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HomeMy WebLinkAboutBLD94-01818 Final Mobile Home - BLD Permit / Conditions - 6/16/2000 MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 B L! 1 1._ 0 1 N 0 P IE R M I 'I FOR I NSPECT'ONS CALL 427-9670 BETWEEN Eipm AND Bata 427-7262 BLD94-1618 PARCEL :32 1 2 754000 8,5 PLAT :L.APLO D I V : BLK : LOT ,JOB ADDRESS : E 60 K I L MARNOCK. RD SHELTON PERMIT OWNER : FELKER PENSION TRUST 272-6400 NULL & VOID BY EXPIRATION CONTRACTORS KIMBFL 426--42.43 LEGAL : LANE I.11FRICK 5 TN 85 ES 09161 111 1118 DATE IAA 4 � BY t''"" �a:.cvu:vn.�r:xc=u•.r..-.a�xar..:-zcse::svacmcazma.-.-vicar�:a�iz�x�r_:acs::�-�::�.ac..ssr":s^uaa�—+"•.••�trss�tua�s.Qm� CLASS OF WORK . . :NEW BEDR : 3 BATH : 2 TYPE ANOUNI RT DA1f RFCEIP1 j1TPf A,NOUWT BY DATE RECEIPT TYPE OF IISE . . . . :MH STORIES . . . . . . . : 1 ->,r. - _ s:: - ,. . _ __ .,- OCCUP . GROUP . . . :? BLDG . HE I GHT . . . 0 .01 t NHOf 1 180,01) TV 01117195 38192 TYPE OF CONST . . ,? FIREPLACES . . . . ; 0 Siff 1 4.50 if 01117195 38192 OCCUP . LOAD . . . . : 0 WOODSTOVf S . . . . : 0 If MCP 1 1,.9.00 11 111/1705 38192 DWELL .UNITS . . . . : 0 PARKING SPACES : 0 IADDR 1 5.00 TV 01/17195 38192 INSPECTION ARFA : 3 SHOFIEI. I NE? . . , . :N !Rt C 1 40.00 11 111111195 36192 TOTAL: 159.51 VALUTATION: 0) SETBACKS-- ------ - TOILETS . . . . . . . . . . . 0 FUFL TYPES- ---------- BOILERS/COMP---- MOBILE HOME--- FRONT . . .E 10 .0ft BATH BASINS . . . . . . : 0 : 0 3 HP . : 01 REAR . . . .W 10 .oft BATH TUBS . . . . . . . . 0 3-15 HP . . 03 MODFI :I_ I BF'RTY SIDE ( I ) .N 15,Oft SHOWE.RS . . . . . . . . . . . 0 FURN < IOfOK BT0 0 15-30 HP . : 0 -1.1AKF• S I DE (2 ) .S 15 .0f t WATER HEATERS . . . . ; 0 FURN >-100K BTU : 0 30 -50 HP . : 0 GLENOAKE:S SHRL INE . 0 .Oft r. .011-IFS WASHERS . - 0 FURN - FLOOR . . . : 0 50.1- HP . : 0 YEAR--- _._._. AREA ---____________.__ KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 94 LOT SIZE . . : FLOOR DRAINS' . . . . . : 0 VENT SYSTEMS . . , : 0 EVAP COOLFnS : 0 LENGTH :44 BUILDING . . . : 1232st DRINKING FOUNT . . . . 0 VENT FANS _ . . . . : 0 HOODS . . . . . . . : 0 WIDTH . :28 BASEMENT . . . : OST L.AIINDRY TRAYS . . . . : 0 DOMFS . INCIN :O -SFR1Af_ - - DECKS . . . . . . : Osf DISHWASHERS . . .. . . . : 0 AIR HANDLING UNITS,—- COMMI_ . 1 NC I N :0 GAR/CARP :? Osf GARB DISPOSALS . . . : 0 <- 10000 cfm .. : 0 RELO(•/REPAIR : 0 AT/DT . :? URINAL`? . . . , . . „ . . . : 0 10000 ufm . : 0 OTHER UNITS . : 0 fl I SC Pt M F I XTI)RES : 0 GAS Oturt F1 S . : 0 �ecr••---•••_aox x:.v_:.�arxa:-susrzs�xsa�s�,a�.�:r.-ms..u.-:yrara�naa¢>ru:ana�.nmxis--x�rsmxxaon.suswrsrsceinu.:�-ur-�-.r,:.-.� t.�ra�s:nrcz-�:anza.-r�cw>czcsi�r.as��,araacus.=���.-�..::r.�r-c-r.au:e1'+axaa:s-.._.:..::.:>r PROJECT OESCAIPTIONYOBILE NONE PROJECT I0CA11011rNASON LAKE RO NORIN, TURN RIGN1 04 010 IY*F R0 tFFT ON Kit.NARNOCK, 3RD tOT ON Aim r9ON CORNER. 11113 PFRNIT BECO119 11 I AND :0iD WORK OR CONSTRUCTION AUTY69)zf8 ISNOT CONVENCIP WITHIN too DAYS, OR If CONSTRUCTION OR wonis SUSPINDF0 FOR AOF 180 DAYS AT ANY 11M AFTERiORCOMME CFD. EVIDENCE OF CONIINUAT►ON Of WORK IS A PROGRESS INSPfCTION 111010 THE 18N DAY PERIOD. FINAI 1NSPft,4I16r ooAPPROVEII BEFORE BUII.AI G CAN E 0 CUpifA. I ` � � OWtitER OA AGfN1�� 1 ` Sink 01'%j 44i4l i l ( C010P . I ENCU TO Al TACH'I f% CONDITIONS IS RHQU I RL:D i CONCRETE MECHANICAL MOBILE HOME 1 / k qn1 A Footings-Setback date by Ribbons date by Gas Piping date 3'�`"/� by bj Foundation Walls date by Set Up , 1I date by INSULATION date t,— �� byL —) BG/SLAB Insulation Floors Final date by date by date (o — I G`OQ byl 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 /-- F--z- 6,z - -- - = t< OcD 1 l /' 1 Page No. 1 CONDITIONS/CORRECTIONS FOR CASE NO.: BLD94-1818 FELKER PENSION TRUST E60 KILMARNOCK RD SHELTON 06/02/00 1) Flammable & Combustible Liquids -- 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 2) Sideyard Setback -- 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 right of ways. X 3) Multiple Setbacks -- Structure must be setback 5' from all utility and drainage easements, a total of 10' from all property lines (OR 15' FROM REAR PROPERTY LINE),or a variance must be obtained from the Building Department. X 4) PLANS REQUIRED ON SITE -- All approved plans are required to be on-site for inspection purposes. If inspection 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 1 hour) will be charged and must be collected by this department prior to any further inspections being performed or approval granted. X 5) POST ADDRESS -- PURSUANT TO 1991 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 1991 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 6) ALL CONSTRUCTION -- ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS X 7) MOBILE/MANUFACTURED SPECS. -- 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. OWNER/CONTRACTOR(indicate which) Signature X • Page No. - 2 CONDITIONS/CORRECTIONS FOR CASE NO.: BLD94-1818 FELKER PENSION TRUST E60 KILMARNOCK RD SHELTON 06/02/00 8) Mobile/Manufactured Landings/Deck -- 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 9) Changes to Approved Plans -- Changes to approved building plans that effect compliance to the 1991 Washington State Energy Code, 1991 Ventilation and Indoor Air Quality Code, the Uniform Building Code and/or Mason County Regulations must be approved by Mason County prior to constructionX 10) Field Correct -- CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x MIS j-! MASON COUNTY .-PRE=INSPEGTION APPLICATION 426 W. Cedar/P.O. Box 186, Shelton,WA 98584.427-9670 4a•� Fee Required prior to inspection PLEASE PRINT i #1 Owner Phone# 2s 3 Site Address to City SWEeTUI.0 Mail Address ,5elZ 3 6 6 e!F- city f V YX L L U io St ZeK l Applicant A,012 X ►� Ste& L L Phone#(ZS3) Applicant Address _S_,rf Z 3 city St zip #2 Parcel No. \3 a' ! 7 - 4 000 F5 Legal Description 9 P h #3 Purpose of Pre-Inspection #4 Use of building 1�w �L L > �Si G G E ;Z�wfi L y #5 Indicate by circling the applicable source if any water is on or adjacent to subject property: saltwater lake creek stream marsh river pond wetland seasonal runoff other Directions to Site: *'X Soa> T U A-2 7- 65.C-2 / A-l"W /lV o Cr k _X 5107- O/--) Show following on the site plan below: Lot Dimensions, Existing Structures, Structure Setbacks, Water Lines, Septic Systems, Flood Zones, Wells, Shorelines, Easements, Name of Flanking & Fronting Streets. Indicate directional by N, S, E, W, etc. 5-�- 0C) 57,33 3 0 �pY �rhuL X_ lop Applicant Signatur Dates l r MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (206) 427-9670 CORRECTION NOTICE Job Location c11 o k ► 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 R t AA o v e 4 LA— lZOO T.S -STCL6A4 i � fi ArD 2LtL' oiz, AA,-I C ` 61 dzTLt-1LJ 4-c., T© A- p e Uj 6 r= 1 Z 1� 'R C e o 2 4=3E r4 O /V Cr - Z 1 C2 e�m U F3 tt z't�FL R�'sIz— ?o ►e CILUZ,W 6- - 'U K 7'n t,�,o e 12,0 C ( t�,O - You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection O.OK to Ft X ANo n!t-cY.c-tin Department T3 w«•D (-/� Date 3 -3— 95 Inspector G��- moos NOT Mo *V THI, TAL • MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location E. �C K i I 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 _ 6. 94 <- You are here y notified that the above corrections shall be made BEFORE 'ROCEEDING WITH ANY FURTHER WORKv--.r----, 11 �afFfor re-inspection when corrections are made before continuing lake corrections, items will be checked on next inspection ©� K to Department ' Inspector 10� * NO OT MOOV THL. -V, ,� it Permit Budin g # MASON COUNTY V2L- BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location b 4 91 1 r« r:o 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 correed to gain code compliance fl e eJ c e— .. '� . G gZ r ak ON Jr You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ^Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection Department Date 1& 00 Inspector ■ AkA NnT MOOV THIV--- T A Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 �T Z-?b CORRECTION NOTICE Job Location F 4�- 0 K> 6-7g21vcxk ;�-d 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 /✓t�j-,0 :S- �14s14 C oc-4t To Vr= 4JATe-� 1:79&Av7 -3 -I)Lc k S L14 t/ e- S L 4-f Ky /tlo T 00.1Av,C,'-'72:V �Nfl �Vltl/�a�T�O08 >_� / Glo!�i! �'�I� ApA� i ova L � �� �,LtI Ticw Lin/D��L /`-l��N►,� fJo^i 5X y4 -::7 l2-3Z SQ r'-�. ,�Z-*ZAroAy Z6)uL,z!Ep Pj peg. s-D ' a AS // 1/EN S , S SQ IN4C4C5 5© 1. iel-i .s VE-1v71 I SQFt `f- ^/7rLA %OA✓ 45 tS " AD D #drJA rZ-A Ito M AlE.00 Si�l�b/� M/M � � � 3�, Lx}�tD�•vy ,� �� ��D� ���A Lies LC)OS� lcaC,KS � w�G�S et�Menr�2� Mg ti BWt,K ^i�t . You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK P. R DRpI-A For- ► O'r°tv sec"vNkr Er'Call for re-inspection when corrections are made before continuing cl, T,5 h�eAJ All a^,e�o2 ❑ Make corrections, items will be checked on next inspection STrna ps, ❑ OK to ❑ This is not a complete inspection DepartmentL+ Date _ s� Inspector moos NnT _ Mk *V THIV--- T A i - MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 I Information and GuideI Intl :i_t� ! : !=i ,!!!.tt &,. iured iiuu i !!_, insst :, ! ! ,, i ion. httt!douL I +„ ti-taI i <. :, descriptions of ail 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 se gned off (approved) by the inspector in the prescribed order , i understand that reinspect on fees and an hourly InVestIyatIon 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 . 1 further understand that this investigation Will will be scheduled as time allows . Until resolution of any/all prob 1 occupancy ( F i na I Inspection ) will be granted for the residence . OWNER/CONTRACTOR ( indloate which ) Signature 8 ) All mobile/manufactured home landings or decks must be freestanding ( selfsupporting ) . The Iarcgest 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 surfacae to finish grade requ i rers a guards i i . Any landing or deck that has 4 or more risers require a; a handra l l . Any landing or deck larder than 36" x 36" must be permitted which requires structural drawings and a building permit apeplication . This Installation Permit does NOT Include a y landing or deck l ar'ger than t.ile 36" x 36" size . A) Changes to approved building plans that effect compiiance to the 1991 Washington State Energy Code , 1991 Ventilation and Indoor Ali- Qualit Code , the Uniform Building Cod€! and/ or Mason Cot t. � yuIatIons rHuf"t be approved by Mason County prior tc.) ronstruc�tion 10) CONSTRUCTION PROCESS TO BF F I FI..D COR C EU AS RIFOU I RED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE I 4 Page No. 1 CASE HISTORY FOR CASE NO.: BLD94-1818 FELKER PENSION TRUST E60 KILMARNOCK RD SHELTON 06/02/00 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- BLDA010 Application received / / / / 12/12/94 12/12/94 KW BLDA100 Approved For Issuance / / / / 12/23/94 DONE KS 12/23/94 KS BLDA500 (F) Issue building permit / / / / 01/17/95 DONE TW O1/17/95 TW BLDA510 (F) Reprint building permit / / / / 04/13/95 customer wanted copy of print out could DONE NJP 04/13/95 NJP find his own BLDA560 Permit cancelled / / / / 01/06/99 DONE KW O1/18/99 KW BLDB110 Structural Plan Review 12/19/94 / / 12/20/94 DONE CDW 12/20/94 CDW BLDB130 Planning Review 12/12/94 / / 12/19/94 DONE MMS 12/19/94 MMS BLDB134 RLC Checklist Review / / / / 12/15/94 DONE AHB 12/16/94 TMJ BLDB135 Addressing / / / / 12/13/94 DONE GMM 12/13/94 GMM BLDB137 Site Address Notification / / / / 12/13/94 DONE GMM 12/13/94 GMM BLDB200 Environmental Health Review 12/20/94 / / 12/20/94 Approved Septic Design DONE HLS 12/21/94 HLS BLDB210 Water Adequacy 12/20/94 / / 12/20/94 Lake Limerick Country Club, letter on DONE HLS 12/21/94 HLS file, called into state BLDC100 Inspection 05/17/95 / / 05/17/95 skirting OK PASS RL 05/18/95 RDL BLDC199 Mobile Strip Footing 03/01/95 03/03/95 03/03/95 1) . Remove all roots and stumps from PASS WLC 03/03/95 WLC footing 2) . Remove all water before pouring. Ok to fix and proceed. BLDC200 MH Setup inspection 04/03/95 / / 04/05/95 Blocking and tidown insp. FAIL DPB 04/05/95 DPB 1.Post address.Where is permit? 2.Tighten all hold downs. 3.Manual shows perimiter blocking at each side of wall openings Oft and over. (windows & doors) 4.Items under home not complete to skirting line-----l.water line(also no insulation) 2.T&P from water heater.3.Dryer duct. (smooth wall metal) . 5.Where is posative connection on cross duct.I feal no screws.------------Do Not Skirt----------- BLDC200 MH Setup inspection 04/10/95 / / 04/12/95 No corrections made from last FAIL DPB 04/14/95 TDH / notice. (this was not called for DPB) MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 PER " I -ir C- 0 1 1 40 N _1E, 1% Case No . : BLD94-IF18 40 For . FEI_KFR FIFN§,-.,l ON 'TRUST Page : I jjL.a n d s t(-)r a 1 ) The ease, hand ) inland oe-of hazarap't1t; mate fta a le ali,Z ombbstible liquids In excess of I 0a I I op§. I sr, not #J I Owed r o-wik I jqf th6. Mason County Fir. a r a I M r e a-t e L4 0,q irk hfrom grade I I no, riv porter r V*ni.Proposed trijr.ture or must maintain a minimi i of 5 ' s ck f al I pro p`t��;,V Q i i eq, I.$er�ot s J right of aselp and FN; 3 ) Structure must be s e t ack 5 ' from a I I ut i.L4 t v 'and r a qe) ek-b,h1;b14ht6N, ­a total of 10 ' from all property fin s, (OR 15 '-FROM REAR ,,CROPiRT.C�,t or 'a i7f 1.0 0�. must be obtained M" p�(, 4 C, rom the tjildin(q Dep Ltment -'s re f I f I nspect I on i f. 4 ) All approved plaits ar qulredAo be ot 4,te or A pelt I on 'T �`r) n t aad i t I on , a cAlled for and plans not on Appr*4val Wll_ ! yl lite, Re- Inspectiort fee In - aniount f $30 .00 r hour 'im .