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Home My WebLink AboutBLD98-00665 Final Mobile Home - BLD Permit / Conditions - 2/18/2000 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 kJ ,1 1 . 0 1 N 0 P IF E R m I C. FOR !NSPECTION'S, CALL 427--9670 BETWEEN 5pm AND Bain 427-7262 BLO98 -0665 PARCEI,. t322027590051 PLAT : DIV -.7 81-14s7 LOT -7 JOB AODAESS : 282 NE TIFF IM+ RD TAI-10YA OWNER . JOSEPH ftft"- 360--275-5626 CONTRACTORt LEGAL - I'll E-A Of S? 112376 SEE SVIV 316 cl..4ss or WORK . . NEW BFDRt 3 BATH : 2 ME A40110T BY PM OECEIPI iTYPEE A*PUv'f BY DATE Rfulpli TYPE OF USE . . . iMH STORIES . . . . . . . . I OCCUP . GROUP . , 1R3 81.DG . HF I GHT . . 3 O .Oft PICK 11 17b.09 K* 0718206 1208 TYPE OF CONST , -1 FIREPLACES . — . 0 #HOF 11 II5-00 (S 07115/9$ BELFAIR OCCUP . LOAD . . . . . 0 WOODSIOVFS . — t 0 Mi $ 4.b6 WS 07115148 MIMI! DWELL .UNITS . . . . : 0 PARKING SPACES : 0 ffiff S SOM KS 071151911 IkEIMA INSPECTION AREA 1 SHOPELINE7 . . . - 5N 11O1AI: 404.50 Vkilltfl1011t SETBACKS- - -- T 0 1 L E T:,3, . . . . . . . . . . 0 FUEL. TY Pf-.S-- --- - 80 1 LE R 5;1 COMP-- MOBILE HOME---- FRONT —W 11510ft BATH BASIN& . . . . . . i 0 0-3 Iip ' ; 0 REAR . . . .E 160 .Oft BATH TUBS . . . . . . . 0 3-15 HP . : 0 MODEL :OAKWOOD SIOEM .S 65 -01ft SHOWERS . . . — . , 0 TURN < 100K BFU - 0 15-30 HP . : 0 --MA K E SIDF ( 2 ) .N 120 "Ort 'WATER HEATERS — . : 0 FURN >-100K BTU ! 0 30-50 lip . : 0 OK48001F SHR I., I NE .E 90 .0ft 'CLOTHES WASHERS . t 0 FURN - Ft OOR . I . t 0 50-4- lip 0 --YEAR-. _._ ___ _ AREAKITCHEN SINKS . . . . 4 0 HEAT PUMP . . . . . . . 0 98 VOT SIZE . . : FLOOR DRAINS - - : 0 VENT sys'r-Ems — t o EVAP COOLERS : 0 LFNGTH -48 BUILDING . . . , Ost DRINKING FOUNT . . . ; 0 VENT FANG — . . . , 0 HOODS . . . . . . . s 0 WIDTH , :27 BASUMENT . , t Ost LAUNDRY TRAYS, , , . , . 0 DOMFS , INCIN :O -,-SF'R IAL# DECKS . . . . . . .t Oaf DISHWASHERS . , . . . ; 0 AIR HANDLING UNITS— COMML , INCIN :O GARiCAPPi? Ost GARB DISPOSALS — . : 0 10000 cjm � - 0 RELIJC/RFPAIRs 0 AT/DT . t? URINAL'S . . . . . . . . . . . 0 > 10000 off" . , 0 OTHER UNITS . : 0 MISC PLM I" IXTURESt 0 G A113 0 6 T L F T S 0 of SC A I I r I ON:#6 8 111 0 4 It PR C7 LOCAT0111:11EAD 001 Tel COLLINS MAIM- STATION. PASS T IPi STATION 011T It 100 CON[ TO PINATIO kO ' (SfCOID ilM PAST FIRE STATIOC RIGIH 09 MWAITC, 1`1145IRST RIGHT Ott LIAO), TEE LAKE_ PINES $149 00 RISHT, PASS 3 409,0,ES ON RIM., 914TH DRIMAY 011-ih#j. T"I PTRdll JECONES NUIt AND VOID if 104K 09 AOTHORIIED It NOT tolvINCE111 WITHIN i8e IM DAYS, OR if CONSTRUCTION OR WORK Is PERAID FOR A PERIOD OF %10 DAYS AT ANY TIME AFTER woof is CONIFOCED, fvlDf#Cf OF C0411116A11011 Of 1011 IS 0 PRQGOESfi 11IMMON 111MIM THE 180 DAY PF9100 FINAI, INSPECTION MOST BE APPROVE0 BFFPPF Bljll,�jIIIG CAN bF OCCUM0. OINfl OR Milli.. 4�c--ju CONCRETE �G:%r0 • MECHANICAL MOBILE HOME Footings- e ack date by Ribbons date �.— �� by Gas Piping date -,:`�r b Foundation Walls date by Set Up date --I• by INSULATION date by BG/SLAB Insulation Floors Final c/ ,� date by date by date 2 —� O '� by n� FRAMING Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D W WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by �,��/,�'9�-,.c.— T� /r�7/3Or� - 2� /3�i��/>T d /�/ty% /%:� CC6//n�-✓�v' 1/19/(_ (�/ /ti f% LC U= �l�� C/U Z 1 e�i�lCYiio% s- T- p/�/d� (fin C1-1 r//fLG'LOnr j-e_ a / bay — /tom,•<�3-7 ski�Ti�r �� Sc-��nyc✓ /y�J L/-'/�-k /Yf=/��? r_�.si i��- jz-T /5�1/ I Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTI E Job Location CGrJll rY Z-�L 7'�� c-./C ��0. This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been f0 d: Items Listed below must be corrected to gain code compliance C. G-C ••-� 0 Spuv Cps- _Tf D /,s 12 S,pEc�/oy You are hereby no ' ' he 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 13C ? Date 2- -E-r-4b Inspector %_ P . moos NOOT vi MOOV T 1 - � TA& LORM J Building Permit # MASON COUNTY BUILDING 1114210 