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HomeMy WebLinkAboutBLD94-1861 SFR - BLD Permit / Conditions - 2/20/1995 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 " t-I I L- D I NO PERM I -r FOR IN8PECTIONS CALL 427-9670 BFTWE-EN 5pm AND Elam 427-7262 BLD94-1861 PARCEL : 123315100131 PLATiBEPI-0 DIV3 BLKi LOT031 JOB ADDRESS NE 1050 LARSON BLVD SFLFAIR OWNERS STEPHEN JOHNSON 975-6734 CONTRACTOR STEPHEN JOHNSON INC 275--6734 LEGAL , BEARDS COVE DIV I SLI[t LOTS 131 FS 04731 1K #57-- CLASS' OF WORK . . sNEW BFDR . 3 BATH s - 2 TYPE A101101 BY DATE RECEIPT IYPE AUOPNI ?y pAlf RECuff TYPE OF USE: . . . iSF STORIES . . . . . . , vl OCCUP . GROUP . . . 47 BLOG — HEIGHT — i O .Oft PANT S 3#3.to KS $2115195 38399 foe? $ 1f.1# KS 02115195 38389 TYPE Of CONST . . t? FIREWLACES . . . . s 0 NADI 1 8.90 KS 02115195 38389 OCCUP . LOAD t 0 WOODSTOVES . . . . v 0 FIN 1 45.98 KS 12115195 38309 DWELL_ .ON I TS . . . . 1 0 PARKING SPACES : 0 NCN 4 31,00 K& 02115 195 36389 INSPECTION AREA 1 SHORELINE? . . . . I N STfl f 4.56 KS 02115/95 38389 TOTAL: 403.511 VA19tAIIO1t SETBACKS------------------ TOILETS . . . . . . . . . . 1 0 FUEL. TYPES------------ SOILFRS/COMP----- MOBILE HOMF - -- FRONT —S 40 .Oft RATH BASINS . . . . . . 1 0 s s 0­3 HP . : 0 REAR . . . .N 10 .0ft BATH TUBS . . . . . . . . 0 3-15; HP . t 0 MODELt SIDEM .E 1010ft SHOWERS . . . . . . . . . . = 0 FURN < 100K STLJ - 0 15-30 HP . i 0 --MAKF-.___ "­._ SIDE(2) .W 10 .0ft WATER HEATERS . . . . : 0 FURN >-100K STU : 0 30-50 HP . : 0 SHRLINE . 0 ,0ft CLOTHES WASHERS — t 0 FURN - FLOOR — i 0 50+ HP , t 0 ._YFAR----­- AREA KITCHEN SINKS . . . . t 0 HEAT PUMP . . . . . . 1 0 LOT SIZE . . j FLOOR DRAINS — _ : 0 VENT SYSTEMS . . . 1 0 EVAP COOLUASs 0 LENGTHr 0 BUILDING . . . - 884sf DRINKING FOUNT . . . , 0 VENT FANS . . . . . . 1 0 HOODS . . . . . . . t 0 WIDTH . - 0 BASEMENT — i 54fLif LAUNDRY TRAYS . . . . 1 0 DOMFS , INCINiO -SERIAL#­---- DECKS . . . . . . . 120sf DISHWASHERS . . . . . . ; 0 AIR HANDLING UNITS— COMML. . INCINsO GARICARPtG " 'i0sf GARB DISPOSALS — ' t' 0 <- 10000 cfm , t 0 RELOGIREPAIRt 0 AT/DT . c'4` UP I NALS . . . . . . . . . . 1 0 > 10000 ofm . : 0 OTHER UNITS . , 0 Ml ',';C PLM FIXTURES : 0 GA,i OUTLETS 0 PROJECT IOCAIIO#t THIS PFRNIT 8frOUFS 0111ft AND VOID If WORk OR CONSTRUCTION A01HORIIED IS NOT COVIE11019 VI THIN 180 DAYS, OR IF COISTROCTION OR fOAk IS SUSPENDED FOR A N-11100 OF 180 8AYS AT ANY TINE AFIF1 4011 IS CONVENCE1. EV10f1Cf Of CONTINUATION OF 101k 13 A PROGRESS INSPECTION VITNIN T4F i88 DAY PFRIOD, TINAt INSPFCTIOO 110.11 1 APPROViD BEFORE 80fIRIOG CAN PE OCCUPIED. CONCRETE 4 zTU L-) 2-Z?- .5r MECHANICAL MOBILE HOME � Footings-Setback r.Je-( I h; ,. < -, ..�f 9 � S date (.o Z - 55 by �✓ Ribbons date �K,c, j V-10" by Gas Piping date b Foundation Walls date by Set Up date -6- �i by INSULATION date by BG/SLAB Insulation Floors Final date 3- 2 (- by date by date by FRAMING Walls FIRE DEPT. date b^Z 3- by date - 2 j 5 by (�n date by PLUMBING OTHER Groundwork Attic date - - 7 by l.�J date by D.W.V. WALLBOARD NAILING date [�-Z 3-S S by 1 .�✓ date by - \ Water Line FINAL INSPECTION date Z - `I by r �, date / s_ c� S by G _/ date by l;i)mrt I AIr4:1, I!_i A f f P U"r V 111imU I I I umb I b 77 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Cease No . ; BLD94--1861 For a }TEPHEN JOHNSON Page . 1 1 ) All approved p i ans� are required to be c!n- : 1 t e3 for Inspect ion pur posses . 