HomeMy WebLinkAboutBLD95-00507 Final Greenhouse - BLD Permit / Conditions - 4/2/1998 L
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
r
E3 t,J I r_) I N C P E= R M II T FOR INSPECTIONS CALL 427-9670
- �oz. c; RFTWFFN 5pm AND Bam 427-7262
E31-095-0507 PARCEL :32136360001 O PLAT : D 1 V : BLK . LOT -
JOB ADDRESS : E 5962 STATE ROUTE 3 SHFL.TON 3M `7 V)\jn v�
OWNER : OAKL.AND BAY GARDEN CENTER 427-6618
CON7 RACTOR : SHAFF F'R
LEGAL. : It 1 OF 121 A. OF J.OACIFII'S D.I .C. S Of RIW SEE SMRVEY 213
' �.. �. -..,: sc�::z-.x�;r_:.�•cax::,:.:rsrs_rrcz�xr TT'Y?f
CLASS OF WORK . . :NEW BFDR : 0 BAIH : 0 T� YPE P40901 BY DATE RECEIPT AMOUNT BY DATE RFCEIPI
1 YPE OF' USE :ACC STOR I FS . . . . . . . :0
OCCUP . GrIOUP . . . :7 BLDG . HF I GHT . . : 0 0f t PRMT $ 118.00 r,:: 11166195 40f6A I
TYPE OF CONST :7 F I REPL.ACUS , . . . . 0 PICK f 47.00 KS 11106195 40660
OCCUP . LOAD . . . . : 0 WOODSTOVES . . . . : 0 SIFE 1 4.50 KS 1TI06195 40660
DWELL .UNITS . . , 0 PARKING SPACES - 0
INSPECTION AREA : 4 SHORE LINF? . . . . :Y 1101Al: 169.50 VAIUTATION: 144001
^�•+�^+�-sic.��.-..rr...x��as.•:es.*s-•a:::sscaarzsz:r�.:�:_:a._-a::wae�tr_ms�=:ax._.s:semis-r_.•A..::�.ez:sacsssssr-_:....�Y-a�-J
SE:TBACKS-----_ ..._.______-__ TOILETS . . . . . . . . . . . 0 FUEL_ TYPES----- - - BOILERS/COMP-- ----- MOBILE HOME-,
FRONT . . . 0 Oft BATH BASINS . . . . . . :. 0 0--3 HP . : 0
REAR — . 0 .Of t BATH TUBS . , . . . . . . : 0 3-15 lip . : 0 MODF I. :
SIDE ( 1 ) . 0 .Oft SHOWERS — _ . . . .. , : 0 FURN < 1;2 OK BTU 1 5-•30 HP .. : 0 --MAKE
SIDE (2 ) . 0 .Oft WATER HEATERS . . . . : 0 FURN >-100K BTU : .0 30-50 HP . : 0
SHRL I NE . O ,Oft CL.OTEFS WASHERS . . : 0 FURN -- FLOOR . . , : 0 504 HP . , O YFAR• . _-.
AREA - _- ... _r_. ..___.._ _ __. K I TCHFN SINKS . , . . : 0 HEAT PUMP . . . . . . : 0
LO7' S17E' . . : FLOOR DRAINS . . . . . 1 0 VENT SYSTEMS . . . . 0 EVAP COOLERS : 0 11 ;TH : 0
BUILDING . . . : 2160sf DRINKING FOUNT . . . : 0 VENT FANS . . . . . . : 0 HOODS . . . . . . , : 0 WIUTH . : 0
BASFMENT . . . : Osf LAUNDRY TRAYS . . . . : 0 DOME I Nr I N :O f R 1 At #
DECKS . — . . i Osf DISHWASHERS . . . . . . : 0 AIR HANDLING UNITS— COMM I NC I N :O
GAR/CARP :? Osf GARB DISPOSALS . . . : 0 10000 cfm . : 0 RELO -PAIR : 0
AT/DT . :7 URINALS . . . . . . . . . . : A 10000 cfln . : 0 OTHE UNITS . : 0
MISC PLM FIXTi1RES : 0 GAS OUTLETS . : 0
aw�.-la.._cz-�.csr.-zseza-=rsan�..c�..:a'�-•:sass::�•sa_-:zssc•��e�- r�r.•.ar..c�z �n. .�scaavoeasr_--r_..._trN:.c�.+�sr;.�esaerz�-c-;.•:_s�.s.��•c.:..'��::xr��cas.Hsu=c:s3:.a-rf-�erxxss.^-s.nsaxs�.�r.::x�sysn� .:...rrr-rrxzmie-+x-�-
P10JECT DESCRIPT10N:6AEENHOUS€
PROJECT LOCA11 100 APPROX I MILES EAST ON NOY 3 DIRECTLY ACROSS THE STREET FROM THE DEERK CREEK ORE, SITE OF THE 010 CFDAR Mill
THIS PERMIT BECOMES NU1.1 AND VOID IF 10D. 01 CONSTRICTION AUTHORI7ED IS NOT COMMENCED WITHIN 180 DAYS, DR 11 CONSTRQCTION OR WORM: IS SDSPENAED FOR A PERIOD
OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. EVIDENCE OF CONTINUATION OF WORK IS A PROGRESS INSPECT1011 MITHIN THE 180 DAY PERIOD, FINAT INSPECTION MUST RF
APPROVED BEFORE BUI1.0116 CAN 8E OCCUPIED.---_
71 OWNER OR AGEN1:. ,. ;� '�_�,r r'��!/� ,c'-•�' �` � ��.�-- ._ DATE+
/ i i_ -mot-.-i_._ 1_- ... .-�� ..�+G.�.....
