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HomeMy WebLinkAboutBLD93-01766 Final SFR - BLD Permit / Conditions - 2/25/1994 MASON COUNTY Mason County Bldg. 11 6 W. Cedar RO. Box 186 Shelton, hington 98584 f I Pit A Hit 093-1 Jibb l AleiA I Aflil 601)ki- 14 H F U I N WIN, .11ADU Cif 41N9 4 7 es t'f1m 1 V j)I- I Ilk f taF jA'j)f-' (:it) 4 S 4 t 'S -10 Ilm A. - HA I it t.I i 0 t ah4 f t0fj 0 Oil f PV`-P11 I ION Akf. '-I' I ti At f. fill I N I W.- lit OF t I H I N til 1.1w lit! I 1 1) 1 11 it W r4 w Ili lit 14 1 f I p I 1 11 R15101 III I Lit$ At 190-09914 ON liko(,HtALf, k1kiff (!# 0 If Ff 0 '31villf IWAR !'I-Alt flof.1 t1k i 40'116"I I too 11111111OR11'r1i P� NAl I I'M 01!ft lit ININ IsiO 116j" lij, it I 11h*'IfAil I Ili Jill" I"I A'w Af Ii ,, ltnkt P thowl"(f 0 f h 111 (if i(lot 10441 M ill wo F ot ; 6 P0.1101 -." IN to AI Aqji livi 0 f;f I lit, 11 ff I yi; tNk R1 A 0 1 P A 4 t A I p v 3 4 0 IN 111 1 A N C I. 10 AI I ACHI- 0 COH01 1 1 ONIA r CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date J Gas Piping date b Foundation Walls date by Set Up date L by INSULATION date by BG/SLAB Ins la'on Floors �p G Final date b 17 y date 7 by date by FRAMING Walls FIRE DEPT. date by date b �� date by PLUMBING y OTHER Groundwork Attic date b date by D.W.V. WALLBOARD NAI�ING� date Q/— lz 9� bydate by FINAL INSPECTION, Water Line date - Z — g by ✓ date 7.,,�= date by 4aA Z 17 �O ,ems S UMO S a o �S Tam i z-9 51" y - f MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (206) 427-9670 CORRECTION NOTICE Job Location fE- /,�FD 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 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 corre tions, ite s ill be checked on next inspection ❑ OK to Department Date 19Z-/02 -- IT' Inspector MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 M S C J �7 COMMISSIONERS RGBERT C.CLSEN HAAVEY H.WARNACA JOF-N H.WHALEN PUBLIC UTILITY DIS-�ICT Du HOMEOWNER AGREEMENT LTSGC# 93-0479 a O.Box 2146•=helton.'//A 985e4 Super Good Cents tBusi 2.6,-26-3255•,,.:.,/,20&425-35a7 HOMEOWNER: JADE CO. PHONE: 790-5531 SITE ADDRESS: E. 180 STONEBRIAR ACCT: MAILING ADDRESS: P.O. BOX 5730 LACEY, WA. 98503 BUILDER: JADE CO. PHONE: 790-5531 MAILING ADDRESS: P.O_ BOX 5730 LACEY, WA. 98503 I understand that in order for the electrically heated home located at the above address to be certified and in addition qualify for "Long Term Super Good Cents" . Home must be constructed in compliance with the Washington State Energy Code, 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. X Prior to installing insulation (structure is framed, roof is on, roughed-in plumbing, heating, wiring, telephone and TV cable are installed, and all penetrati ns are sealed) . X Following installation of insulation and apor retarder but prior to covering. X Final inspection - all components install d. X Other AS NEEDED. NOTE: Final inspection by our Super Good Cents D partment must be completed prior to the final inspection of the ap ropriate Building Department. It is understood that the Super Good Cents Depar ent is to be notified at 426-0777 or 426-8255 Ext. 777, not le s than 48 hours prior to required inspections. I understand the "Long Term" Super Good Cents cer fication by Mason County Public Utility District No. 3 only verifie compliance with the Long Term Super Good Cents program standards d only in respect to energy efficiency. Neither the District nor a employees make any warranty, expressed or implied, in regard to a general workmanship and structural integrity of the resid ce or the future electrical consumption. PUD'S Utility Service Of... By... and For the People M A S O N C O U 'J T COMMISSIONERS RG aERT C.OLSEtI HARVEY H.NARNACA JC'-'+H.WHALEN PUBLIC UTILITY DIS-RIC� lie undez -51 understand that if the home is built according to this a reeme the attached specifications, detailed C11°db'k'1 "f'�"�9;�and addendum, and is certified by the District that I will be eligible to receive Long Term Super Good Cents incentive payment(s) in the amount shown on the attached worksheet. I further understand that it is my responsibility to be aware and adhere to the Long Term Super Good Cents specifications. Only upon verified completion by the on-site inspections listed in the agreement of all the attached criteria by the Mason County Public Utility District No. 3 Long Term Super Good Cents representative, will the house be certified as a Super Good Cbnts home. Signed: omeowneru-iy er ^� Date a e era D# or Social SeF._T_ a era # or Social Sec. # i i y epresen a ive TONI HERMANSEN Utility epresen a ive (print) NOVEMBER 17, 1993 Date Homeowner conservation incentives may be paid directly to homeowner, or applied as a credit on your utility account. PUD's Utility Service Of... By... and For the People WATTSUM 5 .3 LONG TEPM SIVER GOOL OENTSji991 MCC COMPLEANCE REPORT 11/17/9:3 Site: E. 110 STONEPPIAP PL . Analyst; TON! HEFMANGE!'.4' SHELTON, WA durisdiction: MASOk CUUNT'( ( 204 .791-572:7, 1 Utilityi MAS04 COUNTY PUD 4:3 Homeowner : JADE CONS House Type; Single FamilX P.O. 3OX 573C) Floor Area: 1852 Ft2 ( 006 ; 159-4705 Builder: jADE CONST Weather Data : Olympia . WA P.O. BOX 5730 Climate one: I ( 206 )4S9-4725 1 The PROPOSED design QUALIFIES For 300( 91 MC;,:, ) Tier 1. REFERENCE PROPOSED 1 COMPONENT PERFORMANCE 342 341 Btu/hr-F 1 ENERGY BUDGET 3.71 3.77 kWh/ft2-yr REFERENCE DESIGN Reference Component Description Value X Area UA Floor R30 vented joist U-0.029 1074 31.1 Glazing @15% 0.35 U-value U-0.350 277 .8 97.2 Doors Metal R5 base case U-0.190 40.0 7.6 AG Wall R21-FR5 ADV U-0.041 1924 9 Ceiling, Attic R49 blown Attic ADV U-0.020 065 17.3 Ceiling, Vault R38 batt vault vented U-0.027 278 7.5 Infiltration Standard air sealing ACH-0.350 16030ft3 102.7 ------------------------------- Reference UA 3 4 11,21 -------------------------------------------------------------------------------- PROPOSED DESIGN COMPONENTS Component Description Value X Area - UA -------------------------------------------------------------------------------- F 1 oor R38 vented J6 ist 16oc U-0a025 1002- L5.1 R38 vented Joist 16oc U-0.025 72 1.0 Glazing @14% ""ALPINE LOWS/AR XO/PIC/CAS U-0.320 153.0 47.4:'J:: ""ALPINE LOWS/AR XO/PIC/CAS U-0.320 42.0 13.0K ""ALPINE SH LOWE/AR U-0.350 20.0 Items in parentheses not included in COMPONENT PERFORMANCE totals. Denotes non-standard values - check calculation of thermal value. Denotes adjusted UA to reflect 7-1/2 mph wind speed. Page I WATTSUM 0 .3 LONG FERM SUPER .LE: A:Nit EWFTLE ANALPINE LOWE/AR PATIO U, G ,4 t:)t:,r ii-.; i*KAINGULATED DOOR U-0 . 140 21.0 Woud 1-3/4- solid fluJI U-G - A�c 19 .0 06 Wall A21 ADV TI-11 14- eat H'..-( _.-53 1265 RE! + R5. 4 ADO ap Wood , , A, R21 ADV Lap Wood F U-0.051 125 xAR21 + R5.4 ADV TI-11 U-0.040 250 WXR42 BUFFER/R111 U-0.029 100 cailing R49 blown Attic ADV U-0.020 849 R38 blown Attic ADV U-0.026 16 wAR38 HIGH DENSITY VAULT U-0.027 278 7.!-.,' Infiltration Standard Air Sealing ACH-0.350 16030fis 101 .1- ----------------------- --- Proposed UA Struc Mass Light Frame, Sheetrock walls M- 3.000 1852 5556 ----------------------------------------------- -------------------------------- HEATING/COOLING/VENTILATING SYSTEMS PROPOSED Heating System Type: Electric: Central Fu pace System Efficiency: 100 % Modified Efficiency: 75 % Design ACH: 0.60 Heating Load( at 53F dt): 33579 Btu/her System Sloe: 6.7 k:14 Maximum Sloe @150%: 10.1 kw Average Annual Heat: 10124 kWh Annual Cost: $ 456 Ventilation System: Integrated Spot & Whole House Cooling System: SEER: 0.0 ( Ducted ) Cooling Load( at 5F dt ): 20161 Btu/hr Recommended Size @125%: 2.3 tons Annual coal requirement: kWh/yr Solar Access: Partially Shaded ---------------------------------------------------------------'ROPO ;ED DUCT SYSTEM Location Avg Rvalue Surface Area ^t_PPLY Vented crawlspace R-11.0 370.4 ft2 RETURN Attic or garage R-11.0 74.1 .ft2 Page 2 ---------- WATTSUN 1.3 LONG TERM SUPER 600D CENrs/iggi MCC COMPLIANCE REPORT .LE: A:NEWFIL1_1 -------------------------------------------------------------------------- - --- --- OLAZING ORIENTATION PROPOSED- !K) South 6 4.Of North Southeast : Northwest E as t 64.Ci West Northeast :: Southwest --------------------------------------------------------------------------------- Economic and energy consumption estimates are designed for comparative purposes only. Actual cost for heating will vary depending on weather conditions, occupant lifestyle and other factors. Page 3 MASON COUNTY BUILDING DEPARTMENT 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE RESIDENTIAL REQ S (NEW CONSTRUCTION, ADDITIONS, & REMODELS) THE PROCESSING OF YOUR APPLICATION CAN BE EXPEDITED IF YOU PROVIDE COMPLETE AND DETAILED INFORMATION. YOU ARE ENCOURAGED TO COMPLY TO THE 1991 WSEC BY UTILIZING THE APPROPRIATE PRESCRIPTIVE PATH FOR YOUR PROJECT. THIS WILL ALSO HELP EXPEDITE MATTERS. THE FOLLOWING INFORMATION MUST BE PROVIDED: 1) A complete window schedule must be submitted with your WSEC compliance information, even if a window schedule is included on your building plans. Note that sliding glass doors (patio), french doors, and any door with 50% or more glass in it is considered a window with the area (sq.ft.) being the entire units rough opening dimensions. Any windows in doors (less than 50% of area) must be taken out of the door area and put into the window area on the schedule. This window schedule must minimally show the dimensions of the rough openings of each window, the model (casement, horizontal slider, single hung, awning, picture, etc...), and the units tested U-value. 2) If you are complying to the WSEC by prescriptive path and are using the area weighted averaging method you must include your calculations (worksheet). 3) Indicate type of hot water heater, location of exhaust fans (bathrooms, laundry, kitchen), the location of your whole house fan, and all insulation levels (walls, floors, ceilings, and slab) on your,building plans. 4) Indicate how you will comply with the requirement for introducing fresh air to each habitable room on your building plans (window frame vents, through the wall ports, or an integrated system with your furnace). 5) If your home is 2,000 square feet or less, and using electric resistance heating (excluding heat pumps) a $900.00 "Payment to Owner at Time of Construction" will be issued from your service utility after the final inspection has passed Using electric heating or a heat pump in your home???? You may want to talk to your service utility regarding long term Super Good Cents incentives. Call PUD#3 at 426-0777 or PUD#1 at 877-5249. If you need assistance in showing compliance to the WSEC please ask for the brochure "What You Need to Know to Meet the Energy Code"; call the state energy office at 1-800-235-8248;or call and make an appointment with Dan Fitchitt or Debbera Coker of the Mason County Building Department at 427-9670. MASON COUNTY BUILDING DEPARTMENT 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE OWNER TELEPHONE ," — OWNERS ADDRESS :f Z 7� � COMPLIANCE INFORMATION TYPE OF PROJECT: NEW RESIDENCE()ADDITION()REMODEL ()OTHER AREA(SQ.FT.) 1ST FLOOR 22 2ND FLOORq�_ HEATED BASEMENT Note: Heated basements must be insulated and finished to meet minimum energy code requirements. TOTAL SQUARE FOOTAGE OF CONDITIONED (HEATED) AREA / COMPLIANCE METHOD: PRESCRIPTIVE PATH -- circle option -- I II III IV V VI VII VIII Glazing percentage (total glazing area divided by total conditioned area) ( ) COMPONENT PERFORMANCE -- Chapter 5 -- attach documentation and worksheets ( ) SYSTEMS ANALYSIS -- WATTSUN 5.2 -- attach documentation and worksheets HEATING SYSTEM: ELECTRIC RESISTANCE Electric Central Furnace () Electric Wall Heaters () Baseboard Units () Radiant Panels ( ) Other OTHER FUELS Heat Pump () Gas Furnace () Oil Furnace () Other ( ) Boiler System (indicate type) Makes j'/ (:T Model Size AFUE HSPF VENTILATION SYSTEM: Spot and Whole House ( ) Central Ducted System O Integrated with Furnace () Heat Recovery System (air to air heat exchanger -- heat recovery heat pump) GENERAL NOTES: Your building plans should indicate certain compliance measures: framing to be used (standard, intermediate, advanced); type of vapor barriers being used; location of furnaces, hot water tanks and other equipment; location of solid fuel burning appliances, fireplaces and their combustion air duct runs; and termination points of exhaust ventilation fans. OWNER'S NAME: *7;� WINDOW & DOOR SCHEDULE WINDOWS INCLUDE ALL WINDOWS, SKYLIGHTS, SLIDING GLASS DOORS, FRENCH DOORS AND STORE DOORS. ANY WINDOWS IN DOORS (LESS THAN 50% OF AREA) MUST BE TAKEN OUT OF THE DOOR AREA AND PUT INTO THE WINDOW AREA ON THE SCHEDULE. BRAND MODEL U-VALUE QUANTITY SIZE TOTAL SQ. FT. �! 2 E 2 5� ? m 5 ✓�rG � �G �'- 25 9 v lli�!- g 2© 4u 4-f3 10- o TOTAL WINDOW AREA DOORS BRAND MODEL U-VALUE LOCATION SIZE TOTAL SQ. FT. TOTAL DOOR AREA f. 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE PRESCRIPTIVE PATES OTHER FUELS (GAS, OIL, HEAT PUMP) HVACI GLaz3ng wall Wail int' Wag ext' Slab" Equip. %Floor Glazing Doors Vaulbad Above Below Below on Option Eft. Area U-Value, LI-Value Ceiling' Ceiling' Grade Grade Grade Floor Grade I. Med. 10% 0.70 0.440 R-30 R-30 R-15 R-15 R-10 R-19 R-10 Mod. 12% 0.65 0.40 R-30 R-30 R,15 R-15 R-10 R-19 R-10 Ili. High 21% 0.75 0.40 R-30 R-30 R-19 R-19 R-10 R-19 R-10 f. .......... ...'04'21 11-10 Reference case V. Low 219E 0.60 0.40 R-30 R-30 R49 R-19 R-10 R-19 ... R-10 V1.7 Mod. 25% 0.50 0.40 R-38 R-30 R49 R49 R-10 R-25 R-10 V11.7 Mod. 30% 0.45 0.40 R-30 R-30 R-19 R49 R-10 R-25 R-10 1 Mrwrum requvernents for each option listed. For wuuTpls,if a proposal d"n has 5 Flo-over oawi-P-Or--Pced to-0-1 au mnd[ane. A qLaz"1`11,110 to d'"oonditioned%or area ci 1 M 0"1 compty wo"In all of the requwwrwft of the 21%qiszinq option(or highter), Proposed designs whch cannot 6 Requwed slab perimeter ineulatx>n"I be a*-Ater reactant notarial,manufactured meet the xmcdic requirerr-ft of a laaad option above,may caicu Lois coffpiuir fix is intended use,and n9LIJ-14<1 according to ffuunulacureet,sp,,dir-w1ons. See by Chapter A of 5 of the cods. socbon 602.4, 2 Requoremanits applies to all ceilings accept"Is ratter of foist Vaulted ceoiirVa. 7 TI*,"M 00w*"I be awk2blii to buildings less than three stores. 'Add denotes Advanced Framed coiling. 8 This vvJl insulation rectutreow. denotes R-19 voikil cavity inr*uiatpon pi"R-5 loam 3 Requorernent applicable only to single rAher or pat vaulted cerings. sh"hwg. 4 Below grade w&As shall be wisuialed 94har on the sxtwx to a minimum level of P, 9 Minimum HVAC Equil>rnont efficiency rsquiemrent. I-oW denotes an AFUE of 0.74, 10,or on the wylenor to the same level es wails above grade. Externr insulation 'Mod denotes an AFUE of 0.78. 'High*denotes an AFUE of 0.98. installed on below grade vmuk an"be a vAuer resistant mal",mwunuladured for to itn6wdod use,and inata6ed acoording to the marulsotufees specdwAd o. See 80abw WZZ ELECTRIC RESISTANCE HEAT Glazing Wail Wall ine Wail exV Slap' %Floor Gazing Doors Vaulted Above Below Below on Option Area U-Value U-Value Coiling" Ceiling' Grade Grade Grade Floor Grade I. 10% 0.46 0.40 A-38 R-30 R-21 R-21 R-10 R-30 R-10 11. 12% 0.43 0.20 R-38 8-30 R-19 R-19 R-10 R-30 R-10 12% 0.40 0.40 R-38 R-30 8-21 R-21 R-10 R-30 R-10 .................. Si............ 1.... .......... . ......... ............. ...........V. 18% 0.39 0.20 R-38 R-30 R-21 R-21 R-10 R-W R 10 Reference case V1. 21% 0.36 0.20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 V11.7 25% 0.35 0.20 R-38 R-30 R-19+R-5' R-21 R-10 R-30 R-10 V111.7 30% 0.32 0.20 R-38 R-30 R-19+R-5' R-21 R-10 R-30 R-10 I MwwT,<sn ractuffemeft for each option listed. For axxrr%l*,4 a proposed des,-gm her 5 ROO'S over Ot81A-Pats.Or 0-0004d to arni>ent&,r oondtions. &94"V 1`1100 to the 00ndrfonedMoor area of I M[shall oorrviy with all of the rectumornerft of One 21%96Lzw9 option(or higMer). Proposed dowgra reach cannot 6 Requ--d slab P-wer mulation shall be a water rssxtjm malsruik manufadurod eel the speop6o refit smants of a listed option slxwo,may calculate compiuuce for to intended u",and instailed s000rding to misinufaclurses specir-wx>ns. See, by Chapter A or 5 of the oode. %.don 6024. 2 AequwwTwft iirxtlws to ag oeiiings except single rafter or gist Vaulted callings. 7 Thess opti shall be applicable to buildings Was than three stones, 'Adv'denotes Advanced Framed Ceiling. 8 This well ruination requoroment dwxxeo A-12 wvji c&,,ty insulation plus R-5 foam 3 Roquwerrient OPPACable only to single rafter or jont vaulted cailings. sheathing. 4 Below grade,waills shall be wtsuLatod.thew on the sxlero to a minimum ievsw of R- 10.or on the wftsro to the sans e-el as walls above grade Exlww,rniulwon insitaAad on below grade viahs shish be a water resistant nwwW,manufactured for is wvtorded use,and inat.&W a000ding to the manufacturers zpeclficwoons. Seii secoon 602-2. Permit No. �. MASON COUNTY BUILDING PERMIT APPLICATION pa��� 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1 800 562-5628 PLEASE PRINT #1 Owner ,T// V"e G'EtJ Phone#��- Site Address C A&> Fire District# city St _Zipz4g-20 Directions to Job Site /- FV" A'2 Owner Mailing Address City 1 f -�- ' St LV/ Zip Lien/Title Holder Address City St Zip #2 Contractor Name Contractor Reg Address f-i�2 EOA' 577? Expiration Date_/�/ City f A� St _Zip���3 Phone !g2r-�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.32i 3--'- - Z3 - I?©© 13 Legal Description `/-s #5 Building Square Footage: (existing/proposed) 1st FI /4W6- 2nd FI / 3rd FI / Loft / 0 J Basement / Deck / #bedrooms /_�#bathrooms Garage / 4f4Z2 Carport / (Circle: the r Detached?) Other sq.ft. / #6 Use of building /— Describe work #7 Type of Job: New___I,,--' Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION 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 l 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 eachl Fee Mechanical Fixtures ($6 each) I No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins �eTump; Other Bath Tubs No.. Uni Fees _Showers Furn BTU LHot Water Htr 3 �� Heatpumps Laundry Washer 3 Vent Systems Sinks ` Spot Vent Fans _Floor Drains No. Boilers/Compressors Laundry Basins 2 _ HP Dishwasher J No.. Air Handling Units / Disposal 3 _ cfm# _Urinals No.. Fire Protection Systems _Other Auto. Fire Alarm Sys 50.00 Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00�J _ Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ �✓ l her 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 $ to 1 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 WITHO FIR§T OBTAININC�.APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING THE BUIL DEP TMEN DEPARTMENT. X OWN X BY DATE / DATE FOR OFFICIAL USE ONLY: Accepted by: ( Date: !C�' DEPARTMENTAL REVIEW t FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: 9 Environmental Health: IV J N,h �/ O �JQ�rw.M5 Building Plan Review f A Occupancy Group:_ Type of Const:_ Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee 5 .UD Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other Building Valuation: TOTAL FEE