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HomeMy WebLinkAboutBLD2007-01923 Cancelled Addition - BLD Permit / Conditions - 12/7/2010 r Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 ` Shelton,WA 98584 RESIDENTIAL BUILDING PERMIT BLD2007-01923 OWNER: NORRIS SLIDERRECEIVED: 11/8/2007 CONTRACTOR: LICENSE: EXP: ISSUED: 2/28/2008 SITE ADDRESS: 11031 NE NORTH SHORE RD BELFAIR EXPIRES: /28/2008 PARCEL NUMBER: 322245000031 LEGAL DESCRIPTION: CADY'S SUNRISE BEACH TR. 1 OF TRS 46-47 &T.L. PROJECT DESCRIPTION: DIRECTIONS TO SITE: Addition (NO NEW BEDROOMS) 11031 North Shore Road General Information Construction&Occupancy In X,iat 11 Square Footage Information No. of Bedrooms: 1 Type o Co s r.: B Type of Use: SF Insp.Area: No. of Bathrooms: 2 Occ. G 3 Lot Size: Deck: Type of Work: ADD Fire Dist.: 8 No. of Stories: 1 Occ. L Building:351 Valuation: Building Height: Occ. St s: nIn Basement: Manufactured Home Inforplation Setback YqorrrAtion Shoreline&Planning Information Make: Length: Ft. Front: W 5.0 Ft. hovel' 0.0 Ft. Water Body: Hood Canal SEPA?: No Model: Width- Ft. ar: Ft. p Ft. Shoreline Desig.: Urban nil1: 0 Ft Year: Serial No. 2: 31. Comp. Plan Desig.: Rural Plumbing Fixture echanical Fixtures FEES Type Qty. a Qty. Type By Date Amount Receipt Lavatories 2 Ventilation Fan 2 Plan Check Fee CMH 11/8/2007 $392.18 B12007000 Showers Building State Fee MAL 12/27/200 $4.50 S12008000 Water Closets (Toilets) 2 Building Permit Fee MAL 12/27/200 $401.35 S12008000 Bath Tubs 1 Mechanical Base Fee MAL 12/27/200 $25.30 S12008000 Mechanical Fee MAL 12/27/200 $16.00 S12008000 Plumbing Base Fee MAL 12/27/200 $22.00 S12008000 Plumbing Fee MAL 12/27/200 $53.90 S12008000 ADJUST—Plan Check Fee MAL 12/27/200 -$131.30 S12008000 Geotechnical Asses. Report BKD 2/19/2008 $1,205.00 S12008000 EH Plan Review CEW 2/22/2008 $100.00 S12008000 Total $2,088.93 BLD2007-01923 Please referto the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2007-01923 CONDITIONS FOR BLD2007-01923 1) 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 Department prior to any further inspections being performed or approvals granted. X lk! 2) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X �L) 3) The plan review check list and corrections 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 on site for the duration of the project. Failure to comply and/or removal of approved documents will result in failure of required building inspections. X 1) 4) All exterior wall cavities exposed during construction or remodeling work shall be insulated to the full depth of the wall cavity and inspected prior to covering. X 1k 5) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X \ l\ 6) The"approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the "approved" site 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. 7) Washington State Energy Code Compliance has been approved using the following: Heat Type: Electric or other fuels, Compliance Method: Prescriptive option IV, Window(Max U-Factor):0.35, Skylight(Max U-Factor):0.58, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38, Vault Insulation R-38 (see exception), Slab Insulation R-10. Exception: R-30 insulation may be installed, up to 500 sq. ft., in single rafter or joist vaulted ceilings where the distance of the top of the ceiling and the underside of a roof sheathing is less than 12-inches and there is 1-inch vented airspace above the insulation. X ,1. BLD2007-01923 Please refer to the following pages for conditions of this permit. 2 of 5 8) Per 2003 IRC-SECTION 1609-WIND LOADS- 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC WIND SPEED (3-SECOND GUST) the wind speed for Mason County is 85 MPH. x 9) Per 2003 IRC -SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance cordance with he applicable provisions of this section and the manufacturer's installation instructions. 