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HomeMy WebLinkAboutBLD93-01906 Final SFR - BLD Permit / Conditions - 3/25/1998 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 4 t�1 0 9 3—19 0 6 1 A 1; Aox, 4-'HF 1. 1 ON IF 400 At 'AN NO ,9,N5 - C 1, f ARUA I f:R 0FVF I OPKVIN 1 4�17 Wit) I - e.' / 0 IfW11R PPFRII : 0\ I I I-J 14! 1 1 I A A IDN H 06- f P0 1 4 4 1(,Al A 4 aiE A: I K 4 ',0 l 0 10 0 4 4 lil, �A 1) j I o"'i 41, q It 1 'qJh B 01 N I It I i ;V!In I fill All is t A,A 491", f,iwi Bf"fifil, Ont AND volli it w46. h (I R f A A S I R ll 1 1!it 0 A K I D ff11N1A 18 d fit v lap 11 1 all"i 00, lep Ale U14i It it I!t i A �N:I it 11 lit1 f 10 AmR Al" 1 'JANEof fit -.fVTfir*r F Af 170011 NIJA f It'# of wot I A I t fl" Ij A I RI A lfl j 81 lit AVP Itsp r tAl !01�pl I Ifil tlt'I Of Ai'(11'40 W011 011111 rANJ ot ! t11 0 A 6 f,N I CLAPt, IANCV 10 AT I'ACHED CONO I 1 1 W� # ;'.t" ! .i I CONCRETE, •, MECHANICAL MOBILE HOME Footings-Setback date 6.3-- by Ribbons date by Gas Piping date by Foundation Walls date by Set Up date by INSULATION/,'t — date by BG/SLAB Insulation Floors l_ m 4zol date by date 2 Lj by date by FRAMING FIRE DEPT. date Q —/G !y byn Walls date by date by PLUMBING OTHER Groundwork Attic ' Y date �7 4 by �pj2 d!_. D W.V.date b WALL OARI NAILING) 1/T-7 date 03— 6 " 9 Si by drda te ctaS ( O Water Line NAL INSPECTION r �6 75 date p'3 /(,— �j'y by te by date by %Page No. 1 CLEARWATER DEVELOPMENT CORP. E400 JENSEN RD SHELTON 03/16/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- BLDA010 Application received / / / / 12/29/93 12/29/93 KW BLDA100 Approved For Issuance / / / / 02/09/94 DONE KS 02/09/94 KS BLDA500 (F) Issue building permit / / / / 02/10/94 DONE KS 02/10/94 KS BLDA560 Permit cancelled / / / / 09/17/96 Permit cancelled due to know response to DONE CMS 09/17/96 CMS letter sent out. BLDA940 RLC Checklist Completed / / / / 12/07/93 DONE PRM O1/05/94 MMS BLDB110 Structural Plan Review 01/05/94 / / 01/11/94 DONE WLC O1/11/94 WLC BLDB120 WSEC Compliance Review 01/11/94 / / 01/12/94 DONE DC O1/12/94 DLC BLDB129 Sent to Planning / / / / 12/29/93 12/29/93 KW BLDB130 Planning Review 12/29/93 / / 01/05/94 DONE MMS 03/28/94 TMJ BLDB135 Addressing / / / / 01/03/94 DONE GMM O1/03/94 GMM BLDB200 Environmental Health Review 01/12/94 / / 02/09/94 need approved septic permit and design DONE PSD 02/09/94 KS BLDB210 Water Adequacy 01/27/94 / / 01/27/94 It appears from our records that this HOLD CAJ O1/27/94 CAJ water system (Stonebriar #1) has its maximum number of connections. BLDB210 Water Adequacy 02/14/94 / / 02/14/94 paper work problems soleved DONE CAJ 03/25/94 KS � 3 ;4 SS 4 0 FpV Building Permit M MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 47-,ICo ��,v s ic./ �2d This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed belo mus a corrected to gain code compliance AL FAN uc ks to �1-��E7" 1�5t-CG 0'1 S L) e r �E ce n4 5CA-L AROW0 l- ft I I c&tc Te.4Tiv b,00E;Q 51Af(6W 1<t silt! 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 �r� Date 3_/9 >(45 Inspector ■ o* * NOOT MOAV -- T t Tmk* M, MASON COUNTY ' BUILDINr 111,426 W. CEDAR SHELTON, WASHINGTON 98584 (206) 427-967000RRECTION OTICE rn�5 Job Location �e- SOW .c�s�.ci This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: S7 3� 3�/ Items listed below must be corrected to gain code compliance /jc. s��s wyr l ,0 ��7L�,L�/ �57.P.�i,✓T S7�.t� '� Dl��v/J 'Tivti . � �f9/2 —OC/ Tio.� �,�iS�7' �o�4Eisr5f� �.C1�i�J �i i.vt F.�v.v G,�•gU� y. PKA, R;-f-Tiov ega W,o T s2-19,8 . /Vk 70�9 7- P- IV. 