HomeMy WebLinkAboutBLD93-01821 Final SFR - BLD Permit / Conditions - 8/10/1994 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
IC::U ::II:: II"..1 4: it 0 :'' 4.:::: II;Z: 0'11'11 :1 "II"" F O R INSPECTIONS CALL 4 2 7—9 6 7 0
BETWEEN 5pm AND 8am 427-7262
BLD93-1821 PARCEL : 32132329OO92 PLAT : DIV: ? BLK : ? LOT : ?
JOB ADDRESS : E 70 STONEBRIAR PL SHELTON
OWNER : ROBERT MCKIBBIN 427-7189
CONTRACTOR : JOHNNY ' S CUSTOM CONTRACTING 426-6207
LEGAL : Tr 2-8 of SW NW
CLASS OF WORK . . : NEW BEDR : 3 . BATH : 2 TYPE AMOUNT BY DATE RECEIPT TYPE AMOUNT BY DATE RECEIPT
TYPE OF USE . . . . : SF STORIES . . . . . . . : 1
OCCUP . GROUP . . . : ? BLDG . HEIGHT . . : O . Oft P R N T j 396:00 KS 03/08/94 35251 S T F E j 4.50 KS 0 3/0 8/9 4 35251
TYPE OF CONST . . : ? FIREPLACES . . . . : 0 R A 0 N j 8.10 KS 03/08/94 35251 E H F E j 1.00 KS 131/8/94 35 25 1
OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 P L C K j 198.01 KS 03/18/94 35251
DWELL . UNITS . . . . : 0 PARKING SPACES : 0 P L N j 48.00 KS 03/08J94 35251
INSPECTION AREA : 3 SHORELINE? . . . . : N NCH j 45.00 KS 13/18J94 35251 TOTAL: 699.51 VALULATION: 80244
SETBACKS-------------- TOILETS . . . . . . . . . . : 2 FUEL TYPES---------- BOILERS /COMP---- MOBILE HOME--
FRONT . . .W 5O . Oft BATH BASINS . . . . . . : 3 : ? 0-3 HP . : 0
REAR . . . . E 5 . Oft BATH TUBS . . . . . . . . : 1 3-15 HP . : 0 MODEL : ?
SIDE ( 1 ) . N 5 . Oft SHOWERS . . . . . . . . . . : 1 FURN < 1O0K BTU : 0 15-30 HP . : 0 —MAKE------
SIDE ( 2 ) . S 5 . Oft WATER HEATERS . . . . : 1 FURN >=1O0K BTU : 0 30-50 HP . : 0 ?
SHRLINE . ? O . Oft CLOTHES WASHERS . . : 1 FURN — FLOOR . . . : 0 50+ HP . : 0 —YEAR------
AREA ---------------- KITCHEN SINKS . . . . : 1 HEAT PUMP . . . . . . : 0 ?
LOT SIZE . . : ? FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH : 0
BUILDING . . . : 1724sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 0
BASEMENT . . . : Osf LAUNDRY TRAYS . . . . : 0 DOMES . INCIN : O —SERIAL*----
DECKS . . . . . . : 25Osf DISHWASHERS . . . . . . : 1 AIR HANDLING UNITS-- COMML . INCIN : O ?
GAR/CARP : G 528sf GARB DISPOSALS . . . : 0 <= 10000 cfm . : 0 RELOC /REPAIR : 0
AT/DT . : A URINALS . . . . . . . . . . : 0 > 10000 cfm . : 0 OTHER UNITS . : 0
MISC PLM FIXTURES : 0 GAS OUTLETS . : 0
PROJECT 0ESCRIPTI0N:RESI0ENCE
i R 0 J E C T L0CATI0N:ACREAVEY ROAD TOWARD UNION, TURN RIGHT ON J E N S E N ROAD, THEN LEFT INTO STONE8RIAR, S E C 0 N 0 LOT ON THE RIGHT.
THIS PERMIT BECOMES NULL A N 0 VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 186 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED FOR A PERIOD
OF 181 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECTION WITHIN THE 180 0 A Y PERI00. FINAL INSPECTION MUST BE
APPROVED BEFORE 8UIL0IN6 CAM BE OCCUPIED.