10) SPECIAL INSPECTION BY GEOLOGIST An inspection performed by a representative of the Geotechnical Testing Laboratory, or their authorized representative, shall be performed on-site prior to the footing pour to verify that earthwork and foundation installation activities comply with geologist recommendations. In addition a final inspection report, prepared by a representative of the Geotechnical Testing Laboratory, or their authorized representative, shall be required to verify that erosion control, drainage and final work is completed in accordance to geologist recommendations. Reports shall be submitted to the Mason County Building Dept., PO Box 186, Shelton, WA 98584, prior to the footing inspection and available on site for inspections. X 11) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and sh I�I �e collected by the Building Department prior to any further inspections being performed or approvals granted. X J� 12) All construction must meet or exceed all local ordinances and the international codes 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 permit revocatio X 111% 13) 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. ) 14) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regula 'n, must be reviewed and approved by Mason County prior to construction. X 1 BLD2007-01923 Please referto the following pages for conditions of this permit. 3 of 5 15) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector sha be made prior to requesting additional inspections. X 16) All property lines shall be clearly identified at the time of foundation inspection. X Vt�, 17) 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. X J, 18) 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 for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit (older have levented action from being taken. No more than one extension may be granted. 19) The approval of this project is subject to the recommendations and specifications outlined in the attached geotechnical report or assessment. Structures and/or land modifications (grading, cuts, fills, etc.) required in the geotechnical report/assessment, may require a seperate permit. The geotechincal report/assessment shall remain attached to the approved building plans. X 20) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. X \ � 21) Retaining walls needed to support a surcharg 7ch as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X 1 22) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Site Plan" to ensure these structures are shown and meet the setback conditions listed. X 23) Approved per djmensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 1` 24) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures meet the setback conditions listed. X BLD2007-01923 Please referto the following pages for conditions of this permit. 4 of 5 i 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 anytime 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 owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described pr perty and structure for review and inspection. OWN ER OR AGENT: (i zi �1.�2t; / DATE: i7 BLD2007-01923 Please refer to the following pages for conditions of this permit. 5 Of 5 rr ' • CONCRETE MECHANICAL MANUFACTURED HOME N U _..._.�.............__..... r1n:*no(Date backs Date By Ribbons Gas Piping CD By interior-Date By Date By By Exterkir-Date L Z-/� B O Point Load!isotated Footings INSULATION Date By M BG 1 SLAB tNSULAT{ON Date By Data By FIRE DEPARTMENT V>' Foundation Waits Floors Date By Date By Data b By Z DECKS FRAMING _ wails i Date By Date S=/ — d By/�� . Dat a By �G PROPANE TANKS PLUMBING VOUR Oatz ay Date By OTHER Groundwork Attic Date Gam%'/C By Type: Date B y Data By D.W.V DRYWALL I ype- tnt.Brace WaN Date By 03 Date By Date -, G' By FINAL INSPECTION Water Line Fire separation N 0 Bate By S Datu By Data By o 4 Pass or ° Request Inspect. c s Type of Insp. Fail Date Date Done By Comments N 0 U) �Ii t �,>✓b y cGwl�a ��C a+l N w r G CD ewf ,8- f5. LIp1L "� d rim �-�/� �c. S�1�r✓ -/o-�o tiv-- OA-� 0 �, ►, .�z��� s�2�-�d �,� �_ 3 _ y .yam� �a TF Permit# C% 7 /� MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION 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: Items listed below must a corrected to gain compliance p o�✓ Ali � lJ/ � �:. .�/1ij�J� T✓� C/'✓i� /� Y.e kid ,S w /^� 7-oi9a You are hereby notified that above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Call for re-inspection when corrections are made before continuing ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOTa Date 62 2-1_ / Department 13 2 CORRECTION NOTICE. I Inspector Ed 110 NOT , inl1 L"V ' THINRok TAWM * Aff f Permit#_ '' �`©�7 MASON COUNTY • BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 400 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been ound: Items listed below must be corrected to gain compliance �0 i ovi.