I ,, P9 V1.1.1141 -1n ATJ_AC.I-4F_[Z_-(?(l�liZl1
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 Attic OTHER
Groundwork
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date -. by/ `-,) date by
l 2�-21b �,.,oea►arw�r S�-�.trC INrW`
M
l-va/- ivl O.�rJaU,-i ( � 't 5�11C1� C�VW'bvv�� r�ncv-'tee
Y ��
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 7da )
SPECTION
date by - 10 by date by
I
I
I
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
F" f. , FAnn I T" 0' (7) NF3 1 -r I C) NE3
Case No . : BLD95--•0507
For , OAKLAND BAY GARDEN CENTER
Page : 1
1 ) Proposed structure or any port tor► thereof greater than 30" in he icltit rr om grade 1 i ne,
must maintain a minimum of 5 ' setback from all property lines , easements and right of
way�.� .---
X ._ __ �... ._ , ------------
2 ) The us , hand 1 i ng and f torage of hazardous materials or- t t ammab i e and combustible
Iiqui (is 1-,n_.excess of 10 gallons is not allowed without the approval of the Mason County
as) .
3 ) All approved plans are required to be on-site for inspection purposes . 1f inspection is
called for and plans are not on site Appproval WILL NOT be granted . in addition , a
Re.- Inspection fees in the amount of $�0 .0&3 pair hour (mini mum 1 hour ) will be charged and
must be collected by this department prior to any farther inspections being performed or
approval ranted .
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 Bik 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
REINSPf_CTION FEE_ BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WIt. L BE
ASSESSED IF OWNEA/C()NTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO RFOUEST I NG
INSPECTJSA".
X._.._ Lt
5 ALL CONS IfWG-t�lON MUST MEET OR EXCEED ALL LOCAL CODES AND UBC
REQ(J_ FN'T
✓ --
6 ) Changes to approved bit iidIng plans that of feet comp Iianr.e to the 1991 WashIngt(in State
Energy Code, 1991 Ventilation and Indoor Air Quality
Code , the Uniform Building Code and/or Mason Country Regulatlong must
be approved by Mason County prior to construct i onX
7 ) CONSTRUCTION PROCESS TO BE FIELD CORRECT QUIRED PER MASON COUNTY BUILDING
DEPARTMENT AND UNIFORM BUILDING CODE .x
- —
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O, Box 186 Shelton, Washington 98584
(!� This strt e i s fiat growl ng and storage of p I ants on 1 �� . WA to he used for, seta I i
sale- No human occupancy .
9) No septic records owner /buiider assumes all responsihiiity if drainrield area i ,;
encum er-o4-.
10) This project Is approved as a green house tinder 'the rer u i rementf: of the 1994
Non-Residential Energy Code . The structure Is exempt Vrom the envelope requirements .
i_ iyhtimy Is exempt -that is soIe1y used for plant growth during the hour, of 10 .00 p .m . to
6 . 0 a .n) . Heating equipment Installed shall comply with chapter 14 , Building Mechanical
Systems . Efficiency of equipment shall not he less than ?R A . 1= .U .E . or other approved
ineoha�aL.- system .
X
i
r
i
_
i
-• 1
ti.
