The URL can be used to link to this page

Home My WebLink AboutBLD95-01642 Cancelled SFR and Garage - BLD Permit / Conditions - 1/19/1999 MASON COUNTY Mason County Bldg. III 426 W. Cedar L3 u I L_ r, 1 N t3 P L- I P.O. Box 186 Shelton, Washington 98584 It. 427-9670 BLD95-1642 PAROEL t3?_ 12754000::,I t ; :t_APL;,v, [> ; d BI K : Lk?7 .J0B ADDRESS t F. 131 SE_E'AFOPD 1113 SHF1.TON PERMIT OWNER t BRUCE GILLET 764-7562 ��., ' Y EXPSRATR®N CONTRA,C TOR : PACIFIC, MOR1`111WES i. BULKHEAD 866-1608 NULL 8, V LEGAL t LAKE LINE11Cp 5 T9 22 DATE ::14 R BY CLASS OF WORK . _ :NFW BELLDR : 3 -HATI.1 : 2 11, T410UNT BM GATE RECEIPT T(PE Al10UNi 3Y DATE Ifif t' TTYPES OF USE . . . . a SF STORIFS . . . . . . . : 1OC;CUP . GROUP . .. . :7 PI.DG , HEIGHT . O .0ft 11CP I 10.11 Rip M 110196 41065 NCO 0 33.90 UP 01114196 41165 TYPE OF CONST . . 17 FIREPLACES . . . . 0 ADDR I 5 10 NJP Oili0/94 41065 PANT 11 333.00 NJ? flil#196 41465 OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . t 0 ILC $ 42,11a NJP 0111111)6 41465 STFF 11 4.50 NJP 11111/96 411I65 DWE=L.L. .UN I TS . . . . : 0 PARKING SPACES t 0 PICK $ 166.50 NJ? 0111#198 41165 INSPECTION AREA : 3 SHORELINE? . . . ,. :N PI1 1 45.40 01IF 11/1119> 0165 TOTALt 639.60 VAIIltA111011t 569761 SETBACKS— _____ ...__.__ TOILETS . . . . . . . . . . : 0 FUEL TYr'FS - BOILFRS/COMP--- - MOBILE HOME - - FRONT . . . 0 Oft BATH BASINS . . . 0 0 HP . : 0 REAR . . . . O .Oft BATH TUBS . . . . . . . : 0 3-15 HP . : 0 MODELt S i DEs ( 1 ) . 0 .Oft SHOWERS . . . . . . . . . z 0 UUAN 100K BTU . 0 15-30 HP . c 0 - SIDE (2) 0 .0ft WATER HF_ATERS . , . . t 0 FURN y-100K BTU : 0 30-•50 HP . : 0 SHRL 1 NE . 0 ,0f t CLOTHES WASHERS — : 0 FURN - FLOOR . . . . 0 50+ Hp . a 0 -YEAR-.----•--- AREA ----- --- - KITCHEN SINKS . . . . t 0 HEAT POMP . . . . . . t 0 LOT S E ZF . . t FLOOR DRAINS . — . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS .- 0 LENQTH t 0 BUILDING . . . s 8949f DRINKING FOUNT 0 VENT FANS . . . . . . s 0 HOODS . . . . . . . 1 0 WIDTH . : 0 BASEME.NT . . . t 518c4t LAUNDRY TRAYS . . . . . 0 DOMES . INCIN :O •- SFRIAL#- --•--- DECKS . . . . . . 06f DiSHWASHERS . . . . . . t 0 AIR HANDLING UNITS-- COMML . INCIN :0 GAR/CAPPiG 3219f GARB DISPOSALS . . . : 0 <¢.= 10000 (;fm , t 0 RELOC/REPAID ; 0 AT/DT . :A URINALS . . . . . . . . . . . 0 > 10000 cft" . : 0 OTHER UNITS . : 0 M1SC: PLM f IXTURE�; . 0 CAS OUTLETS . t 0 IIIJECT OFSCRO rlON;RESIOEICE - 4ARAGE PROJECT tOCATIOk:SR 3 10 I1ASOM I.AKE RO HUTI, I14111 RINIT AFTEO RR TRACKR 11}RN LEFT GN C1.0011II7 TURN NIGHT ON SIEAIOR9 LOT AN (EfT. THIS PEINIT BECOMES AVU AN9 VO10 IF WORK OR CONSTNOCTION AUTHORIZED 13 RIOT CONN(II(FO NITNIN 160 DAYS, UI If CORSTINCTIOH OR MORE. IS SUSFENAED FOR 1 PERIOD OF IS1 DAIS AI ANY TINE AfEEA WOIR !S 0111FMCED. EYIOE1110 OF CONTINVA11104 Of WORK SS A PROGRESS INSPECTION 1111111 THE lie pty PERIOD. FINAL INS►EC11011 MUST 0E APPROVED 8fFJIE 6UIL0111& AN it OCCUPIER, r , OWNER (tA AGENT: 0kif ", BL0 P1Mr 13!91191 COMPLIANCE TO ATTACHED CONDITIONS IS REOU I RED a CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons J date _ __ I _by t� r2\_� Gas Piping date b Foundation,Walls C� date b Set Up date � l�- Ip INSULATION date by BG/StAH 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 