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Home My WebLink AboutBLD97-00257 Final Mobile Home - BLD Permit / Conditions - 4/12/2005 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 ` Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD97-00257 OWNER: ALFIE ANDERSON RECEIVED: 3/13/1997 CONTRACTOR: LICENSE: EXP: ISSUED: 3/25/1997 SITE ADDRESS: 211 NE LARSON LAKE LN BELFAIR EXPIRES: 9/21/1997 PARCEL NUMBER: 123305200070 LEGAL DESCRIPTION: BEARDS COVE DIV 5 LOT: 70 211 NE LARSON LK LN BELFAIR PROJECT DESCRIPTION: DIRECTIONS TO SITE: MOBILE HOME TAKE NORTH SHORE TO SAND HILL 2ND LEFT LARSON BLVD., THEN TAKE 5TH RIGHT TO CULDESAC 2ND TO LAST TRAILER ON LEFT. General Information Construction &Occupancy Information Square Footage Information No.of Bedrooms: 0 Type of Constr.: ? Type of Use: MH Insp.Area: 1 No. of Bathrooms: 0 Occ. Group: ? Lot Size:O Deck: 0 Type of Work: NEW Fire Dist.: 2 No.of Stories: 0 Occ. Load: 0 Building:0 0 Valuation: Building Height: 0 Occ. Status: Basement:0 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: 0 Ft. Front: W 10.0 Ft. Shoreline: 0.0 Ft. Water Body: Rear: E 10.0 Ft. Slope: Ft. SEPA?: No Model: Width: 0 Ft. Side 1: N 10.0 Ft. Shoreline Desig.: Year: Serial No.: Side 2: S 10.0 Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Building Re-Inspection KKK 4/4/2005 $58.00 S22005 Mobile home fee....` KS $155.00 44141 Building State Fee KS $4.50 44141 EH Plan Review KS $26.00 44141 Total $243.50 BLD97-00257 Please referto the following pages for conditions of this permit. 1 of 3 CASE NOTES FOR ` BLD97-00257 CONDITIONS FOR BLD97-00257 1) The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Managment Hearings Board's Order of October 2, 1996, and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by the Order, the undersigned property owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting actions"), which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid. X 2) The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X 3) Structure must be setback 5'from all utility and drainage easements, a total of 10'from each property line, or a variance must be obtained from the Building Department. X 4) Proposed structure or any portion thereof greater than 30" in height from grade line, must maintain a minimum of 5'setback from all property lines, easements and 10'from all County and State Road right of ways. X 5) PURSUANT TO 1994 UNIFORM BUILDING CODE, SECTION 305(C)AND SECTION 513, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING 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 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 6) All mobile/manufactured home landings or decks must be freestanding (self supporting). The largest landing or deck permitted without drawings or a building permit is 36"x 36". Any landing or deck that is 30"or more in height from walking surface to finish grade requires a guardrail. Any landing or deck that has 4 or more risers requires a handrail. Any landing or deck larger than 36"x 36" must be permitted which requires structural drawings and a building permit application. This Installation Permit does NOT include any landing or deck larger than the 36"x 36"size. X 7) Proposed structure or portions thereof with an projection over 30" in height from grade line, must maintain a 5'separation distance between adjacent structures and that furthest projection. X BLD97-00257 Please referto the following pages for conditions of this permit. 2 of 3 1 8) REQUIRED INSPECTIONS (Footing Inspection-prior to pour, Set-up Inspection-prior to skirting, Final Inspection-prior to occupancy). I have received a copy of the General Information and Guidelines-Mobile/Manufactured Housing Installations Handout for detailed descriptions of all required inspections on my mobile/manufactured home installation. I hereby assume all responsibility for the scheduling of these required inspections. If these 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 1991 UBC, Table 3A will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered. I further understand that this investigation will be scheduled as time allows. Until resolution of any/all problems ` no occupancy(Final Inspection)will be granted for the residence. OWN ER/CONTRACTOR(indicate which) Signature X 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 owneror the agent on the 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. OWNER OR AGENT: DATE: BLD97-00257 Please refer to the following pages for conditions of this permit. 3 of 3 r 00 • r 0 (.0 CONCRETE MECHANICAL MANUFACTURED HOME o Footings / Setbacks Date By Ribbons r 4 D ate B y Gas Piping Date B y Foundation Walls Date B y Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date By Date By Date By PLUMBING Attic OTHER Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date By Date By FINA4 INSPECTION Water Line By L Date By Date By Cle CD 0 z L CD d C 8 J � a 0 O o N V 10CD ITI J r 0 Building Permit # ft,0?7-02..5-7 nnAsoN COUNTY PS BUILDING III 426 W. CEDAR P -- SHELTON, WASHINGTON 98584 L 'r (360) 427-9670 1123�� _52� �00�0 P JobCORRECTION NOTI Location 21/ Ali 8 y PERMIT - This structure has been inspected bb Nip BY p y ason Coun ulldrng Depal-tment ,3 c. nd the following VIOLATION of County Laws and Ordin ances nances has been Items listed below must be corrected to gain code compliance n 4- // r h �OI � 0/ 3- 7Z; Altr' � �5' s � 6 r•L� . i'1 '"` el 7` < Fiz You are hereby notified that the above cor PROCEEDING WITH ANY FURTHER WORKs s FORE f``_ -G -S no f-c>r c mall for re-inspection when corrections a made before continuing A Make corrections, items will be checked on next inspection JOKto Department )ate 7— 2 — 9 ? Inspector ■ 040 :J40T MO * THI - V Building Permit # fLP97-02-s7 MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 ` (360) 427-9670 ORRECTION 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: 3�,T7 Items listed below must be corrected to gain code compliance — i -<--C- /J 1 J L , 3 �G'v��- G /�c� G1l�CG_T�t1 �LTG�G��C Doi cal��v` r / / n ? y You are hereby notified that the above cor SS nuidkKFORE PROCEEDING WITH ANY FURTHER WORK -% !�'_3�� 9-Call for re-inspection when corrections a�made before continuing ��,, ❑ Make corrections, items will be checked on next inspection ❑ OKto Department 23,// 5 Date - 2 — '9' Inspector Z- ■ oo s NOOT MnV THF T Lot uilding Permit # 97— o�S7 MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 r (360) 427-9670 �I CORRECTION NOTICE to jJob Location 21 l Z-,:::xr Sc,Y-, Lc,4-L e- L„ This structure has been inspected by Mason County Building Department and the following VIOLATION of Co my Laws and Ordinances has been • r' _ ' �P found. Items listed beloWIT st be corrected to gain code compliance le- e2 Zc-�S P _ f"L i n �'r►1 L L,, f -c---x r-i T [-S V2 I/ L S, G�-s ��' �-�- �� '-►�•►�...� l o,,, � s;-,5<� ��;gip �,.. ,`.� �v' �'� You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORKS 3(- l b. rc)o / � Cr ecl Call for re-inspection when corrections are made before continuing Pee r 'b4a !L S/O d• C-- D Make corrections, items will be checked on next inspection ❑ OK to .Si z I'dr Department ;n L-k es o w Date Inspectorev an « an' moo * NOOT ; 'MOOV MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 BETWEEN 5Rm AND Sam 427-7262 BLO97-:0257 PARCFL. t 123305200070 PLAT iBE:PLO D F V : BL.K t LOT : 70 JOB ADDRESSt NE 211 [ARSON LAKE IN BFtFAIR OWNER t ALF lE ANDERSON 275-6351 CONTRACTOR : [ EGAI : BEARDS COVE DIY ! BLKt 1011 7D aiLXT.eiYd:'TYJ%DP.::1.�.5�-t:;:'LEID,�'+9:n:S". R�IC"'+4t:.'2:7TL:C�2:�3T3G6c:dY:^Y.Y'CtY.3+'_YL'C':K�V"CK'VZ31'•!SEIW'JGRCafSR.;•-.mt:t CLASS OF WORK . . :NE:W RF_DR : 0 BATH t 0 1TYPE AMOUNT BY DATE RECFIPT 11FE AMOUNT BY DAIS RECEIPT ) TYPE OF USE _ :MFI STORIES . , . . . . . t0 OCCUP . GROUP , . . 17 BL.DG . HE I GHT . . : O .Oft OF 1 155.00 KS 03125197 44141 TYPE OF CONST . . t 7 F IREPLACES . . . . : 0 ISTFF 1 4.50 KS 03125197 14141 OCCUP . LOAD . . . . 0 WOODSTOVIF S . . . . s 0 4FRCP 1 26.00 KS 03125197 44141 } DWELL .UNITS . . . . t 0 PARKING SPACE^St 0 INSPECTION AREA : 1 SHOP F.L I NE 7 . . , . :N TOTAL t 185.50 VALULAT ION: tl' SETBACKS-.____ __ .__ .._ .._... TOIL.ETS . . . . . . . . . . .. 0 FUEL TYPES------- ---- BOILERS/COMP-- -- MOBILE HOME--_ FRONt . . ,W 10 0f t BAT11 BASINS — _ : 0 : 0-3 I-IP . t 0 REAR . . . .E 10 .Bf t BATH TUBS . , . . . . , . . 0 3-15 HP . c 0 MODEL : S1DF ( 1 ) .N 10 Oft SHOWERS . , _ _ . . . t 0 f7URN - IOOK BTIJ : N 15- 30 141' : : 0 -MAKF---- IS I OF ( r ) 10 .Bf t WATER HEATERS . . . . . 0 FURN >-100K STt1 : 0 30-50 HP, : 0 SHRL. 1 NE 0 , Oft CLOTHES WASHERS . . s 0 F URN - FLOOR . . . : 0 50+ HP . - 0 --YEAR-. . - -- AREA - _---- - --- _- - KITCHEN SINKS . .. . . t 0 HEAT PUMP > . . . , . s 0 LOT S I Z_E . . : FLOOR DRAINS _. 0 VFN'I SYSTEMS . . . : 0 EtVA;P COOLERS : 0 I-.ENGTH s 0 BUILDING . . . t 0sf DRINKING FOUNT . . . . 0 VENT FANS . . . . . . : 0 HOODS . , . . . . . t 0 WIDTH . : 0 BASEMENT . . . s iris t LAUNDRY TRAYS . . - 0 DOMES . I NC I N :0 -SFR I AL 1]1- UECKS . . , . . . . Osf DISHWASHERS . . . . . . . 0 AIR HANDLING UNITS-- COMML , 1NCINt0 GAP/CARP :? Osf GARB DISPOSALS . . . . 0 <- 10000 r.fm . c 0 RELOC/REPAIR t P3 AT/DT , s? URINAL.S . . . . . . . . . . . 0 > 10000 c:fm . s 0 OTHER UNITS . : 0 MISC PL.M FIXTURES : 0 GAS OUTLETS . : 0 .YY,.SYS:pS��Irr�F�Y��-.:�'Y�R:'�'.:-:--4-n.,'�-_-•.,�_.X��s�l.Sf�:..�.:::��Y3:.,Ci:,C�;-:tC..#-__�-.t_ SC.! dJG-,�l-1C':=.�'�CSKG:-�L.=-t...-.u—Y��.-X::,:—:-�E.��t,�..f�,.—.Z�� FROJFC► UESCRIPT10NsM0811E HOME PROJECI IOCATIONO AKE NORTH SHORE TO fiAND Httl 209 LEFT [A-RSON BIVO.. THEN TAKE 5TH RIGHT TO CULDESAC 210 10 LAST TRAILER ON iFFI. 1013 PERMIT BECOMES NUt,1. AND V014 IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED MITHIM 180 DAYS, OR 11' CONSTRUCTION OR WORK 13 SUSPENDED FOR A PER1011 OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIDENCE OF ^ONIINUAIION OF WORK IS A PROGRESS iNSPECIION 11111111 1111� 140 DAY PEPIOD. FiNAI INSPECTION NIBS? BI APPROVED BEFORE s 01.1116 CAN SE OCCBPIED, OWNER OR AGENT; " ..-_...__ DATE-,BtO-PRNT, rev: 03131191 COMPI. I ANCIF TO ATTACHED CONDITIONS IS REQUIRED ----- - -------- --- - - -------------------- ---- - ------ ---- - - MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Case No . i B[ D97--02,5)' For ; ALFIE ANDERSON Paget I 1 ) The undersigned property owner Is aware or the unverta i ntV regard ino 414 Mason rount� ' development regulations created by the Growth Managment Aearings Board 's Order o October 2, '1996, and In consideration of Mason County ' s willingness to proceed with processing of a plications which might be affected by the Order , the undersigned ropertV owner M,eby agrees to waive any law�;ult , action , or claim for damages again6t Mason County which may arise out of Mason County 's actions in acceptance, pf"Doessing and/or Issuance of ouch permits or approvals ( hereinafter "permitting actions" ) , which damages are attrit)utable tt-i the County 's decision to take permitting actions despite the risk that changes to the County ' s deveinpment regulations might later make the Count g rmit " in actions Invalid . *71 X 2 ,1 The use , hand linit and storage of hazardotis rat.car lals or flammable and comhu�;tible liquids In excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal . X___ 3 ) Structure must he setback IS ' from a I I ut I I I ty and dr-a I naqe eaf;ements tntal (-.)t 10 ' from e,,anpproperty line, or a variance must be obtained from the Buii 'ding Department , X 4- 4 ) Proposed t; ti-ticture or any port Ion thereof greator than 30" in tie I ight f rom pt ar1e I I no , must maintain a minimum oaf 5 ' setback from all property lines , easements and 110 ' from all untV and State pond ricilit of way-.:; . X 5 PURSUANT TO 1994 UNIFORM 13UI (.DING r-ODF SECTION 305( C ) AND SFCTION 513 , All SITES MUST HAVE APPROVFI) NUMBERS OR ADDRESSES PR6VIDFD IN SUCH A POSITION AS TO BE PLAINI-Y VISIBLE AND I FG I SLF FROM THE STRrUT OR ROAD FRONTING THE PROPERTY , MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPFCTION FFF , BASED ON RATFS IN 'TABLE 3A OF THE 1994 UNIFORM BUILDING CODE Will BF ASSESSED IF 0WNEP/CONTnACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INCZ V SPE TI()I N S X r-4 MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O, Box 186 Shelton, Washington 98584 6 ) A I i mob i 1 e/mantrf aa+ t ure(I home i and i rt+as car oe,u — wu: t tie l r•erh t.aand i rry ( : � 1 f support i iig ) . The i ar get,t landing or deck perm i t� ed without drawings or a building perrn i t is 36" x 36" Any landing or, deck that in, 30" ()r more In he iclht from wa I k i nq surfae e3 t:c. finish, grade requ i r�s a guardra i 1 . Any 1 anti i ng car deck that has 4 or more risers regrr 1 res a handrail AnY i and i nq or duck 1 aRrcreAr than 36" x 36" must be permitted which r equ i res structural drawings and a bu I I d I nc permit application . This Instal i at i on R9rsn i t does NOT . 1 pry. i`tide Finy l and i riq or deck larger- 'khan the 36" x 36" size . I ) Proposed structure or 5 ou t l ons thereof with an projection over ;30" In hey i ght: from grade I i ne. must ma i nta i r, a ' separlation d i stance between adjacent structures and that furthest puo sect i on . X � 8 ) REQUIRED INSPECTIONS ( F oot i nq Inspection _.prior to pour , Set-up Inspection-prior t+:) skirting Final inspect ion-prior, to o o o u p a n c y) . I have received as co y of the rerner a i Information and Gu ide i i nes••Mobi 1 e/Manufactured Mousing I nsta I 1 at i ons aandout for detailed det;cr I p t I ort�; of all r°egt! ired ina.peotions on my mobiles/manufacturer) homo installation . I hereby assume all responsibility for the scheduling of these required Inspections . If these required i nspe-t i ans are not requested, inspected and signed off (approved ) by the I nspectot In the prescribed order , I understand that re i nspect i nn fees and an houriy ir+vest igaition fee pur,:uant try the 1991 URC, 'Table 3A will be aays"ssed In addition to my original permit fees to resolve any ;:guest l unab l e practices i ces or pprob l e3ms t hat have been discovered . 1 f ur t her, enderst and that this I nvest i slat i can will tie scheduled as time allows . Uht i I resolution of any/a 1 l problems, no occopancy ( Final I nsper•t i ort ) will be qr tinted for the residence . OWNER/CONTRACTOR ( indicate which ) Signature ?( Permit No. d MASON COUNTY (� BUILDING PERMIT APPLICATION y� �� 5 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT v #1 Ceer , F d 7 L y y ,U ��SOiU Phone# 3(O -� 75' �Jl Address Agrax\ /fir.5n,!u L,4ke 1,04N Fire District# o�8P 114 A;r St 'lam A. Zip Q Directions to Job Site Tf}�j c Al- 5h ore 4a S,yud W 1I 61Nd L.PY �La.c a)Al U[ ,7 �-k eiv •1-�a KP - Q ;� ��f- ,l-a C(�lc�e.S�IG =�'`'� �n Lds� +r-A 'ler 0,4) Owner Mailing Address & Q 1 I LQ r Sok L_A& J_AA)P City o rD I�A If, St. w Iq , Zip Lien/Title Holder ) . h,A)a4o4)M u-4u 4 L Address SD Q �P'A6,� 'C., AOP . City $�Lw►,9,4110,1J St VJ4- Zip #2 Contractor Name Contractor Reg# Address Expiration Date City St Zip Phone# #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply WeL. Connect to Sewer System? Name of System CA M M L� ,'4Y (If residential, proof of potable water is required) #4 rcel No.` egal Description CL:) 1& D 1 J #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building F( L Describe work #7 Type of Job: New Add Alt Repair ---C)# #8 MOBILE/MANUFACTURED HOME INFORMATION ��ryuA�--- Model Year�9 91 Make Model Length Width Serial No. U n # Bedrooms # Bathrooms Type of Heat Purchase Price$ #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 Indicate Directional by (N, S, E, W) Name of Flanking Street Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SIT PL14�N BELOW � I � QE0K ----- ON 0.4 � ® NS L I APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 each) No. Toilets CIRCLE FUEL TYPE: Gas, Elect ' , Bath Basins Heatpump, Other Bath Tubs No. Units Fees S ers Fur BTU Hot Wat tr eatpumps _Laundry Wash _ Vent Systems Sinks _ Spot Vent Fans Floor Drains No. Boilers/Compressors -_Laundry Basins _ HP Dishwasher No. Air Handling Units Disposal _ cfm# Urinals No. Fire Protection Systems Other Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Perm' asic Fee 16.75 _ to Fire Sprink Sys 35.00 OTAL PLUMBING $ No. Other Gas Outlets Wood, Gas, Pell lt►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 16.75 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE 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 X BY }} DATE 1' DATE FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: � � Environmental Health: Building Plan Review� � ��X�iG � 5 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 Other Other OC Building Valuation: TOTAL FEE OV5-