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HomeMy WebLinkAboutBLD2000-00311 Final SFR and Garage - BLD Permit / Conditions - 12/10/2001 Line 360) 27- 262 ection MASON COUNTY PERMIT ASSISTANCE CENTER Phonpe: (360)427(96704ext7352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 ti RESIDENTIAL BUILDING PERMIT BLD2000-00311 OWNER: EDWARD SMITH CONTRACTOR. RECEIVED: 03/20/2000 SITE ADDRESS: 530 E MIKKELSEN RD SHELTON ISSUED: 05/17/2000 PARCEL NUMBER: 321341390112 EXPIRES: 11/17/2000 LEGAL DESCRIPTION: TR 2 OF SP#2478(R) SEE SURV 8/32 + SP #784 E 530 MIKKELS PROJECT DESCRIPTION: DIRECTIONS TO SITE: RESIDENCE AND GARAGE MASON LK RD TO MIKKELSEN RD General Information Construction & Occupancy Information Square Footage Information No. of Bedrooms: 3 Type of Constr.: 5N Type of Use: SF Insp. Area: No. of Bathrooms: 2 Occ. Group: R3U1 Lot Size: Deck: Type of Work: NEW Fire Dist.: 5 No. of Stories: 1 Occ. Load: Building:1,112 Garage-Attached 576 Valuation: $69,076 Building Height: 14 Occ. Status: Unknown Basement: Cvr Porch 12 Manufactured Home Information Setback Information Shoreline & Planning Information Make Length: Ft. Front: N 25.0 Ft. Shoreline: Ft. Water Body: Model: Width: Ft. Rear: E 20 Shoreline es .0 Ft. Slope: Ft. SEPA?: oreline Di Side 1: E 20.0 Ft. g.: Year: Serial No.: Side 2: W 25.0 Ft. Comp. Plan Desi .: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Dishwasher 1 Exhaust Hood 1 Plan Check Fee KLW 03/20/200 $42.00 52927 Hosebibs 2 Ventilation Fan 2 Building State Fee MJB 04/21/200 $4.50 53453 Kitchen Sink 1 Building Permit Fee MJB 04/21/200 $699.75 53453 Lavatories 2 Mechanical Fee MJB 04/21/200 $22.50 53453 Showers 1 Mechanical Base Fee MJB 04/21/200 $22.00 53453 Water Closets (Toilets) 2 Plumbing Fee MJB 04/21/200 $75.00 53453 Water Heaters 1 Plumbing Base Fee MJB 04/21/200 $20.00 53453 Bath Tubs 1 Planning Review Fee SLO 05/04/200 $38.00 53453 Clothes Washer 1 Public Works Review SLO 05/04/200 $31.10 53453 Environ. Health Plan PSD 05/15/200 $50.00 53453 !}svi�tro Total $1,004.86 BLD2000-00311 Please refer to the following pages for conditions of this permit. 1 of 4 8) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE • PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF OR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x 9) Changes to approved building plans that effect compliance to the 1991 Washington State Energy Code, 1991 Ventilation and Ind o r it Quality Code, the Uniform Building Code and/or Mason County Regulations must be approved by Mason County prior to constructionX_ 10)' CONSTRUCTION PROCE TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x 11) All property lines shall be clearly identified at the time of foundation inspection. X_ 12) The Mason County Resource Lands and Critical Areas Ordinance requires vegetative management of the site. There shall be a minimum disturbance of trees and vege tion in order to minimize erosion and stabilize Landslide Hazard Areas. Limbing trees for view purposes is preferred over tree removal. Veg t on removal on the slopes of banks shall be maintained to the greatest extent possible. X 13) Regulations whi(h apply for GRADING of the site (per Mason County Resource Lands and Critical Areas Resource Ordinance): A. No grading shall be performed in Landslide Hazard Areas or slide prone areas prior to obtaining a grading permit subject to approval by the Director and based on recommendations contained in the geotechnical report with slope stability analysis and grading recommendations. B. Clearing, grading, and other construction activities shall not aggravate or result in slope instabiinstability or surface sloughing. C. Undergrowth shall be retained to the extent feasible. D. Clearing methods which minimize soil disturbance shall be used. E. No fill, dead vegetation (slash/stumps), or other foreign material shall be placed within a Landslide Hazard Area. X --4 --- 14) All conditions and recommendations outlined in a geo-technical report by Geotechnical Testing Laboratories dated May 2, 2000 shall be met. This shall include a mina of a 15 foot setback for structural improvements and a 25 foot setback for septic drainfield installation. X_ 15) All upland areas disturbed or newly d by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X BLD2000-00311 Please refer to the following pages for conditions of this permit. 