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Home My WebLink AboutBLD97-00069 Final Barn - BLD Permit / Conditions - 9/26/2008 r MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 f tJ 1 1_.- C7, 1 N t; 1a V V4 INN 1 `TF FOR INSPECTIONS C-Al. L 427--9670 BETWEEN 5pm AND 64m 427--7262 BLD97-0069 PARCEL :3 2 1 101 1 00000 PLAT - D I V - i,t i - JOB ADDPFSS r IF 4780 MCREAVY RD UNION pE�M1E�pIRAT1O� OWNER : L I SA OUR 426-- 1334 $ VQID E3 CONTRAC Tt�R : TOZ I ER BROTHCRS 4?R--241 1 ULI- LEGAL . ME NE Ct AC-;S Of WORK . . ...NEW BE DR : 0 SATHr 0 11YFE AMOUNT 8Y DA•IE RFC!IP1 ITYPE AMOVNT '&Y ow RIt"F1011 TYPE Of' USE . . . sA`,C STORIES - - —,0 �.��•�«�r.��a��-:��,�A� : r,,:,�� :,��a�, � xi �� OCCUP . GROUP . . . :7 BL DG _ kit" 1 QHT . . : O .@fit I ADDR t `�.00 NJ? 03100191 44035 IENCP t 26.011 NJP 03106181 441135 i TYPE OF CON ;T . r 7 F I RE PE.ACE'S r 0 RtG t 44.08 NJP 03146141 `440 S OCCUP . L0AD • . . . . 0 WOOD)-; iOVES . . . . : 0 IPRMT t 177.50 N.iP 0310616.7 44035 ) DWFL L- .UN ITS . . . . e 0 PARKING SPACES: 0 IPI CK t 71 .60 Nip a310619li 1 44035 INSPECTION AREA r 2 SH0RFL INF7 . . . . rN ISIFF t 4.50 NJP 03106!47 44035 TOIAI : 3?9.00 VALUtAT100: 207361 �:.�1Ci�A.�',::�th�%ZZ"i�IDB'l4'FXPi11'Si"A:Sr:1Ci�4'�t.'A.'.['Z �s'•4'T1:.:3�'S:'�I.".'�".3tS�'@Si:Jfi7C.YC3.'='.LST.}_4�FE'�= SE:7'BACKS- ____._.___.__..__.._ -• TOIL.ETS . . . . . . , , 0 F1JEi T'Y('F. _.._ ._.______ I301L.ERS/COMP----- F,408it_E HOME- - FRONT . . . 0 .Oft BATH SA'; 1 NS . . . . . . t 0 u, Lt TIP 0 REAR . . . . O .Offi BATH TUBS . . . . . . . . 0 3-•15 1-1P . : 0 MODE I. : SIDE: ( i ) . O .Of t sHoWI EIS . . 0 FORN - 1OOY. RTU : 0 15.. .:;0 lip . : 0 .. MAKIr _._.._.... I DE (2 ) . 0 _0f t WA-rFR HEATERS . 0 FOR14 '---100K STU .! 0 30-50 HP 0 SHRL INE . 0 .0f' t CL0tHFS WASHE R``~ . . : 0 FURN -- f`LOOP 0 5 0+ HP 0 --YFAIT- -._..- AREA -_.. _ -ay.____.__. KITCHEN SINKS . , . . : 0 )I-IFAT PUMP . 0 L0T S ! 7.F . . . FL OUR DRAINS . . . . . . 0 VENT SYSTEM"" , . . . 0 f VAP COOLIFRS t 0 I_FHlGTH s 0 BUILDING . . . : ?_304st DRINKING FOUNT . : 0 VENT FANS . . . . . . . 0 HOODS . . . . . . . : O WIDTH . : 0 BASEMFNT . , , : Ost LAUNDRY FRAYS . . i DOMES . I NC I N .0 DECKS . . . . . . r 09f DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS— COMML . iNCIN :0 GAP/CARP:? Osf GARS DISPOSALS . . 0 <- 10000 cfm _ : 0 RELOC/REPAIR : 0 AT/D7 . r7 URINALS . . . . . . . . .. . : 0 7�- 10000 ofim - : 0 OTHER UNITS . : 0 ' M I SC PL.M F 1 KTURE S : 0 GAS OUTL FT'S, : : 0 :=;a'Ane:,M�.:s�:Rq'^A.+raaa:3�ta °'s.rars�Nc.::ss:c.:uCa:.4.x:4a ar:FSr::Y�,AfL••d7i.^,.A's•:...:-::.::nrr`aa.'3er'.r.^x�a:.xaxra::avZ7c^xaxrr x.».^.s:et'rx'tar:'.:e..".:A..,:us:,r•sxr�Ysr+r.3�..F':x�-'!YG'�sR:::;,�.:Fsssr:.r^.::ta:.:lsx.Sfw:atccsnezx:Sa:i:m.r a-:.^...Tk.�ansSS•CR'IRn:�L^"6as9,.-,msaracr_x<t-Kss:±r.LviYa9¢2xc PaO,IfCT DI:SCRIPTiOM,FARN PROJECI 1.0CATiON;fO11011 MAP, Off V.P.00 RD 1081 NORTH Of Tiff 5 MILE 00fil TURN RIGHT AT PD 2tl40 SOUIH. IRIS PE11I T BECONES Nutt ANN VO1 71f 1<D�K Of CONST1UC1100 AVINORI7ED IS NOT CONVENCEO NITRIP 184 DAYS, 01 If SON011ICTION OR WORK IS S03PEADED FOR A PfRIOO OF 18r DAYS AT ANY 111E AFTER W14 iS CONMF ViDEVE OF C0411NVA1100 Of HONK 1S A PROGRESS INSPECTION WITHIN THE 180 DAY tF11106. FINAL INSPECTION 1111r7 BI APPROVfO 8EfORf 8011,OING PAN 8,F✓'"OCCUPIF9. ' OMNER AGE N1: stOPANT, v r R`,;3I i ff /' COMPLIANCE TO ATTACHES) CONDITIONS IS RE:OIJ I Hfra i CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date 3-Z 4 by% Gas Piping date b Foundation Walls date by Set Up IIdate• by INSULATION date by BG/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 b date by y D W WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by -/s " 43A* rou:1lo• sow o�- 4�N 1bL5 yfytQ I -)AIT he -(0' e-,,, I� I I I I I I I CONCRETE MECHANICAL MANUFACTURED HOME Footings / Setbacks Date By Ribbons Date By Gas Piping Date By Foundation Walls Date By Set-up Date By INSULATION Date By B G / Slab Insulation Final Floors Date By Date B y Date B y 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 Bv 1.1) Date By Date By o 10-0C 4 L-,A_' Or 7'/Fae r 0 v 0 8 a o" U) 0 CD m 0 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 PE' i�iM i -r C t') NU) I T_ I >C-1Nf3 Case No, BLD97-0064 For LISA 01, 1N Page : i 1 > The unders Igriel property owner 1 3 aw€er a Fsf the uricer to i my reclard i ng Mason County development regulations created by the Growth Managrnen t Hearings Board 's Order of notoher 2, lg96 , and in (.-,ony= iderat lor► of Mason Cuunty 'P wi 1 l ingnes, to prooeead with processing of applications which ;night he affected by the Order , the undersigned property owner hereby agrees to waive any lawsuit , action, or oisim for damages against Mason County which may ar l s,e out of Mason County 's actions In accept rance , process i ng rand/or rssu%anr:e of Much permites or approvals ? hereinafter "permitting actions " ) , which damages are attr i brrtabl e 'to the County 's dec i f; i on to take permitting actions despite the risk that ohange s to the County 's development regulat iorac. might Dater make the County ' erm i t t: l ng ,art i ons invalid . x. 2 App1icant acknowledges that thit•. deveIc,pment is subject to poticIos and reguI atioris of Mason C unty Compreahen,= i vw Plan and ( eve l opmerit Regulations . 3 ) Str uctcrra reust he: setback 5 ' frum rat i ut i 1 its sand drainage► easeme ntct , a total of 10 ' #rorn,, e ch property line , of a variance roust be obt:aIned froi the BuIIdIng Depautmont . X �J• —" 4 ) .pub ieot to pond 11, I ons of Resource Lands and Cr i t i oa. I Areas (RI.C ) Check 1 i st not i f i cat i can letter . X_ r, } Proposed watructtire or, any poi 1 lon theareot greater than 30" in tie Ight from tirade 1 Info , must maintain a minimum of 5 ' setback from all property l i ness, easements and 10 ' from a I I ou ty and State Road right of ways . g) At l apprcaved plans are required to he on -,> i ter f nr i nspper,t I Fan pur poses . If i nr.p"at Ion Is ca l l esd for, and plans are not on site, Approvn i WI tL NOT be granted . In add i t i can , ki Re- inspection fees In t13.e amount of * 32 .00 p+?r• h0kir (m i n i mum 1 hour ) w I 1 I toe charged Fangf must be oo l l ected by this department prior to an,; further inspections being performed or approval 4ar, nted . ' MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 X 7 ) I'I)RSUANT TO 1994 UNIFORM BUILDING CODE: , SECTION 305(G ) AND aEC'1 ION 513. Al 1. SITES M01811 HAVE APPROVED NUMBERS OR ADDRESSES PHOV i DED IN SUCH A POS I T i ON AS TO BE PLAINLY `,/I S i Bt.F AND t.FG i BL E FHOM THE S1 RE"ET OR ROAD FlION'T I NG THE PROPERTY . MASON COUNTY BU 1 I D I NO DEPARTMENT RFOU i RFS THAT THIS BE COMPI..E TED PRIOR TO CALLING FOR ANY SITE INSPECTIONS , A RE I NSPF'C T I ON FEF . BASED ON RATES IN 1 ABL.F. 3A OF THE 1994 1IN i FORM E1111 1.D i NG CODE WILL BF ASSESSED i r OWNER 1 r✓l3NTRAG I OR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . x_..__ t. ..'.__ ..� 8 ) AI I._.. .o ,'TRIIC F ION MUS1 A4E E:T OP. F"XC(- ED Al L I. OCAL_ CODES AND t.►bC RE0 0I REMWI S , x 9 ) Chanqes I o upproved bu i I d I ttcl r,I ans that effect oomp I i anc.P to the 1991 Washington wtate Energy Code, 1991 Ventilation and Indoor Air Quality Code , the Uniform Building Cocie andlor Mason County Rt�. I ,ns 811v.;L he apprw--rt-1 by Mar:mt Country prior to constructionX 10) ALA. r')NST'RI►(; FION MUST MFFT OR EXCEED IOGA1_ CODUIS . IF ANY OUEtiTIONS . PLEASE r,A Lk W C -F- I CF RFFORF CONSTRUCTION . _ X. 1 1 ) CONSTRUCT ION PROCESS [0 RF.. T I F1_D CORRECTED A '0 I R D PFP MA<t .41 r OIiN fY W i L O I NG DEPARTMENT AND UNIFORM BU I LD I Nc CODF . x_ �` :_ 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 11014 Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD97-00069 OWNER: LISA OLIN RECEIVED: 1/31/1997 CONTRACTOR: LICENSE: EXP: ISSUED: 3/18/2008 SITE ADDRESS: 4780 E MCREAVY RD UNION EXPIRES: 9/18/2008 PARCEL NUMBER: 321301100000 LEGAL DESCRIPTION: NE NE PROJECT DESCRIPTION: DIRECTIONS TO SITE: BARN FOLLOW MAP, OFF MCREAVY RD JUST NORTH OF THE 5 MILE MARKER TURN RIGHT AT RD 2040 SOUTH. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: 0 Type of Constr.: ? Type of Use: ACC Insp.Area: 2 No. of Bathrooms: 0 Occ. Group: ? Lot Size:O Deck: 0 Type of Work: NEW Fire Dist.: 5 No. of Stories: 0 Occ. Load: 0 Building:2,304 0 Valuation: Building Height: 0 Occ. Status: Basement:0 Manufactured Home Information Setback Information Shoreline & Planning Information Make: Length: 0 Ft. Front: 0.0 Ft. Shoreline: 0.0 Ft. Water Body: Rear: Q.Q Ft. Slope: Ft. SEPA?: Unkn Model: Width: 0 Ft. Side 1: 0.0 Ft. Shoreline Desig.: own Year: Serial No.: Side 2: 0.0 Ft. Comp. Plan Desig.: Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Final Expired Permit KS 3/17/2008 $68.00 S12008000 Address Fee NJP $5.00 44035 RLC Checklist Fee NJP $44.00 44035 Building permit....' NJP $177.50 44035 Building plan check' NJP $71.00 44035 Building State Fee NJP $4.50 44035 EH Plan Review NJP $26.00 44035 Total $396.00 BLD97-00069 Please referto the following pages for conditions of this permit. 1 of 3 CASE NOTES FOR BLD97-00069 CONDITIONS FOR BLD97-00069 1) The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Managment Hearings Board's Order of October 2, 1996, and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by the Order, the undersigned property owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting actions"), which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid. X 2) Applicant acknowledges that this development is subject to policies and regulations of Mason County Comprehensive Plan and Development Regulations. X 3) Structure must be setback 5'from all utility and drainage easements, a total of 10' from each property line, or a variance must be obtained from the Building Department. X 4) Subject to conditions of Resource Lands and Critical Areas (RLC) Checklist notification letter. X 5) Proposed structure or any portion thereof greater than 30" in height from grade line, must maintain a minimum of 5' setback from all property lines, easements and 10' from all County and State Road right of ways. X 6) 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$32.00 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 7) PURSUANT TO 1994 UNIFORM BUILDING CODE, SECTION 305(C)AND SECTION 513, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION FEE, BASED ON RATES IN TABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 8) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS. X 9) 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 BLD97-00069 Please referto the following pages for conditions of this permit. 2 of 3 10) ALL CONSTRUCTION MUST MEET OR EXCEED LOCAL CODES. IF ANY QUESTIONS, PLEASE CALL THIS OFFICE BEFORE CONSTRUCTION. X ' 11) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended fora period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of work is by means of a progress inspection.The 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 property and structure for review and inspection. OWNER OR AGENT: DATE: BLD97-00069 Please referto the following pages for conditions of this permit. 3 of 3 "' nj�-1�`�-' � S.sl�.