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 Inspector ■ ok s NOT MOOV � MASON COUNTY BUILDING-1II 426 W. CEDAR . SHELTON, WASHINGTON 98584 (206) 427-9670 CORRECTION NOTICE Job Location 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 41 M4ck5' 7Zus s j-z ;Sry JD ':5 ��E � 401 Cq u t v-1� 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 ID Make corrections, items will be checked on next inspection ❑OK to Department Date Inspector ■ ioo * NnT MkAV THI , T 'RL* 1 MASON COUNTY BUILDING III -426 W. CEDAR SHELTON, WASHINGTON 98584 (206) 427-9670 CORRECTION NOTICE Job Location 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 E:Pr:t L�u a • 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 / - � Inspector NOT Mo AV ltHlmsh, TAL , MASON COUNTY ' BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location F=- , yM 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 COO__ LLZA' �- - You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Sall for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OKto Department Date 2-2 Inspector f k--O tAA' *4 0 NnT MnV THI, TA ;��= Building Permit #2—�90r MASON COUNTY BUILDING III 426 W. CEDAR 1 - l5�14 W� SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECT.10N NOTICE Job Location (500 ( LE4 X? L009 7-,E /?- E Q E L 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 NO EAl4L aysP(fe//op/ IVC) Nr- 14o m f-, Lo c.IC F- 00 7�� u F /Y 0 l 7X is 6 IJ y F�7y tz A�,Cx 7- I AISP cr--71 b.I 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 El Make corrections, items will be checked on next inspection ❑ OKto � Department Date - Z Z- Inspector S lok s NnT MOOV T14F TmL* - MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 L. it 0;I 1 1, 1 1 if 11 flit t 1— ia ' wo i ;it ilw ; 11 ) IsFiAa i Iu 1991 UNII-ti IIAV�` All"VROVE.0 NUMPIEW-, OP A0001 I1W1%/ It1lH kH vI ':)jHjj A NO f f 01.81 F IROM ff4t. Ok 1 1`1At1 11:'W4 I J N6 I fit Pk(1111 P I Y' llii,(M 4 WIN I Y f'; I 1 1 I'l I'N il ra A I f0l( NI R L OU1 V f, i I H A I I 14 1 ') til. 1,1 Mf,1 I If it iti I me 1 1) 1 AI I tNil flit, 0,iNY , III I N' Pf C I 1 0 N'i A N t C f 1.0N V f F , 14 A'�L,f N P i f L", 1 N 1 AHI f (A Ill I !if I I IIIAJJ 111;'m Hifil nlNri I "M, t-141 I H A I I i 0 1 lll� I fill H k 1 1; N I I 1-k I(-,I N F R f4 At H I Plk 1 1 110 Will I mt 1 11 flit j I i (110 11 ltt11 it i it Fri: i q y 1 V t r Ill lit i� .1 f I mm"clit I ill'ifif CONCRETE MECHANICAL MOBILE HOME Footings-Setback date - by Ribbons date by Gas Piping date by 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 Groundwcrk Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I I I � 1 KV p C1It f y I n7 r j Q I ��drS o+rvd o�� 4tZ�. I ,5z .ch c� C M /,,OOb —Z£ Z£IZ£' 0 r N 9�Z 8s'hb 3• �1 1& MASON COUNTY DEPARTMENT of GENERAL SERVICES Mason County Bldg.III 426 W.Cedar P.O.Box 186 Shelton,Washington 9a5a4 (360)427-9670 BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION 'Y's/ IN96 TO: OJ-00► Loa. � Le�'Op. -Sl/�CI-fiv n, W)C)I qv yz/ RE: Permit Number # 6LIJCl� 8f0 6--7 To Whom It May Concern; During a recent review of our files, it was determined that your permit may meet one of the following criteria: 1 . Permit is expired and needs to be renewed or have a final inspection 2. Due to the type of your permit and scope of work it is possible that the work has been completed and it needs to be inspected to close the permit or 3. The permit is ready to expire and needs to be inspected or an extension needs to be requested. Permits are valid for 180 days from the date of issue to the inspection date and remain valid for 180 days between each required inspection. If our records are inaccurate and you have had a final inspection, please send a copy of the signed off permit to this office so that we can update our cards. If you have not had a final inspection and your permit is expired or will expire within 30 days, please contact this office for a final inspection, update P P inspection or extension prior to f�_/�/96 to avoid renewal fees. All permits which are expired or due to expire within the next 30 days will become null and void if contact is not made with our office. If you should have any questions regarding permit validity or the purpose of this notification, please contact the building department for clarification. Sincerely, ew4o Building Department f.r* Pmnarhr Filn MASON COUNTY BUILDING DEPARTMENT 1991 WASHINGTON STATE ENERGY CODE AND VENTILATION AND INDOOR AIR QUALITY CODE OWNER C 1P.6/wo.z-E►Z I rotow ps ,rn�- TELEPHONE y2,7- 9161 OWNERS INIAILING ADDRESS COMPLIANCE INFORMATION TYPE OF PROJECT: l)4 NEW RESIDENCE() ADDITION()REMODEL ()OTHER AREA(SQ.FT.) 1ST FLOOR tl s6�( 2ND FLOOR HEATED BASEMENT —� Note: Heated basements must be insulated and finished to meet minimum energy code requirements. TOTAL SQUARE FOOTAGE OF CONDITIONED (HEATED) AREA. COMPLLACNCE METHOD: () PRESCRIPTIVE PATH — circle option — I H III IV V VI VII VIH 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) Make Model Size AFUE HSPF VENTILATION SYSTEM: Spot and Whole House () Central Ducted System () 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:_ G'BAri.,u&ez 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. Sl2O .�S S° Y ° 7-d K. v 2y 2ZO 71 62Zo 1 3vS� 1 S .s-zo sJ36 1 ,S ZO Aos.0 O 2. z°y ° 4016 ,Sz z o z°s° 10 S 2a l S°s° i e"6a. Fvll t:k. n Z.�' S 5- TOTAL WINDOW AREA DOORS BRAND MODEL U-VALUE LOCATION SIZE TOTAL SQ. FT. if r- +4 1Cfk Z!T6 q TOTAL DOOR AREA_ �� WATTSUN 5.2 1991 WA STATE ENERGY CODE COMPLIANCE REPORT FILE. C: \WA'TTSUN5\CLF J1$69. WS HOUSE ID: Har'stene Island - lain. #415(p Site: 1569sq' Rambler Analyst: Jim Westall Jurisdiction; Utility. Sunset Air Homeowner : Spec, House Types Single Family/Duple:: Floor Area: 1569 ft2 Builder: Clearwater Properties Inc. Weather Data: Olympiao WA 825 S. 1st Climate Zone: 1 (206) 4?7•-9196 1 The PROPOSED design *COMPLIES* with 1991 WA 'State Energy Code. REFERENCE PROF'O2SE'D 1 C:(:JI"1PONE=N1' PERFORMANCE: 362 291 Stu/hr-F i ENERGY BUDGET 1. 74 2. 78 k:Wh/ft2--yr REFERENCE DESIGN Reference Gomponc:nt Value X Area Flour U-0. 041 1569 t�Q Glazing ►5% U-0. 650 ;Z5. 4 153. 0 Doors U-0. 4c:0 �42. 0 16.0 AS Wall U-O. 062 1 14 7 7 L . 1 Ceiling, Attic U- 0. 036 15S5 57. 1 1 of i 1trat ion ACH-0. 3 0 12552ft s. 80. q.1 Reference UA 367 --------------------------------------------------------------------------- - F'F,(:)E"OSE:D DESIGN COMPONENTS Component Description VZ-Alt.te X Area - UA On Grade Slab RIO 2' vertical F-0. 540 Oft 0.0 F loar RIF vented Joist: 16oc U-0. 04 1 1569 b4. 3 Glazing @13 **Vinyl 1/2'' U-0. 450 179. Q So. 5 **Wood 1/2" French Door U-0. 750 21 . C) 7. 3 Doers Metal R-5 base case U"-0. 190 42. 0 Ko AG Wall K9 STD Lap Woad U-0.U62 1122 73. 3 Skylights @1%**Vinyl 1/2'' U-0. 560 16. 0 7. 0 Items in parentheses not included in COMPONENT PERf=ORMANCE. totals. $S Denotes non-standard values - check calculation of thermal value. page � . WA'7T.SON 5.2 yY---==1991TWA STATE ENERGY TCODE rCOMPLIANCE-REPORT 1 2/21 /9` FILE: C: \WATT5UN5\CLRW1569.WS HOUSE ID: Har,tene Island - Pin. #f4150 wCeiling F:.1$�blown-Attic^STD ibaffled u-`rN0311569 16Y-6: -. Infiltration Standard Air Scaling ACTH-t 050 12552'ftZ ( e0&V Proposed UA 2-41 ,true Mass Light Frame, Sheatrock walls M- 3.000 1569 4707 ----------------------------------------------------------------------- HEATING/COOLING/VENTIL.ATING SYSTEMS PROPOSED Heating System Type: Heat Pvmp: Air Source Make: Carrier Model : 38YKDQT0/F84ANA030 System Efficiency: 7. 2 HSPF Modified Efficiency; 153 Design ACH: 0. 60 Heating Load(at 5.1F dt) : 23463 Btu/hr System Size: 31 . 4 kPtu/hr at 47F 21 . 0 kBtu/hr• at 1 /F maximum Size 050 : 10. 3 kW Auxiliary: 1 . 0 kW HP Balance Point: 16 F Average Annual Heat: 6325 kWh Annual Cost: $ 349 Ventilation System: Integrated bpot & Whole House Cooling Lead (at 5F dt ) : 19576 Btu/hr Recommended Size 0250 20 tong Solar Access: Partially Shaded --------------------------------------------------------------------------- - PF'tiOPOSED DUCT SYSTEM Location Avg Rvalue Surface Area SUPPLY Vented-crawlspace R- $10 313. 8 ft2 RETURN Attic or garage R- 8. 0 62.8 ft2 Page 2 ______������_=________��_�__-_____ 1 T 41 IWATT'SLIN 5. 2 1991 WA STATE ENERGY CODE COMPLIANCE REPORT 12/71 /91 FILE: C: %WATTSUN5\CLF:W1569.WS HOUSE ID., Harstene Island pin. 0411,() --------------------------------------------------------------------------------- GLAZING ORIENTATION PROPOSED PROPOSED South; 50.0 ft2 North: 50-0 ft2 SOLItheast: Northwest: East: 50. (.*) West: 5o.0 Northeast: SOUthWeSt: -------------------------------------------------------------------------- - Economic and energy consumption estimates are designed -Far comparative PUrpa5Es oilly. Actltal cost for heating will vary depending on weather conditions,, occupant lifesty1c-, and other factors. MASON COUNTY Permit No. BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 42`9 `q0 PLEASE PRINT #1 Owner C l w wATe R pr'edta , rix,_ Phone# 112 7- '1 ) Ci 6 Site Address Yba Rt1AO Fire District# City '%6✓L St � Zip QSSB Li Directions to Job Site B ro(k< e 4-o -rR ast,1 fn r)4 A t X14d �a do w /0 -sippae ^.'of 4,1Yl . AUD-V s5fra—A- Owner Mailing Address Z City 1-'L 6c St zip �$y Lien/Title Holder 0WV' ,f Address —C¢}Me Clty St Zip #2 Contractor Name CleWWArir R PrapL,1zTt1g& ,1 x, _Contractor Reg # Lt CARP�o70 R ] Address 92 S- ��`� Expiration Date_?. / Z 3 /91— City'S.c 1-61J St zip 9 8S$� Phone#_ �J Z 7-11 91:3 #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. z f 3 cz� - 32- . Legal Description-s`d Oa&Ala Lv f' � d�or'��la� z Z 7Z-. #5 Building Square Footage: (existing/proposed) 1st FI / / Bq_2nd FI 3rd FI / —' Loft / Basement / -- Deck / ^ #bedrooms 3 #bathrooms / Z Garage / IWO Carport (Cir . ace eta Other sq.ft. / #6 Use of building4e Describe work #7 Type of Job: New _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: t River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other f V n w i: 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 f P:�oxibina Fixtures ($3 each) Fee Mechanical Fixtures ($6 each) No. 2—Toilets CIRCLE FUEL TYPE: Gas Electri Bath Basins Heatpum , Other 3 gYK9V30/J'-B 1AtiA030 2Bath TubSIShove.- cv,-6 `� No. uDiia Fees _Showers Furn BTU Hot Water Htr Heatpumps Laundry Washer Vent Systems J_Sinks Spot Vent Fans � �. Floor Drains No. Boilers/Compressors CD Laundry Basins _ HP Dishwasher No. Air Handling Units �1 Disposal cfm# y Urinals No. Fire Protection Systems Other Auto. Fire Alarm Sys 50.00ek'� Fixed Fire Supp. Sys 50.00 Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00 TOTAL PLUMBING $ "I . Other Gas Outlets Wood, Gas, Pellet Stove O�cte � r 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 OF 180 DAYS AT ANY TIME AFTER WORK IS COM- TOTAL MECHANICAL $ 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. ( T X OWNER X BY�" 110 - DATE DATE _Z-/Z 7/ FOR OFFICIAL USE ONLY: Accepted by: Date:_ j DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: NO Environmental Health: k5m, Building Plan Review ' W Occupancy Group:R 3 M Type of Const: S- Fire Marshal: Other: Special Conditions: FEES Building Permit 362- OT) Plan Check Plumbing Fee �(S Mechanical Fee ��• Wood/Gas/Pellet Stove Radon Monitor $• Violation Fee Site Inspection Building State Fee Other F�` Other