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 1 � � ate` - V►f - '' "� L v% 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 /9 OK to ❑ This is not a complete inspection � Department Date - `"' Z.S''g9 Inspector ■ so v tw' osT ► Mo *V T 1 T ' Low, Building Permit # 6,S MASON COUNTY BUILDING Ill 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 7- = Z-A Lin 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 f - - e>/? are hereby notified that the above corrections shall be made )RE PROCEEDING WITH ANY FURTHER WORK r re-inspection when corrections are made before continuing corrections, items will be checked on next inspection of a complete inspection Department 7 - 7-Y Inspector : /? No VT P1 Mo *V T t T A ,��- MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 P f-- F1 M I -T C-1 C3 N " 1 -r 1 0 N 11'1 w Case No . t BL.D98-0665 y. Fort JOSEPH CURRY Paget 1 11 Appr 1qved per dimensione and setbaoks on submitted site plan ; setback to, wetland on east isT10 f et and owner shall maintain vegetation cover in this wetland buffer . X- ------ 2 ) Tempo+ary erasion control measuros must he Implemented to prevent wat-4f, qua lltv degrj1dat,jon of adjacent waters or, wet I ands . S I I t fene.- I n must be Installed anti ffl� ii, a , (/fied unt I upland veoetation has be e s com establihe.3 , X Q--,- 3 ) Proposed f.,tructure or, arsy portion thereof greater than 39)" in heiqht from - made I I rie , must f�alptain a minimum of setback from all property lines , easements and 10 ' from all )1 ourtv and State Ptiad riqht of waVs . X 4 )- Th loat ion I s subject to 140 ter and Landscap I nq requ I rements as. e-;tab I I shed under, Maspp County Ordinance ' 1 .03 -.036 , The u I e handling and storage of hazardous materlails or flammable and oombustible Itqul�s ',-in exoess of 10 pallons Is. rint allowed without the approval of the Mason County r F1 ,t ,1MajshA ; X 6) Provisions for surface/subsurface drainage control mu,:4 be implemented with new construction or development on site and MUST NOT adverstel,-,i impact adjacent parcels . Under the ie(juirements of Mason County Stormwater Ordinance, either private ditcheg and drains will meet requirements of the stormwater ordinance or or- lor approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose . For further I rif or-mat I on r#fja r d I nq t b I s ordinance and the SFOUIRFMENr to obtain an ACCESS PERMIT for the Installatlon/construction of a driveway or access i,otinect Ing from a Mar-on County Rood, Conta,t the Mason County Pubf le 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 wav , it is sugges t"d to contact that office to review future planned work which -------------------------------- ------------------------ MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 may jar/f ect your, pro ject X 7 ) TO 1994 LIN I FORM BUI LE)I NG GODE , At L tS I TES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AZ8 TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING rIEPART"FNT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A REINSPECTION FEE , BASED ON RATES IN TABLE 3A OF THE 19",44 IJNIFORM BUILDING CODE WILL BE ASSESSED IF (_)WNER,,1'/COjNTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPFCTIONS . X_ P ) THE FOUNDATION SYSTEM SHALL RE PLACED ON UNDISTURBED, NATIVE SOIL . 9) The approved plot plan Is required 'to be on-site for, inc,peotiore u r p v ti e f.4 It In5pertion is called for and plot plan Is not on site, Approval ML. NOT he granted . In addition , a Re- Inspect Ion fee I n the amount of $42 .00 per hour (min imum I hour ) will be char d and must- be collected by this department prior to any further inspections being pe r e, or approva I granted . 