lam. �l.E\J u�—t�rJ eJ PL 1 PI Um bin Fixj�.ves ($3 each) FPg Mechanical Fixtures ($6 each) No. ZToilets CIRCLE FUEL TYPE: Gas, Electric, 2 Bath Basins to Heatpump, Other )Bath Tubs No. Units Fees _Showers Furn BTU Hot Water Htr _� _ Heatpumps _Laundry Washer _ Vent Systems 1 Sinks Spot Vent Fans _ _Floor Drains No. Boilers/Compressors _Laundry Basins HP Dishwasher 3 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 $ C ` No. Other Gas Outlets Wood, Gas, Pellet Stove NOTICE: THIS PERMIT BECOMES NUILL 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 OWNER °'1i ... _ X BY � s DATE DATE Zl �oJ FOR OFFICIAL USE ONLY: Accepted by: " Date: f DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: mA- sz '� �voMV �, j,r?-s, IM Les S S's ICv 1� c Q j S CYGyt k-&/, Environmental Health: Building Plan Review 3.259'S Occupancy Group: Type of Cons : J»-- Fire Marshal: Other: Special Conditions: (oE)J eoq 8 FEES Building Permit Plan Check 177 Plumbing Fee 4A Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other " Building Valuation: TOTAL FEE 1 ,