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Home My WebLink AboutBLD99-00625 Cancelled Mobile Home - BLD Permit / Conditions - 10/3/2001 CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date 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 by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Building Permit # W-005" 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 co rected to gain code compliance A TC_ r 4 /V` P � � ,� /AxS %3iBR /l / `t-12 c i F� 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 5i<I jz7 ,q f l , 3ca ❑ This is not a complete inspection Department c x2ll'v'�F Date _ ` Inspector f w ■ �k0 NOT MOOV THImvi& T ,� � 1 Building Permit # , cl"7 e6,ZS MASON COUNTY BUILDING 111426 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 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 0 OK to 4G,/ t'��i c. if-//'�T ❑ This is not a complete inspection Department Date `�% Inspector moo * NnT MOOV THImelk TmLolm' MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 _ r-__aT p cl—sue Ful F- 114 e cal $ 1 ( !'f? E W;1,14{' 1"—rH-Wi—i-srrr-4f' i� 4iiTIA BETWEEN 5pok AND Bare 427--72162 BLD99-062.5 PARCEL s 321361 390000 PLAT : D I V : BILK : JOB ADDRESS : 11 E AGATE. AD SHELTON OWNER : GARY E:STERI_Y 432.--0656 PERMIT jr) ;BY EXPIRATION CONTRACTOR ,- NULL & VO LEGAL I, SIR RE S OF BY A F Of CO kD TR 8 OF SP 1413 PIN 5111 NF MCSCC J06101 01 AGATE ROAR rF— b IDI! BY t:'t•_'O'.:•.'�'^..T::A'.1'-JL'%^.J."%L:�:'.'ukt..Yt.3^.M.1.:._'�'.. �]'.y.42.�.:"...s:� WRSAS45Yt."9C"MC53fS.:.:\.. : .• ..". "- CLASS OF WORK NEW BEDR : 2 BATH : 1 ITYP: AMOUNT BY DATE RECEIPT TYPE AMOUNI BY DATE RECEIPT TYPE OF USE � . . . .MH STOR I F S . . . . . . . . 1 � µm� OCCUP . GROUP . . . : s BLDG . HEIGHT . . : O ,Oft �MHSf S 175.11 KW ►T7;P9199 51831 1ptpS $ 3&.11 1<`�07116199 5/934 TYPE OF CONST . . :s F I RE::PLACES . . . . . 0 f ADOR 9 15.11 KS A7116199 51934 OCCUP . LOAD _ . - 0 WOODSTOVES . . . . : 0 EHCP 1 51.10 KS 61116194 51934 DWELL .UNITS . . . . r 0 PARKING SPACES : 0 MkDL t 175.01 KS 07116199 5IP34 f INSPECTION AREA : 2 SHORELINE? . . . . ..N STfE 1 4.56 KS 0, 116i99 59934 ITOTAt : 457.50 VAtUtATIONt 55195� ---. -ms�cr�..rs:ar.�.xrxsrscs:ars�_::s_srs�.c+c>.�ss.;�.:.ar.-x:.;,-�-.'»-.-,a+c�sa.xrsrmv+-..m�r�r.:•�:ss:�rx.^ass�xxs:.�..�� TOILETS . . . . . . . . . . 1 0 FLIEL_ TYPES BOILERSICOMP-- -- -- MOBILE HOME---- FRONT . . .W 40 .Oft BATH BASINS . . . . . . . 0 0 3 Hp. : 0 REAR . . . .E 680 .Oft BATH TUBS . . . . . . . . : 0 3•-15 HP ! 0 MODEL :KIT SIDE ( 1 ) .N 29 .Oft SHOWERS . . . . . . . . . . . 0 FORN < 100K BT(Jo 0 lEi-30 TIP . : 0 -- MAKE- -._ SIDE (2 ) ..S 10 .0f t WATER HEATERS . . . . ; 0 FURN —100K BTU ; 0 30-50 HP . ; 0 OAK CREST SHRL I NE: .N O .Oft CLOTHES WASHERS . 0 C URN - FLOOR _ - 0 50+ HP . . 0AREA _.... _.__._._,..-_.__. _ KITCHEN SINKS _ , . : 0 HEAT' PUMP . . . . . . .. 0 99 LOT' S i ZE . . : FLOOR DRAINS . . . . . : 0 VENT SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH :48 BUILDING — ,. Osf DRINKING FOUNT , . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . . : 0 WIDTH . : 14 BASEMENT . . . : Osf LAUNDRY TRAYS.— : 0 DOMES . I NC I N :0 --SERIAL#--- -- DECKS . . . . . .. : Osf DISHWASHERS . . . . , ., 0 AIR HANDLING UNITS-- COMML . INCIN :0 GAR I CARP :? 0%f GARB DISPOSALS . . . . 0 <_= 10000 off" _a 0 RELOC/REPAIR : Sit ATlDT . :7 URINALS . . . . . . . . . . ... 0 _ 10000 rfm . : 0 OTHER UNITS . : 0 ` MISC PLM FIXTURES : 0 GAS OUTLETS . t 0 PROJECT DESCAIN IONtM081LE HOME PROJECT LOCATIONtHTIY 3 TO AGATE RD, TURN RIGHT, FIRST ORIVIWAY OM IJJ T SIDE. THIS FFAMiT BECOMES NULL AND VOID IF WORK 09 CORSiRUCTION AOTHOIN FI) IS NOT COMMENCED WITNiN 186 JAYS, OA IF COISTAUCH ON OR NORK is SUSPENDED rot A PFRIOD OF 180 DAPS AT ANY TIME AFTER IORK IS COMMENCED, EVIDENCE OF CONTINUATION Of 1019 IS A ?@OGRESS INSPE01011 111HIN THE 186 DAY PERIOD. fINAt 11SPECTIOM MUST BE APPROVED BEFORE BUILDING CAN Rt OCCUPIED. ONIIER OP AGF11T: _ _ _ a-� __ _._.w__ �__. -. --; . yr =�. 1 ,-__-.. . __ 9ATE:•_M. ; .. r .4 __ h82991, revi 03/31191 COMPLIANCE T-O ATTACHED CONDITIONS IS REQUIRED MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 &Zr- RA-4 I -:F_ C- C,tl:4110 1 4- 1 c4b., -<Ll Case No . , BLD99-0625 For GARY ESJF.RLY Page : I 1 ) Owner/builder assume-. all responsibility if dralnfield/ reierv- area is encumbered . X 2 ) The use, handling and storage of hazardous materials or f I amittab I e and combust I b I e liquids in excoss of 10 gallons is not allowed without the approval of the Ma,3(-.in County Fire Marshal . 3 ) Proposed structure or any portion thereof greater than 30" In he I ght from grade I I fie, must maintain a minitnum (it 5 ' setbacit from all property lines. easements and 10 ' from a-1 I (--,ounty and State Road right of ways . 4 ) Provisions for surface/sutisurface drainage control must he Implemented with now construction or development tin site and MUST NOT adversely impact adjacent parcels . Under, the requirements of Mason County Stormwater Ordinance , 'either private ditches and drains will meet requirements of the stormwater ordinance or, prior approval will be granted to use art existing utilltv and drainage easement dedic.died for, that spec; lf 10 purpose . For, further information regurding tfils ordinance and the REQUIREMENT to obtain art ACCESS PERMIT for, the InF;tal lationtconstructiors of a driveway or access connecting from a Mason County Road, Contact the Mason County Public.: Works Department prior to construction at Ext 450 . For any construction which Is proposed to be located within 25 ' of a Mason County road right of way, it is suggested to contact that office to review future planned work which may affect your project . X 5 ) PURSUANT TO 199"' UNIF70RM EAU ILOING CODF , ALL SITES MUST HAVE APPROVE[) 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 THA'r THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THr 1997 UNIFORM BUILDING CODE WiLL BU ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REOUESTING INSPECTIONS , MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 6) THE FOUNDATION SY_wfE.M SHALL BE PLACED ON UNDISTURBED, NAIIVL SOIL . X 7 ) The approved plot plan Is required to be on- site for inspection purposes . If Inspection is called for and plot plan Is not on site, Approval WILL NOT be granted . In addition, a Re- Inspeotion fee in the amount of $42 .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 . X 8 ) REQUIRED INSPECTIONS ( Footing Inspection-prior to pour , Set-up Inspeotion-prior to skirting. Final Inspection-prior to occupancy ) . I have received a copy of the General In formMon and Gul deg lines-Mobile/Manufactured Housing InGtallations Handout for detailed descriptions of all required Inspections on my mobile/manufactured home installation . I hereby assume all responsibility for the soheduling of these required inspections . If these required Inspections are not requested , inspected and 8 igned off (approved) by the Inspector In the prescribed order , I understand that reinspectlon fees and an hourly investigation fee pursuant to the 1994 UBC, Table 3A will be assessed in addition to my original permit fees to resolve any questionable practices or problems that have been discovered . I further understand that this Investigation will be scheduled as time allows . Until resolution of any/all problems no occupancy ( Final Inspection ) will be granted for the residence . OWNER/CONTRACTOR( indicate wh1oh) Signature 9) Al I mobile/manufactured home landin s or decks must be freestanding ( self supporting ) . The largest landincl or deck permit without drawings or a building permit Is 120 sq fit or less AND MUST be under 30 it) height from surrounding gra-de . NO —second story decks, or decks above 30" cart be built without a permit , Any landing or deck that is 30 or more in height from walking surface to finish grade requires a Permit . Any landing or, deck that has 4 or more risers requires a handrail . 10) Proposed structure or gortions thereof with an projection over: 30" In heiciht from grade line, must maintain a separation distance between adjacent structures and that MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 furthe st 1 1 ) Changes to a�proved building plans that effect compliance to they the Un i forts Building e Cod and/or, ason County Rego iatton:, must be ;fa{ RrovPci by Mayon County prior, to construct ionX. .�__ --__M_.______w_�_� _ _.__._._ 12 ) All upland areas disturbed or newly ore:ateed by construction activities: shall be fseeded, vegeAat�ed or given some other equivalent type of protection against erosion . X - 113 ) New residence wi l 1 only be used for ftami lv menbers as required tar Mason County Ueve.. -1Tfent Regulations , Ordinance 62-•96 . X Case No . : BL,D99-0625 I Mason County Dept. of Community Development Mason County Bldg. 3 426 W. Cedar IP10 P.C. Box 186 (360) 427-9670 Local (360) 482-5269 Elma Shelton, WA 98584 (360) 275-4467 Belfair Notice to Obtain Final Inspection December 01, 2008 GARY ESTERLY 51 E AGATE ROAD SHELTON WA 98584 Case No.: BLD99-00625 Parcel No.: 321361390000 Project Description: MOBILE HOME The Mason County Department of Community Development is currently reviewing all permits that are expired and have not been approved for occupancy and use. Pursuant to Mason bounty Code, Title 14 Building and Construction, a permit and final inspection for this type of activity is required under the 2006 International Building Code or the code your permit was issued and your property is currently in violation status of occupancy and use. Please contact our office to make the necessary arrangements 21 days from the date of this letter. Failure to contact our office to make the necessary scheduled inspections will result in enforcement actions. To bring your site into compliance, you must schedule an inspection. One (1) $68.00 site investigation fee will need to be paid prior to inspection along with any outstanding fees currently due on your building permit. For every inspection required after that, you will be charged $68.00 again, per inspection until final inspection and conditions are met. To schedule an inspection, please call (360) 427-9670 ext. 262. If you should have any questions regarding this notification, please contact me at (360) 427-9670 ext 356. Sinc Mindi Broc Mason County Department of Community Development Cc: Property File December 01, 2008 BLD99-00625 ,�4V y a 7-5 N t 230 -� rrti6 ci€GL c<C h< Fd. SNEo 40 E . S.T �rzotbs�D _ z0 f / IV 00 `V R'' E G �J/ /cJ I'm � o • z ' / �/ GCSE/ .,_ EBLEN v gam° OF WAstii `��► SITE: FLAN _ r� �° o SITC SCALE: l "=60' O 28508 a o �? s/0NALL E� bP 3P� Fjamm 10-30-z�n VICINITY MAP -_-— - ----- - --- - LEGAL DESCRIPTION: 1# ADVANCED ENGINEERING OWNER: T/?�9oUMB r B - SP `11-3 . JOB NUMB 3427 W. Mud Bay Rd. s/ �q�a f� �Pc�. 'r.P.# ,32, 136 —/3 — 9D000 120 ATE -�- Olympia, WA 98502 352-3669 Scale: / �=6o North _ SHT OF Sl,e l 1� q8s"�'y 2�tow-, e0�c�e�l' /[obo acola� ti�z-d 656 Ga�4- G,41,1 e, Cr-e Q, , dr�,► :`etc� n. Washington Home Center, Inc. Floor Plan Oak Crest U 24-J-28-Lynne Fairbanks 24-J 28 48x14 640 sq ft utaay �O; t - - KRchen I aC- 2: droom O Dining M0 }. Living Room 11'-0" Bath Q� 2 IT-2" Opt.Buffet &Overhead \ Opt. Walk-A-8ay 1 Porcelain Lav W/Overflow 2 Bedroom Ceiling Lights(Each) Specifications subject to change. (c)1996 softsell, Inc. Jun/29/1999 PERMIT NO.: BLD MASON COUNTY BUILDING 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 INFORMA ION CONTRACTOR INFORMATION Owner a Contractor Nam Mailing Ad ress Mailing Address City S �-�C)I(1 State Zip Cod �_1 Stat Zip Code PhoneoeC2)y`-,�z-040er Ph.( Ph. t��iQther Ph.(� s� Lien/Title Holder / A Con ractor Reg. # y Address 50 „ C ew orf h Expiration / / a6c SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System Well Water System-,<_Name of Water System PARCEL INFORMATION-12 digit Tax Parcel No. /1:/ _i '-" Fire District�r_ Legal Description Site Address(Please include street name, street number and city) Directions to site � 4r4 S"Q , W t Will timber be cut and sold in parcel preparation? (Yes/Non(—)_ Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs —)< TYPE OF JOB New Add Alt Repair Other Use of Building Describe Work No. of Bedrooms_Z`No. of Bathrooms_SQUARE FOOTAGE-1st FloorL94() 2nd Floor 3rd Floor Loft Basement — Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make 6� Model(" ,��CwF'f°ram. —Model Year)�7QQ Length L4& Width�Serial No. No. of BedroomsZ_No. of Bathrooms_ Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer 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-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 hall 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 U E BEYOND THIS POINT Accepted by- Date (]a. Submittal Amount Due / Receipt No _6�)z 59 DEwP,ARTMENTAI..::Rf«UIEW ROVENIED CONDITION CQ<E5 Building Department / 1,949, /jj Occ Group Type Constr. l Planning Department Environmental Health Department Public Works Department I Fire Marshal Valuation $ FEES Building Permit Fee ion Plan Review Fee UFC Plan Review Fee Plumbing & Base Fee Public Works Review Fee Mechanical & Base Fee Other / Wood/Gas/Pellet Stove Fee Other /A—d Imlaie+�-F-s� Pa / Pre-Paid at Submittal ( ) TOTAL FEES 5 FORM MUST BE COMPLETED IN INK PLEASE PRESS HARD MASON COUNTY PROJECT SITE INFORMATION Case No. Name aA ` r`l PARCEL NUMBER ��3(`/3 76V&) Date7,A�lelwi_ ' I SHOW THE FOLLOWING ON SITE PLAN Show Direction by indicationg N, S, E, W in relation to the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Well Location (including adjacent) Drainage Plan Names of Streets Easements 11 Names of Fronting Streets Septic System I DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet pf adjacent property line. adjacent property line- I I <-adjacent property line I I I , I I I � I I � I • I � tiTM ti I t$ �V •J h oh Jet V I NN W 6�& 51IIPP(I I r I / J 1 � •I � I �C� I adjacent property lined Gtu' <-adjacent property line s SAMPLE SITE PLAN Aykcr'.f adja1�t property lined 3zo' f-adjacent property line I D 30" rRFs Rve .gEA_SG w/AL '• h L _�PT7L__i1 �. fi HOM t ]� G n a6�u I HOu3 G_ I j PraoPosen R I. 1 — \ J I r� b o' __JSO•--'�I I R\ I VAGNT I GARAti6 \ I I � o' i lipi I� �\ T F--4o, \ I I . I 80, \ i /00' I � I t_._.aLL I I 'Il I I L.a�GLL adjacent ro ert lined ; I a"- a \; E-ad'acent ro ert' line TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the P 9 degree of slopes. See sample topography profile.) SAMPLE TOPOGRAPHY PROFILE Rd1'8;5ta s+a»tm to r,LL to 20y nCL V � dis+an�rz 4 0 a. CA Signature Nate f g0N COU MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. III, 426 West Cedar Street -- - PO Box 186, Shelton, WA 98584 1854 www.co.mason.wa.us (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269 Notification of Mason County Code Violation December 31, 2008 Mason County Department of Community Development Shelton WA 98584 Claimant Vs. Gary Esterly 51 E Agate Road Shelton, WA 98584 Notice The receipt of this notice shall constitute service regarding notification of violations of the Mason County Code, and shall also serve as Warning Notice pursuant to Mason County Code, Title 15, Section 15.13.035. The violation(s) are occurring at the following property: Enforcement Case No.-. BCC2008-00339 Parcel No.: 321361390000 Site Address: 11 E Agate Road, Shelton, WA ❑ Building permit to install a manufactured home, permit number BLD99-00625, failed to obtain final occupancy inspection. According to the Mason County Assessor records, parties named above hold legal interest in the parcel and are therefore subject to enforcement action for failure to comply. The parties shall respond to the county within twenty days of the postmark, posting on site, or delivery of the notice. Records indicate that this enforcement issue has not been resolved and is outstanding at this time. Order YOU ARE HEREBY ORDERED to abate violations in the following manner: 1) Do no occupy the structure until a final occupancy inspection is approved. To request a final inspection pay the necessary fees including $68.00 enforcement fee plus $73.00 site inspection fee. When the fees are paid schedule a final inspection with permit center staff. Note that for every inspection required after that you will be charged $73.00 again, per inspection until final inspection and conditions are met. for each inspection 2) Remove the structure and notify our office that the structure has been removed. Penalties This notice is to inform you that in the event that you fail to comply, we will pursue additional enforcement action against you, including but not limited to recording against the parcel, civil infractions, liens against the property through the Mason County Hearings Examiner process and/or criminal prosecution as allowed under Title 15.13 of the Mason County Code. You have e feel In the event that you received this notice in error or that the facts are inaccurate, I Y strongly encourage you to contact me at (360) 427-9670 ext. 510 to discuss your concerns immediately. Sin erely, De era Coker Lead Plans Examiner/Code Enforcement Cc: Property File DELIVERY SENDER: COMPLETE THIS SECTION ■ Complete items 1,2,and 3.Also complete A. Signature _- ❑Agent item 4 if Restricted Delivery is desired. X ❑Addressee ■ Print your name and address on the reverse so that we can return the card to you. B. Received#A(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. s delivery address differeril from item 1? Dyes 1. Article Addressed to: If YES,enter delivery addres �1gvQ N o CID JAY_6? GARY ESTERLY � 51 EAST AGATE ROAD SHELTON WA 98584 3• ice Type rtified Mail ❑ Exp Register ❑Return R erchandlse ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7�07 268� 0001 7961 8958 (transfer from service lai PS Form 3811,February 2004 Domestic Return Receipt 102695-M-M-1540 13-10000 COMPLETE THI . • SECTION . SEN ■ Complete items 1,2,and 3.Also complete A. Signature 0 Agent item 4 if Restricted Delivery is desired. )( ❑Addressee ■ Print your name and address on the reverse C. Date of Delivery so that we can return the card to you. B. Received b Printed Name) ■ Attach this card to the back of the maiipiece, or on the front if space permits. Yes D. Is delivery addre differen m item ss 1. Article Addressed to: if YES,enter delivery a re elow: 0 o �lF G 'AS�TERLY J 1ARY 1 E AGATE E ROAD 3. Se ice Type N011 S f I E L,"I'ON WA 98584 Certified Mail ❑EXPO Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7007 2680 0001 7961 9276 mransfer from service labeO 102595-02-M-1540 PS Form 3811,February 2004 Domestic Return Receipt