� • '3��G/� 7 1/3/2008 Case Activity Listing LD97-00069 9:30:OOAM uP�G 1611q+ lot$ Case#: B Assigned Done Activity Description Date i Date 2 Date 3 hold Disp To By Updated Updated By BLDA010 Application received 1/31/1997 None 1/31/1997 KW BLDA015 Waiver in File 1/31/1997 None SENT KW 1/31/1997 KW BLDB138 Planning Pre-Review 1/31/1997 1/31/1997 None NONE N/A 3/4/1997 TMJ BLDB135 Addressing 1/31/1997 2/10/1997 None DONE _ GMM 2/10/1997 GMM BLDB134 RLC Review 2/11/1997 None DONE HRF 2/11/1997 HRF No site plan was submitted with application. RLC evaluated cleared areas asssuming that these are project areas.No critical values present on site.Further development along this property will require RLC evaluation. BLDB130 Planning Review 2/10/1997 2/13/1997 None DONE HRF 3/4/1997 TMJ BLDB110 Structural Plan Review 2/13/1997 2/27/1997 None DONE RL 2/27/1997 RDL BLDB200 Environmental Health Review 2/27/1997 3/3/1997 None DONE PSD 3/3/1997 PSD 40 acre site.There is no conflict.psd BLDA100 Approved For Issuance 3/3/1997 None DONE KS 3/5/1997 KS BLDA500 (F)Issue building permit 3/6/1997 None DONE NJP 3/6/1997 NJP i I Page 1 of 2 caseActivity-rpt 1/3/2008 Case Activity Listing �. 9:30:OOAM Case #: BLD97-00069 i� Assigned Done Activity Description Date I Date 2 Date 3 Hold Disp To By Updated Updated By BLDC220 Hole inspection 3/20/1997 3/20/1997 3/20/1997 None FAIL DWH 3/20/1997 DWH Road is blocked with water.No way to access,re-schedual for monday.. BLDC220 Hole inspection 3/20/1997 3/24/1997 3/24/1997 None PASS DWH 3/24/1997 DWH BLDA560 Permit cancelled 1/25/2000 None DONE KW 1/25/2000 KW Page 2 of 2 CaseActivity..cpt 1/3/J008 Conditions Associated With 9:29:51AM Case #: BLD97-00069 � Permit Condition Status Updated item# Code Title Status Changed By Tag Date By 1) 5 DISCLAIMER/WAIVER OF LIABILITY Met 2/11/1997 HRF The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Managment Hearings Board's Order of October 2, 1996,and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by the Order,the undersigned property owner hereby agrees to waive any lawsuit,action,or claim for damages against Mason County which may arise out of Mason County's actions in acceptance,processing and/or issuance of such permits or approvals(hereinafter"permitting actions"),which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid.X 2) 250 Comprehensive Plan Met 2/11/1997 HRF Applicant acknowledges that this development is subject to policies and regulations of Mason County Comprehensive Plan and Development Regulations.X 3) 5022 Multiple Setbacks Met 2/11/1997 HRF Structure must be setback 5'from all utility and drainage easements,a total of 10'from each property line,or a variance must be obtained from the Building Department.X 4) 5024 RLC-Notification Letter Met 2/11/1997 HRF Subject to conditions of Resource Lands and Critical Areas(RLC)Checklist notification letter. X 5) 5025 Sideyard Setback Met 2/11/1997 HRF Proposed structure or any portion thereof greater than 30"in height from grade line,must maintain a minimum of 5'setback from all property lines,easements and 10'from all County and State Road right of ways. X 6) 1001 PLANS REQUIRED ON SITE Met 3/5/1997 KS 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$32.00 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 7) 1002 POST ADDRESS Met 3/5/1997 KS PURSUANT TO 1994 UNIFORM BUILDING CODE,SECTION 305(C)AND SECTION 513,ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION FEE,BASED ON RATES IN TABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 8) 5003 ALL CONSTRUCTION Met 3/5/1997 KS ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS. X 9) 5030 Changes to Approved Plans Met 3/5/1997 KS 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) 5040 Excessive Corrections Met 3/5/1997 KS ALL CONSTRUCTION MUST MEET OR EXCEED LOCAL CODES. IF ANY QUESTIONS,PLEASE CALL THIS OFFICE BEFORE CONSTRUCTION.X Page 1 of 2 CaseConditions..rpt 1/3+08 Conditions Associated With 9:29:51AM Case#: BLD97-00069 i too Permit Condition Status Updated item# Code Title Status Changed By Tag Date By 11) 5045 Field Correct Met 3/5/1997 KS CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x Page 2 of 2 CaseConditions..cpt NORTH WEST PROPERTY CORNER p ` • ' ti11 .' PROPERTY L114E 200, EL I 11so� TO 130, PROPERTY' -' LINE 111C 6' 6' 6' 6' The green areas are the existing porch areas. 