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 PURSUANT 'TO 1 1 UNIFORM BUILDING CODE , SECTION 30f)(C ) AND SECTION 513, ALL. SITES MUS F HAVE APPROV NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM 7HE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A RF I NSPECT I ON FEE BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE W 1 L I.. BE ASSESSED IF OWNEA1CONTRACTOR FAILS T4 POST ADDRESS ON SITE PRIOR TO REQUESTING e I NS PE C.'T 1 ON.' . ' X <Z�� 3 The urge , h d 1 i nq and storage cif hazardous materials or flammable find combustible liquids In e#xcess of 10 qa 1 1 onv Is not allowed without the approval of the Mason County Fire Marshal . x 4 ALL CO FIUCT I ON MUST MEET OR EXCEED ALL LOCAL. CODES AND UBC REQUI TS 5� Changes to approved building plans -thrat effeot comp l 1 anc:e to the 1991 Washington State d Energy Code, 1991 Ventilation and Indoor Air Quality Code, the Uniform Building Code and/or Mason County Iations must be approved by Mason County prior to cons3truct I onX _,.�� 6> CONSTRUCTION PROCESS TO BE F 1 E i.D CORRECTFD REQU i RE1 PF=R MASON COUNTY BUILDING DEPAPTMEN r AND UNIFORM BUILDING CODE . x � _ 7). Strisctu must be setback 5 ' from a I ut i ty and draInarle earsements , a tat,al of 10 ' from I ropeI4y I i nes , or a variance must be obtained f rorfr the Bu i l d l ng Departme3nt x 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/SLAB Insulation Floors Final date FRAMING 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. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 8�\ Proposed str uotut , of purt I -Lin thereof greater tharo 30" in height from grade I finer, must maintain a minimum of 5 ' setbaok from ai i property I Ines, easements and right of ways X CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping z date b Foundation Walls date by Set Up date 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 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 BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRE TION NOTICE Job Location &���- l��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 corrected to gain code compliance Z, G. ar, 4 Cus-e_ Lrre,0 M� -)4-115, ;j0 s , ,v. Pcz)o�A 4o-- -61"s- IDL) ,er- +L-,e— � a .P rnc.� �� ..��� s.�c_c- S Q 1' nS 1G Ct c 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 00K to .�g�_1 -� e �� - J tl c ePrr'e—c—'1;cv,> Department Date Inspector L 01000 NOT MOOV Hl,wft T " ,� MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location _8t D j L/ /ge-a / / -�7) / -JS 0-5 31L 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 ty, Ear 7 >C /_S ._ l 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 Department Date - y- SS Inspector l ■ ok * COOT MOOV THII T " ,�' SWTAA,TE GTONttachment ENERGY Building Record WSEO Contract# 1-19- B CODE PROGFAM For Site-Built Residential Buildings Heated by Electric Resistance or Heat Pumps (please check one) (please check one) New Building ❑Addition over 500 sq.ft. '�]Single Family ❑ Duplex Jurisdiction: Mkt 6OA-/ ❑Multifamily ❑Zero Lot Line Home ❑ Planned Unit Development + please check one: ❑ City County Permit# / y —/c-(D Fi le I D#(if different from Permit#) + A. Site Information B. Owner Information Address NE /DSO L eL_*'5on J6 It-ty- . Owner owner at time of construction receives utility payment) City e1 zip Company Assessor's ro ert Tax# or attach legal descri tion : Address /1/6 O/ / 55cO A- l� ,Qea.,-dS ✓ .08. L 1,31 Cit / tate AZi �a��y Servicing Electric Utility z3ua 3 Phone ( i 1v0 ) a 757 C. If Single Family,Zero Lot Line or D. Duplex E.If Multifamily(R-1) Planned Unit Development First Duplex Unit s .ft. Total #/Bld s. Total Conditioned Floor Area s . ft. Second Duplex Unit s .ft. Total #/Units A. Primary Space Heat Type B. Secondary Space Heat Type C. Water Heat Type (check one) (check all that apply) (check one) ❑ Electric Baseboard None Electric _'-i� Electric Wall Heater ❑ Wood ❑ Gas ❑ Electric Furnace ❑ Electric Baseboard ❑ Other (spgcifybelow) ❑ Electric Heat Pump ❑ Other (specify below) ❑ Other :.