�o „�,r --�' 145 J 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 ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOTa Date Lj-- —/ Z /0 Department C/12 CORRECTION NOTICE. Inspector ■ NCOTt� , M00V ' THI m4ft, TAO ' Permit# d 7- 6'1%zj MASON COUNTY • BUILDING III 426 W. CEDAR _ SHELTON, WASH/NGTON 98584 (360) 427-9670 CORRECTION 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: Items listed below must be corrected to gain compliance �W-9 -,�sT.g Z /y0 �d�S> v�sO �r/ b1o�.IL Ilo o. • `� d H' c,g vc�c vi g L c 1052GJ 1 �'i✓ of/ ad� �G o r � You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK corrections are made before continuing Call for re inspection when 9 ❑ Please contact our office Make corrections, items will be checked on next inspection regarding possible structural OK to damage incurred by recent "natural/man made" Lj This is not a complete inspection disasters.This is NOT Date Z Z -/?2 Department LO CORRECTION NOTICE. Inspector T Du NOT REMUV ' THIS TAomff Permit# MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location //G/31 `�- S- lel-'2 This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been A. f und: Items listed below must be corrected to gain compliance Oi- -v `— � 22,' ( T /i /? t5 y ' — E = ? r-LI d jgF,44- 17",11' ee�P17 JlPfX�5 c. /'77. �H4( o You are hereby notified that the above corrections shall be made EFORE PROCEEDING WITH ANY FURTHER WORK ,1"s� ' tt.C L Cow'o�jl G= . Call for e i pec'tion when correc ons are made before/continuing ❑ please contact our office ❑ Makcorrections, items will b�checked on next inspection / regarding possible structural ❑ OK to W'� /►' ,S/lJi= damage incurred by recent ���;��� "natural/man made" ❑This is not a complete inspection '� disasters.This is NOTa Date .S -� /G CORRECTION NOTICE. Department Inspector T/S . v�L ,o N* ,oT , �-�I �4 ' ' THINE& TAvm * mlff Permit MASON COUNTY BUILDING Ill 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location /L03/ 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 compliance c Z-- ,13 vr/ Z L- y 7� /��-�f 7C/� �� �%vim--��z- t�/�-T/=�.✓� s'`-/7/c� You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK (N Call for re-inspection when corrections are made before continuing ❑ please contact our office ❑ Make corrections, items will be checked on next inspection regarding possible structural ❑ OK to damage incurred by recent "natural1man made" ❑This is not a complete inspection disasters.This is NOT Date Department CORRECTION NOTICE. Inspector . ,0* " NJT , iml�L N4 ' ' THImb, Th,- * Mw • • 118*45 70*00 10 49 s oti 0 I aim i. PROPOSED == -i BLOCK PROPOSED OF v -- M.- .. _ cns �• • TO BEACH • APPROVED � l /• •• • : • • 1O�. • 1.31 N COUNTY • 13E ON REQUIREDTO APPROVAL • �. - 118-45' 000 05-11-' 10 11: 02 FROM-NL OLSON & ASSOC. 360-876-2487 T-947 P001/001 F-628 N.L. OLSON & ASSOCIATES, INC. Engineering, Planning and Surveying FAX TRANSMITTAL TO: Building Inspector DATE: 5/11/10 FIRM: Mason County Building Department PROJECT: 11031 North Shore Road FROM: Matt Zawlocki, PE PROJECT NO: 6786 RE: Framing Inspection PHONE: 427-9670 ext 352 CC: FAX: 427-7798 Comments: Mason County Permit# BLD2007-01923 A framing inspection on April 22Id noted 10 items that needed to be addressed. A follow-- up inspection on May 4th was completed but there were still two items to be addressed. These items were 1) Double joist under interior braced wall, and 2) Foundation at Section B-B. I am sending this fax in response to those two items. #1 Unfortunately, the plumbing was completed under the interior braced wall line before the framing inspection. In lieu of the double joist, it is acceptable to install full depth blocking perpendicular ( at 16" on center) to the joist under the braced wall. The intent is to make at least two joists act compositely under the braced wall line above. #2 During construction of the foundation for the addition, I was on-site to inspect the condition of the common foundation wall between the existing house and the addition (section B-B). The foundation is acceptable to meet the design intent. The pony wall construction on top of the stemwail is also acceptable to meet strength requirements for the house. Please feel free to contact me with any questions. �W M. NVA'1114,Y�O c�hoo✓ ? O R�Qraa fo �s G� asl�NAL j Number of pages including cover: 1 Sent by: Matt Zawlocki 2453 Bethel Avenue, P.O. Box 637,Port Orchard,WA 98366, Phone (360)876-2284, Fax(360)876-1487 ON_srgTF MASON COUNTY �P5 c DEPARTMENT OF COMMUNITY DEVELOPMENT 0 S u Planning Division ~ 0 T L? P 0 Box 279, Shelton,WA 98584 J Y 0 (360)427-9670 1864 REQUEST FOR ADDITIONAL INFORMATION December 26, 2007 NORRIS SUDER 13035 15TH AVE NE SEATTLE WA 98125 Parcel No.: 322245000031 Project Description: Addition (NO NEW BEDROOMS) Dear Applicant: You have submitted a permit application (case no. BLD2007-01923) for proposed construction or development in the county. Upon review of your application, I require additional information to complete the permit review process. Therefore, review of your application will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is submitted and the application is complete, I will continue to process your application accordingly. If the additional information is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. Please contact me at (360) 427-9670, ext. 363 if you have questions. Sincerely, Kell McAboy Land Use Planner Mason County Planning Department 12/26/2007 1 of 2 BLD2007-01923 REQUEST FOR ADDITIONAL INFORMATION 12/26/2007 Case No.: BLD2007-01923 Comments: Your geotechnical report has been sent to and reviewed by Russell W. La Force, P.E. of Vector Engineering, Inc. According to the enclosed memorandum from Mr. La Force, your geotechnical report requires additional information to meet the requirements of the Ordinance. These issues must be addressed before a building permit can be approved. If you have already received this notice, please disregard. 12/26/2007 2 of 2 BLD2007-01923 MASON COUNTY PERMIT NO. ' )00 / aaJ BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 041/ Shelton (360) 427-9670 • Belfair(360) 275-4467• Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICA T INFORMATION CONTRACTOR INFORMATION Owner Company Name Mailing Address — Mailing Address City tate Sec_-Zip Code City State Zip Code Phon - - Other P Phone Other Ph. Lien/Yitle Ider- Ca ►nno �(,�IA Contractor Reg. # Exp. E mail address E Mail Address Drivers Lic. OB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION- 12 igit Parcel No Fire District Legal Description 7 Site Address(Plea a incl a street n me, reet n mber and city Dire ions to 'te Will timber be cut and sold in parcel pre ration?Ye /No Is property within 200' of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add -Alt Repair Other PRIMARY RESIDENCE SEASONAL ❑ Use of Building Describe Work No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make 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. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and on County access to the above described property and structure for r iew an inspection. P OF F OF WO K IS NS OF A PROGRESS INSPECTION. X Date Owner/Owners Re resenta' /Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVEjD DENIED NOTES Building Department Z Planning Department Environmental Health Department Public Works Department Fire Marshal FEES BuildingPermit Fee Site Inspection Plan Review Fee to EH Review Fee Plumbing &Base Fee — Planning Review Fee Mechanical&Base fee 39 Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal (� Valuation $ az&Z — TOTAL FEES MASON COUNTY PERMIT NO. PLUMBING/MECHANICAL 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 Company Name Mailin Addres lex 5z Mailing Address City 'a tate Zip Code City State Zip Code Phone" — Ot er Ph Phone Other Ph. Lien/Title H der 6d4Q— Contractor Reg.4 Exp. E mail address E Mail Address Drivers Lic.#_q3L_:!N6j IVIS DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION - 12 Digit Parcel No. = Fire District Legal Description Site Address (Please in I e street n me, s reet number and ci ) Direct' s to site a Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff—Stream—Slopes or Bluffs > 15% TYPE OF JOB - New AddX Alt Repair Other Use of Building Location of Fixtures/Units - 1 st Floors 2nd Floor Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:ElectriG_ LPC-L--- Natural Gas,_ Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on 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. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: off Owner/Owners RepresentativI/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning I'd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. Planning Department Environmental Health Department FEES Plumbinq & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES