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Home My WebLink AboutBLD99-0524 SFR, Garage - BLD Permit / Conditions - 7/6/1999 �(NiaLr � l� ••2� `'� 1 MASON COUNTY J -Cc '�� j- ,, 2Z; Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 B Li I k__ 0 1 N (3 PERM I -T FOR INSPECTIONS CALL 427-9670 BETWEEN 5pm AND Sam 427-•7262 BLD99---0524 PARCEL :3213442 0032 PLAT" 4 D i V :? BLK :? LOT' :? JOB ADDRESS : 61 E KATHRYN CT SHELTON OWNER : NATE BRIENCE 427--0205 CONTRACTOR : BRAD W I LSON 426 -02 r 7 LEGAL. - TO 8 OF SP #2438 SEE SP 1662 A 8LA #93-79 CLASS OF WORK . . rNEW BEDR : 3 .BATH : 2 TYPE AMOUNT 8Y DATE RECEIPT TYPE AVONNT PY BATE RECEIPTI TYPE OF USE . . . . :ACC STORIES . . . . . . . s 1 �� _ s�,. �. =� �.: _ - •.max OCCUP . GROUP . . :R3U1 BLDG . HEIGHT . . : O .Oft P(CK $ M.53 KN t6114149 50541 MCH 1 34,75 KS 01116191 50812 1 TYPE OF CONST . . :5N FIREPL.ACES . . . . .. 0 P1R5 1 38.4/ KS 07t66199 56819 �MCN1 f Me# KS #T10199 50019 OCC:UP . LOAD . . . . .. 0 WOODSTOVES . . . . : 0 PRAT I 868.50 KS 87106799 50819 STFE t 4.58 KS 071116189 50811 DNIELI .UNITS . . . . a 0 PARKING SPACES : 0 Lilt 87,## KS #71/6M 56019 EHCP 1 50.00 KS 171#6199 MIS INSP"CTION AREA : 2 SHORELINE? . . . . :N 2#,#0 KS P71/6199 50119 TOTAL: 1680.28 MULATION: STOP#' -TOILETS . . . . . . . . . 2 FUEL TYPES;-.--.--__--_. SOIL.ERS/COMP---_ MOBILE HOME•-_ z FRONT . . .E 125 .Oft BATH BASINS . . . . . . . 2 : /E:LE:1 I / : 0- 3 Hp . -. 0 REAR . . . .W 146 .Oft BATH TUBS . . . . . . . . s 2 3- 15 HP . : 0 MODEL : SIDE ( i ) .N 49 .0ft SHOWE.RS . . . . . . . . . . . 1 FURN { 100K BTU : 0 15-30 HP . : 0 S I UE: (2 ) .S 25 .t?t t WATER HEATERS . . . . , 1 FURN }-100K. STU : 0 :30-60 HP . : 0 SHRL I NE .N O :Oft CLOTHES WASHERS . , : 1 FURN - FLOOR . . . 9 0 50+ HP . t O -YEAR-------•- AREA -- -- ------- - -_-- KITCHEN SINKS . . . . : 1 14EAT PUMP . . . . . . : 0 LOT S I Z_E: . . : FLOOR DRAINS _ — : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH : 0 BUILDING . . . : 162 1 sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 3 HOODS . . . . . . . : 0 WIDTH . . 0 BASEMENT . . . : (Osf LAUNDRY TRAYS . . . . : 0 DOMES . INCINiO -SERIAL#-.-- -- DECKS . . . . . . . 96sf DISHWASHERS . . . . .. . : 1 AIR HANDLING UNITS-- COMML . INCIN :O 4YAR/CARP :? Osf GARB DISPOSALS — : 0 <— 10000 ofm . : N REL.00/REPAIR : 0 AT/DT . :? URINALS . . . . . . . . . . : 0 > 10000 cfm . : 0 OTHER UNITS . : A MISG PLM FIXTUPES : 0 CAS OUTLETS . s 0 P ••t:e�x:r�.,ca-�+rsr.x.:�.:ax�cmca�ax.�a.:. _ :f�s5:aar:yc�:�.=:�y.:�.rx.:x:,xru,rmtcs.-.....�xarrraxs�u�ars.crr.�sas�cv:n.:�:a.uzmc. :t.•.:a.:�r.::a�:�:s=::s�:n:z_,"..sauscY..^w::—�.u: PROJECT QfSCRIPTION:RE31Of.NCE AND CAQABf PROJECT' LOCATION:CATM-11 IM RO AMOX, 401 TO 506 YROS RD TO 1.EfT £NA Of ROAD, Ti11S PERMIT BECOMES NULL AND Vale IF NORf4 ON CONSTRICTION AUTNORIIED IS NOT Ca11111 111THIN 190 DAYS, OR If CONSTRUCTION 09 /IRK IS SIISPE10E1 FOR A PERIOD Of 180 DAY; AT ANY TIME AFTER NORK IS CONVINCED, EVIM NCI OF ',CNTINUATION OF 1099 18 A PROGRESS 11IM CTIDN 1110111 THE 190 DAY PERM, f1#AL 10M CTION MUST 8f A MOVE6 BFFQIE 80118 M CAN 91 OCCUPI Q. OYNIR 01 AGENT:_____ - -.._-_ . _- _"_ __.