HomeMy WebLinkAboutBLD97-01362 Cancelled SFR, Deck and Garage - BLD Permit / Conditions - 10/3/2001 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O, Box 186 Shelton, Washington 98584
mu i L. 0 G NO P I_ IFS M I T' FOR INSPECTIONS CALL 427 -9670
BETWEEN 5pm AND gam 427 _726'-'
HLD97-1362 PARCEL. a 3213.17590091 PLAT : D I V : ? Ili
JOB ADDRESS:- 151 E iMIARJOR F E L.N ;;HE1 TON PERMIT
OWNER : DISCOVERY HOMES INC . 427-5605 NULL VQI�I nY EXPIRATION
CONTRACTOR : DISCOVERY 110MES 4P7 -5605 BY
LEGAL : TR 9 OF 810VEY 2.190 DATE
ycycaeas.*.a�s�m�ssz:m-ncros+• .W;-_:-.:. :�:,:=s .::s.:..
CLASS OF WORK , , sNEW BFDR t 3 BATH : 3 {TYPE AMOUNT BY DATE R4r'IIPT TYPE AMOUNT BY bATf RECEIPTS
TYPE OF USE _ SF STOFT I FS . . . , . . . :2 �. ,,, _ a _., ��Wv=4,-
OCCUP . GROUP . . . :83U1 BLDG . HEIGHT . . : O .Oft PANT ! 529.50 TNJ fIN600 46263 ENCP $ 2c.#6 TMJ 0916i'98 46263 i
TYPF OF CONST . . :SN F IR1=P1_ACES . . . . : 0 �PICM S 264.75 TNJ #106198 46263 {
OCCUP . LOAD . . . : 0 WOODS'TOVFS . . . . : 0 I'll 1 56.95 TNJ 01116198 46263
DWE1_L. ON I TS . . . : : 0 PARKING SPACES % 0 NCH a 64,00 TMJ 91116198 46263 1
INSPECTION .AREA : t SHORELINE? — . :N Slit 1; 4.50 TNJ 91116198 46263 TOTAL: 945.70 VALUTATtON: 34i6fil
SF TRACKS--- _ TC►ILET;; ' FUEL TYP[ S- ____-._.,_.. - E3011_Ei3S1COMP - -- MOf3111= HOME
FRONT . . .N AO . Oft BATH BASINS . . : 3 : /FLE'I i ! : 0 -3 HP , , N
REAR . . . .S 108 .Oft PATH TUEiS . . , . , 0 3 15 HP . .. V MODEL ;
' SIDE ( 1 ) .E 100 .3ft silo irRS , . . . : " FURN < 1OOK RTIi : 0 15- 30 lip . : 0 .. MAKE -
S1DE (2 ) .W 110 ,Oft WAFER HEATERS . . , . t I FURN >9100K BTU , 0 30-50 HP . : 0
SHRL INE .N @ , oft CLOTHES WASHERS , . 1 F IRN -- FLOOR . , . : 1 5?4 tip . : 0 YEAR
AREA ------ _ _._.___..___ KITCHEN INKS . . . . : 0 HEAT PUMP . , . . . . : 1
LOT S I .7E . , , FLOOR DPA I NS 0 VENT SY` TFMS , . , . 0 E VAP COOLERS - 0 I FNQ VII • 0
BU I L.D 1 NG . . . : 1664 sf DRINKING FOUNT — : 0 VENT FANS . . . . . . : 5 HOODS . . . . . . . .. 0 WIDTH . : 0
BASEMENT . . . a Iosif I.AUNURY TnAYS . . , . : 0 DOMES . I NC I N -0 S&R I At #
DECKS _ . . . : 3849f DISHWASHERS . . . 1 AIR HANDLING UNITS-- COMML . INC1N :0
CAR/CARP ,G 576sf GARS DISPOSALS , . . 0 � - 10000 rfm . : 0 RELOC/REPAIR : N
AT/DT . to URINALS . . . . . . . . . . . 0 > 10000 oft" . : 0 OTHER UNITS . i N
MISC PI.M F IXTIORFS : 0 GAS OtITI ET`7 . : 0
a2u�-�_mm^.:xu^..xCrss:•rs i axr•:-n.or:�:�rr::s-'+�s*acseas:¢.aar.x��ma-.sn:z_�:cxss�s^.3s-c-.nGra�K:s'mc:sffissaoT.s:.:coazertcv:r*xssrs�:x-.�:^sccza:.;zys:•..w.�::t xi.mr-vsrir-e:.m:-�.c�.^:vz-aCas«scx:a::.s: ...-r:a�_saes.s:.:s�e�_•-<as�:_e.^-x.-r¢;z�;^r
PIOJECi OESCRiPTtON�AES16ENCE, uFCK, GAR'.GE .
