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HomeMy WebLinkAboutBLD2008-00452 Garage - BLD Permit / Conditions - 6/27/2008 Inspection Line(360)427-7262 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone (360)427-9670,ext.352 Mason County Bldg. III 426 W. Cedar P.O. Box 186 ' Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2008-00452 OWNER: BRUCE GOTTOWSKI RECEIVED: 4/22/2008 CONTRACTOR: TOWN AND COUNTRY POST FRAME BLDG 800-824-9552 LICENSE: TOWNCPF099LT E) ISSUED: 5/29/2008 SITE ADDRESS: 7570 NE BELFAIR-TAHUYA RD TAHUYA EXPIRES: 11/29/2008 PARCEL NUMBER: 322027500090 LEGAL DESCRIPTION: TR I OF SURVEY VOL 3 PG 6 PROJECT DESCRIPTION: DIRECTIONS TO SITE: Garage. RT FTER OVER H TENE ISLA RIDGE. R AT "T" TO Stock Plan #2006-0014 HA TSTE IS AND S. S FRO RE S ATION/ A OR PA T Y 0 1 General Information Construction &Occupancy Informa 'on X Square Footage Information No. of Bedrooms: ype of nstr.: kBType of Use: SF Insp. Area: No. of Bathrooms: Oc roup: Lot Size: Deck: Type of Work: ACC Fire Dist.: 8 No. of Stor1 1 Oc Loa Building: Garage-Attached 672 Valuation: Building Hei ht: Occ. s: Prima Basement: Manufactured Home forma in Se ack for ation Shoreline& Planning Information Water Body: None Make: Le the Ve : 285.0 Shoreline: Ft. g SEPA?: No Model: dth: Ft. 53.0 Ft. Slope: Ft. g.: Not Applicable 153.0 Ft. Shoreline Desi pp Year: Serial No.: 200.0 Ft. Comp. Plan Desig.: Rural Plumbing Fix res Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee KKK 4/22/2008 $61.45 S22008000 Planning Review Fee KKK 4/22/2008 $190.00 522008000 EH Plan Review TW 4/29/2008 $40.00 B12008000 Building State Fee ARC 5/1/2008 $4.50 612008000 Building Permit Fee ARC 5/1/2008 $307.25 612008000 ADJUST--Plan Check Fee ARC 5/1/2008 $70.55 612008000 Total $673.75 BLD2008-00452 Please refer to the following pages for conditions of this permit. 1 of 5 CASE NOTES FOR BLD2008-00452 CONDITIONS FOR BLD2008-00452 1) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-64 982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) The international code requires a fire apparatus access road for every facility, building, or portion of a building that is more than 150' from an approved access road. Roads are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such ro onnect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. l/ X 3) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X 4) Approver dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 5) All approved plans are required to be on-site for inspection purposes. If an inspection is called for and plans are not available on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and must be collected by the Building Departm nor to any further inspections being performed or approvals granted. x_n& 6) Owner t is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X `�J9 7) The plan review check list and corrections are part of the approved plans and must remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked "APPROVED", they shall not be changed or altered without authorization from the Building Official. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project. Failure to comply and/or removal o, armroved documents will result in failure of required building inspections. X 8) This structure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use permit shal pplied for, reviewed and approved prior to the change. X 9) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X BLD2008-00452 Please refer to the following pages for conditions of this permit. 2 of 5 10) The "approved" site plan is required to be on-site for inspection purposes. If an inspection is requested and the "approved" site plan is not on site, then approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour) will be charged and shall be collected by the Building De ment prior to any further inspections being performed or approvals granted. X -7s 11) Per 2003 IRC - SECTION 1609-WIND LOADS - 1609.1 Applications. Buildings, structures and parts thereof shall be designed to withstand the minimum wind loads prescribed herein. Decreases in wind load shall not be made for the effect of shielding by other structures. Per FIGURE 1609 BASIC XSPEEID (3-SECOND GUST) the wind