__ - __ DATE:. 20i_ w -v 8L0_PR41T, rev i #3131 i 9I COMPLIANCE TO ATTACHED CONDITIONS IS REQU I IIE D CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SL.AB Insulation Flom Final date by date by date by FRAMIN' Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date 9I Iftte by z� C 7- 12— 5`7 Igo _ ,� 7j.�c��i 'O L;D�'.E'�L'TiO�✓ /�,/af GE dL To 7;,VSJIIgY.c. Aol P SCc 19 /Oa3 A r D,eV ry 14og TO•✓ ow vEc-77o-v 1ve? F,,o nno000,eA42-7 100(16)-1//C _�._�l C1 c��e 7 a c.,� /✓a.�;.�,� !r.( �jf3ir✓ uS� S� t1.i wJc— C-\ cJ c. 4 Z ` I�i 't ) l/ 1 3. i I•�� r n L rG J 1 �� T`�y-. 1, c--P vc, 'r, e-, T. uotleNz Awn, om t-o6AL 4eKi-r-ej-, Pia3ai l/Ltd) 12tSY tom cya�r�✓z )��Y'?-6 cry ::b C,\YkA &IV--P YNg PLA� vfi A16-t-R4Y", MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Case No . : BLD99-0524 Fors NATE BRFNCE Pages I 1 ) This application Is subject to Bufter and Landscaping requirements as established under Mason County ; Ord ln*nce 1 .03 .036 , 2 ) The use , handling and st rage of hazardous materials or flammable and combustible liquids in exoesflof 10 qallonF. is not allowed without the approval of the Mason County Fire Marsha I 3 ) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUSI* NOT adversely Impact adjacent parcels . Under the requirements of Mason County Storinwater 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 Countx Road, Contact the Mason County Public Works Department prior to construction at Ext 450 . For any construction which I proposed to be located within 25 ' of a Mason County road right of way, It Is sug est jol contact that office to review future planned work which X may affect your projec? . 4 ) Proposed structure or any portion thoreof greater than 30" to height -from grade line , must maintain a mitt lmum 1 5 ' setback from all property 11nes , easentents and 10 ' from all County and State Ro d right of ways . 5 ) Owneribuilder assumes all re4ponsibility It drainfield/ reserve area is encumbered . X BY All upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given sonte other, equivalent type of protection against erosion . AIE9g � 2 > A ƒ \ � o Q E § m § c m £ § £ c 0 i z E § § 0 2 a. ° @ / 0 E 7 ' I $ —0 ( / ( & g B g a g m ° kV. K 2 2 ■ m 2 / § z » z E § C7 CY � EMclCL � s ( � CD mCD (D CD § m a m . � 2 m (7 ( cr � - • MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 7 ) Approved per, dimensions and setbai.,,,ks on submitted :site plan . X 8 ) All a 7roved a e pins are required to b on-site for ins ection purposes . If inspection is CZ ed for and plans are not on - ite, Approval WIrL NOT be ranted . In addition , a me- Inspection fee in the amount of $42 .00 per hour (minimum I gour ) will be charged and filu�;t be co I Lected by th i s. dep a rt merit prior to any 'further Inspections being performed or approval g�a 'to K 9) PURSUANT TO 1997 UNIFORM BUILDING CODE , 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 COMPLETFD PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A HEINSPECYION FEE BASED E 1997 UNIFORM BUILDING CODE WILL ON RATES AS ADOPTED BY THE JURISDICTION AND THE I ASSESSED NER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTI X 10) The apg . , t ovedplotplan is required to be ort-site forins ection urcoses . if s in ec ton i cal ed for and plot plan Is not on al a, Approval &IL NOT be granted . In addition, a Re- Inspection fee In the amount of $42 .00 per hour (minimum I hour) will be charged pnd mVst be oollected by this department prior to any further Inspections being perforxaey, 19�.* pproval granted . X 11 ) ALL. CONSTROCTION UST MEET OR EXCEED ALL LOCAL CODES AND USC REOUIREMENTS AND OCCUPANCY Is LiMITFRJO APPPOVED CLASSIFICATION . ANY CHANGE OF USE OR OCCUPANCY T�y,HIPERMI *rTED AND WOULD RE P ERMIT REVOCATION , C14ANGE OF USE MUST BE APPROVED PRIOR TO CHANGE . X 12) Changes to approved building plans that effect compliance to the 1991 Washington State Energy Code, 1991 Ventilation and Indoor Air Quality Code, the Uniform Buildiny Code and/or Masan Count RegulatlOnS be approved by Mason Coun y prior to constr.ctIM I I/ CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping — date b Foundation Walls date by Set DP date by INSULATION date by BG/SLAB Insulation Floors Final date AMING by date by date by 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.O. Box 186 Shelton, Washington 98584 '13 ) CONSTRUCTION PROCESS TO BE f t EL D CORRE(;i� Lv ��« REQUIRE: _ €'04MA;;ON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING C&se No . ; BLO99-D524 g kCD § / g a c ■ 7 7 C M =. E ` �_ § § f Q � Q J :E / E � ƒ ( § ( � 7 / ( A ( � § m t 0 ƒ s � 2 n m v 0 g 2 E § � C % CD222CDCD m 13 7m ■ 2 m c u � . �o 1 CASE HISTORY FOR CASE NO.: BLD99-0524 ' NATE BRENCE E81 KATHRYN CT SHELTON 09/03/99 4/ Action Description Re Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- ---- BLDA010 Application received 06/08/99 / / 06/14/99 DONE KW 06/14/99 KW BLDA100 Approved For Issuance / / / / 07/06/99 DONE TW 07/06/99 TW BLDA500 (F) Issue building permit / / / / 07/06/99 DONE KS 07/06/99 KS BLDB007 Plans Revisions Submitted 08/16/99 / / 08/16/99 approved plans were destroyed. RECD 08/16/99 DLC Submitted new plans to DMM for Friday review. - 8/16/99 - DC BLDB110 Building Plan Review 06/14/99 / / 06/23/99 sent to case mgr. DONE DMM 06/23/99 DM BLDB120 WSEC Compliance Review 06/23/99 / / 06/29/99 ELECTRIC, 14.8% GLAZING DONE DC 06/29/99 WLC BLDB130 Planning Review 06/17/99 / / 06/22/99 DONE SLO 06/22/99 SLF BLDB134 RLC Review / / / / 06/22/99 N/A SLO 06/22/99 SLF BLDB135 Addressing 06/14/99 / / 06/17/99 DONE GMM 06/17/99 GMM BLDB138 Planning Pre-Review 06/17/99 / / 06/17/99 DONE MMS 06/17/99 MMS BLDB200 Environmental Health Review 06/14/99 / / 06/17/99 NEED APPROVED DESIGN FOR THREE BEDROOM HOLD CEB 06/17/99 CEB BLDB200 Environmental Health Review 06/22/99 / / 06/22/99 bedrooms and plot maps match. DONE CEB 06/22/99 CEB BLDB210 Water Adequacy 06/22/99 / / 06/22/99 water system is not current on bacti and HOLD CEB 06/22/99 CEB nitrate samples BLDB210 Water Adequacy 07/06/99 / / 07/06/99 received satis bacti and nitrate test DONE CEB 07/06/99 CEB for water system BLDC110 Footing inspection 07/12/99 07/12/99 07/12/99 NO APPROVED PLANS ON SITE. FAIL LW 07/13/99 KW BLDC110 Footing inspection 07/14/99 07/14/99 07/14/99 STILL NO PLANS ON SITE. FOOTING POURED FAIL LW 07/15/99 KW WITHOUT APPROVAL. BLDC110 Footing inspection 07/14/99 07/14/99 07/14/99 BRAD CAME IN LATER SAME DAY WITH PLANS. PASS LW 07/15/99 KW FOOTING BUILT PER LAST INSPECTION. BLDC140 Fr/P1/Mc/Pen Inspection 08/30/99 08/30/99 08/30/99 1. GABLE BRACING TRUSS SPEC. FAIL GDR 09/02/99 KW 2. DOUBLE NORTHEAST BEDROOM STUD UNDER KING TRUSS 3. VENT OVER FRAMING OF ROOF. 4. STRAP BREAK IN PLATE SHORT THAN 48" LUNADRY 5. PROVIDE LEDGER AND BLOCK RDIGE BOARD /� r 07 F P. �� AT RAFTER. tom(/ ((/� 6. CAULK VENT PIPE MASTER. 7. NEED TEST DWV. PA ss 0 Q 8. NEED GAS PIPING INSTALLED AND TESTED OK TO INSLATE. WATER OK 3 ! 1 -rl Su A4 �� MECH OK �j9SS2'� Page No. 1 CASE HISTORY FOR CASE NO. : BLD99-0524 NATE BRENCE E81 KATHRYN CT SHELTON 07/09/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- BLDA010 Application received 06/08/99 / / 06/14/99 DONE KW 06/14/99 KW BLDA100 Approved For Issuance / / / / 07/06/99 DONE TW 07/06/99 TW BLDA500 (F) Issue building permit / / / / 07/06/99 DONE KS 07/06/99 KS BLDB110 Building Plan Review 06/14/99 / / 06/23/99 sent to case mgr. DONE DMM 06/23/99 DM BLDB120 WSEC Compliance Review 06/23/99 / / 06/29/99 ELECTRIC, 14.8% GLAZING DONE DC 06/29/99 WLC BLDB130 Planning Review 06/17/99 / / 06/22/99 DONE SLO 06/22/99 SLF BLDB134 RLC Review / / / / 06/22/99 N/A SLO 06/22/99 SLF BLDB135 Addressing 06/14/99 / / 06/17/99 DONE GMM 06/17/99 GMM BLDB138 Planning Pre-Review 06/17/99 / / 06/17/99 DONE MMS 06/17/99 MMS BLDB200 Environmental Health Review 06/14/99 / / 06/17/99 NEED APPROVED DESIGN FOR THREE BEDROOM HOLD CEB 06/17/99 CEB BLDB200 Environmental Health Review 06/22/99 / / 06/22/99 bedrooms and plot maps match. DONE CEB 06/22/99 CEB BLDB210 Water Adequacy 06/22/99 / / 06/22/99 water system is not current on bacti and HOLD CEB 06/22/99 CEB nitrate samples BLDB210 Water Adequacy 07/06/99 / / 07/06/99 received satis bacti and nitrate test DONE CEB 07/06/99 CEB for water system -7- / 2 � q rDJ C clfl PERMIT NO.. BLD 1-IM22 MASON COUNTY (6,tq BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275.4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT I.NFORNRATION CONTRACTOR INFORMATION Owner N it 7 r jS P (P Contractor Name C� i 150 0 C o St. Z Mailing Address--Jo-2 Y I& 4r I v a•+ ON I Mailing Address E. W E%acgre-st City 7-0 4J State VIC Zip Code y City Ux1 j On State LOFJ Zip Code q$ _rj_a Phone O -U ther Ph.( ) Ph.