PROJECT 0CATIONtPAST CATFISH IAKF LEFT 00 NARJO.Rif IAO TO F10 Oh IF11.
THIS P011T RECONES NULL A19 VO16 IF 109f 08 -.`ONSTNOCTION AUTNOri?fO I1�.. AOT CO 0110E0 WITHIN 160 DAYS. 01 IF CONVOUCINK OR 'RCRK 13 SUSPiNOEO FOR A PERIO°i
OF i88 DAYS AT ANY HUE 0](11I WORK IS t,i�MNENCED. EVIDENCE Of CONTIMUA1100 Ol 'WORK IS A PROSRES3 fNSPFCTION-11TNfN THE 18D DA► PERIOD, FINAL INSPECTI9N MIST BF
4PPAOVED BEFORE BUILDING CAN BE OCIW+H, f
a1NNE& 0A A6ENTt
BI D_Fill, revs P COMPLIANCE .:D COND I rI ONS IS REQUIRE?
i
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date q-15-- 9 d' by �� Ribbons
date 1-2- 1 -q� 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 3(3---5'�
date L/-/-5 `�F5 by �' by / date by
3" L
PLUMBING Attic OTHER
Groundwork date by
date by WALLBOARD NAILING
D.W.V. date -15 by a—✓
date by
Water Line FINAL INSPECTION
date by date by date by
SLC G'rTLG
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
E RM i T C, CINU 1 -F 1 C>N ::
Case No . s Bi..D97-1362
For- D I SCOV[ NY 110MES INC .
page ! 1
1 > The us4, hand i I ng and � touage of hazardous materials or flammable and co►ubu�-,t I b I e
IIqui(Js,..t-a. excess of 10 gal tons Is not allowed without the approval of the Mason County
Fi "W-1:1a sha .
2 ) Propr�s#st" struct►ava or any port Icon ther•eol' greator than 30" 1n height from grade line,
mu"t maintain a ►nlr► imum of 5 ' setback from all property lines , easRments and 10 ' from
nd.: State Road r F(tht of ways
3 )v Apt:.l I canl:-A,oknow i edges that this development Is subject to po l boles a►,d reyu l at. l on s of
MastiT y Co preteens i ve P I an and De�ve 1 opment Regulations .
r
4 ) A I 1 approv -i d i ans are requ It, ed t be on-s i te3 for ins�r ect i on purposes . If i nc>pevt F tin
is c or and plans are not on sites Approval WILL NOT be ggranted . In addition , a
Re I nspect I ors fee! In the amount of $':2 .06 per hour (minimum 1 ho►►r ) w i I I be charged and
must be co i I ected', by this department prior to any flarthe t, inspections being performed or
approve 1
x
5) PURSI. T-'0 1994 UNIFORM BUILDING CODE , SECTION 305 (C ) AND SECTION 513 AIA. SITES MOST
HiAVIF APPROVED NUMBERS OR ADDRESSES PROVIDED 1N SUCH A POSITION AS TO Bt.. PLAINLY VIS1B►.F=
AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING
DEPARTMENT REOU1RES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
REINSPECTION FEE BASED ON RATES IN TABLE 3A OF THE 1994 IINiFORM BUILDING CODE WILL HE
ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REOUFST1NG
I NSPEC-1 t-O*S.
(5 ) The correction i ist , _aloncl with the► Enwrgy Compliance Wor•krheet (when appl icable� ) is
part of the plans and. must remain attached thereto. It is the responsibility of the
aTlp t l giant to make cor rent i ons indicated can t hf* plans f r,om the oor rect i on I t ,, s . Once
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
the PIUM4 e, - o ,
from the building Ot'i' icisal . the permit holder is repontittele t retain 'the complete
approved set of plans on site for the duration of the project . Failure to compIV will
result In fa l l (#re of required bu i l d i n i nspect i cans . Fver y germ i t sha 1 1 expire by
limitation and become null and void �f the bulld,� nq or worC authorized by such permits
is not commenced within 180 days from the-date of i iguano:e, or if the building or work
authorized by such permits is suspended of b ned at any time after the work is
commenced for a period of 1&0 °
days . �t _
7 ) ALL . ''"DUCT 1 ON MUST MEET OR EXCEED ALL `'LOCAL CODES AND UBC REQU I RFMENTS .