speed for Mason County is 85 MPH. X 12) Per IRC - SECTION R905 - REQUIREMENTS FOR ROOF COVERINGS - R905.1 Roof covering application. Roof coverings shall be applied in accordance 10 the applicable provisions of this section and the manufacturer's installation instructions. X � 13) A Mason County Stormwater Management Worksheet was completed and signed as part of this building permit application. Design, sizing, placement, inspection and maintenance of stormwater management systems shall be the responsibility of the owner/agent of the developed parcel. It is the owner/agent/contractor's responsibility to ensure that Mason County Department of Public Works has approved the stormwater site plan for this parcel prior to the commencement of any development activities. *NOTE if Stormwater Management option "A"was selected on the Small Parcel Stormwater Management Application/Worksheet the document entitled "Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan" constitutes an approved plan based on the criteria listed on the application/worksheet. If the development has, or will have, a septic/drainfield system you are responsible for contacting Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this, or any other, parcel. You may also wish to consult with the septic design professional involved with the project. By calling for a final inspection of the building permit the owner/agent/contractor is owledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X ' 14) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete workwork exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X -�/l'1' 15) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the internationa es and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. X 16) Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged an 11 be collected by the Building Department prior to any further inspections being performed or approvals granted. X 17) All construction must meet or exceed all local ordinances and the international codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit rev ?!!5 BLD2008-00452 Please referto the following pages for conditions of this permit. 3 of 5 18) Provisions for surface/subsurface drainage control must be implemented with new construction or development on 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 an existing utility and drainage easement dedicated for that specific purpose. For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction 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. elx_ 19) All changes to "approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulatiq��ust be reviewed and approved by Mason County prior to construction. X �// 20) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the inW, ade l codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building In prior to requesting additional inspections. X 21) All property lines shall be clearly identified at the time of foundation inspection. X�i,�� 22) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County nances and building regulations. X W 23) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have 2rz ed action from being taken. No more than one extension may be granted. 24) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, ashing. Install metal connectors approved for contact with the new types of pressure treated material. X 25) Retaining walls needed to support a surcharge c "as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X r 26) Landings and stairs m st meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Sit P,/ P' ensure these structures are shown and meet the setback conditions listed. X BLD2008-00452 Please referto the following pages for conditions of this permit. 4 of 5 2t Prior to final approval, all upland areas disturbed or newly erosion protection (silt fencing or straw matting). X Wed by construction activities shall be seeded, vegetated or given an equivalent type of 28) Temporary erosion control measures must be implemented to prevent water quality dation of adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 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 building can be occupied. Proof of continuation of work is by means of a progress inspection.The owneror the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and struc re f revie and inspection. OWNER O(AGE� DATE: BLD2008-00452 Please refer to the following pages for conditions of this permit. 5 of 5 00 o CONCRETE MECHANICAL MANUFACTURED HOME o Date B CD Footings/Setbacks �C-/�S Gas Piping y Ribbons O o Intenor Date P���s'�a By Interior-Date By Date By C N Exterior Date 6Z/,L,2 By Exterior-Date B C(n Setup � Point Load I Isolated Footings INSULATION Date By Date By Data SLAB INSULATION By FIRE DEPARTMENT X Foundation Walls Floors Date By C n Date By Data By DECKS rtt FRAMING Walls Datc _ By Date 7/ -,!5> By Data By PROPANE TANKS PLUMBING Vault Date By Date By OTHER Groundwork Attic Date By Type. Date By Date 131 D.W.V DRYWALL Type- Int Brace Wall Dam By co Date By Date By FINAL INSPECTION 0 w Water Line Fire Seperation C Date B y Date B y L�ato 6. 1� L1 yT� p m � Pass or Request Inspect. c 0 Type of Insp. Fail Date Date Done By Comments 4h, CD o a ��,f,�1,��- •9Ss 7- 7- Imo )- v N - O � 8 — a N O 0 Site Plan Suite B•16521 Highway 99•Lynnwood,WA 98037.3199 PI ase Check After Doing Site Plan: Septic and drainfield ot size Draw North Arrow in Circle Town &COUntYy= Everett: (425)258-4171 Puyallup: (253)840-9552 i�Property dimensions ❑ ewer lines Ld Elevation of property POST FRAM FAX: (425)742-4378 Toll Free: 1-800-824.9552 E BUILDINGS Administrative Headquarters: (425)743-1555 xisting buildings L►7�Setbacks of proposed&existing buildings ❑Bodies of water Contractor's Lic.a:TOWNCPF099LT Proposed building 3ain road with name ❑Floorplan IV r CCBB: 129311 ❑Easements PJAccess to proposed building ❑Slopes&Contours(5'increments) Quality:Our Future Depends On/r."' 7t� r y - Job Name: ISIRtIM' �a�sk I Job Site Address: l�0 N.S. 31kLma 2 �yA RV Legal Description: Tax Account A- 312o k 7S 0000 O.Or Q O -Ja �c rts' tts' t o IGS 3 s a +so' r �R1V�wAYrtk1N�, ._. TI&Qk-ta ui .1Qit �ttdrlsP� r o DRAG@ 6.7 1� C J -AA?,A ! Q }} I Z .A �. his � GAMtarE► +10' aRlvc�� -+rs �l(ISTIIJ(� R�t�bHCl I ,c O �1 Ili APPROVED MASON COUNTY DCD i'LANNINC SITE PLAN REQ�JI. E,) TO BE ON SITE CHA E SUBJECY TO APPROV 3Y —— u:,tc) L iQ O.p• DO NOT SIGN INCOMPLETE SITE PLAN! Customer has verified and approved the location of the building,orientation of the building to the North,and verifies that all white-Customer Copy Canary-Office Copy Pink-Accounting Goldenrod-Productioi utilities are shown on this drawing in the correct location. Q , Customer Signature:�!/u�ti[ t Lead#: 7-G ©I995 PetmaBilt Industries FR#34 5/9 IL_ & CQ11I1ti1'V® Suite C•16521 Highway 99•Lynnwood,WA 98037-3161 POST FRAME BUILDINGS Everett:(425)258-4171 Puyallup:(253)840-9552 Administrative Headquarters: (425)743-1555 DIVISION of FAX: (425)742-4378 Toll Free: 1-800-824-9552 PERMABILT Contractor's Lic.#:TOWNCPF099LT Quality:Our Future Depends On IL- DIRECTIONS TO SITE JOB NAME: Ca-ZTO]l� D S K) SHIP TO ADDRESS: 7570 t.E . 16BLr-A)R- -MM uYA KkD T�NvX�B II TELEPHONE#AT JOB DROP: 3 6 0 - - 2-7 71 THOMAS GUIDE 12--A I Can a semi'turn around at the job drop? ❑Yes 54o ❑Back-in Only ❑Other Can a two ton`get into the job drop? 5Yes ❑No ❑Other Can a concrete truck get into the drop? P(Yes ❑No ❑Other Will a 4 wheel drive vehicle be required for deliveries? ❑Yes dNo ❑Other Directions ;jbL FN I p DIRECTION 0 FwhB -D ROT MAIVRIALS t N KoN-T OIF 1),cG 1Uw- w OXA'it tNouaN ROOK Fos, G-" WNT-11 eP- To ° CUMe IN OUT OTt=0 o P- � o, uxl oc►�a> �X WDFAWTO / r Q` ST GRRv@� (man o ('1c-Hj D I=F d F EvJ P070 IR0R u 'Truck Dimensions:65'long,8'wide, 121/2'high,and it weighs 35,000 lbs.empty. `Truck Dimensions:30'long,8'wide, 121/2'high,and it weighs 18,000 lbs.empty. 01991 Penna-Bifl Industries FR-35 6/07 I I"I'I II'II'I'I II'I 1 4 TOW n kM Country- Su_C• _,Highway 99•Lynnwood,WA 98037-3161 POST FRAME BUILDINGS uy�W:( Everett:trade Headquarters; P 743- 555 Building Design p1���10A"10F Administrative Headquarters: (425)7a&lsss t IMROW— IL PERMABILT FAX: (425)742-4378 Top Free: 1-8OD-824-9552 (,duality:Our Future Depends On lt." Contractoes Lie.4:TOWNCPF099LT PLEASE CHECK FLOOR PLAN '�Roll-up doors fit in Bays a Wind MPH Draw North Arrow in Circle ®Roll-up doors will not hit Truss i . Wind Exposure j1'�'' Roof Pitch _jt: Eave Height S Snow Load � Minimum Clearance f !E3 FAvF F s I L4 !O t BUILDING ELEVATION Customer has verified and approved the orientation of the building to the North and verifies that all items specified in Paragraph B of the contract are shown on this drawing and vice versa. Customer Name: t3f G,C:'Tt>i4?S ? Lead#L "' !(% IIIIII IIIII IIII IIII Customer Signature I ' y 0 8 y White Customer Copy Canary Office Copy 01995Perrna-Biltindustries FR-85 6/07 Name G Parcel# 322 Q-2ZSCiUo R D BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page I of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development, or redevelopment', with more than 2,000 square feet of impervious surface 2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table SurfaceType Length X Width = Area * All dimensions in feet Buildings X X 2 _ Measurements for buildings are taken at the _ perimeter of the farthest projections (example: X eaves/gutters) X = Driveways t S XF=11.511flis _ -$`- X = Length of drive begins at the right of way X Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X = X = Any paved, gravel or packed area per definition above table X = Others X X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small.Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) &7 If the Total Impervious Surface Area is LESS THAN 2000 Square Feet, please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-described property for review and inspection as may be required. X Owne A ent/Contracto (circle one)Date: ql l 9I m If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 Name Parcel# BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to "Title 14, Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70). You will receive a copy of the Public Works document entitled "Managing Storm Drainage on Small Lots,The Small Parcel-Stormwater Site Plan". This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the system will.be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples. (Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT.450 Mail: P 0 Box 1850, Shelton WA 98584 Physical: 415 N 6th St, Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel. You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT. 352 Mail: P 0 Box 1666, Shelton WA 98584 Physical: 426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states, in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am.the owner,owner's legal representative, or the contractor. I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: Page 2 of 2 MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION 426 W. Cedar - P.O. Box 186, Shelton, WA 98584 I Shelton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner OG� C. rn tus tc 1 Company Name �T"utu�l 1'ouN Ry Mailing Address7570 N.E . 'R®LFA►R--roWuj^ IL, Mailing Address-I/.SZI NWy q9 City gn a JA State u` . Zip Code 98SAA City_1,NNW voD State I_ Zip Code q A057 Phone '"'�'� ' Z7T 1 Other Ph. '£ Phone *,I- - a:tLf_0`5!T,7' Other Ph. Lien/Title Holder " h Contractor Reg.# y14 CPf-c)4917' Exp. E Mail Address kA�1A g t LT . E mail address •' �A � Drivers Lic.# DOB Drivers Lic.# N JA DOB � ' 'A SEPTIC/WATER SYSTEM INFORMATION - Connect to New Septic ik o Existing Septic N o Connect to Water System Name of Water System Well Water System Name of Water System PARCEL INFORMATION - 12 Digit Parcel No. Fire District Legal Description Site Address (Please include street name, street number and city) _75Z2 N 6- B Pi. jQ- 7D /YA R TA N UY/ Directions to site 7 U (=ryC60 Si?P (1 t Q r IONS if.' e'l=. Will timber be cut and sold in parcel preparation?Yes Is property within 200'of Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ r` Use of Building AF Describe Work No.of Bedrooms No.of Bathrooms Square Footage - 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No.of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X ,�+tfsf/ d, ., . Date Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date_ DEPARTMENTAL REVIEW APP 0VED DENIED NOTES Building Department J Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee 07. Site Inspection Plan Review Fee 70 , SS. EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee So Violation Fee /V0 C­V'�C­ Pre-Paid at Submittal Valuation $ j J S'7- TOTAL FEES