� . WSEC Compliance Method For Heat Pump Only: ❑ Prescriptive Path Built to the Electric Date of Permit Application /aZ -a 7 - ❑ Component Performance Requirements of WSEC? Date Building Permit Issued - /S S' Date of Insulation Inspection (y -v; -9 7- System Analysis ❑ Yes ❑ No (If yes, Date of Final Inspection utility may offer incentive.) I hereby certify that this building or addition has been inspected for the measures required by the 1991 Washington State Energy Code(WSEC), that it is in substantial compliance with the WSEC, and that the WSEC checklist for this building is on file. Sig u e of Building Official or Authorized Representative Date ■ Building Department:Return white copy to Gail Burris,Washington State Energy Office, P.O.Box 43165,Olympia,WA 98504-3165. ■ Owner or Building Deparment: Forward canary copy to the servicing electric utility to trigger WSEC compliance payment. ■ Building Department: Retain pink copy for jurisdiction's building file. WSEO#94-015 5-95 rr /- � C .BUILDER/HOMEOWNER AGREEMENT'' APR -5 199; LTSGC FILE NO. '� 5-O?a8 T k.13o h PHONE: a-7s-8-7 SITE ADDRESS: M rz I DSZ L.a rSon 91 V� ACCT: MAILING ADDRESS: KI E '7a I Crk O-A U ,k r BUILDER: SC�- PHONE: � -- MAILING ADDRESS: I understand that in order for the electrially heated home located at the above address to be certified as Long Term Super Good Cents, the home must be constructed in compliance with the attached Wattsun heat loss and Long Term Super Good Cents addendum/ specifications. I understand that inspection by District staff is required at each of the following stages Prior to pouring of concrete slab, if required. Prior to installing exterior insulation and damp proofing the below grade basement walls, if required_ __Prior to installing insulation(structure is framed, roof is on, roughed-in plumbing, heating, wiring, telephone and TV cable are installed and all penetrations are sealed.) X Following installation of insulation and vapor retarder prior to covering. XFinal inspection - all components installed. _Other As Needed NOTE: Failure to have inspections performed by the PUD at the required times may result in the reduction or elimination of incentive payments. It is understood that the Super Good Cents Department is to be notified at 426-0777 or 4264255 Ext. 777. not less than 48 hours prior to required inspections. I understand the "Long Term" Super Good Cents certification by Mason County Public Utility District No. 3 only verifies compliance with the Long Term Super Good Cents program standards and only in respect to energy efficiency. Neither the District nor any employees make any warranty, expressed or implied, in regard to the general workmanship and structural integrity of the residence or the future electrical consumption. I, the undersigned, understand that if the home is built according to this agreement, the attached specifications and heat loss detailed checklists and addendum, and is certified by the District representative that I will