3 of 4 This-permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended fora period or180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before bui ing can be oc upi OWNER OR AGENT: DATE: BLD2000-00311 Please refer to the following pages for conditions of this permit. 4 of 4 I' i- rCONCRETE 1e7t ra MECHANICAL MOBILE HOME Footings-Setback oK pLK CO2vl�SrO"5 date `-�J'�l by, Ribbons date S=Z(.— ZO 0 o by g Gas Piping date b Founda n Wall 1 date by Set Up date by l INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING , Walls FIRE DEPT. date t by date `/—2.7 - Z OO I by " !>2 Ij date by PLUMBING Attic OTHER Groundwork date b date _by _ WALLBOARD AILING f 4w T D.W.V. dates U/ byOt.� date -, 7- LC C"1 by Water Line FINAL INSPECTION / date 7— e'1 byy� date Z by Lam/ date by 2t0/ Id s G o 10 1c,. 2L r, Side r�' Gk �,L�.�,c f►/� .� 04 a /ui i�. A LL Ro-r �/11, n, 1f� " I O/ Aa 4 /gSSea/ JAD 1 LA-3 F-I vW 4 1 f^V y LA SHORT PLAT OF LOT D SHORT PLAT NO. 784 Al ?NOR T FOR 5. E 2�5' / PL A T ED SM 1 TH °A CURVE TABLE GLAVEN M 0A T E P. O. BOX 633 C I A600/ '47' R 443. 90 L 46. 72 C 6 y0y Q ',PPROV D 0 C 2 0 35 l9'08' R 312. 71 L 192. 76rL OLYMPI A. WA. 98548 / a- � C 3 A0008'54' R 312. 71 L 0. 8l Z p (206) 352-4439 ® �9 Lu C 4 0 2.12'l 8' R 929. 32 L 35. 76 �0 T 4 j C 5 A 7°46;34: R 929. 32 L 126. 13 C 5 0. 52 AC yoy60 W r%FEL OR OF C 6 0 80 2l 26 R 929. 32 L 135. 55 s, ca / mN $� �a o � o " ITY WARNING . MASON COUNTY HAS NO +� � ,/ `��+ J, k m ) PMENT RESPONSIBILITY TO BUILD. CENTERLINE MI CKEL SON ,0°� ® LOT 3 ,��' cn O MAINTAIN, IMPROVE OR OTHERWISE COUNTY ROAD ,y6 , LOT 2 SHORT Q � p SERVICE THE PRIVATE ROADS y y �, 0. 40 AC 0a ,h'h' m �A fpp' s� cV PLAT • 782 APPROX. CENTERLINE OF CONTAINED WITHIN OR PROVIDING ( GLAVEN ) C ! `''`�� N ( BOWER LOT ) `CRANBERRY CREEK PER SERVICE TO THE PROPERTY C 2 4 2 . 46 C 0 SCALE VOL. 8 OF SURVEYS, PG. 32 DESCRIBED IN THE 77 .� SHORT PLAT. C /� �e1,24 to aw LOT l o�sQ"� �a a0 0 160 200 ' O tS WAS 35 �' � . � c S 82'01 '39' E 7 • = 5/8 " REBAR /PLASTIC ` LOT C SHORT PLAT 449' gs CAP SET S 28237 t�0a LEGAL DESCRIPTION NO. 784 5' WATER L INE O = 1/2 " REBAR W PLASTIC 7 ( SEE ATTACHED SHEETS ) ( FLETCHER ) EASEMENT CAP FOUND 11355 I1 10. 64 ® = SOIL LOG A PORTION OF THE SOUTHWEST QUARTER OF pig THE NORTHEAST QUARTER CF SECTION 34, ( SAHLI ) W APPROX. CENTERLINE TOWNSHIP 21 NORTH, RANGE 3 WEST. W. M. COMMON/TY WELL LOT B � CRANBERRY CREEK PER IN MASON COUNTY, WASH I NGT ON. SHORT PLAT 784 N LOCATED ON THIS LOT VOL. 8 OF SURVEYS - �' AGATE LAND SURVEYING PARCEL NO 's. 32134 1 3 901 10 Z LOT 1 SHORT 'Pq� PAGE 32 PLAT • 782 E. ?E80 AGATE RD. CENTER SEC 34, T. 21 N. , ( SMITH ) R. 3 W. , W.M. - Sf-EL TON, WA SH 98584 - 282. 62 N 89047'44 W R) 1260. 55 M) 1260. 70 (4"06 ) 426-481 8_ l A237-10 LEASE WITH PURCHASE OPTION R237-04 BY THIS AGREEMENT made and entered into on 7/ Z� (year),betwee �40ke� ern ITN' in referred to as lessor,and i?rLQr,� y y�Y Srn i herein referred to as Lessee,Lessor reases*to Lessee the premises situated at ,in the City of'$Pckcounty of A4 Sc-)J ,State Of 4.9 iA 1,44 and more particularly described as follows: together with all appurtenances,for a term of 1S ftwT46,to commence on C' 10 t 0710V (year),and to end on (year),at o'clock .in. 1. Rent. Lessee agrees to pay,without demand,to Lessor as rent for the demised premises the sum of r Dollars ($ 7 TV oo )per month in advance on the day of each calendar m ntl'begmnldgy (year),payable at ,City of j��C7�n/ ,State of f0�L ,or at such other place as Lessor may designate. 2. Security Deposit. On execution of this lease,Lessee deposits with Lessor Dollars ($ _4:i� ),receipt of which is acknowledged by Lessor, as security for the faithful performance by Lessee of the terms hereof,to be returned to Lessee,without interest,on the full and faithful performance by him of the provisions hereof. 3. Quiet Enjoyment. Lessor covenants that on paying the rent and performing the covenants herein contained, Lessee shall peacefully and quietly have,hold, and enjoy the demised premises for the agreed term. 4. Use of Premises. The demised premises shall be used and occupied by Lessee exclusively as and neither the premises nor any part thereof shall be used at any time during the term of this lease by Lessee for any other purpose. Lessee shall comply with all the sanitary laws,ordinances,rules,and orders of appropriate governmental author- ities affecting the cleanliness,occupancy, and preservation of the demised premises, and the sidewalks connected thereto, during the term of this lease. 5. Condition of Premises. Lessee stipulates that he has examined the demised premises, including the grounds and all buildings and improvements,and that they are,at the time of this lease,in good order,repair,and in a safe,clean,and ten- antable condition. 6. Assignment and Subletting. Without the prior written consent of Lessor,Lessee shall not assign this lease,or sublet or grant any concession or license to use the premises or any part thereof. A consent by Lessor to one assignment,subletting, concession,or license shall not be deemed to be a consent to any subsequent assignment,subletting,concession,or license. An assignment,subletting,concession,or license without the prior written consent of Lessor,or an assignment or subletting by operation of law, shall be void and shall,at Lessor's option,terminate this lease. 7. Alterations and Improvements. Lessee shall make no alterations to the buildings or the demised premises or construct any building or make other improvements on the demised premises without the prior written consent of Lessor. All alter- ations,changes,and improvements built,constructed,or placed on the demised premises by Lessee,with the exception of fixtures removable without damage to the premises and movable personal property, shall, unless otherwise provided by written agreement between Lessor and Lessee,be the property of Lessor and remain on the demised premises at the expi- ration or upon sooner termination of this lease. 8. Damage to Premises. If the demised premises,or any part thereof, shall be partially damaged by fire or other casual- ty not due to Lessee's negligence or willful act or that of his employee, family, agent, or visitor, the premises shall be promptly repaired by Lessor and there shall be an abatement of rent corresponding with the time during which, and the extent to which,the leased premises may have been untenantable;but,if the leased premises should be damaged other than by Lessee's negligence or willful act or that of his employee,family,agent,or visitor to the extent that Lessor shall decide not to rebuild or repair,the term of this lease shall end and the rent shall be prorated up to the time of the damage. 9.Dangerous Materials. Lessee shall not keep or have on the leased premises anything of a dangerous,inflammable,or explosive character that might unreasonably increase the danger of fire on the leased premises or that might be considered hazardous or extra hazardous by any responsible insurance company. 10. Utilities. Lessee shall be responsible for arranging for and paying for all utility services required on the premises, except that shall be provided by Lessor. 11.Maintenance and Repair. Lessee will,at his sole expense,keep and maintain the leased premises and appurtenances in good and sanitary condition and repair during the term of this lease and any renewal thereof. In particular,Lessee shall keep the fixtures on or about the leased premises in good order and repair;keep the furnace clean;keep the electric bells in order;keep the walks free from dirt and debris;and,at his sole expense,shall make all required repairs to the plumbing, range,heating apparatus,and electric and gas fixtures whenever damage thereto shall have resulted from Lessee's misuse, waste, or neglect or that of his employee,family, agent, or visitor. Major maintenance and repair of the leased premises, not due to Lessee's misuse,waste,or neglect or that of his employee,family,agent,or visitor,shall be the responsibility of Lessor or his assigns. Lessee agrees that no signs shall be placed or painting done on or about the leased premises by Lessee or at his direction without the prior written consent of Lessor. 0 53926 20237 9 Rev.6/98 ATHH 12. Right of Inspection. Lessor and his agents shall have the right at all reasonable times during the term of this lease and any renewal thereof to enter the demised premises for the purpose of inspecting the premises and all build- ing and improvements thereon. 13.Display of Signs. During the last days of this lease,Lessor or his agent shall have the privilege of displaying the usual"For Sale"or"For Rent"or"Vacancy"signs on the demised premises and of show- ing the property to prospective purchasers or tenants. 14.Subordination of Lease. This lease and Lessee's leasehold interest hereunder are and shall be subject,subordi- nate, and inferior to, any liens or encumbrances now or hereafter placed on the demised premises by Lessor, all advances made under any such liens or encumbrances; the interest payable on any such liens or encumbrances,and any and all renewals or extensions of such liens or encumbrances. 15.Holdover by Lessee. Should Lessee remain in possession of the demised premises with the consent of Lessor after the natural expiration of this lease;,a new month-to-month tenancy shall be created between Lessor and Lessee which shall be subject to all the terms and conditions hereof but shall be terminated on' days' written notice served by either Lessor or Lessee on the other party. 16.Surrender of Premises. At the expiration of the lease term,Lessee shall quit and surrender the premises here- by demised in as good state and condition as they were at the commencement of this lease,reasonable use and wear thereof and damages by the elements excepted. 17.Default. If any default is made in the payment of rent,or;any part thereof,at the times hereinbefore specified,or if any default is made in the performance of or compliance with any other term or condition hereof,this lease,at the option of Lessor, shall terminate and be forfeited, and Lessor may re-enter the premises and remove all persons therefrom. Lessee shall be given written notice of any default or breach,and termination and forfeiture of the lease shall not result if,within days of receipt of such notice,Lessee has corrected the default or breach or has taken action reasonably likely to effect such correction within a reasonable time.Lessee shall pay all reasonable attorneys'fees nec- essary to enforce lessor's rights. .,. 18.Abandonment. If at any time'during the term of this lease Lessee abandons the demised premises or any part thereof,Lessor may,at his option,enter the demised premises by any means without being liable for any prosecution therefore,and without becoming liable to Lessee for damages or for any payment of any kind whatever,and may,at his discretion; as agent for Lessee, relet the'demised premises, or any part thereof,for the,whole.or any part of the then unexpired term,and may receive and collect all rent payable'by virtue of such reletting,and,at Lessor's option, hold Lessee liable for any difference between the rent that would have been payable under this lease during the bal- ance of the unexpired term,if this lease had continued