X
t
8 ) Prbv4sions for surface/ subsurface drainage control must- be implemented with new
construction or development on site and MUST NOT adversely impact adjacent &reels by
being directed off` the parcel being developed un I e-,o requirements of Title V RCW r
Private,IU,tchas and Drains have been met or a roval has been granted to use an existing
ut I III .} f and dr�a i nage easement ded i c,ated for nat specific purpose .
X
g) C,Wa.ttpixos to approved building plans that: effect compliance to the 1991 Washington State
Energy Cade, 1991 Ventilation and Indoor Air Quality
Code, the Uniform Su i 1 d i n Code and/or Mason Count Regu Lt�t_I4D sT �us`t
be approved by Mason County prior .to construction
10} at.L. C.DN��UCIFION MUST MFE'I OR FXCElFD LOCAL Corw, 11" Aht1r QUF..STfONS, rL; ASE
GA THii�J S . 'OFFICE BEFORE CONSTRUCTION .
X.
1 1 ? CW�S� TRU0JJ_J #--'PROCESS TO BE. FIELD CORRECTED '1 F I Rf PEP MASON COUNTY BUILDING
PEPAIrn4 -NT AND UNIFORM BUILDING CODE . x� x .,�_
r ,'
r r
r
Pay- - -02 CASE HISTORY FOR CASE NO.: BLD97,1362
DISCOVERY HOMES INC'.
E151 MARJORIE LN SHELTON
03/27/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
BLDC140 Fr/P1/Mc/Pen Inspection 03/16/98 03/16/98 03/16/98 1. PLEASE CALL FOR A REINSPECTION WHEN FAIL LW 03/19/98 KW
THE APPROVED PLANS ARE ON SITE.
2. PUT A TEST ON THE PLUMBING, NO WATER
IN DWV PIPES AND THE GUAGE ON THE SUPPLY
SHOWS 0 POUNDS
BLDC140 Fr/P1/Mc/Pen Inspection 03/20/98 03/20/98 03/20/98 1. STRAP DOUBLE TOP PLATES THAT WERE CUT FAIL LW 03/23/98 KW
AT 3 1/8" X 12 GLB OFF KITCHEN ALSO ON
ALL OTHER TOP PLATE STRAPS, A 6" MINIMUM
LAP ON THE TOP PLATE BOTH SIDES OF THE
CUT WITH 4-8D NAILS PER SIDE IS REQUIRED
2. SEAL ALL DUCT JOINTS.
3. NO HEADER SIZES ARE SHOWN FOR OVER
THE WINDOWS, CHECK WITH THE PLANS
REVIEWS IN THE OFFICE AND HAVE THEM MARK
THE PLANS.
4. VENT THE GARAGE ROOF 1/15-, 5.6 SQ FT
IS REQUIRED, 3.5 SQ FT IS IN PLACE NOW.
5. IMPROPER ON DWV, NO WATER IN UPPER
FLOOR PIPING. FILL WITH WATER TO HIGHEST Q
VENT.