`Dour ) *qII ba charged and ,4�wtl -hero nseeot i ons-be I nq performed or must be collected by is department prio t o Any. tyrit p r I granted , 5 ) PURSUANT TO 1991 UNIF:iiRM BUILDIN'(-t-CODE , f"Emloff 3 ,) A NA-15_- S E d"T k) 13 ALL' SITES MUST k HAVE APPROVED NUMBERS OR ADCRESS *--PROVIDE%�+,N S �k POSITION AS "TOPLAINLY VISIBLE AND LEGIBLE FROM THE ' 'THE r=xRTY— MA-KT.)l`j CW0 SLJ 11-D I NG I%REETIORBRW FRONT - I)FPARTMENT REQUIRES T TH S E CVMFLt1t1J'3RjOR MR !(;fvE INGPECTIONS . A ,3 1 REINSPECTION FEE , SASfD ON RATES IN TABLE , ­4F THE >4�P91 UNIFU4C ILQ:ING CODE WILt BE AS"ESSED IF OWNER/CON,1;RACTOR FAILS.' POST DRESS 01,(,f IT F PR RMUESTING INSPECTIONS , , " - ,. %".:, N % Z 6 )Nt,L CONSTRUCTION MUSThIFFT OR, E4(CC:Ep At L_ 1. 1.4; CODE S 4AND USC MENTS 7 Ir D INSPFCTION', C' r,�ootin( r i�pc t o- p cr*r 4- f et I on- pr i or to skirting , Final Ins Q*�' 1 Ion-prior Inspef tion- p e t -u p I n c to occupanjQ() . reenived a - n,o of the General ——————--—————————————————---——----- FOR OFFICIAL USE ONLY: Accepted by: � Date: - ' Receipt No. t Referred To DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Proposal Proposal Approved Denied Planning.- Building: Fe �✓ v6e— ' O C �An �`orre /-2 ' /?0 717ce s 3 q S Fire Marshal w I Special Conditions Permit No. MASON COUNTY DEC o 8 04 BUILDING PERMIT APPLICATION ce�,' 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 Q j OJCW% Roth ri #1 Ow r eV2 `�' ST—' Phone# �»d�"ZI" a ess F W) Kifn3a.Lno6L g,04J Fire District# qJ Zip c185�4' Direlltionsto Jo SiteAl ZZ4 L Owner MailingAddress S l'2. c,0Te V_ 1 City 1k4sm4m St—W j4 Zip98 1 1 Lien/Title Holder Address Clty St Zip (16LUj #2 Contracto Na e eC-Ot- 10JC_. Contractor Reg# Address Expiration Date City a L.-M 0 St Zi Phone# #3 If septic is located on project site, include records. Connect to Septic? 'X Public Water Supply � Well Connect to Sewer System? Name of System (If residen ' I, proof of potable water is required) #4 No. gal Description t�MQ R-1c 14�V 5 �"� g #5 Building Square Footage: (existing/proposed) 1 st FI A&L-Z 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport / (Circle:Attached or Detached?) Other sq. ft. / #6 Use of building �Q-s Describe work #7 Type of Job: New _Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMA I N Model Year kc&� Make � teft-MModel P t.0fW_ Length '" idth Z8 Serial No. # Bedrooms # Bathrooms Type of Heat & cT 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 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 eachl Fee Mechanical Fixtures ($6 each) No._Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other _Bath Tubs No. Units Fees Showers Furn BTU _Hot 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- 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 OF THE 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 /L Oa X BY DATE I z 8 DATE FOR OFFICIAL USE ONLY:Accepted by: Date: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: c~w ,i'yte i <Q.4 bccj�( @Eat n ice-y fts - V �'� _ Environmental Health: Building Plan Review 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 o mac+ e Building State Fee Other Lj Other Building Valuation: TOTAL FEE