10) REQUIREn INSPECTIONS ( Footing e or e P Ins ction- pri to our , St- e oto,s up Inspction-prir tkirting, Final Inspection-prior to occupancy) . , have received a copy of the General Information and Guidei Inefs-Mobi le/Manuf acti.ired Housing Instal lat ions Handout for detailed descriptions (,;f all required Inspections on my mob iletmanufactured home Installation . I hereby assume all responsibilitV for the scheduling of these required inspections . It these required inspections Are not requotsted, inspected and signed off (approved) by the Ins ector in 'the prescribed order , I understand that reinspection fees and an hourly investigation fee pursuant to -the 1994 UBC, Table 3A will be assessed In addition to my origina 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 . kintil resolution of) any/all problems no occupancy ( Final Inspet",tion ) will be qranted for the residence . OWNER) CONTRACTOR ( 1 nd i1cate wh,iGh ) Signature X f1j A,t-L i . 11 ) All mobile/manufactured home landings or decks must be freestanding ( self supporting) . The largest landing or deck permitted without drAwings or a building permit Is 120 sq ft MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 or less AND MUST be under 30" i r+ or docks above 30., can be built without a permit ., Any landing or deck that Is 30 or inore A n height from walking surface to finish grade requires a Permit . Any landing or deck lit hat has 4 at more risers requires a handra i I . 12 ) Proposed structure or inrt,lns thereof with an projection over- 30 in height front grade o I i ne, must maintain a pc► `at ' can distance between adjacent structures and that f o rthest projection . X _....__( 13 ) ALL ON)9TRUCTI(yid MUST MEET OR EXCEED LOCAL CODES . '€ F ANY QUESTIONS, PLEASE CALi_ T IS OFFICE BEFORE OONS7Rl,O ION . X r ' 'J. .'tip Family Size Morning Room Credenza with Full Si. � tched Glass Washer, Dryer, Pa Doors 20' Side by Side Over Range ,Su Formal Microwave DiningRoom Refrigerator. _ ar' _ _ Self Cleaning Range & Dishwasher 13'-0' 10 7 6-0' 1 --- e -- Big Separa - _� - — �'• � _ 'Cr�a... L-o,.d Utility Roo _ �uw ' Q�=..y. p •a, Bedroom with Walk-in with Storage ` K„;kd,a,�-___ ��,�d Wardrobe Area -- �---- --------_ FAU Dream!'taster Bat( -- - with Double Sinks,L;rt ,ri.... wnLK Separate Shower and Corrinr Tub puss Windows I Mirrors aad Brass L+ghts a s tr x uN Private Arm �� '�r•ay.� e r RMONIE Large Bedroom Tue - and Wardrobe 8.8 - - 12 8' - ♦- -- 16,-8• - -�— 101-0' , 1,296 Square Feet•Morning Room ' Three Bedroom Model No. Mast ,=,t 35— a, NC 19 GA f _ r+ x JF �4r # •4. F J 4 - - Permit No. gc OCR , nw'— MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 (Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269) PLEASE PRINT #1 wner Jos Phone#l (oo� ite Address 2520 T LAKE R Fire District# City Ta 1At l aL St \�A zip `9EM Directions to Job Site NERD DUT To 01)1-LIQ LAK,!�. �lr2c. ��ATioN . PAS E I R� '�;—IATi A SECON R-T PR EIRE- R tN 856 El Rc,-T RE CltL L-K RD T ;a ptt\ve-c--) 7;�5 i RT-, Pass 3 Rou,--e� o� RT , 441 otJ PT Owner Mailing Address Jlp`�io �•�. &A-FNI R TA"IWA RD City TAN[AVA St WA zip Lien/Title Holder Address 2 1 City C'I IC4 UJRII-R St WA zip S S2q #2 Contractor Name (3--XL0ckfJ& ► `O�<—'5 6", Contractor Reg # Address Expiration Date City St Zip Phone# Try n`�PoY t ►-nc7f'�n Ors i�C�t� fr-,, �f �L #3 If septic is located on project site, incl e records. Connect to Septic? S Public Water Supply Well—cmtw1Myv1-i Connect to Sewer stem? Name of System tJ (� (if resid tial, proof of potable water is required) # Parcel No. 22 2 - `l5 - 90�51_ Legal Description LDS' E- ShoRT Pla+ ' 231b ,TUtnit�S�llp 22 NbRTN, � WQ.A",�/�l• . O(A-Sa1v #5 Buildin uare Footage: J 1 st FI 2nd FI 3rd FI �_ Loft Basement # Bedrooms '_#bathrooms-'--- T Deck Other Garage Carport (Circle:Attached or Detached?) #6 Use of building etSta6AAt , Describe work #7 Type of Job: New ✓ Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION U Model Year , 1 `b MakeDAK,,6M Model UK (F Installer Name: (au'd W 5 Length FT Width 2` FT Serial No. " �0 Certification Num�be�r: # Bedrooms # Bathrooms 2 Type of Heat F—U—C, R Purchase Price$ #9 WATER ON OR WITHIN Z00' OF