MASON COUNTY Mason County Bldg. III 426 W. Cedar P FF R M 1 `T- C", t.:3 N L7 RO. Box 186 Shelton, Washington 98584 c Page , i 1 > Subject to ound l t ions of Resource Land! end Cr It lea f A( a as (RI C) Check 1 I st not It i cat i or, l rat 2r . PLC95-0764 . X 2 ) A l l approved p I a iie, ar a requ I red to Lle on- s I teA for i nepAe-t Ion purposes . It f ncopect f un i called for and Flans are not on site, Approval WILL NOT be granted . In addition , a Re- I rispeot i on tors i n the amoun'l of `30 .00 per hour On i ri I mum 1 hour ) w i I i be charged and mist be collected by this department prior to any further inspections be i nq performed or approval granted . X_ 3 ) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305 K ) AND SECTION 513 , ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINL'r VISIBLE AND t.EOIBiE FROM THE STRFFT OR ROAD FRONTING "THE PROPERTY . MASON COUNTY RUII.DING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A RE I NSPECT I ON FEE BASED ON RATES IN TARI F 3A OF THE 1991 UN I FORM BUILDING CODF WILL BE ASSESSED iF OWNER/CONTRACTOR TAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING 1 NSPEEC��T I ON;a . k 4 ) The correotion list , alon�?lt with the Energy Compliance Worksheet (when applicable) is part of the plans and musremain attached thereto , it is the responsibility of the applicant to make corrections indicated on the plans from the uorre�ction lists . Once the plans are marked APPROVED, they may not he changed or altered without authorization from the Building Official . The permit holder Is reporosible to retain the complete approved set of plans on site for the duration of the project . Failure to comp iy wiIf result in failure of required building i nspevt i ens . Every perm i t sba l I expire by I Imitation and become null and void If the building or work authorised tV suoh permits Is not commenood within 180 days from the data of IssFranoe or it the building or work authorized by such permits Is susp ed or abandoned at any time after the work is commenced for a period of 180 days . X 5 ) The use, handling and st;oraea of hazardous materials or f l ammabl ,a and combustible liquids in excess of 10 gallyons Is not allowed without the approval of the Mason Co+onty Fire Marshal . X �� a MASON COUNTY Mason County Bldg, III 426 W. Cedar s Atr�. � nur'r i ON P.O. Box 186 Shelton, Washington 98584 BENTS . rue vire otist be fte :,riL'K rrom 11 u'A t s , + : ren(: -O lv 'fl S a 'totai or trolly ach property line, or a variance must be obtained from the Building Department . 8 ) Proposed structure or ,any portion thereof greater than ;30" in height from grade line , must maintain a minimum of 5 ' setback fr-r.►m all property i i nes , easements and right of Q) Proposed struWtttre or portions thot-eol' with at) projection over 0" in height from Ur•ade line, must maintain a ar tion distanc4 between adjacent structures and that furthe st projection . X 10) Changers to approved building plans thflt of Pec t compliance to the 1991 Washington State Energy Code, 1991 Ventilation and indoor Air Quality Code , the Uniform Building Code and l or Mason County Alf I at i ons must be approved by Mason County prior to c-onstruct ionX r CONCRETE MECHANICAL MOBILE HOME Footings-Setback date 44-10 -YL 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 tt date by FRAMING Walls FIRE DEPT. date 10- - (, by date y 9 i5 by 3 date by PLUMBING Attic OTHER Groundwork date 2 I L{`' ' b ybA date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Cop ��r}--e s1•rr.�P��_( ,� �Sr(la�n ma�Q d�� c,.��-{ti �6�� fd! elzyv insu�f �6� BU1LDF_R/, FJ'(DME0WNER AG Q EEMENT �cE G"IIJT LTSGC FILE NO. q�-eVfl HOMEOWNER: We i1 u 8u ec re I PHONE: SITE ADDRESS: F- ACCT: MAILING ADDRESS: 1,110, BUILDER: PHONE:3 b � (o - I P MAM1NG ADDRESS: 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 ligme 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. is C - Prior to installing exterior insulation and damp proofing the below grade basement 2 walls, if required. - :'y 1_ _X-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_) X Following installation of insulation and vapor retarder prior to c 11 j i X _Finai inspection - ail components installed. LLO F 1E MAR 4 7199� _Other As Needed ;ENERAL SERVICES NOTE: Failure to have inspections performed by the PUD at the required times may result in the reduction or elimination of incentive payments. It is understood that the Super Good Cents Department is to be notified at 426-0777 or 426-8255 Ext. 777, not less than 48 hours prior to required inspections. I understand t-le "L6ng T,-,.n" Super Good Cents certification by Mason County public Utility District No. 3 only verifies 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 accordingto this agreement, the attached specifications and heat loss derailed 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 untUl June 30th ofthe 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 ofthe homes , I further understand that it is my y to be aware and adhere to the Long Term '=� Super Good Cents specifications. Only verified.completion by the on-site inspections d in listed, the agreement of all the attached criteria by the Mason County Public Uility Distal No. 3 Long Term Super Good Cents respresentative,will the house be certified as a S Good Cents home, and the stated incentives paid. 77 Builder Date Dale " C7 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 ag-greement will receive the incentives) in effect at the time constrution begun. W.ITTSUN 5.5 LONG TERM SUPER GOOD CENTS/1991 MCS COMPLIANCE REPUxT 02/21j96 gb-o7'/ FILE: C:\\DATA\\WS\\KELLYB.WS HOUSE ID: Site: /3 S -� Analyst: RON TEWALT Jurisdiction: MASON COUNTY ( ) - Utility: MASON COUNTY PUD #3 Homeowner: House Type: Single Family Floor Area: 1448 ft2 Builder: Weather Data: Olympia, WA Climate Zone: 1 ------------------------------------------------------------------------------ The PROPOSED design QUALIFIES for SGC(91 MCS) Tier 1. REFERENCE PROPOSED COMPONENT PERFORMANCE 302 295 Btu/hr-F ENERGY BUDGET 2.93 3.34 kWh/ft2-yr REFERENCE DESIGN Reference Component Description Value X Area = UA ------------------------------------------------------------------------------ BG Wall 2' R21 batt 2' w/TB U-0.042 16 0.7 BG Slab 2' F-0.592 8ft 4.7 BG Wall 3.5' R21 batt 3.5' w/TB U-0.040 39 1.6 BG Slab 3.5' F-0.556 lift 6.1 BG Wall 7' R21 batt 7' w/TB U-0.035 347 12.1 BG Slab 7' F-0.503 39ft 19.6 On Grade Slab