- __..
f hr
ow
oQ
Page No. 1 CASE HISTORY FOR CASE NO.: BLD95-0235
THOMAS DUNCAN
E5960 STATE ROUTE 3 SHELTON
06/20/95
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
------ ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- ---
BLDA010 AppLication received 02 24 95 02 24 95 KW
BLDA100 Approved For Issuance / / / / 03/14/95 DONE KS 03/14/95 KS
BLDA500 (F) Issue building permit / / / / 03/28/95 DONE KS 03/28/95 KS
BLDB009 Fire Marshal Review / / / / 03/06/95 DONE DLS 03/06/95 DLS
BLDB110 Structural Plan Review 02/24/95 / / 02/28/95 DONE MJB 02/28/95 MJB
BLDB130 Planning Review 02/27/95 / / 02/28/95 gave to Mike Byrne on 2/28/95 so that he DONE GBM 03/02/95 PSD
may forward to next department.
BLDB134 RLC Checklist Review / / / / 02/27/95 DONE AHB 02/27/95 TMJ
BLDB135 Addressing / / / / 02/27/95 DONE GMM 02/27/95 GMM
BLDB200 Environmental Health Review 03/01/95 / / 03/02/95 DONE PSD 03/02/95 PSD
BLDC155 Final inspection 03/29/95 03/30/95 03/30/95 NO FOOTING INSPECTION WAS CALLED FOR, I FAIL LW 04/04/95 LAW
ASKED FOR 3 FOOTINGS TO BE EXPOSED. ALSO
THE OWNER STATED THAT THE STRUCTURE WAS
BEING USED AS A RETAIL STORE (B-2) NOT
HOLE SALE AGRICULTURE AS FOR WHAT THE
PERMIT WAS ISSUED FOR THE OWNER NEEDS TO
RESUBMIT FOR THE CHANGE IN USE. OWNER
TOM DUNCAN.
f
O410i* V4� UC4f
GREENHOUSES
GREENHOUSES MANUFACTURED BY IVAN&LYNNE SCHUENING AND SONS INC .
Semi-Gable
Our Semi-Gable Greenhouse,
' \ designed as a multi-use
structure, can be a growing
or a holding house. Use it for
---- = -- - u flowers, hanging baskets,
. I nursery stock, etc. It does not
require a truss to be used for
hanging baskets. This model
is recommended for use in
heavy snow areas and can be
covered with Fiberglas.
<< ,� Note that we run our center
perlin on top of our bows to
stop poly sag and wear. Also,
it helps the greenhouse shed
BOWS: 1'R°�steelpipe; 5 rain and snow better. And,
ga.((.09�g in heavy snow areas); `
stre�sga�tn our greenhouses can stand u
g. 55,000 psi, 5 or 6 P
!2 centers per need (4' for Fiberglas); to winds of 90 mph or
Secured with 1' x lye" sleeve, .072 ga. more.
g Available in 2'/N", .130 gauge tWhen assembled correctly.
1 20t4Bvto7oh.Wie. SIDEWALL: Built-in, 6 ft.
PERLINS: 3 rows, lye" pipe, .065 ga.
—PERLIN LEGS: 3' x 2%1' steel
PERLIN pipe, .065 ga.Bow END END BRACES: 4 Q 21'
2.4 WOOD x 1%11 pipe, .065 ga.
20 Wood
Hardware and complete
instructions for assembly
— included. Though lumber
for end framing and —�-
.. sideboards is supplied by
the customer,pre-fab steel Nature blows away the competition
end walls are available and leaves Oregon Valley Greenhouse
from the manufacturer. standing.
COVERS' available in
Poly (48' x 100' ground "Covering Nurseries Throughout the West"
to ground), Shade Cloth Oregon Valley Greenhouses, Inc.
44' x 100' ground to 20357 Hwy 99E • Aurora, Oregon 97002
ground) or Fiberglas in (503) 678-2700
corrugated or flats.
*Covers extra. 1-800-347-2701 (outside Oregon)
4r
{
uonset 30 to 40 ft.Q
GREENHOUSES MANUFACTURED BY
IVAN&LYNNE SCHUENING AND SONS
Our Quonset Greenhouse is
also a multi-use greenhouse. 'j,
..oft'• a
It may be used as a propaga-
tion house, growing house
wintering house, etc. This
model has come through sus- y'
Y
tained winds of 90 mph
without damage.t Our
Quonset Greenhouses are
built with the center perlins r. i��:
�ray
on top of the bows to stop
poly sag and wear and help
the greenhouses more easily
shed rain and snow. In addi- f'
tion to Poly and Shade Cloth, BOWS: 13/8° steelpipe, .072 or.095
this structure can also be ga; Stress rating: 55,000 psi; 5' or 6'
centers per need (4' for Fiberglas);
covered with Fiberglas. Secured with 1' x 1yR" sleeve, .072 ga.
tWhen assembled correctly. SIDEWALLS: 3 f[.
PERLINS: 3 rows, 1 y," pipe, .065 ga.
±
LEGS: 5' x 23/N" steel 25,o30ft
pipe, .110 ga. i—,PERLIN
END BRACES: 4 ® 21'
` PERLIN
x 13/a" Pipe, .065 ga.
' End Blau +-6OW
Hardware and complete 2.4 WOOD
instructions for assembly 2.6 WOOD
1,. �.� , • included. Though lumber ,� y�+�
for end framing and
sideboards is supplied by
the customer,pre-fab steel
end walls are available
from the manufacturer.
20 to 40' wide
COVERS' available in
Poly (40' x 100' ground
to ground or 48' x 100'
"Covering Nurseries Throughout the West" with sidewall) ShadeCloth(46' x 100'ground
Oregon Valley Greenhouses, Inc. to ground)or Fiberglas in
20357 Hwy 99E • Aurora, Oregon 97002 corrugated or flats. . y ' .
(503) 678-2700
1-800-347-2701 (outside Oregon) 'covers extra.
Fo r Growing or
Wintering Over - Low
Profile Quonset - 20 ft.
0 ..... ..
GREENHOUSES MANUFACTURED BY
`• � �+ IVAN&LYNNE SCHUENING AND SONS
Our Low Profile Quonset
Greenhouse may be used as a
�I r
w< propagation house, growing
house or wintering-over
r house. This model is also
recommended for heavy
f
snow areas and can be
covered with Fiberglas.
ji Note that Oregon Valley
Greenhouse puts the center
perlin on top of the bows.
This Stops poly sag and wear
and allows the greenhouse to
shed rain and snow easier.
i-PERLIN
And, it will come through
2.4 storms of 90 mph sustained
winds with no damagej
tWhen assembled correctly.
c
v
Ih
I� 201E
BOWS: 15/," steel pipe, .065 or .085 ,
ga. (.085 ga. in heavy snow areas); 5' J M>A
or 6' centers per need (4' for ,
Fiberglas, 5' for heavy snow areas); �►
PERLINS: 1 row, M" pipe, .065 ga.
LEGS: 6' x 134" pipe, .072 or 0.85 ga. s
END BRACES: 4 @ 21' x lj/a" pipe,
.065 ga.
Hardware and complete instructions
for assembly included. Though lumber "Covering Nurseries Throughout the West"
for end framing and sideboards is COVERS* available in 32 ' Poly, Oregon Valley Greenhouses, Inc.
supplied by the customer, pre-fah steel
end walls are available from the ground to ground, or Fiberglas in 20357 Hwy 99E IS Aurora, Oregon 97002
manufacturer. corrugated or flats. (503) 678-2700
*(rovers extra. 1-800-347-2701 (outside Oregon)
napled
?' _ - Other Uses for
' Oregon Valley MECHANICAL
' t!
Greenhouses PIPE
GREENHO
USES MANUFACTURED BY
IVAN&LYNNE SCHUENING AND SONS
t
We Also Supply .
Thermostats, Air Heaters,
Sprayers and Humidifiers, shutters
and fans for ventilation and ex-
hausting, Ground Covers, Shade
Cloth, Poly, Wire Lock and Fiberglas.
Year Round Pool Covers.
r .
Shade Structure. Carport/Boatport.
"Covering Nurseries Throughout the West"
Oregon Valley Greenhouses, Inc. "The bitter taste of poor quality remains
20357 Hwy 99E • Aurora, Oregon 97002 long after the sweetness of 'Lowest Price'has vanished."
(503) 678-2700
1-800-347-2701 (outside Oregon) Ask us about Custom Greenhouses.
AA -
1
• 1 1 � 32W,oEPOLY
P VI
c[«I[l d•4(p
a[nurKO RKNCS
!kl 1 44(N
1.f 00)11D• i
1
V Y
]'[[n114 IN Min
�V 4(W .lrf/1CDb 1
f4 rQl")d�'jl N'NVIL1.«Tlpl M11
EN LI YI V( i01/K.N 4/0u4LD•I
RI D Ory cTlb
U.n(R W.
N n
11 14
i
TOP VIEW
kNa�N i41(«.n4 4 to Ion
•4(`N
�1M f
I.N IOlMr
!0[[K•41 nKniNRrn
/ «�Ryt
4ppp.)III.1'nu«Is
4<k 1 n4([S O
ENQ VI W
SiD E U CoNN CTI, vw■\
.\ 8 TO 4
Z
1 4n
O fit( `
ARCH Rip(,F 5rr"TI/]A/
'1.70•
CONLEWS y RuNs Sioe p�RIiNS
MANUFACTURING d SALES
SINCE 1 W
GREENHOUSE-WAREHOUSE
4344 MW)ON BLVO.,POMONA,CA 81786
(714)en-oDa1 J
MASON COUNTY
DEPARTMENT of GENERAL SERVICES
Mason County Bldg. III 426 W.Cedar
P.O.Box 186 Shelton,Washington 98584
(360)427-9670
BUILDING PARKS& RECREATION FAIR/CONVENTION CENTER ADMINISTRATION
February 23, 1996
Thomas Duncan
E. 5601 Agate Rd.
Shelton, WA 98584
RE: Change of Use
Parcel No.: 32136-38-00010
Site Address: E. 5960 State Route 3, Shelton, WA
Dear Mr. Duncan,
On March 28, 1995 our office issued a permit to construct a greenhouse for private use
only. This original permitted greenhouse was given a priority status in order to begin
construction due to weather. This permit was issued for M-3 occupancy to be used as
storage and growing of plants only.
This building is being used as a B-2 occupancy or retail sale and will require a change
of use permit. If any woodstove, or gas heat is installed this will also require a permit
and inspection.
Mason County will review the change of use permit for sanitation facilities
I have enclosed the necessary applications to apply for a "Change of Use" application
from private greenhouse to Commercial Use/Greenhouse.
If you should have any questions you may reach me Monday through Friday between the
hours of 8:00AM - 9:00AM (360) 427-9670 Ext. 357.
Sincerely,
Dana Herron
Building Inspector III
cc: property file
enc: applications
f
Permit No. GI q J' 50
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT
#1 eSite
4 Phone# 7 4Z— �z 9
ress Fire District#
City St 4'/ ZiPZX
Directions/to Job Site mow
s
Q G p ,i
Owner Mailing Address
City , / � St :�6 Zi
Lien/Title Holder
Address
City St Zip
#2 Contractor Name Contractor Reg#
Address APP Expiration Date
City St Zip Phone#
#3 If septic is located on project site, include records.
Connect to Septic? ublic Water Supply Well
Connect to Sewer ysfem?µ Name of System
(If residential, proof of potable water is required)
#4 rcel No� - -
Description T(2— 1 l D Legal a ��• I �-
iD LG y °►-I �J
#5 Building Squa o tage. (existing/proposed)
1st Fl 2ndo FI / I / Loft /
Basement / ` Deck bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building # Describe work
#7 Type of Job: New Add A' Repair Other
#8 MOBILE/MANUFACTURED H ME INF MAtION;
Model Year Make odp�f
Length Width S lal
# Bedrooms # athr ype of Heat
Purchase Price$ A.RR 1 1 1995
#9 Indicate by circli applicable source if any water is on or adjacent to subj -H SERVICES
River Pond Creek tream Wetland Lake Marsh Saltwater Seasonal unoff Other
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
Indicate Directional by (N, S, E, W)
Name of Flanking Street
Name of Fronting Street in relation to plot plan
APPLICA T TO RAW SITE PLAN BELOW
1 k t.
A2 4, =
� �- /V
e.
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
• t:
i
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No._Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins r' Heatpump, Other
_Bath1T bs / No. nits / Fees
_Sho rs f _ Furn �TU
� z
_H Miter y4r _ Heatpugx s
and 1 Msherr _ Ven yst�s
ASinks ` _ S of Vent Fans
1 f` �
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
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
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 OWNL< � X BY
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
�Prov
ed Cond. Hold
qq / Approval
Planning: q�-[X19f�� f� �� � u'Q 1� SCr«,« rid
Environmental Health:
Building Plan Review U
q-Z-F
Occupancy Group:/Vi-.3 Type of Const: S N
Fire Marshal:
Other:
Special Conditions: AM7— 7Z) #4yt: FEES
ilUMAAY a.S e Building Permit
w'IV 0A1/ !Z Plan Check 4?
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee c
Other
Other
Building Valuation: Vop TOTAL FEE