( 3(r C� )�1a(c Oa��Other Ph. Lien/Title Holder Contractor Reg. # ,-Y-C Address Expirations=/ / 91,000 SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic_X Existing Septic Connect to Sewer System Name of Sewer System Well Water System X Name of Water System PARCEL INFORMATION-12 digit Tax Parcel No. 1 / y 7 2 Fire District_ , Legal Description Site Address(Please inclu street namg street number nd city 7 ✓ GW— Directions to site I� P T U C i 7F r P OIFF 71 T U 4/hor I&C f I d N q d lelr :1 q te Will timber be cut and sol in parcel preparation? (Yes/No) A Is your property within 200' of the following: Body of Water (Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB Ne dd Alt Repair Oth r Use of Building 14-1 Describe Work 1C �T4✓ e No. of Bedrooms No. of Bathrooms 7- SQUARE FO TAGE-1st Floor 2nd Floor 3rd Floor oft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME FO ON-Make Mo I RMA Model Year Length Wi Serial No. No. o edrooms No. of Bathrooms Type of Heat urchase Price eplacement Unit ?(Yes/No) Installer Name Ce ' ication No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currentlytegistered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of th6-ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformanc therewith. No changes shall be made without approval. first obtai ' approval. X Date X Date%2�1 FOR OFFICIAL USE BEYOND THIS POINT Accepted by ,�.�. DatO Submittal Amount Due '� �`"� Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED CONDITION CODES Building Department p Occ Group R30 Type Constr. VOd .I-A. Planning Department Environmental Health Department Public Works Department I Fire Marshal Valuation $ FEES Building Permit Fee �� Q X� Site Inspection Plan Review Fee v� �l cS2 UFC Plan Review Fee Plumbing & Base Fee o T99- CpO, o Public Works Review Fee Mechanical & Base Fee 3y.71 a�- Other . Ac Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) TOTA FEES PERMIT NO.: MASON COUNTY 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 Seattle 206 464-6968 APPLICA T INF RMATION ` ',/ / CONTRACTOR INFORMATION Owner (� 1 l,w e Contractor Name to ►r 1 + oI I u Mailing Address J0 Z t e, r�o.6 Mailing Address 30 ' City State Zip Code 5( City r?(�; States'+ Zip Code Phone( t n ) they Ph.L � Ph.L A -4--�Other Ph.(36 Lien/Title Holder Contractor Reg. # . Address_ Expiration / / f'c SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. Fire District Legal Description —� Site Address(Please include set n me, street number an it ) ✓ c.r AN Directions to site < TT / ,� -t- ' N� Is your property within 200' of the following: Body of Water(Name) tv Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1 st Floor. ✓— 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets /5!"O Type of Unit No. of Units Fees Bath Basins Furnace Bath Tubs —�� !Y I Heatpumps Showers '7. I Vent Fans �3 / Water Heater Propane Tank Laundry Wsher 5 Gas Outlets Sinks <. c Wood/Gas/Pellet Stove Dishwasher �_ "� Direct Vent? OtherAN e_4M - Other Other Other j Base Fee Qkc X Base Fee TOTAL PLUMBING f0 . - TOTAL MECHANICALSY. 2- A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining pproval. F r J X Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. AE"PARTMENTALIREV[EW.,: APFROVEFI: . DENIED ... :: ?NRt#IS?i51`GOD 3 Building Department Occ Group Type Constr. Planning Department Other Other _ _ ____. . MIES _ ... ...: Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES