HomeMy WebLinkAboutBLD2003-01102 Final SFR, Garage and Porch - BLD Permit / Conditions - 3/26/2004 Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (3 0)427-9670,ext.352
Mason County Bldg. 3 426 W. Cedar P.O. Box 186
Shelton, WA 98584
RESIDENTIAL BUILDING PERMIT BLD2003-01102
OWNER: SCOTT BROWN RECEIVED: 8/8/2003
CONTRACTOR: HI LINE HOMES LICENSE: HILINH*981 BT EXP: 1/30/2004 ISSUED: 8/28/2003
SITE ADDRESS: 1091 NE BELFAIR MANOR DR BELFAIR EXPIRES: 8/4/2004
PARCEL NUMBER: 123307590263
LEGAL DESCRIPTION: TR 26 OF SURVEY 2/149 S 27/187 LOT: C OF SP#2104
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
SFR, ATTACHED GARAGE, COVERED PORCH FROM NORTH SHORE RD TURN RIGHT ON SAND HILL RD CONTINUE
PAST SCHOOL AND CHURCH. LEFT RIGHT AFTER YOU PASS CHURCH
ON BELFAIR MANOR DR. FOLLOW ROAD TO GATE, TURN RIGHT. 2ND
LOT ON LEFT,.
General Information Construction &Occupancy Information Square Footage Information
No. of Bedrooms: 3 Type of Constr.: V-N
Type of Use: SF Insp. Area: No. of Bathrooms: 3 Occ. Group: R-3, U-1 Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:2,776 Garage-Attached 624
Valuation: Building Height: 24 Occ. Status: Primary Basement: Cov. Porch 228
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 83.0 Ft. Shoreline: Ft. Water Body:
Rear: W 225.0 Ft. Slope: 2.0 Ft. SEPA?: No
Model: Width: Ft. Shoreline Desig.:
Side 1: N 44.0 Ft.
Year: Serial No.: Side 2: S 53.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 8/8/2003 $1,009.94 S12003
Hosebibs 2 Ventilation Fan 4 Planning Review Fee KS 8/8/2003 $150.00 S12003
Kitchen Sink 1 Dryer Vent 1 Address Fee GMM 8/14/2003 $140.00 S12003
Lavatories 5 EH Plan Review CEW 8/19/2003 $75.00 S12003
Showers 1 Building State Fee JRN 8/20/2003 $4.50 S12003
Water Closets (Toilets) 3 Building Permit Fee JRN 8/20/2003$1,553.75 S12003
Water Heaters 1 Plumbing Fee JRN 8/20/2003 $105.00 S12003
Bath Tubs 2 Plumbing Base Fee JRN 8/20/2003 $20.00 S12003
Clothes Washer 1 Mechanical Fee JRN 8/20/2003 $46.90 S12003
Mechanical Base Fee JRN 8/20/2003 $23.50 S12003
Building Re-Inspection KS 1/14/2004 $56.80 S12004
Total $3,185.39
BLD2003-01102 Please referto the following pages for conditions of this permit. 1 of 4
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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 BLD2003-01102
OWNER: SCOTT BROWN RECEIVED: 8/8/2003
CONTRACTOR: HI LINE HOMES LICENSE: HILINH`981 BT EXP: 1/30/2004 ISSUED: 8/28/2003
SITE ADDRESS: 1091 NE BELFAIR MANOR DR BELFAIR EXPIRES: 2/28/2004
PARCEL NUMBER: 123307590263
LEGAL DESCRIPTION: TR 26 OF SURVEY 2/149
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
SFR, ATTACHED GARAGE, COVERED PORCH FROM NORTH SHORE RD TURN RIGHT ON SAND HILL RD CONTINUE
PAST SCHOOL AND CHURCH. LEFT RIGHT AFTER YOU PASS CHURCH
ON BELFAIR MANOR DR. FOLLOW ROAD TO GATE, TURN RIGHT. 2ND
LOT ON LEFT,.
General Information Construction &Occupancy Information Square Footage Information
No.of Bedrooms: 3 Type of Constr.: V-N
Type of Use: SF Insp.Area: No. of Bathrooms: 3 Occ. Group: R-3, U-1 Lot Size: Deck:
Type of Work: NEW Fire Dist.: 2 No. of Stories: 2 Occ. Load: Building:2,776 Garage-Attached 624
Valuation: Building Height: 24 Occ. Status: Primary Basement: Cov. Porch 228
Manufactured Home Information Setback Information Shoreline& Planning Information
Make: Length: Ft. Front: E 83.0 Ft. Shoreline: Ft. Water Body:
Rear: W 225.0 Ft. Slope: 2.0 Ft. SEPA?: No
Model: Width: Ft. Side 1: N 44.0 Ft. Shoreline Desig.: Not Applicable
Year: Serial No.: Side 2: S 53.0 Ft. Comp. Plan Desig.: Rural
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Dishwasher 1 Exhaust Hood 1 Plan Check Fee KS 8/8/2003 $1,009.94 S12003
Hosebibs 2 Ventilation Fan 4 Planning Review Fee KS 8/8/2003 $150.00 S12003
Kitchen Sink 1 Dryer Vent 1 Address Fee GMM 8/14/2003 $140.00 Si2003
Lavatories 5 EH Plan Review CEW 8/19/2003 $75.00 S12003
Showers 1 Building State Fee JRN 8/20/2003 $4.50 S12003
Water Closets (Toilets) 3 Building Permit Fee JRN 8/20/2003$1,553.75 S12003
Water Heaters 1 Plumbing Fee JRN 8/20/2003 $105.00 S12003
Bath Tubs 2 Plumbing Base Fee JRN 8/20/2003 $20.00 S12003
Clothes Washer 1 Mechanical Fee JRN 8/20/2003 $46.90 S12003
Mechanical Base Fee JRN 8/20/2003 $23.50 S12003
Total $3,128.59
r BLD2003-01102 Please refer to the following pages for conditions of this permit. 1 of 4
CASE NOTES FOR
BLD2003-01102
CONDITIONS FOR
BLD2003-01102
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
1-80010982. The 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
Dep�m�ent prior to any further inspections being performed or approvals granted.
3) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located 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 re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or
X ntral r fail to post the address on site prior to requesting inspections.
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4) 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
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5) 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 County ordinances and building regulations.
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6) All upland areas disturbed or new created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt
fencing or straw matting). X S�
7) Approved per dimensions and setbacks on submitted site plan. X
BLD2003-01102 Please refer to the following pages for conditions of this permit. 2 of 4
8) 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
DeparW,Wt prior to any further inspections being performed or approvals granted.
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9) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located 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 re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or
contract fail to post the address on site prior to requesting inspections.
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10) The plan review check list and corrections, along with the Energy Compliance Worksheet(when applicable)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 oil site for the duration of the project. Failure to comply and/or removal of approved documents will result in failure of required building inspections.
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11) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X SS(3
12) The "approved" plot plan is required to be on-site for inspection purposes. If an inspection is requested and the"approved" plot plan is not 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 shall be collected by the
Building Department prior to any further inspections being performed or approvals granted.
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13) All construction must meet or exceed all local ordinances and the 1997 Uniform Building Code 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 per it revocation.
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14) Proposed structure or portions thereof with an pr ection over 30" in height from grade line, must maintain a 5'separation distance between adjacent
structures and that furthest projection. X S(>
15) All changes to"approved"building plans that effect compliance with the Uniform Codes as amended and adopted, or any other Mason County ordinance
Xr regulation ust be reviewed and approved by Mason County prior to construction.
16) The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the Uniform Codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building
Inspect r shall be made prior to requesting additional inspections.
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17) All property lines shall be clearly identified at the time of foundation inspection. X
BLD2003-01102 Please refer to the following pages for conditions of this permit. 3 of 4
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18) 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 my ordinances and building regulations.
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19) 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 fora period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit
holder ha prevented action from being taken. No more than one extension may be granted.
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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 con n tion of/ is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied.
OWNER OR AGENT: / DATE:�S 6
BLD2003-01102 Please referto the following pages for conditions of this permit. 4 of 4
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o CONCRETE MECHANICAL MANUFACTURED HOME
w Footings I Setbacks Date By Ribbons
0
Date By Gas Piping Date By
0
N 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 FINAL INSPECTION
Water Line Date C�tl By
Date By :y .... . Date By
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N Foundation Walls Date B y Set-up
Date ' �i,5:P-e- By �/ INSULATION Date By
B G / Slab Insulation Floors Final
Date By Date 1410LI By t O V- Date By
FRAMING Walls FIRE DEPT
Date 1 —.54 By Date By Date By
PLUMBING Attic OTHER
Groundwork Date '���1/0�i B y WAL-
Date By WALLBOARD NAILING
D.W.V. Date B y
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Water Line Date-') By T/<
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MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
WSEC/VIAQ Compliance Application
Owner: C f7Lri'cr Parcel#: a a� do
Type of project ) New Residence ( ) Addition ( ) Remodel
Total Sq. Ft. 1S Floor :�7 0 / 2" floor: Heated
of heated area:: c277& / 4a' 9a
Heating System: Electric wall heater O Electric Central Furnace OLPG Furnace
O Heat Pump with Electric Furnace O Heat Pump with Gas Furnace O Boiler, specify fuel type
O Other: Specify:
Glazing Prescriptive Option see reverse side circle one: I II IV
Percentage: Compliance
Method O Component Performance , Chapter 5— Calculation worksheets required
Check one::
/,2• % O Systems analysis, Chapter 4
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Whole House Ventilations stem y O Whole House Ventilation using a Heat
Ventilation using exhaust fans&window or wall fresh air Recovery Ventilation System (VIAQ 303.4.4)
System vents (VIAQ 303.4.1)
Check one
O Whole House Ventilation Integrated O Whole House Ventilation using an inline
with a Forced Air System (VIAQ 303.4.2) supply fan. VIAQ303.4.3)
Window & Door Schedule (If needed, attach an additional sheet)
Total
Manufacturer Room/location U-Factor Size Quantity Square Feet
Windows:
Sew b\.w.e�orint- •
Windows: Total Sq. ft. 3 y q
Doors:
Doors: Total Sq. Ft
Total window and door area 3�q
Total window &door area (divided by) total sq.ft of heated area 99 76 %of glazing
MASON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
Permit Assistance Center
SHELTON (360) 427-9670 BELFAIR (360)275-4467 SEATTLE (206)464-6968
ELMA(360)482-5269 FAx: (360) 427-7798 WEB SITE: www.co.mason.wa.us
P.O. Box 186, SHELTON 98584
2001 Washington State Energy Code (WSEC)
effective July 1, 2002
2000 Ventilation and Indoor Air Quality Code (VIAQ)
Code Compliance Application Form
The following information will be required for the WSEC and VIAQ plan review:
1. Complete the Washington State Energy Code/Ventilation and Indoor Air Quality Code
(WSECNIAQ)application located on the reverse side.
2. Complete the window and door schedule on the reverse side. Include all windows, skylights,
sliding glass doors, french doors and any door that is more than 50% glass. Use rough opening
dimensions of the windows and doors. Information about the U-factor of the window will also help
to expedite the energy code review. If you are complying with the WSEC by prescriptive path and
are using the area weighted average method you must include your calculations.
3. On your building plans note the location and fuel type of water heater, location of exhaust fans
(bathroom, laundry, kitchen, etc.) and R-factor of insulation proposed for walls, floors, ceilings and
slabs,
4. Questions? Call Mason County Community Development at (360) 427-9670 ext. 284. Additional
WSEC and VIAQ compliance information is available on the internet at:
www.energy.wsu.edu/buildings/
Prescriptive Requirements 0,1for Group R Occupancy
Climate Zone 1, Table 6-1
Glazing Glazing U-factor Wall Wall Wall
Area%of Door Ceiling Vaulted Above interior4 exterior Slab
4
Option Floor „ U s 2 Ceiling3 Grade below 4 Below Floors on
�� Vertical Overhead Factor 12
grade Grade Grade
I 12% .35 .58 .20 R-38 R-30 R-15 R-15 R-10 R-30 R-10
II* 15%* .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
IV Unlimited
Single
Family Res .40 .58 .20 R-38 R-30 R-21 R-21 R-10 R-30 R-10
(R-3)Only
*Reference Case/Call (360)427-9670 ext. 284 for footnote information. Log &solid timber wall with a min. avg.thickness of 3.5"are
exempt from the above grade wall insulation requirements.
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MASON COUNTY PERMIT NO.O
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 (• .o Q.�� �1i-r inn ��1YD���r� Contractor Name 14 kric Alt,vr]eS
Mailing Address P6 13cx L441 Mailing Address Woo ►%a-Ay'e, 9:_
City State t4A Zip Code City vA 1% State�A Zip Code%S13,
Phone Oa►'75-8ta0lc Other Ph. ( ) Phone (�,g3)gyp 18L19 Other Ph.
