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Home My WebLink AboutBLD98-00682 Final Garage - BLD Permit / Conditions - 8/14/1998 MASON COUNTY ` Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 k3 tJ 1 L D II N CA P F. 1-1 M I T FGw I NSPF . ' i '',N;. -ALL. 42 .." BETWEEN 5pm AND Bam 427-7262 OL.DOS-0682 PARCEL. :32132.2290040 PLAT - D I V : BLK : LOT : JOB ADDRESS : 1201 E JFNSON RV SHE TON OWNER : JERRY %IlMW 427-9318 CONTRACTOR : SHEARER AND SON 786-- 9702 LEGAL : TO 4 OF 111 NW E1 TO 8 OF SP t1168 ' i-ASS OF WORK . . :NEW BFDR : 0 BATH : 4I TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT TYPE OF USE . . :ACG STORIES . . . . . . . :0 °'6C,C1IP . GROUP . . . :U1 Lit. DG . HE IGHT . . : 14 .Oft PUCK Y 373.59 K.W 07110198 47632 I TYPE OF CONST . . :5N FIREPLACES . . . . 0 FR1111 $ 574.75 TJ 07131198 47893 j C)CCUP . LOAD . . . . : 0 VYOOpSTOVES . . . . : 0 SIFF 4 4.5/ TJ 0701196 47893 DWELL .UN I 1 S : 0 PARKING SPACES : 0 ENCP S �0.10 TJ 07131198 41893 � 1 N4PECT I ()N AREA : SHORELINE? . . . . :Y IOTAh 1#02.84 VAI UtA11ON: 49041 SETBACKS -.-- TOILETS . . . . . . . . . . : 0 FUEL. TYPES-_ - -- BOILERS/COMP-- - MOBILE HOME FRONT . . .N '70 .Of t BATH [SAS I NS , . . . . . : 0 0--3 HP . : 0 REAR . . . .S 200 ,Oft BATH TABS . . . . . . . . : 0 3-15 HP . : 0 MODE-L. : SIOF ( 1 ) .IF 300 .Oft SHOWERS . . . . . . . . . . .. 0 . UOFIN P 100K BTU*: 0 15-30 lip . : 0 MAKE._.-._. SIDF (2 ) .W 100 .Oft WATER HEATERS . . . . : 0 FURN --100K ETU : 0 30-50 HP . : 0 SHRL INE .S 200 .Oft CLOTHES WASHERS . . -. 0 FURN -• FLOOR . . . . 0 50+ lip . . 0 -YEAR-_..__-. AREA --- - _______..__. . _. KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . : 0 LOT SIZE . . : FLOOR DRAINS . . . . c 0 VENT FYSTEMS . . . : 0 EVAP COOLFR: : 0 LENGTH : 0 BUILDING . . . . 08f DRINKING FOUNT— : 0 VENT FANS . . . . . . . 0 HOODS . . . . . . . . 0 WIDTH . : 0 BASEMENT . , . : Osf f..AUNDRY TRAYS . _ : 0 DOMES . I NC I N tO - SERIAL#-•_ ._ _. DECKS . . . . . . : Osf DISHWASHERS . . . . . . . 0 AIR HANDLING UNITS -- COMML . INCIN :O GAR/CARP :G 2592sf GARB DISPOSALS . , . : 0 <_ 10000 c:fm . : 0 REL OC/REPAIR : 0 AT/DT . :D URINALS . . . . . . . . . . : 0 > 10000 orm . : 0 OTHER UNITS . : 0 M I SO PL.M FIXTURES : 0 GAS OUTLETS . 0 PROJECT DESCRIPT100:GARAGE PROJECT LOCATION:NORIN ON BROCKDAtE TO RIGHT ON JSENEN TO LID Of PAYMENT TO LEfT ON GRAVEL `RD TO NORSE ON LEFT. THIS PERMIT BECOMES NUIt AND 'VOID If WORK OR COISTRUCTIO`N AUTRORIlEO IS NOT COMMENCED NITHIN 181 DAYS, OR If CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD Of 180 DAYS AT ANY JIN€ AFTER WORK IS COMMENCED, EVIDENCE Of CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 180 DAY PERIOD, FINAL INSPECTION MUST BL AP?ROVf.D BEFORE BUItgING BAN BE OCCUPIE1. `l�71CfRA AGENi:_� "� 4%(: ' OJ ✓ __ _�_ ___ ____ D�l1E: _ � 17 r —BLD_PRMT, rev-131 I i:'91 — — i ` — �— � — — — —COMPLIANCE TO ATTACHED CONDITIONS IS REQUIRED 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 by date by date by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by 5`-c18 date by WALLBOARD NAILING D.W.V. date by date by Water Line FINAL INSPECTION date by date g— `�—� by C date by I� I I — I I _ MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Case No . a BLD98--0682 For . .IEP,RY WARb Pages 1 1 ) This application is subject to Buffer and Landscaping requirements as established under Mason aunty Ordinance 1 .03 .036 . 2 ) The use, handling and storage of hazardous materials or flammable and nombust i bl e Iiquids in excess, of 10 gal ions is not ailowed without the appr ova I of the Mason County Fir/e,MarshaI X� � 3 ) Provisions for sajrface/subsurface drainage control must be implemented with new conf;truction 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 by granted to use an existing utility and drainage easement dedicated for that ;a e(1, ific pus-pose . For further information regarding i.h i s ord i n€ance and then REOU I RFFA N to obtain an ACCESS PERMIT for the installation/construction of a driveway or access connecting from a Mason County Road, Contact the Mason County Publio Works Department tterior to construction at Ext 450 . For any constructioii 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 fut+ire planned work which may affe�r,t your pro jest . X- 4 ) Proposed structure or, any pork I oft t hereof great er than 30" 1 n he i ght from grade l i ne , must maintain a minimum of 5 ' setback from all property lines , easements and 10 ' from all Co n y and State .Road right of ways . X 5 ) All approved p I arts are reclu i red to be on-- €t i to for i ns :sect I' On purposes . If inspection is called for and plans are not on site, Approval WIFL NOT be granted . In addition , a Re- Inspection fee in the amount of $42 .PLO per hour (minim►im 1 hour ) will be charged and must be collected by this department prior to. any further inspections being performed or approval granted . X - n MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 G ) PURSUANT TO 1994 UN I FORM E30 11.17)1 NG CODE , ALL S I TFS MO _. : APPROVED NUMBE"S O1, ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE: STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BU I I D I NG DEPARTMENT RFOI.1 I RF(' THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES IN TABI. F 3A OF THE 1994 UNIFORM BUILDING CODE Wilt BE ASSESSED If OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . X 7 ) TH I STRUCTURE; IF, CONSIDERED UNHEATED SPACE; (NOT 10 EXCEED 1 WATT/SQUARE 1`001 OR 3 .4 BTU/HR/SQUARE FOOT ) . AT SUCH TIME.. THIS CONDITION CHANGES, A CHANGE OF USE PERMIT AND A MECHANICAL PERMIT SHAIA. BE APPLIED FOR AND APPROVED PRIOR TO THE CHANGE . X f 8 ) No Occupancy . This structut,e i ..i i imited to (1-1 use only . Any other use wi I t be in violation of the Un I farm Eau i i d i ng Code and Ma sort Cou�r y ecru i a1 ions unless a "Change 'of Use" permit is appt oved . x-_ -------- 9) Any charr(tes in c:onstrur.t I on sha i 1 he reviewed by engineer ofi record and submitted In writing o the Mason County Rtillding Department prior to construction . X 1 r 10) Proposed strtic:ture c I port ions thereof with an prajQotion over, height In hpifit from grade line, trust maintain a separa.t n distance between adj4cent structure: and that furthest projection . X 11 ) Changes to approved building plans that effect compliance to the 1991 Washington State Enercty Code, 1991 Ventilation and I ttdoor Air Quality Code, the Uniform Building Code and/or Mason County R7gulp,,t ores must be approved bV Mason County prior, to const rttc�t I onX ; l i?_ ) ALL CONSTRUCTION MUST MEET OR EXCEED -LOCAL CODES . IF ANY QUESTIONS, PLEASE: CAL T/f+"° OfF I GE RE FORE CONSTRUCTION . 13 ) If the garage has plumbing, the .applicant will need to apply for a septio permit (ma InteLn;4p1ceI . X f MASON COUNTY Mason County Bldg. ill 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 14 ) Al I upland areas disttirbed or newly create,,: b'v '.iis-ti iti - ndII ::tied, vegetatq,d�or) given some other, equivalent type of protection against erosion . X_. 15 ) Applicant eknowledes that this development is subject to poiioieti and reguIations of Xas, -n C nt compregens i ve Plan and Development Regulations .� __ s: a r ✓ INN' �f v� �1r.H ? W1 .. r N'1 1 -w- 1 t a l l e r% zTto T�." .t fir. A \ ,�/ (, c!8 wr.ith 'rvi ier thoitnn. ter 7$7!4 �� . E i- ram' / Y 2-1 rJ IL u C' 1p , r Ij v.� I KXMi TWO t XAm" C-•n•y hz.-- no r.iponmibiiity t^ �f2C, L�e'vt . muint�ie ^� ==�C:'::� ::i�iic• � � , the �rivete co"tsine6_ within nr wit i1W to un4 pro-port-, decCr .," ill the mi�ori - ' biota Exhibit A THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF WASHINGTON, COUNTY OF MASON AND IS DESCRIBED AS FOLLOWS; PARCEL 1 : TRACT(S) B OF SHORT PLAT NO. 1768, AS RECORDED APRIL 4, 1988, UNDER AUDITOR'S FILE NO. 479240, AND BEING A PORTION OF NORTHWEST QUARTER OF THE NORTHWEST QUARTER IN SECTION 32, TOWNSHIP 21 NORTH, RANGE 3 WEST, W.M. , IN MASON COUNTY, WASHINGTON. TAX PARCEL NO: 32132-22-90040 TOGETHER WITH A 1989 MOBILE HOME. PARCEL 2 : TOGETHER WITH AND SUBJECT TO AN EASEMENT AS SET FORTH IN SHORT' PLAT NO. 1768, RECORDED APRIL 4, 1988 UNDER AUDITOR'S FILE NO. 479240, RECORDS OF MASON COUNTY, WASHINGTON AND BEING A PORTION OF THE NORTHWEST QUARTER OF THE NORTHWEST QUARTER IN SECTION 32, TOWNSHIP 21 NORTH, RANGE 3 WEST, W.M. , IN MASON COUNTY, WASHINGTON. MASON COUNTY DEPARTMENT of GENERAL SERVICES Courthouse Annex I N. Fourth & W. Cedar P.O. Box 186 Shelton, Washington 98584 (206) 427-9670 building environmental health maintenance landfill parks&recreation fair/convention center planning sewer&water CHECKLIST FOR PROPOSED CONSTRUCTION No Yes / /0 C ] C✓ ] Within 200 feet of designated shoreline or wetland C J C ] Proposed construction on/over/in wetland [✓ ] C ] Proposed construction within floodplain [/ ] C ] Commercial Development (Parking Standards , Sign Ordinance , Public Works Review, other applicable agencies ) [V ] C J Mobile Home and/or R.V. Park What Type Of Construction Is Being Proposed? G/ J C J Exempt from building permit application C ] [1] Exempt from S.E .P.A . process (WAC 197-11-305, WAC 197-11-eOO ) [ J C ] Meet all requirements (Which section (s ) of S.M.P. does proposed construction pertain to? [ J] C ] Variance or Conditional Use Permit required C J C✓ J Exempt from Shoreline Substantial Development Permit process (WAC 173-14-040 ) [ J [✓] Exempt from Substantial Development but within Army Corp.jurisdiction (WAC 173-14-115 ) Printed 3/69 s- �r_t Date Initials ZONE A ZONE � ZONE A Ly y 27 \/ 29 28 ZONE C 91' 32 33 34 ZONE A O ZONE C REX LAKE w c ZONE A z z ZONE A 5 o q 3 '{ Oeek z m z L � f i s i f r to the FLOOD INSURANCE RATE MAP EFFECTIVE date n on this map to determine when actuarial rates apply to tures in the zones where elevations or depths have been estab- S! etermine if flood insurance is available in this community i ,act your insurance agent,or call the National Flood Insurance ;ram,at(800)638-6620. I II I 4 t APPROXIMATE SCALE IN FEET 2000 0 2000 j ) t . 6 f ZONE A ZONE A lqqw6y yP-T 27 30 29 28 c ZONE C tit yti 31 33 32 34 ZONE C ZONE A ZC REX ZONE C LAKE T. 21 N. T. 20 N. c ZONE A - BUILDING PERMIT ## DATE G(i G te/ S� 7 Planner Area 3 ,Z/31 CHECKLI - , • �ST FOR PROPOSED CONSTRUCTION No Cal 1 [ t ] Within 200 FT of designated shoreline, wetland, or associated wetland x Where? :5c�) [ ] [ 7 Proposed construction on/over/in wetland C/� 1 Proposed construction within floodplain ��/ 5 � [ 7 Eagle nest ] tate road access needed [ 7 [ 7 Commercial Development (parking standar6s, sign ordinance, public works review, other applicable agencies) [ 7 [ ] Mobile Home or RV Park [ 7 [ ] Exempt from building permit application [ 7 [ ] Exempt from SEPA process (WAC 197-11-305, WAC 197-11-800) [ 7 [ ] Meets all requirements (which section(s) of SMP does proposed construction pertain to?) [ 7 I ] Variance or Conditional Use Permit required [ ) [ ] Exempt from Shoreline Substantial Development Permit process (Wac 173 -14 -040) [ [ ) Exempt from Substantial Development, but within Army Corp. jurisdiction (WAC 173 -14-115) [ ) [ ] Address needed D; recr. DEPARTMENT OF COMMUNITY DEVELOPMENT- PLANNING Weekly Time Sheets Employee's Name: — - ---.. From: WORK DISTRIBUTION `---- To: Sun Mon Tues Wed Thurs Fri Sat Total Shoreline Permits Short Subdivisions Large Lot Subdivisions BLAs Subdivision SEPA Compliance Building Permit Review Building Permit - Field MH/RV Park Review Addressing Complaint Investigation/Violations FPAs Growth Management Efforts Misc. Counter Work/Phones Misc. Long Range Planning Floodplain Ord, Compliance Clerical Other Other — — Other Other Misc. Leave