4780 E. McReavy Rd. Union, WA 98592 MASON c 10 08 oUN� GARY YANDO,DIRECTOR SrArFo A U N U DEPARTMENT OF COMMUNITY DEVELOPMENT NT cz PLANNING - SOLID WASTE - UTILITIES Y 0 BLDG. I • 411 N. 51"ST. • P.O. BOX 578 1864 SHELTON, WA 98584 • (360) 427-9670 DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD, LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS: The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's willingness to proceed with processing of applications which might be affected by that Order, the undersigned property owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of Mason County's actions in acceptance, processing and/or issuance of such permits or approvals(hereinafter"permitting actions'),which damages are attributable to the County's decision to take permitting actions despite the risk that changes to the County's development regulations might later make the County's permitting actions invalid. Date (Parcel No. or Legal Description) Prope ner's signs re otarized) (or the)LNounty may acce signature of the owner's authorized agent upon proper proof of authorization) ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL) STATE OF 77,j1,/ COUNTY OF On this—Z day of �, in the year , before me Notary Public, personally appeared personally known to me to be the person whose name is subscribed to this instrument, and acknowledged that he/she executed it. WITNESS my hand and official seal. -For County use only- Reviewed by applicant on (Date) Notary's signature Staff Initial: My Commission Expires: Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 Ow r ,�.rS/ C'f�i9/'LE1 �LL/r� Phone# 3�C�� j42 ite Address Fire District# S ---T city Sf/�"�C/Ui(/' St &c 14 Zip PAS 8:iK Directions to Job Site --GL4UlO "-4oe j Q//C"/fCU 1 /fG ";lIlaE dT fT /fib Owner Mailing Address city St &)4 zipe9-'5-954 Lien/Title Holder A/ i¢ Address Clty St Zip #2 Contractor Name C'Zien T!4r2 .J Contractor Reg # TZ�f�4T/ �JJ Address //L� !��/!</ <� 7 Expiration Date /Z/ F Z city St zip Q&521,'S` Phone# Y242 --2�61 #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply Well Connect to Sewer System? Name of System r1lyl (If residential, proof of potable water is required) #4 Parcel No. 32/,30 - // ) n t Legal Description fiyl'f 2/XX(,W/W 3 C,&S #5 Building Square Footage: (existing/proposed) 1 st FI l 230 Y 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage / Carport 1 (Circle: Attached or Detached?) Other sq. ft. / Use of building 234101V e i Mi #7 Type of Job: New _Add Alt Repair a4r2 9 1997 #8 MOBILE/MANUFACTURED HOME INFORMATION -IEALTH SERVICEc Model Year Make Model Length Width Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price $ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences �Vv/ Structure Setbacks V Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Name of Flanking Street Indicate Directio (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW L� I � LA N PLC C c-- APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3.25 each #- Mechanical Fixtures ($6.50 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 16.25 _ Auto Fire Sprink Sys 35.00 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 16.25 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 PPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEP TMENT. DEPARTMENT. r� X OWNER Lz/. X BY DATE .2 7 DATE I FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW ' FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Z(-C cP✓Ki UX&4( C4—'� ��. /✓0 t e.iy�crtir Wes/' 412P Environmental Health: Building Plan Review Se Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES 7 O 80 Building Permit Plan Check �� oQ Plumbing Fee I Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee S Other Adj i(144 5 aU Other [=Bingaluation: `� .�"1,��, TOTAL FEE NORTH WES T PROPERTY• CORNER 1 20f� �+F--110, BRAN ;: 1220, TO o f PROPERTr• LINE 2U0' I WELL � 1180, TO 180, PROPERTY ----` LINE