OWNER OR AGENT: DATE:
Ri n DDYT roar. Al 11 I01 rnmpl Tam F Tn GTTarwFn f nunTTTf1 C TC RFf11iTAFf1
MASON COUNTY
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- Mason County Bldg. III 426 W. Cedar
t " P.O. Box 186 Shelton, Washington 98584
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1 i)N!-1sA' Tlif� ' 10"NMY O S CUS70M CONTRAC I M; 42.6-6207
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CONCRETE MECHANICAL }},,��, � MOBILE HOME
Footings- ttiack W(� date 05(-/k-9u byrd"FiK� Ribbons .
date Q by _ Gas Piping date b
Foundation I
s date by Set Up
date be INSULATION date by
BG/SLAB Ins lation Floors Final
date by date by date by
FRAMING FIRE DEPT.
date D y /8 -9 y by d tes U D date by
PLUMBING Attic y --Z b y � OTHER
Groundwork
date by
date b
D.W.V. WALLBOARD NAILING
date D y-/�-gfC by d
ate
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MASON COUNTY
BUILDING III 426 W. CEDAR
SHELTON, WASHINGTON 98584
(206) 427-9670
CORRECTION NOTICE
Job Location <�-- ?0
3'!�:& /�L��/,�' a, 5
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 compliance
gain code
9
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 C Inspector 6 C1
NOT M 4 ov-
t14 I T
MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(206) 427-9670
CORRECTION NOTICE
Job Location _ 7C S'To --%
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
w ll/ f345 ,¢,o�,
14
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 7— Inspector
■ loos NnT MnV THI, Tmkolw
i
MASON COUNTY
- Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Case No . : BL093-1821
For : ROBERT MCKIBBIN
Page : 1
1 ) The use , handling and storage of hazardous materials or flammable and combustible
liquids in excess of 10 gallons is not allowed without the approval of the Mason County
Fire arshal .
X
2 ) Pro osed structure or any portion thereof greater than 30" in height from grade line ,
must intain a minimum of 5 ' setback from all property lines , easements and right of
ways .
X
3 ) All approved plans are required to be on—site for inspection purposes . 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 . +I
X I
4 ) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305 ( C ) AND SECTION 513 , 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 COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
REINSPECTION FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE
ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
INSPEC ONS .
X
5 ) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC
6 ) Changes to approved building plans that effect compliance to the 1991 Washington State
Energy Code , 1991 Ventilation and Indoor Air Quality
Code , the Uniform Building Code and /or Mason County Reg Na ons mus
be approved by Mason County prior to constructionX
7 ) THIS PROJECT WILL MEET THE LONG TERM SUPER GOOD CENTS REQUIREMENTS AS AGREED UPON WITH
THE ELECTRIC UTILITY SERVICING THE PROPERTY . INSPECTIONS FOR ENERGY CODE COMPLIANCE
I
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
II
I
MASON COUNTY
�\ Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton Washington
g on 98584
(INSULATION & INDOOR VENTILATION) WILL BE PERFORMED BY A UTILITY REPRESENTATIVE .
If changes occur and you decide not to go with the LTSGC program contact the MCBD at
extension 284 to arrange energy code compliance .
x
a
— - I
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
R
l
Page No. 1 CASE HISTORY FOR CASE NO.: BLD93-1821
ROBERT MCKIBBIN
E70 STONEBRIAR PL SHELTON
04/18/94
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
------- ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- ---
BLDA010 Application received / / / / 12/02/93 12/02/93 KW
BLDA100 Approved For Issuance / / / / 03/02/94 DONE KS 03/02/94 KS
BLDA500 (F) Issue building permit / / / / 03/08/94 DONE KS 03/08/94 KS
BLDA940 RLC Checklist Completed / / / / 12/03/93 DONE PRM 12/06/93 MMS
BLDB110 Structural Plan Review 12/03/93 / / 12/22/93 DONE WLC 12/22/93 WLC
BLDB120 WSEC Compliance Review 12/22/93 / / 12/27/93 LTSGC PUD3-ELECTRIC HEAT LTSG DC 12/27/93 DLC
BLDB129 Sent to Planning / / / / 12/02/93 12/02/93 KW
BLDB130 Planning Review 12/06/93 / / 12/06/93 DONE MMS 12/06/93 MMS
BLDB135 Addressing / / / / 12/09/93 DONE GMM 12/09/93 GMM
BLD8200 Environmental Health Review 12/27/93 / / 12/28/93 Need approved design and permit HOLD MMT 12/28/93 MMT
BLDB200 Environmental Health Review 03/02/94 / / 03/02/94 PER SEPTIC PLANS DONE CAJ 03/02/94 CAJ
BLDB210 Water Adequacy 12/27/93 / / 12/27/93 DONE MMT 12/28/93 MMT
BLDB210 Water Adequacy 03/02/94 / / 03/02/94 STONEBRIAR - 4TH CONNECTION TO A 6 DONE CAJ 03/02/94 CAJ
PARTY WELL
BLDC111 Footing/Foundation Wall Inspct 03/07/94 / / 03/10/94 2' wall no inspection told them about PASS WLC 03/10/94 WLC
lateral restraint holddowns garage.
9
3
v
50
l
qgq
r3�
ilartne)
LOT 4 Lo
ri
00 AC.
vi
LOT 3 I I — 312.90
10 AC. I o I 15 ' DRAINAGE AND
2 i� Icd ® I ►� UT I L I TY EASEMENT
�l\ I "'Vl1 LOT `°
1 . 000)
AC. -
r ,
WELL NO. 3
L1LOT
_ \ \ 1
VIELF, NO. 2 N1 ci (`, LOT 4
N �� !; 1 . 90 AC. WATER SY i S 89'47'10' W 445.63 I STEM
_S 89 7 �`I�`` EASEMENT
' '4 '10' W 4?_6.73 -� � -K��
S 89'47 10' W 415.30 --7—® --� J
WIFUL
to
--'3.29 AC.-i-
III
40 SCALE. 1"=100'
50 100 200
O
O / I I \ \ EDOF._
� �j � I I \ \� PA t�Elf�N
LOT 1 1 � ���� — —
I
0 1 .00 AC. I 1 �\ I= mm
25 ' GREEN
rn
ARE
A
AEA I l �
EASEMENT I �
o I ,
�o
I I ( �, LOT 3 i 13O 30 EASEMENT
LOT 2 I I � FOR
I I 1 . 00 AC. ( I 1 . 00 AC. 1 ; �(, T ,4 I. w INGRESS, EGRESS,
I I ( I 1 � 1 .30 AC. I n o AND UTILITY PURPOSES
# 321323200040 I I I to "' AF,#278563 r (i♦ r -r I I . p
I `'
94.59 124.21 � � � HOL MA _ -
194.15 N & ASSOCIA TES
244.51 S 88 59 27" E 657.46 PROFESSIONAL LAND SURVEYORS
2323 N. ADAMS SHEL TON, WA .
(206)426-2990 98584
t
BUILDER\HOMEOWNER AGREEMENT LTSGC## 93-0492
Super Good Cents
HOMEOWNER: ROBERT MCKIBBIN PHONE: 427-7189
SITE ADDRESS: LOT 2 STONEBRIAR ACCT:
MAILING ADDRESS :
BUILDER: JOHNNYS CUSTOM CABINETS PHONE: 426-6207
MAILING ADDRESS : 280 SE WILDCAT COVE
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 penetrations are sealed) .
X Following installation of insulation and vapor retarder
but prior to covering.
X Final inspection - all components installed.
X Other AS NEEDED.
NOTE: Final inspection by our Super Good Cents Department must be
completed prior to the final inspection of the appropriate Building
Department.
It is understood that the Super Good Cents Department is to be
notified at 426-0777 or 426-8255 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, 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.
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 p Cents home.
Signed:
Homeowner er
k\,- 30 - 43
Date a e
Federal ID# or ocial Sec. # Federal ID# or Social Sec. #
U y Representative
TONI HERMANSEN
Utility epresen a ive (_p_r-1_nET
NOVEMBER 30, 1993
Date
Homeowner conservation incentives may be paid directly to homeowner,
or applied as a credit on your utility account.
i
LE: A:jOHN.W,.*-;
Site: L2, STONEBRIER Analyst: TON! HERMANGEi,i
SHELTON, WA 98584 jurisdiction: MASON COUNT-,,
Utility: MASON COUNTY RUD 44
Homeowner: BOB MCKIBBIN House Type: Single Famll�.,
L2, ST ONE BRIER Floor Area: 1724 fK''
( 206 )
Mi
ibf
Builder: jOHNNYS CUSTOM CABINETS Weather Data: Olympia, wA
280 SE WILDCAT COVE Climate Zone: J..
( 206 )426-6207
1 The PROPOSED design QUALIFIES for SOC( 91 MCS ) Tier 1.
REFERENCE PROPOSED
1 COMPONENT PERFORMANCE 3 3 21 332 Btu/hr—1:7
1 ENERGY BUDGET 2.817 2.93 kWh/ft2-yr
REFERENCE DESIGN
Reference
Component Description Value X. Area
-----------------------------------------------------------------------------
Floor R30 vented joist U-0.029 1724
Glazing @15% 0.35 U-value U-0.350 258.6 900;5'
Doors Metal R5 base case U-0. 190 42.0 0 .
MU wall R21+R5 ADV U-0.041 1348
Ceiling, Attic R49 blown Attic ADV 1 1-0.020 1760
infiltration Standard air sealing ACH-0.350 14461fQ von.J:
----------------------------
Reference UA 3 5
-------------------------------------------------------------------------------
PROPOSED DESIGN COMPONENTS
Component Description Value X Area
--------------------------------------------------------------------------- .......
F I o or R30 vented joist 16oc U-0.029 1724 50 .k)
Glazing @14% ""ALPINE LOWE/AR X0/PIC/CA0 U-0.32C.; 180. 0 558_'-
%%ALPINE LOWE/AR PATIO U-0.4' CA-) ,A/ .41.0
-TAVANTI FULL LITE LOWE/Ai.:i U-0.306 021.0
Doors %=INSULATED DOOR U-0.141-1 21.0 2,9.-�::
KAPEACHTREE AVANT! A300 OR EQUAL U-0.090 21.0 1, 9:4
-------------------------5--------------------------------------------------------
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 1
WATTSUN 5.3 LONG TERM SUPER 00010 CENTS/1991 MCS COMPLIANCE REPORT 11Y10''
LE: A:jOHN.W,-.-' HOUSE TD: Mi&i SF
G Wa R2 A LPA QA WOOD U-0.049 1365
Skylights 0 ""ALPINE SKYLITE U-0.590 8. 0
Gelling R49 blown Attic ADV U-0.020 410
P49 blown Attic AD;J
R49 blown Scissor 5:12 ADV U-0.020 300
R49 blown Scissor 5:12 ADV U-0.020 612 L2 ,
infiltration 3tan a drd Air 3ealip;;j ACH-0.350 14461fts 02 , .
---------------------------
Proposed UA A32
Struc Mass Light Frame, Sheetrock wells M- 3.000 172a 51K
------------------------------------------------------------------------------
HEATING/CDDLING/VENTILATINO SYSTEM,*.;
PROPOSED
Heating System Type : Electric: Zoned
System Efficiency: too %
Modified Efficiency: too It;
Design AGH: 0.60
Heating Load( at 52F dt ): 21080 Btu/hr
System Sloe: 6.2 kW
Maximum Sime @150%: 9.3 0,0
Average Annual Heat: 7324 k4h-,
Annual Cost: $ 330
Ventilation System: integrated Spot
is Whole House
cooling system:
BEER. 0.0
Cooling Load( at 5F dt ): 20904 Btu/hr
Recommended Size @125%: 2. 4 tons
Annual pool requirement,", so= kWh/yi-
Solar Access: Partially Shaded
-
------------------------------------------------------------------------------ --
BLAZING ORIENTATION
PROPOSED PROPOSED
South 60.5ft2 North 60.5ft2
Southeast Northwest
Northeast Southwest
-------------------------------------------------------------------------------
Economic and energy consumption estimates are designed for comparative
purposes only, Actual cost for heating will vary depending an weather
conditions , Occupant lifestyle and other factors.
Page 2
l
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
nn
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 ��0S Z`
PLEASE PRINT �
#1 Owner 1` cb� 4 G\(1 \bb M Phone# 474— 71 S9
Site Address 'F- -1 O S-to Y1 Q- b r t ar ko'<-e- Fire District# S
City C—� k-e v� k . St u3Ru Zip gfSsi?4
Directions to Job Site Q n 6k b v-%
%^d Vc
Owner Mailing Address "3 Z O \ �-�o�� �.� y�rz Z 1 ,� `.10 .
City St Wco-, Zip -
Lien/Title Holder No N T'�
Address
Clty St Zip
#2 Contractor Name--5O\-\h -D. Ar c-o,* b Vz'h )&'my's &ASt4)VV1� Contractor 43eg
Address 2.160 cQ E. Expiration Date t l /fib _/ c%Lk
City St ',o cL, Zip Phone# 20 b - y2b -b Z ti-1
#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.1 Z 13 Z - Z - do Z
Legal Description T Ek 2. O S (0"9- 22-- L*
#5 Building Square Footage: (existing/proposed)
1st FI \1 'A-a / 2nd FI '\J / Pr 3rd FI A/ / Loft ti/ / 'k- _
Basement_ Deck '-SO / #bedrooms :3 / #bathrooms / 3
Garage Carport / (Circle(Attached r Detached?)
Other sq. ft. /
#6 Use of building &-5 LA-C V\C- Describe work
C._.mvt k s k�r v.c_-fir t e ,"\ 'ca4 t/le.-
#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: hh�
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other 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
312 . oe N
I70
.�5
1 \ I
a
i
r 3 oC
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
0.S�C.C,(1� ct ��� VAO r`ay. �V\,I �VCs�I
S (O?o- OU0arA �O�
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No.1- Toilets CIRCLE FUEL TYPE: Gas, Electric,
3 Bath Basins Heatpump, Other
Bath Tubs 3 No.. Units Fees
Showers Furn BTU
t Hot Water Htr 3 Heatpumps
Laundry Washer 3 Vent Systems
cc%
Sinks 4 Spot Vent Fans `f cam;
_Floor Drains No.. Boilers/Comlressors
_Laundry Basins HP
Dishwasher 3 No.. Air Handling Units
_Disposal I cfm# 'gc
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 APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY cA --- Q
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW •
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning: �\o
.17
Environmental Health:
Building Plan Review
U"
Occupancy Group:�9 3��—Type of Const: 5
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check Cl
Plumbing Fee 1{
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor ,
Violation Fee
Site Inspection
Building State Fee .
Other
Other
Building Valuation: Zyy TOTAL FEE