Codes Totals: Comp. Vacation Sick Benefit Time Time Personal PH�. Sick S ; Time Float holiday Prev. Bal. Comp. Time P C Vacation V Accrued Used Funeral Leave FL Holiday Court/Jury 1 Training Duty Balance Leave w/o pay LA heave w/d pay L.0 ' (Approved) (Unapproved) ` Compensatory thne must have prior supervlsor approval »»»** I hereby certify that this is a true and correct claim. Approved by Employee's Signature Supervisor Permit No. MASON COUNTY BUILDING PERMIT APPLICATION 7_1o, 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 O ner 5/_--i /{ /r )p Phone# yl 7 Site Address Fire District# City St r✓/9 Zip_9 g-J-'FX Directions to Job Site '6ii c /�i�� T�' />'/ti�> o�- S/';:so,✓ %u i`^�� v/' /�/!Y cv, �= NT T'� L /=�% O N G/i'.f>✓I�L /t� T a //o r s," y� ��-t % Owner Mailing Address_ - Z Z k M City s�i'1 T v ��" w,9; /� St 'V/� Zip y J-X Si Lien/Title Holder Address City St Zip #2 Contractor Name S i=ii e Contractor Reg# syf iz t i 1 o f Address Expiration Date__ r City Tl- wi St zip Phone Phone# 7 Y< t- #3 If septic is located on project site, include records. Connect to Septic? Public Water Supply Well Connect to Sewer System? Name of System (If residential, proof of potable water is required) #4 Parcel No. /3Z - 2-Z - o o Legal Description le-4- J nLL3 0LJ EX I-IC08 #5 Building Square Footage: (existing/proposed) 1st FI / 2nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / #bathrooms / Garage r z / Carport / (Circle:Attached or Detached?) r Other sq. ft. / #6 Use of building �� -/-, Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION � D Model Year Make Model QUl690 Length Width Serial No. # Bedrooms # Bathrooms Type of Heat PERMIT ASSISTANCE CENTER Purchase Price $ #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Driveways Water Lines Shorelines Drainage Plan Topography Septic Systems Wells Proposed Improvements Easements Name of Flanking Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW Plumbing Fixtures ($3.25 each) Fee 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 APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE 7Z yV F S� FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW 76 .3 FOR OFFICE USE ONLY Approved Cond. Hold 14 Approval Planning: 071�? Environmental Health: Building Plan Review K ! /q Occupancy Group: Type of Const: Fire Marshal: ` Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE Plumbing Fixtures ($3.25 each) Fee Mechanical Fixtures ($6.50 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Unils 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 APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. X OWNER X BY DATE DATE 7Z y/t F FOR OFFICIAL USE ONLY: Accepted by: Date: I DEPARTMENTAL REVIEW 76 3 FOR OFFICE USE ONLY � Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review 7�q Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee { Mechanical Fee i Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE Plumbing Fixtures ($3.25 each Fee Mechanical Fixtures ($6.50 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other I Bath Tubs No. unk Fees Showers _ Furn BTU j _Hot Water Htr _ Heatpumps { _Laundry Washer _ Vent Systems f 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 i MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I 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 r CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUILDING DEPARTMENT. DEPARTMENT. s 4 X OWNER X BY DATE DATE 7I y/t F FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW 76 3� FOR OFFICE USE ONLY //� �� Approved Cond. Hold 14 Ap proval Planning: I Environmental Health: Building Plan Review M / 1q Tl 1 i Occupancy Group: U^ 1 Type of Const: Fire Marshal: Other: i Special Conditions: FEES � 9 �74-75 Buildin Permit i Plan Check 373•S Plumbing Fee Mechanical Fee i Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other t� Other Building Valuation: / FToTALFEE