R15 2' horizontal w/TB F-0.520 34ft 17.7 Floor R30 vented joist U-0.029 413 12.0 Glazing @15t 0.35 U-value U-0.350 217.2 76.0 Doors Metal R5 base case U-0.190 38.0 7.2 AG Wall R21+R5 ADV U-0.041 1192 48.9 Ceiling, Attic R49 blown Attic ADV U-0.020 930 18.6 Infiltration Standard air sealing ACH-0.350 11976ft3 76.7 ---------------------------- Reference UA 302 -------------------------------------------------------------------------------- PROPOSED DESIGN COMPONENTS Component Description Value X Area = UA ------------------------------------------------------------------------------ -------------------------------------------------------------------------------- Items in parentheses not included in COMPONENT PERFORMANCE totals. ** Denotes non-standard values - check calculation of thermal value. * Denotes adjusted UA to reflect 7-1/2 mph wind speed. Page 1 ===sa=x:c==sxsasxxx==s sssas=as=a :=x=s====c==s=xxxx=xx-s----==ca :saxxas==a---- W`TTSUN 5.5 LONG TERM SUPER GOOD CENTS/1991 MCS COMPLIANCE REPUXT 02/21%96 FILE: C:\\DATA\\WS\\KELLYB.WS HOUSE ID: BG Wall **R13 BATT WITH R5 EXT FOAM 21DEPTH U-0.034 16 0.5 BG Slab ** F-0.570 8ft 4.6 BG Wall **R13 BATT WITH R5 FOAM EXT 3.5 DEPTH U-0.033 39 1.3 BG Slab ** F-0.540 lift 5.9 BG Wall **R13 BATT WITH R5 EXT FOAM 7' DEPTH U-0.030 347 10.4 BG Slab ** F-0.493 39ft 19.2 On Grade Slab R10 2' horizontal w/TB F-0.540 34ft 18.4 Floor R25 unvented Enclosed U-0.037 413 15.3 Glazing @9t **NFRC PHILLIPS .33 U-0.330 103.0 33.0* **NFRC PHILLIPS .31 U-0.310 33.0 9.9* Doors **INSULATED DOOR U-0.140 38.0 5.3* AG Wall R30 + R13 Double Stud INT T1-ll U-0.030 707 21.2 R21 INT T1-11 U-0.056 166 9.3 R13 INT T1-11 U-0.087 400 34.8 Skylights @1$**VELUX FSVHH-4AL LOWE/AR U-0.370 16.0 5.8* Ceiling R38 blown Attic ADV U-0.026 456 11.9 R38 blown Scissor 4:12 ADV U-0.025 458 11.4 Infiltration Standard Air Sealing ACH-0.350 11976ft3 76.7 ---------------------------- Proposed UA 295 Struc Mass Light Frame, Sheetrock walls M- 3.000 1448 4344 -------------------------------------------------------------------------------- HEATING/COOLING/VENTILATING SYSTEMS PROPOSED Heating System Type: Electric: Zoned System Efficiency: 100 $ Modified Efficiency: 100 rk Design ACH: 0.60 Design Load(at 53F dt) : 18532 Btu/hr Total Load: 18532 Btu/hr System Size(Output) : 8.0 kW (150W) Average Annual Heat: 7010 kWh Annual Cost: $ 300 Ventilation System: Integrated Spot & Whole House Cooling System: NONE SEER: 0.0 (Unducted) Cooling Load(at 5F dt) : Btu/hr System Size (%Over) : tons (@125%-) Annual Cool Requirement: kWh/yr Solar Access: Partially Shaded -------------------------------------------------------------------------------- _____________________________________ Page 2 1 w,aTSUN 5.5 LONG TERM SUPER GOOD CENTS/1991 MCS COMPLIANCE REPORT 02/21/96 FILE: C:\\DATA\\WS\\KELLYB.WS HOUSE ID: -------------------------------------------------------------------------------- GLAZING ORIENTATION PROPOSED PROPOSED South ft2 North 136.Oft2 Southeast Northwest East West Northeast Southwest Eff S Glz: 1.8%; -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Economic and energy consumption estimates are designed for comparative purposes only. Actual cost for heating will vary depending on weather conditions, occupant lifestyle and other factors. Page 3 i! Date Checklist Prepared 9� MASON COUNTY BUILDING DEPARTMENT PLAN REVIEWER AND INSPECTOR CHECKLIST 1991 WSEC AND V&IAQ CODE COMPLIANCE ay 00 Permit Number / V"��!' Address p5 S Ft. F � Zh ee e/ Name on Permit C7I L L L T, -Bru Ge �ue eAe/ Contractor/Phone# �- - Compliance Method: ) Prescriptive Y (Option) ( ) Component ( ) Systems Analysis L:I e-L-t '�c Date FOUNDATION Insp. Rev. Slab: R-_ (Ext.foundation down to frontline/slab bottom;or interior 24"top of slab&horizontal. Radiant under entire.) ( ) ( ) Below grade exterior wall insulation: R- ( ) ( ) Crawlspace ventilation: (I sq.ft.N A1150 sq.ft.floor area-cross vented) FRAMING ( ) (V) ( ) Standard Intermediate ( ) Advanced Woodstoves and/or fireplaces: (6 sq.inches combustion air supply duct with damper direct to firebox.) Standard air seal: (Bottom plate/subfloor,rim joist/mudsill,window/door frames,penetrations condition to non-condition.) ( ) (v ) Attic ventilation (1 sq.ft.kTA1150 sq.ft.ceiling area) Spot exhaust fans: (4"exhaust-bath/laundry 50 cfm @.25 WG;kitchen 100 cfm @.25 WG. Vented out with dampers.) ( ) (�► ) Fresh air ventilation: Available to all habitable rooms. Installed and operational. (Integrated forced air,windows,wall ports.) $O - Whole house exhaust fan: 06 cfm(Intermittent system manual&auto controls/sone less than or=to 1.5 at.1 WG) I INSULATION ( ) ) Attic baffles installed to deflect incoming air(Rigid material resistant to wind-driven moisture,extend 12"above loose fill or 6" above batt insulation) Mechanical ventilation ducts R-4(Exhaust in unconditioned space&supply in conditioned space.) Wall insulation(above grade) R- 02/ (Batts face stapled) ( ) ( ) Wall insulation(below grade-interior) R- (Batts face stapled) ( ) ) Vapor retarders on walls (Faced ban,or 4 mil poly or perm.paint.-circle one) Rlm Joist(Insulated with vapor retarder-rigid foam and caulked or 4 mil poly.) ( ) ( ) Vaulted ceiling insulation R- (Vapor retarder&1"air space) FINAL ( ) ) Floor insulation R- �30 (Substantial contact w/surface,supports less than or=to 24"OC,not blocking vents.) Ventilation system is operational(spot,whole house,fresh air to all habitable room. If integrated system,certification by installer is required.) ( ) ( ) HVAC ducts in unconditioned areas R-8 (.mints sealed;mechanically fastened with a minimum of 3 fasteners.) Pipe insulation R-3 (Hot and cold lines in unconditioned areas-service or recirc.see Table 5-12). SHW heaters: (NAECA label,separate power or gas shut-off,on R-10 pad if electric in unconditioned or on concrete.) ( ) ) Heating system type: E I e-C f►y"C u'_)r,_J I m n c)!2 f— ( —Radon-mmi for on site with instructions.No. - Supplied by MCBD ( ) ( ) Thermostat: (Heat range 55-75;AC 70-85;both 55-85. Backup heat controls(lockout)prevent simultaneous operation of primary system.) ( ) ( ) Solid fuel appls.: (Glass/metal tight-fitting doors;dir.comb.air source,or 4"dia.dampered,indir.source for existing const.) Ground cover: (6 mil black polyethylene or approved equal lapped 12"at joints,extending to foundation wall.) Penetrations(All exterior`wall and ceiling penetrations sealed to drywall-plumbing,exposed beams,wall receptacles,fans,recessed lights.) ( ) (-A Ceiling Insulation R-�(Insulate&weatherstrip access,baffle to prevent spillover-no cardboard) Vapor retarder paint if a vapor retarder was not installed when insulation was installed. s • - GLAZING Plan Reviewer-Fill out this glazing section or attach a window schedule to this checklist. Ins c o - Verify window information during field inspections. Include skylights, glass doors and all other glazing on this form. Use rough opening area for calculations. Date Size uantit Area S . Ft. U-Value Manufacturer Rev. Insp. Y to 0 Total glazing area: 3 Total conditioned area: �a/I�j Percentage glazing: 9-` Verified: DOORS Plan Reviewer-List opaque doors by type(solid core,insulated,etc.)quantity,U-value,and manufacturer. Impector- Verify door information during field inspection. Date Type/Quantity U-Value Manufacturer Rev. Insp. 6,600 cNi .a v FMrr7 dorms .Se e f rea'ov o ?-r7�,c act few ),5 e t e r Signature of Building Inspector: Date of Final Inspection: 407o Sto p& _ �Z) C)oaa tad D� • '' � i \ \ �'� \ 3i I aq Y7 f a3. ay 3s \ \ D w��es 0 X /oo Slera�o2 � Permit No. 0" MASON COUNTY qo BUILDING PERMIT APPLICATION 4 6 W, Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRI T Y 1 / c` #1 er4�� CSt- Phone# 7 SSE — 7 Q ite Addres 1 dQ Fire Distr' t#� City St GAJ.o Zip , Directions to Job Site 2 Owner Mailing Address ��20 (��_ 0-r_n k ?y� City ��`v� St�_Zip�'_Se I Lien/Title Holder 4 ZA Address Clty St Zip #2 Contractor Name �G�'Yt� 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_XC Well Connect to Sewer System? Name of System Lam¢-kS LrW.4X tCk (If residential, proof of potable water is required) #4 O �-Nb._`3 L gal Description #5 Building Square Footage: (existing/proposed) 1st FI kE�Pf° 2nd FI / 3rd FI / Loft / Basement Deck / #bedrooms _/ #bathrooms Garage l / Carport / (Circle:Attached or Detached?) Other sq.ft. /q y 2 / #6 Use of building �<v�T�� c l 7 /C-�q�W5 11_c IL Describe work #7 Type of Job: New_ Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION D D Model Year Make Model NOV 1 3 1995 Length Width Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price $ HEALTH SERVICES #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 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 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No. Toilets CIRCLE FUEL TYPE: Gas, Iectric Bath Basins , Other c (( mo oc k — Bath Tubs No. QDila Fees Showers Furn BTU _LHot Water Htr _ Heatpumps Laundry Washer _ 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_ Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00_ TOTAL PLUMBING $ No. Other Gas Outlets Wood, Gas, Pellet 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 15.00 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 O TAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPAR ENT. X OWNER XF DATE DATE \ 2 FOR OFFICIAL USE ONLY: Accepted by: ice- f Date: zz - �� A�) --- - -- - _ _ _----- - ------ DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: f ll'2� 1 Building Plan Review Occupancy Group: ,L-? Type of Const: U' "1 Fire Marshal: Other: Special Conditions: FEES Building Permit 3 Plan Check Plumbing Fee QD� Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee / Other 5 Other 2Li , Building Valuation: TOTAL FEE