Lien/Title Holder Wes+ Contractor Reg. # 141 Li Jo W xp. 1L-1 07 2pp3
Email Address /V/A Email Address
DD
SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic Existing Septic
Connect to Sewer System Name of Sewer System
Well Water SystemX Name of Water System
PARCEL INFORMATION - 12 digit Tax Parcel No. /0?59 / OQ.&3 Fire District 7-
Legal Description o+C. o� SS 2104 0 R±n 4 SE ' X —
Site Address (Please include street name, street number and city)
Directions to site t
" i u
Will timber be cut and sold i parcel preparation? (Yes/No) 960p-u'"` h+. c-
Is property located within 200' of saltwater Lake River/Creek Pond 'S -,LYN011-
Wetland Seasonal Runoff Stream Slopes or Bluffs �l 4k{+, �
PERMANENT RESIDENCEJX SEASONAL RESIDENCE ❑
TYPE OF JOB - New Add Alt Repair Other Use of Building i
Is this permit submittal the result of a Stop Work Notice, Correction Notice or other enforcement action?(Yes/No)
Describe Work wl P
No. of Bedrooms 5 No. of Bathrooms -13 SQUARE FOOTAGE Ist Floor 2nd Floor 1A9.q
3rd Floor Loft Basement Deck Other -Por-c k sq. ft. 9,:P.S'
Garage _Attached_Z,,—Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model 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.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION'AUTHORIZED IS NOT COMMENCED WITHIN
180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. THE
OWNER OR AGENT ON OWNER'S BEHALF, REPRESENTS THAT THE INFORMATION PROVIDED I TE AND GRANTS
EMPLOYEES OF Mason COUNTY ACCESS TO THE ABOVE DESCRIBED PROPERTY AND STRU IEW AND
INSPECTION OF THIS PROJECT. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INAC TE INF ION MAY
RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCF!MUTE
Acyinently
E BELOW:
OWNER AFFIDAVIT- I certifythat I am exempt from the require- CONTRACTOR'S AFFIDAVIT th t I
p q 4>� regis-
ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Wa"sMn tr�t I am aware
9
of the ordinance requirements for which this permit is issued and of the ordinance.requirements regulating the work-fdr which this
that all work will be done in conformance therewith. No changes permit is issued and all work shall be done in conformance there-
shall be made wit out first obtaining approval. with. No changes shall be made without first obtaining approval.
X Date T/l/03, X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by S Planning Pd /��—R Ck#� (�C/
Date _ Bld Pd. Reciept No.-_�
DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES
Building Depa ry
ent �,1
Occ Groupe o str. w -
Planning Department
Environmental Health Department
Public Works Department
Fire Marshal
Valuation $
FEES
Building Permit Fee �� Site Inspection
Plan Review Fee EH Review Fee
Plumbing&Base Fee IOS•oo A Vo Planning Review Fee
o.
Mechanical&Base Fee 4(,•4o o Other
Wood/Gas/Pellet Stove Fee State FeeC
Violation Fee Pre-Paid at Submittal ( )
TOTAL FEES
113.Pi Iva
PERMIT NO.:
MASON COUNTY
PLUMBING/MECHANICAL PERMIT APPLICATION
426 W.Cedar/P.O.Box 186 Shelton,WA 98584
Shelton(360)427-9670 Belfair(360)175-4467 Elma(360)482-5269
APPLICANT INFORMATION CONTRACTOR INFORMATION
OwnersS�-- &eAcL Cosr�L�_hro.lr� Contractor Name N j i rle_ >�nrn P_S
Mailing Address Maili dress I 1 al lJoad land Ave- E
City State W Ar Zip Code City F State JAL& Zip Code gR 3'7 3
Phone(31oo )a7S-&0(Other Ph.( Ph.CaAB) Other Ph.( [ "
Lien/Title Holder Contractor Reg. # JA l L I N N*483 p b
Address IVIA Expiration /07_/
SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of
Sewer System ,
PARCEL INFORMATION- 12 digit Tax Parcel No.'
eZ 33 / 0759 / O—2-G 3 Fire District
Legal Description I I —crP-3—
Site Address(Please include street name,street number and city)
Directions to site '
a
2r,ol. o ti v- on -rhe, ►eft.
Is your property within 200'of the following: Body of Water(Name) Saltwater
Lake River/Creek Pond Wetland Seasonal Runoff Stream
Slopes or Bluffs
TYPE OF JOB New Add Alt Repair Other Use of Building Pr i mary`RP—Sidenc Q
Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Fuel Type: Electric
!ype of Fixture No.of Fixtures Fees LPG Natural Gas Heatpump
Toilets 3 Type of Unit No.of Units Fees
Bathroom Sink 5 Furnace
Bath Tubs Heatpumps O
Showers Spot Vent Fan 44
Water Heater 1 Propane Tank Q
Clothes Washer ( Gas Outlets O
Kitchen Sinks 1 Wood/Gas/Pellet Stove O
Dishwasher I Kitchen Exhaust Hood 1
Hosebibs 2 Dryer Vent
Other Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
e
A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT.
NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF
CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED.
PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the
information provided is accurate and grants employees of Mason County access to the above described property and structures for review and
inspection of this project. Acknowledgment of such is by signature below:
OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a
Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance
requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work
conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. first obtaining approval.
X $ X Date
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by Date Submittal Amount Due Receipt No. _
AEFATt7NEEtVTIIEtz£1/# t :::::' <APPRr]VED RZNIED CONRt€IfjR1Ct?FTES
Building Department
Occ Group Type Constr.
Planning Department
Other
Other
FEES
Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing&Base Fee Other
Mechanical&Base Fee Other
Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( )
Violation Fee TOTAL FEES