be eligible to receive Long Term Super Good Cents incentive payment(s) in the amount shown on the attached worksheet. Homes started by September of a given year will have untill June 30th of the following year to pass a final inspection to receive the stated incentive(s). Homes completed after June 30th of the following year will receive the incentive(s) in effect at the time of completion of the home. I further understand that it is my responsibility to be aware and adhere to the Long Term Super Good Cents specifications. Only verified completion by the on-site inspections listed in the agreement of all the attached criteria by the Mason County Public Uility District No. 3 Long Term Super Good Cents respresentative, will the house be certified as a Super Good Cents home, and the stated incentives paid - Signed: Homeowner Date ate 3/a 8 Qs 'ti ity Representative Ron Tewalt Date Homeower conservation incentives may be paid directly to homeowner, or applied as a credit on your utility account. *Homes which have not started construction within 60 days of signing this agreement will receive the incentive(s) in effect at the time constrution begun. WATT>t JN 5. ?• A LONG TERM .`.'SUPER GOOD CENTS/1991 MC;S COMPLIANCE REPORT 3/27/95 FILE: C.`-\DATA` \WS5\\._T.fimt 'r&t.WG HOUSE I D. JOHNSONI Site: NE 1050 LARSOi l BLV G Analyst: RON TEWALT BEL FAIR, WA Jurisdiction: MASON C;OUNT'`! { - Utility: MASON COUNTY PUD #3 Homeowner: STEVE JOHN SON House Type: Single F=am : 1.y Floor Area: 1392 ft^ Builder: S•;EPHEN JOHN •>ON 1 NC Weather Data: Olympia, WA NE 701 MISSION CREEK ROAD Climate Zone: 1 ( :360)2 5--67?4 The PROPOSED design QUALIFIES for 0GC(_ 9.-1_ MCC ) Tier 1.. REFERENCE PROPOSED COMPONENT PERFORMANCE OF;MANCE '_ 'tt.t:''r,l�-i:- 0e> -' =r5 L ENERGY BUDGET 2.72 2.93 ::USh "f-t`-;='r~ REFERENCE DESIGN Reference orrrl:onent Description Val ue X Area = UA --------•----------7----------------------------------------------------------- Orr Grade Slab R15 2 ' horizontal w/TB F-0.520 92f t 47.0 Floor R30 vented joist t_i-0.029 352 10.2 Glazing @1.5% 0.35 U--va1r_tt t_t--0.350 208. 7:3.1 Doors Metal R5 ease case U-0.190 :38.0 7. AG Wall R21+05 ADV l_i•-•0.041 1440 59.t J Ceiling, Attic Rota blown Attic ADV U-0.i=120 972 17.4 Infiltration Standard air se>_t 1 i nl., ACi I- i:a. 50 11093•fts 71.1 ----------------------------- Re-f`erenc:e UA 2861 ---------------------------------------------------------------------------------- PROPOSED DESIGN COMPONENTS Component Description Value X Area = UA -------------------------------------------------------------------------------- On Grade Slab R5 Fully insulated F-0.460 2f t 42.3 .'* ;?_ t_ nvente d Enclosed l.: t.: . ...._7 352 9.�.:> Glazing @11% :*:"INSULATE INTERCEPT LOW-E ARGON XO U- :t.350 118.0 4 i.1:'`: ''N I NSiJi_..r= TE I ND£: . SOD I._.Oral-E ARGON U -0.350 34 . 0 11.c:.;K Doors ANTHERMA-TRU F I BERCLAS S I C or equal 1 t f- i.t.390 38.0 3.4:*: AG Wall R21 I NT T1-._:1.1 t J-•-0 .056 1497 83.Irr --------------------------------------------------------------------------------- I temp: in parentheses not included in COMPONENT PERFORMANCE totals. . Denotes non-standard values ..... check calculation of thermal 1 a l ue . *: Denotes adjusted UA to reflect lect 7-1/2 mph wind speed. w 'e ATTSt_1N 5 .. 4A LONG TERM SUPER GOOD CENT S/1`._i9::1.. MCS COMPLIANCE REPORT 03/; 7/95 `r s LE: C:\\DPTA\\WS5\\JOHNSONI.WS HOUSE I D: JOHNSONI Ceiling R49 blown Attic STD baffled t 1-0.0r27 858 23.2 i..i:38 blown Attic STD baffled ►_1•-•0.031 1.4 0.4 Infiltration Standard Air Sealing ACH-0.350 11093ft:3 71.1 ------------------------------ Props used t 1A 285 S truc Mass Light Frame, Sheetrock walls M-- 3.000 1392 4176 -------------------------------------------------------------------------------- HEAT I NG/COOL I NG/VENT I L_AT I NG SYSTEMS PROPOSED Heating System 'Type: Electric:: Zoned System Efficiency: 100 % Modified Efficiency: 100 % Design ACH: 0.6t z Design Load( at 53F dt )." 17816 Btu/hr Total Load: 17816 Btu/hr System Size: .0 kW (: 150% ) Average Annual Heat: 5914 kWh Annual Cost: $ 66) Ventilation System: Integrated Spat A Whole House u_e Cooling System: NONE Cool i )ig Load(a t 5F dt): Btu/hr System S i oe(%over )., 'tons( @1;;:.'5% ) Annual Coot Requirement: k:Wh/yr Solar Access: Partially Shaded --------------------------------------------------------------------------------- `wLAZ I NG OR I ENTAT I OI-4 PROPOSED PROPOSED South 38.Oft2 North 38.Oft2 Southeast Northwest East 38.0 West 38.0 Northeast Southwest . --------------------------------------------------------------------------------- i:•.i.:o1#om i is cil')d energy consumption estimates are designed for comparative purpose:_ only . Actual cost for heating will vary depending on weather conditions, occupant lifestyle and other factors. Co 1_Z�3 - S L o©c - - 80' - - - - - - - 34-- --- - - - - - - - -r- -- - - - - --.... - - - i , I , I i �d t^s.oN Lfv - 'r _ Permit No. ���'1' �lJtl� MASON COUNTY BUILDING PERMIT APPLICATION ` � � 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628('1� �A PLEASE PRINT �( #1 ner —�pine� C �O �,�,so�, �nl�_ Phone # Site Address n/C/oSc> G 4r-sorn a/ud Fire District# Z City Or ��M � igr St _Zip 7NS� Directions to Job Site Owner Mailing Address ' City �►�--- St 14Zip Lien/Title Holder 84 r Address Clty St 1 #2 Contractor Name Contractor Reg #! P(eJ �`�7LLAJ Address l_-7 P I (m;SS io" C r^ (��-1 Expiration Date_ / / �t City_Z:R f4A- I h St U)?' Zip Phone # 27S 6 73 #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 rcel No. tZ33 I - S ( _ co13 gal Description �;Lf. �,o y 131 2-e"5 Co Ue-- #5 Building Squ re Footage: (existing/proposed) 1 st FI ' / 2nd FI / 3rd FI / Loft / Basement / Deck (Z0 / # bedrooms / # bathrooms / Garage Carport / (Circle: Attached or Detached?) Other sq. ft. / #6 Use of building R�? -Describe work c PSG��t�rf41 #7 Type of Job: New _Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. # Bedrooms # Bathrooms Typ o HftVj_ Purchase Price $ 11_� f #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 C� Q�o e- APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each No. 7—Toilets CIRCLE FUEL TYPE: Gas, Electric, 'Z-Bath Basins Heatpump, Other Bath Tubs No. Uni Fees 'Showers Furn BTU Hot Water Htr _ Heatpumps Laundry Washer ,� Vent Systems C Sinks 3 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 TOTAL MECHANICAL $ 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 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 APPROV ROM THE BUILDING THE BUILDING DEPARTMENT. DEPART X OWNER X BY DATE DATE Ice J' FOR OFFICIAL USE ONLY:Accepted by: �� Date:--� 4� DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: I„9Sep I'l5 14 Environmental Health: Building Plan Review cp Occupancy Group: R-72) Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit oa Plan Check Plumbing Fee o0 Mechanical Fee c Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other F� d J Other Building Valuation: �� TOTAL FEE