in force, and the net rent for such period realized by Lessor by means of such reletting. If Lessor's right of re-entry'is exercised following abandonment of the premises by Lessee; then Lessor may consider any personal property belonging to Lessee and left on the premises to also have been abandoned, in which case Lessor may dispose of all such personal property in any manner Lessor shall deem proper and is hereby relieved of all liability for doing so. 19. Binding Effect. The covenants and conditions herein contained shall apply to and bind the heirs, legal repre- sentatives,and assigns of the parties hereto,and all covenants are to be construed.as conditions of this lease. 20. Radon Gas Disclosure. As required by law, (Landlord)(Seller)makes the following disclosure: "Radon Gas"is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient quantities,may present health risks to persons who are exposed to it over time.Levels of radon that exceed federal and state guidelines have been found in buildings in Additional information regarding radon and radon testing may be obtained from your county public health unit. 21. Lead Paint Disclosure. "Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead poisoning.Lead poisoning in young children may produce permanent neurological damage,including learning disabilities,reduced intelligence quotient,behavioral problems and impaired memory. Lead poisoning also poses a particular risk to pregnant women.The seller of any interest in residential real estate is required to provide the buyer with any information on lead-based paint hazards from risk assessments or inspection in`the seller's possession and notify the buyer of any known lead-based paint hazards.A risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase." 22.Purchase Option. It is agreed that Lessee shall have the option to purchase real estate known as: 00 for the purchase price of ' 9�s�svv r" Dollars($ y L. � � ) with a down payment of Dollars($ ) payable upon exercise of said purchase option,,and with a closing date no later than days thereafter. This purchase option must be exercised in writing no later than (year), but shall not be effective should the Lessee be in default under any terms of this lease or upon any termination of this lease. IN WITNESS WH); OF,the parties have executed this lease on the year above written. ssor sse NOTICE: State law establishes rights and obligations f parties to n a ments. gre in to comply with the Truth in Renting Act or the applicable Landlord Te t Statute or code of your state. If you have a question about the interpretation or legality of a provision of this agreement,you may want to seek assistance from a lawyer or other qualified person. PERMIT NO.: BLD aR-6D31 I MASON COUNTY BUILDING PERMIT APPLICATION 3 ZO 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner 49E-OAlV f340iix.0 Contractor Name OLlJlZ/�� Mailing Address Mailing Address City;4 •t7a7/ State�%L Zip Code City State Zip Code Phone( 3/�) f�27-ZL%-15ther Ph.(31o0 ) 2Lo- Ph.( Other Ph.( Lien/Title Holder rr-y Contractor Reg. # Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well LWater System Name of Water System b PARCEL INFORMATION-12 digit Tax Parcel No. 32/34 / !S/ 90/J Z- Fire District S- Legal Description Tie y a�' _10510 4L1 Site Address(Please include street name, street number `cl y)_-SAD 9- .5,�4To A.) Directions to site Mq eA-, Ak Pb_ - rO /Y!]"Am--4 L© _ j I Will timber be cut and sold in parcel preparation? (Yes/No) Is your property within 200' of the following: Body of Water (Name)_ Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs j TYPE OF B Cnr-�-� Adder Alt Repair Other Use of BuildingOE�- Describe Work No. of Bedrooms No. of Bathroo y SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basemen Deck Other sq. ft. Garage_ Attached ✓betached Carpo Attached Detached i MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. �edrooms No. of BathrooType of Heat Purchase Pr Rplacement Unit ?(Yes/No) ° Irfstaller Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes s be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by D G-, bmittal Amount Due <�)` Receipt No._I�D DEPARTMENTAI»;REVIEW APPROVED DENIED CONDITION CODES Building Department Ha .2 a1 00 Occ Grou 3v' Type Constr. 50 too Planning Department Environmental Health Department Public Works Department Fire Marshal ' j Valuation $ FEES Building Permit Fee )S Site Inspection Plan Review Fee STDcK Pt le 00 UFC Plan Review Fee Plumbing & Base Fee 00 Public Works Review Fee Mechanical & Base Fee cv Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) v:.fi.{w:::::::.�::::::::::::::::::::::::•::. J..w..+iNii: %>.v'ti>ti"ti:S:uj:•?.:':;:::'vi:ii vi:4:v:•ii:^:......iiii:v:.i:J::L:iiii ................................... :.... •:.:..>. ..y:.?..................................... TOTAL FEES :;•.:::..:..:.:. ....:..:..:FX?•::•isdt.�.�:ii:.}.{+..•$.:.:.?F:v+i]v+::??wi::???:�:i;.iiii:•i:ii::ii:.i:iii�iii:::i:.i PERMIT NO.: MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275.4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner AEPvoga Contractor Name Mailing Address Mailing Address City Jy State k)k Zip Code S City State Zip Code Phone(---,�60)U*2- 1-2 EWtther Ph.(36cA 6 Ph.( Other Ph.(� Lien/Title Holder E'�w.IAQ'� '�rti,tT%.}r Contractor Reg. # Address Expiration SEPTIC INFORMATION-Connect to New Septic_ Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. '3 Z 1 J / VOU 21 Ire District Legal Description TE' 2- Site Address(Please include street name, street number and city) K &U . Directions to site r— °I S Is your property within 200' of the following: Body of Water(Name) 411A - Saltwater, Lake River/Creek Pond Wetland Seasonal RAnoff . Stream Slopes;or Bluffs TYOE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1 st Floor 2nd Floor Basement Garage '°Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fusels Type:'Electric r Type of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilets —rl- Type of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers �_ to UI•`0 (�•`'� Vent Fans � �/` ' t �o Water Heater _� )Propane Tank Laundry Wsher�_ Gas Outlets Sinks 1 Wood/Gas/Pellet Stove Dishwasher �_ Direct Vent? Other �R _ 5•�O Other --A Other ijOther ,,.e D Base Fee , ono Base Fee 3a.oU TOTAL PLUMBING ^;RS,0y TOTAL MECHANICAL,�1 ,50 A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approv first obtaining approval. X - Date —5 X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. OEPAR7fUfFIVTAtREVfEyV: AP. 0VEp [JEIVIEI} COND[TIC3N GOt?E5 Building Department Occ Group Type Constr. Planning Department Other Other j FEES......... I Permit Fee Site Inspection Plan EFee UFC Plan Review Fee Plumase Fee Other Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal ( ) Violation Fee TOTAL FEES MASON COUNTY PROJECT SITE INFUmMATION Case No. Name avo 0 /7 _ PARCEL NUMBER .3Z/34Z -1-3 Date 5--- 3 SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions— Fences N Existing Structures Driveways Structure Setbacks- Shorelines Water Lines-- Topography v_ Well Location (including adjacent) Drainage Plan Names of Streets v- Easements Names of Fronting Streets Septic System DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line. adjacent property line- I tsq I Fadjacent property line 11J lI . e/�C 1 I I I ! I I I � I adjacent property line-� ' I E-adjacent property line /11J/l.�E4--SAFU SAMPLE SITE PLAN .asCd�jart property �pe y line- . II rf—a FadjacGHe4oncatA tspnar1 o perty linert D 30 rt-SC_RVe M 6 REEK p' M.0POSLD sx pt:c 1 bo' V T CARAac£�GtvT I % I a I i l� I V0.oPasCD T A&-R=L.LTu_MAL 50 I � I I RS i /00" I \ 1 I \ I I I X /00' I I L-.a.�GLL 1 •\ adjacent property line-� Fad'acent ro ert'line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE dtsto.,cm to SrtruttL�YL &5t'ar,LG to Slopm f'a i .� dis+anc2 40 AL Signature Date