OK TO INSULATE EXCEPT OVER CORRECTIONS. 3'
n5 � rah
c� 3
le 4C9
�a
Building Permit # MASON COUNTY
BUDDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location P11 ar I'o r i G
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
72 4--
w�
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 /2,
Department A6�C
Date Inspector L
■ 104 0 NOT MOOV THI , T' ,* mi
1
Building Permit # MASON COUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 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
�. .S // Carc C
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
❑ This is not a complete inspection Department 't'�S
Date G `25 SJ� Inspector E c�
■ o« * :SOT MOAV THIV-- T A
Ading Permit# MASOMCOUNTY
BUILDING 111 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location
'his structure has been inspect b Mason Cou Building Department
ind the following VIOLATION of County Laws and Ordinances has been
ound: Items Listed below must be corrected to gain code compliance
o . _
f- r r Sb i a t r c
Z M J2 ro P pC-i ✓ , /1 a r c- i of cr -�G� r, �,✓ a • I I LJ 1
J,- +-y-, 1 4-�) k4L a� J T
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 tonS�� � Lr� c�g '(
❑ This is not a complete inspection
Department
Date -3— 2y Inspector
moos NOAT MOAV THV ,kT ' Lo
'
WATTSUN 5 .4A 1991 WA STATE ENERGY CODE COMPLIANCE REPORT - 10/28/97
FILE : C: \\WATTSUN5\\NEWFILE HOUSE ID :
HEATING/COOLING/VENTILATING SYSTEMS
PROPOSED
Heating System Type : Heat Pump : Air Source
Make : AMS
Model : 6H0024A100A/TWV03OB140
System Efficiency : 7 .3 HSPF
Modified Efficiency : 152 %
Design ACH : 0 .60
Design Load( at 53F dt ) : 21363 Btu/hr
Duct Losses( % Dsn Load ): 4847 Btu/hr( 23% )
Total Load : 26209 Btu/hr
System Size : 11 .5 kW ( 150% )
Outdoor Unit Size : 2 .0 Tons ( @47F )
Auxiliary Size : 6 .0 kW ( 150% )
HP Balance Point : 25 F
Average Annual Heat : 4729 kWh
Annual Cost : $ 184
Ventilation System: Integrated Spot
& Whole House
Cooling System: Example
SEER : 10 .0 ( Ducted )
Cooling Load( at 5F dt ): 13527 Btu/hr
System Size( %Over ) : 1 .6 tons( @125% )
Annual Cool Requirement : 599 kWh/yr
Solar Access : Partially Shaded
-----------------------------------------------------------------------------------
PROPOSED DUCT SYSTEM
Location Avg Rvalue Surface Area
--------------------------------------------------
SUPPLY Vented crawlspace R- 8 .0 200 .8 ft2
RETURN Attic or garage R- 8 .0 66 .6 ft2
--------------------------------------------------------------------------------
GLAZING ORIENTATION
PROPOSED PROPOSED
South 58 .9ft2 North 58 .7ft2
Southeast ; Northwest
East 58 .7 West 58 .7
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 2 -_
WATTSUN 5 .4A 1991 WA STATE ENERGY CODE COMPLIANCE REPORT 10/28/97
FILE : C : \\WATTSUN5\\NEWFILE HOUSE ID :
Site : Analyst : OLYMPIC HEATING AND COOLIN
Jurisdiction:
Utility:
Homeowner : House Type : Single Family
Floor Area: 1664 ft2
Builder : Weather Data: Olympia , WA
Climate Zone: 1
' The PROPOSED design *COMPLIES* with 1991 WA State Energy Code .
I
' REFERENCE PROPOSED
COMPONENT PERFORMANCE 357 242 Btu/hr-F '
ENERGY BUDGET 3 .35 1 .96 kWh/ft2-yr
REFERENCE DESIGN
Reference
Component Value X Area = UA
______________________________________________________________________________
Floor U-0 .041 832 34 . 1
Glazing @15% U-0 .650 249 .6 162 .2
Doors U-0 .400 41 .0 16 .4
AG Wall U-0 .062 1841 114 .2
Ceiling , Attic U-0 .036 832 30 .0
Infiltration ACH-0 .350 13312ft3( 85 .3 )
----------------------------
Reference UA 357
----------------------------------------------------------------------------------
PROPOSED DESIGN COMPONENTS
Component Description Value X Area = UA
------------------------------------------------------------------------------
Floor R30 vented Joist 16oc U-0 .029 832 24 . 1
Glazin @14a 3G1 Vinyl 1/2" U-0 .400 235 .0 94 .0
Doors NO DOOR U-0 .000\ 41 .0 0 .0
AG Wal R21 ADV T1-11 U-0 .053 1856 98 .4
Ceiling R38 blown Attic STD baffled U-0 .031 832 25 .8
Infiltration Standard Air Sealing ACH-0 .350 13312ft3 ( 85 .3 )
----------------------------
Proposed UA 242
Struc Mass Light Frame , Sheetrock walls M- 3 .000 1664 4992
________________________________________________________________________________
Items in parentheses not included in COMPONENT PERFORMANCE totals .
Page 1
r C LIZTIFICATE OF INSPECTION
a J O-Jer's rlam,-
6-n b � . r� �5
W.W.F.A. Ceal ed
Lumber Grade
buyer: C'15 0 u No m 6 S
e
pate.
Lumber tr�l:ied below was pencil trimmed, as ne, ea, and sorted to
grade. Sizes complied with the Buyer - Seller agreenie,J. L.unber,was rough
sawn, and air dr'Y A - }�
All grade.. <ind trim wqe discussed with the Buyer during the
inspection. Q r
, :Di tensions-Length Grade i oard Foota-e
Provisions Grac`A Under:
Tru s � o�S
�
C
, J
.q.;. �r v: ._ rF •+' � -' A 2 � � ern, - � �
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l
TOWNSHIP 2 .1 SECTION 34
SCALE I" ■ 400" N
I
100000
••..n /
Aro"01 100010
100000 DEAD(h(
200000 100030
f 100020
r
• 100010 ! / �P► 100020
mat
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0 r 400010
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a
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321342002000 19009011 •+ r1
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100000 • » •t•.w •,• W •» t•'
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1°aA off+. ►«.rr I e/o 100030 S 1r 661 0 r»w oo •t/••
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I •/I7 N N O 100090 100010 O
f stir r•. , u ur r .1t u' •....• ... .'
100060 i 7500100 11 •. •••
100040
1 0 1 •/1► ' :; , T500U90 1 ' 7500140' 7500150
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100010 100090 0 100070 I 7500080 1 1 W
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r l�, 7500220 ••sa4�
•v yr i0 ;
(3)
t. INI•N see •1 11/7S 4
b►16L�61� 1.70
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION ��
426 W. Cedar/P.O. Box 186, Shelton,WA 98584 427-9670/1-800-562-5628 O� d�
PLEASE PRINT
(Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269) /Vli-;
#1 Owner -C VV
CO'Ll / f�U��f -;-A-*-(f Phone# 2 3�o
Site Address / .�5-1 ,,t-:7 /y,! iX To/1 L�.v C� Fire District#
city .Sh GITO Al St Y!14 zip
Directions to Job Site S ; e'h-j,C i' L ,a,T LP,,�T
�t X 2 e 4-,o..--e - i v e Al.D D rL) j) T
Owner Mailing Address
City 5;�e /Ta"A/ St w4 Zip 9 kEV-'"
Lien/Title Holder GRi� �� �•l�,�O/C
Address
City L Q C e y/ Grto- St Zip
#2 Contractor Name P -S CO ae'( y Contractor Reg#
Address l 6 Expiration Date
city dn/ St 6�Zip %'may Phone# �2 -,�60>L_
#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.i2�.L3Y
Legal Description L,,r 'T !Z Sd o27- Z 6
#5 Building Square Footage:
1st FI J� 3 2, 2nd FI 5? 3 Z 3rd FI Loft Basement
#Bedrooms 3 #bathrooms Z yz Deck 3 J Y Other
Garage ? Carport (Circle:Attached or Detached?)
#6 Use of building P S- Av.✓C Describe work
#7 Type of Job: New Add Alt Repair Other
a
W
#8 MOBILE/MANUFACTURED HOME INFORMATION �-
z
Model Year Make Model
Length Width Serial No. o� W
#Bedrooms #Bathrooms Type of Heat c
Purchase Price$
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
rw
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Drainage Plan Wells
Septic Systems Easements
r'
Proposed Improvements
Name of Side Street Indicate Directional by (N, S, E, W)
in relation to plot plan
Name of Fronting Street
APPLICANT TO DRAW SITE PLAN BELOW
�r
P dL1 POsep r
At
ty / 36 2-00
y
` .
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
A �
N
Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 eachl
No. J Toilets CI UEL TYPE: Gas(,Elect��
Bath Basins Heat ther
Bath Tubs No. nits Fees
Showers Furn�_ �' "` BTU z r
Hot Water Htr r Heatpumps �0 7s
Laundry Washer _ Vent Systems
Sinks S Spot Vent Fans 33
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
12X3 ,35: _ Fixed Fire Supp. Sys 50.00
Permit Basic Fee 16.75 _ Auto Fire Sprink Sys 35.00
TOTAL PLUMBING $5(0 .75-
No. Other
0 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 16.75
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD S�
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 DEPART DEPARTMENT.
X OWNER-7; X BY
DATE DATE �12
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
f' Approval
Planning: t7 G /" 'H
Environmental Health:
Building Plan Review
�2 ZZ—
Occupancy Group: jZ3 y-1 Type of Const: SIJ
Fire Marshal:
Other:
Special Conditions: FEES
11&6y 6 q6 = � ,4`f�f Building Permit
576 K f3 SO = -7, '7 7{' Plan Check f
38�c X (0 7 = 2 -S2 6�( =
2�51� g 7S = Z 14S`f Plumbing Fee S� 9�
Mechanical Fee
Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee 14 ,50
Othergc);- V, H(-7?Y, 00
Other
Other
Building Valuation: '�o TOTAL FEE