THE PROPERTY [ ] SALT [ ]RIVER/CREEK [✓J POND [ ]LAKE [ ]WETLAND NAME OF BODY OF WATER ��f�Syrz� �OY S,lopes/Bluffs [VfIYES [ ] NO Show following on the site plan Lot Dimensions Fences Existing Structures Driveways Structure Setbacks Shorelines Water Lines Topography Drainage Plan Wells Septic Systems Easements Proposed Improvements Name of Side Street Indicate Directional by (N, S, E, W) Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW 5� SSA L ON . v �XtS�ItJ NEW NouS� D Qd%N F1&Z I� 21 APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW tyo C ROAD FT. Plumbing Fixtures Fee Mechanical Fixtures N\_HotW \ CIRCLE FUEL TYPE: Gas, Electric, s Heatpump, Other e No. Units Fees Furn BTU tr Heatpumps shgr"� Vent Systems _ Spot Vent Fans Floor Drains No. Boilers/Compressors _Lauddry BasiA HP ishwasher No. Air Handling Units Disposal _ cfm# Urinals No. Fire Protection Systems Other _ Auto. Fire Alarm Sys _ Fixed Fire Supp. Sys Permit Basic Fee _ Auto Fire Sprink Sys TOTAL PLUMBING $ No. Other Gas Outlets Wood, Gas, Pellet Stove Propane Tank 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 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD 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 ENT. DEPARTMENT. X OWNER '� I X BY DATE G DATE FOR OFFICIAL USE ONLY: Accepted by: Date: h k n`- Receipt No. 1X9 Amount Paid -75 DEPARTMENTAL REVIEW Cash Check_ Check # 341 FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review Occupancy Group: Type of Const: Fire Marshal: Other: Fee Calculations: FEES Building Permit — Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee UFC Plan Review Other Other Building Valuation: TOTAL FEE Plumbing Fixtures Fee Mechanical Fixtures No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Units Fees Showers Furn BTU _Hot Water Htr — Heatpumps —Laundry\WashW'/ Vent Systems Sinks _ Spot Vent Fans Floor D ins No. Boilers/Compressors —Lau dry Basins _ HP ishwasher No. Air Handling Units Disposal — cfm# / —Urinals No. Fire Protection Systems Other Auto. Fire Alarm Sys Fixed Fire Supp. Sys Permit Basic Fee Auto Fire Sprink Sys TOTAL PLUMBING $ No. Other _ Gas Outlets Wood, Gas, Pellet Stove Propane Tank 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 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 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 DEPARTMENT. DEPARTMENT. X OWNER X BY (0/`9 DATE "~ DATE FOR OFFICIAL USE ONLY: Accepted by: Date: f Receipt No. Icx.9 Amount Paid-1-1.41z-,W DEPARTMENTAL REVIEW Cash Check Check # 3�'1 FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review Occupancy Group: Type of Const: Fire Marshal: Other: j Fee Calculations: FEES Building Permit V5� Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee �S_0 UFC Plan Review Other Other Building Valuation: TOTAL FEE . cj Receipt No. , Amount Paid 15Q DEPARTMENTAL REVIEW Cash Check_ Check # k,54- FOR OFFICE USE ONLY A pproved Cond. Hold Approval Planning: Environmental Health: Building Plan Review Occupancy Group: Type of Const: Fire Marshal: Other: Fee Calculations: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee UFC Plan Review Otherw Other Building Valuation: TOTAL FEE I Plumbing Fixtures Fee Mechanical Fixtures N\Bath \ CIRCLE FUEL TYPE: Gas, Electric, s Heatpump, Other No. Units Fees Furn BTU Htr Heatpumps asher _ Vent Systems _Sinks ` _ Spot Vent Fans _Floor Drains\ No. Boilers/Compressors _Lauofdry Basin�� _ HP Ishwasher �R No. Air Handling Units Disposal _ cfm# _Urinals No. Fire Protection Systems _Other �� Auto. Fire Alarm Sys Fixed Fire Supp. Sys Permit Basic Fee \ _ Auto Fire Sprink Sys TOTAL PLUMBING $ No. Other _ Gas Outlets Wood, Gas, Pellet Stove Propane Tank 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 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 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 ENT. DEPARTMENT. X OWNER , h 4. 1 X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by: Date: