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HomeMy WebLinkAboutBLD98-00422 Final SFR - BLD Permit / Conditions - 12/18/1998 � Z MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 - E3 U I L_ E3 ; N Cs P E= R PA I T FOR 1 NSPFCT I ONS CALL. T-9670 BETWEEN 5pm AND Bam 4t7-7262 B1.10198-0422 PLAT : D I V . BLK : LOT : JOB ADDRESS : 171 NE TRUVEAU MOUNTAIN AD BE L.FA IR OWNER : E_ESI. I F��'125 -SfiB_f8 !F3'i CONTRACTOR s CLASS 017 WORK . . :NEW BEDR : 0 RATII ! A IYPF AMOUNT BY DATE CECEEP4 !YPE ANOUNI 8! DA)E RECEIPT TYPE OF USE . . . . :SF STOR I FS . . . . . . . : i :.: OC;CIIP . GROUP . . , :R,; Etl. DG . HE I GHT'. . : O .Oft PRNT ; 499.41 KS 06122198 47456 RIC ; 44.11 KS 66122198 47456 TYPE OF CONST . . :5N FIREPLACES . . : 0 PICK 1 249.14 KS 06122198 47456 ENCP 1 SO.00 VS 06122196 47456 I OCCUP . LOAD . . . . 0 WOODSTOVES . . , , : 0 Pig 1 51-75 KS 06122198 47456 DWELL .UNITS 4 . . . a 0 PARKING SPACES : 0 MCN ; 45.25 KS 0612.2198 47456 INSPECTION AREA : 1 SHOREL. I NE? : . . . .N S1ff ; 4.50 KS 06122198 47456 701AI : 944.71 VALULATION: 19994 SETBACK - - - -- TOI LETS . . . . . . . . . , 2 FUEL TYPES-- ._-_._.____- BOILERS/COMP._---- MOBILE HOME-.- FRONT . . ,W 240 .0f# BATH BASINS . . 2 : f ELC! / ! @ IiP . : CO REAR . . . .E 50 .0ft BAT14 TUBS . . . . . . . . s 2 3- 1 5 HP , : 0 MODEL: SIDE ( l ) . S 150 .Oft SHOWS RS , . . . . . . . 0 FORN r 100K E'tIU : 0 15--30 ili' . : 0 MAKE S i DE (2 ) ,N 500 .Rift WATER HEATERS — , -, 1 TURN >=100O PTU : 0 30--50 HP . ; 0 SHRL I NE N 0 .0ft CLOTHES WASHERS 1 FIIP,N FLOOR - - 0 1150 f HP . . 0 YEAR----- ---- AREA _...__._____.__ ...__._. KITCHEN SINKS . 1 HEAT PUMP . . . . . . : 0 LOT SIZE . . : FLOOR DRAINS . . . , 0 VENT SYSTEMS , . . : 0 EVAP COOLFRS : 10 LENGY14 : 0 BUILDING . . . : 1702-;f DRINKING FOUNT . '. . - 0 VENT FANS . . . . . . : 4 HOODS . . . 0 WIDTH . : 0 f BASEMENT . , . : 0sf LAUNDRY TRAYS . ;' 0 DOMES . INC I N :O SER i .Al.tt nFCKS . . . . . . : 09 f DISHWASHERS . . . . . ..: 1 AIR HANDLING UNITS-- COMML . 1 NC; I N :O r GAPICARP0 Osf GARB DISPOSALS . . . : 0 -- 10000 otm . : 0 RELOC/REPAIR : 0 AT/DT . :? UP I NAL.S . . . . . . . . . . . 0 > 10000 01m . : 0 OTHER ON ITS . 0 MISC P1.M FI )JURES ?. 0 GAS OUTLFTS . : 0 PROJECT DESCRIPTION:Rr.''iOENCf 044JECT 10011010 01 TO SNELTON HNY 3, 15 NILFS TO PELFAIN, T.EFT ONTO OLD BEI.FAIR .ND 2 NILES LEFT ONTO BEAR eRE1K DENATT3 RD, 5 411LES LEFT ONTO TRfUbEAU SITE ON �EfT. . 111ISiPFRNIT BECONES NULL AND VM D If 101K OR CONSTNUC1181 AUTNONIIFD IS NOt CONVENCED 111010 181 DAYS, OR IF CONSTNUCTION OR WORK IS SUSPENDED FOR A PERIOD Of Id/ DAYS AT ANY TINE AFIFR 1001 IS 'CONNENCFD. EVIIF.NCE- OF CONTINUATION Of NDNK IS A P80G.RFSS INSPECTION NITRIN THE 164 DAY PE1108. FINAL INSPECTION MUST BE APPROVED RFFORF BUILDING �fAN 8f 0 ." ►IE/. A j " OWNER OR AGENT, '�•- 0 6LOJAill, rev. 1313! 9 COMPLIANCE TO ATTACHED CONDITIONS IS RFOUIRED a CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date '7 20 5 b;1 Gas Piping date b Foundation Walls 56e1X(-* date by Set Up date 1- by INSULATION date by BG/SLAB Insulation Floors Final date by date _Z ., by date by FRAMING r Walls FIRE DEPT. date �� / � y date b date by y PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date e7— � by / /r date d /�/-�� by Water Line FINAL INSPECTION date by date L_/f_`�'� by '17 1 date by t, ' j yo►, 4 lu 4o vpor 'i u,-0 `iud 1 Z-0<-YY>o;y al-,Ow v Des �Y�t�.c .� s f� �rT T.T_ —ice qEr s0?y !vim<C- Building Permit # -aS`2Z MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 4 ;7- / .x�e") 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 AQ/�©�/�O!s ✓�CciiyjG ��ij,C �/=/� O v /9 U- /LC�v 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 insI66ction Department .8C-t':2 Date /'/-/�yf1 Inspector ■ sov NUT Pilo M « 4V T Ulth, T ' , � r Building Permit # -�' L Y2 MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location / 7/ - zi 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 OK to ❑ This is not a complete inspection Department `' -� Date q 2 Inspector T- ■ o * :JnT ' MUV THU- T A Lot MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 PE F3RA 1 `T" c_; 0Nt.r i I I a...si,J : Case No . : BLp90 - 0422 For : LESL IF HAM I t TON Pagel 1 , XApproved per dimensions and setbacks on c3 1 t.e p i tar► submitted on 05-28--98 by fax . X r A , > Proposed structure or any port ion thereof grepater than 30" iri height from grade I ine, ,must maintain a minimum of 5 ' s, back from all property I i nrr easements and ic�J ' from a I 1 C ►j t y and State Read right of ways. . Temporar Prosion control measures must be Implemented to prevent watery quality degradation of adjacent waters or wotlandr . 3�1 The use, handling and storage of hazardous innter i a l s or- flammable and t-combust i h 1 e liquids In excess of 10 qa l i nns is not allowed without the approval of the Mason County Fire Afar h:it . X 5'k Provlsione� Pore surfave/ tlubsitrface drainago oontrol must be implemr-ntod with new I sons truot t can or development on site and MUST NOT adversely impact adjacent parcels . Under the: requirements of Mason County Stormwaater Orr! i nancf. , either private ditches; and c1-a i ns will meet. re3q►t l remeAnts of the stormwater ordinance or prior approval will be granted t,�) ►.ise an existing tut i i I t y Fined drainage easement dedicated for that sppec I f 11`. purpose . For further Information regarding this ordinance and the REQUIREMENT to obtain an A('CFSS PERMIT' for the i nFsta l i at i on/construct l on of a driveway or ac•uess: connecting from a Mason Countv Read, Contact thA Mason Counted Public Works Department prior to construction at rxt 450 . For any construction wb i rh i ss proposed to be located within 25 ' of a Ma...t on Go+rnty road r I ght of way , it Is suggested to contact -that office to review future p l antied work which may ft of ynur, pro ieot 6A This SappIioattoo is subiea.ot to Puffer and l +andsnaping requirements as established under Mason County Ordinance 1 .03 .9138 . MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 A 1 1 approved p # ans are required to be an—:i # to for 1 nsppeat i on purposes . If # rrspect i on is called for and plans are not on situ, Approval WIL1_ NOT be granted . In addition , a ne-- Inspect. ion fee in the ,amount of $34 00 per hoijr (minimum i hour ) wi i I be ohArged and must be collected by this department r+r i or to any further Inspections bo i nq performed of i approval granted . X-___ _� __ £ 'f PURSUANT TO 1994 UN I r0RM BUILDING (A)DE , SECTION 305(C ) AND Sr CT I ON 51.3 A.I_l. S 1 T f S M11 1 HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO Bt PLAINLY VISIBLE AND LEGIBLE FROM THE STRuET OR ROAD FRONTING T HF PROPERTY . MASON COUNTY Bit 11.1) I NG DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A RE 1 NSPECT I AN Fir . RASED ON HATES IN TABLE :3A OF THE 1994 I)N I r'ORMI FU I LD I NG CODE Vi I L i. BE ASSESSED IF OWNERfCONTRAC'TOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIQNS . X f�3 The correction list , along with the Fnergy C:ompi lanoe Work�3heet (when appl Icable ) is part of the plans and must remain attached thereto . It is the responsibll1ty of the appIleant to make correntionr, indicated on the pplans from the correction Iists . Onoe the plans Are markets APPROVED, they may not be ot►anged or ' altered without authorization from the Bui Idin(1 Off iciai . The permit holder Is reponrible to retain the complete* approved set of plans on site f br the duration of the prey«�c t . Failure to comply will result In failure of required building I rispe?at i ons . Every porm i t sha I l expire by 11mitation and become null and void if the building or work authorized by uuoh permits i s not cunarnenved within 180 days from the date of Issuance , or it the twu I I d i nq or war k authorized by such permits is suspended or ahq%4. oned at any time after they work is commenced for, a period of 180 days . X. 1 AL I- 11,E Ruc, r I ON MUST MEET OR EXCEED ALL 1-(.,)CAL CODES AND UBG REQUIREMENTS . ., x 111�. Changers to -iipproved hui Iding p.i ;ans that effect compl iance to the 1991 WiAchington StAste Energy Code, 1991 Ventilation and Indoor Air Qualityy i'ode3, the Uniform Building Codes and/ or- Macon Count V Re- t i�sn ; must approved by Mason Count.V prior to c,.onstr-uctionX "� j 1 e?A_ ALL CONSTRUCTION MUST MEET OR EXCEED LOCAL. CODE S . I F ANY QUESTIONS, PLEASE MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 x } CONSTRUCTION PROCESS TO BE FIELD CORREf,TE ) S' EQU1RED PER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE - x__ I i THE INFORMATION ON THIS PLOT PLAN HAS BEEN PROS,„,„AND REVIEWED BY THE PROPERTY GV'�'NER WHO,CY SIGNING BELOW:1.) /;oNOWLL0GES AND ACCEPTS FULL RESPONSIBILITY FOR ITS ACCURACY AND COMPLETENESS:2.)IS RESPCiJSi(iLE i0 ENSURE THAT THE IMPROVEMENTS TO THE SITE TAKE PLACE CJ CONFOR14ANCE WITH THIS 3 3 PLAN:3.)WILL CSTABLISH ALL THE CORNEP.IRONS,LOT LINES AND CODE. REQUIRED SETBACKS fiIQUIt;Ef)OF THIS PPOPERTY ANY CHANGE(S)TO THIS ftgN MUST VIE FRE•APPROVED BY THE GOVERNMEtJTAI�.sE1�IES t4'ITH ?i$UiCitt);J,11;E hSOf;TGASE LEiJU� �ANDE CON1RACi0R AND UTtEIJTEU.� I i'ER DATE "NER DATE 7 ly E ,0 J v -SAS£ n -1 Lo'T' -t--7,l r1N FOjt ENIARI. M£iJT IS L111 LFSk Ifs �1�nL1t Ton) ,� 1 8 0 9 n/4. 5-/` S T 74-6pic,,1p , wA L-- _. PY # SG, - 0vt8,5 7-4 x �;.3�z�J �1302 7S00YO -5/Tc f1 DAZESS 7 / rvL 7;ZubCAO nYTn/ TO i K � o J WELL }� sG F # w �1 .zyo` - - - foR — � 4"C' i ,JUN 15 199� rERMII ASSISTANCE CENTS SENI' BY:CUSfOMER SERVICE / CCC: 3-22-88 : 12:03 PUGET SOUND ENERGY-{ 360 943 0701 ;# 21 2 0\4 o VVELL OtISE U MTN TN RD RD SEPTIC DF DRIVE EAR CREEK DEWATTO ,¢1 LA Y� ox LL V�yj S 1 1�� K � i JUN 15 199�8 'ERMI) '42ISTANCE CENTE', i D A A I N I I r FO[718.Att 1rTf9�G m ➢N LU Al FELT CM 7/9'VHt7l G4U . CTXOL73N S=IA7 m1 vz,tar RTV= r C=6N QVFRIANCA O1 KrGT T1411 71 At N Y-r ILL rATrD1 TRII=M VALLS V/ ►AAM"ARD= r rRN=vFnm=7 rim I Emwi Ar vvm TC NAINSA71 1 Jrr Atr?#C£ ATTZ DMUTMN"KJJD ULIC NM WIMACTDV vmwnmi Mul cm 137iT AA'!IlOI DNO WU pv,,=vlxm VDatArIK IOC]3 No JCT AOr£Twm , =n VDrtnJ1TOU W WM 1OMN Or JTAa Ar D UXT S FUT ANY[rAVL AALMm W(mrl� VDRIIAI=rl VUD r<DA VWM A S t2 I Vt Z uI yr 1lQ I ALL VALJ.S yr no U1.1% 3A I/C iAJial AJTTIR7 rrrStJ.i]1omtVDIxi. rrrrmArIA'Dri C t'ArIDot ICE ArTLT A JII WO art.V3WW A6 MCK W%?CM onJ7m nrrr7tma C A9W D evTA Lrr ays-ao ucm rs,JL FVALM KI ATr,tJJ.G/ MINN SOH PC.VJTM nA1a a1 7/W LY.r MM21GL IA►=PC r r A'rI w A TRFi1Tm sIIl Y/ yr rAr n 71m r,I '4'="Cva Vr a'rL" t2'=r lr r s mTS AT �WXmm r DA lr m m m 7/ti'VArumm a NOT= r-r 6c Am 1t`r+m ess a trl�m dV01 yr Tt6 RTV1r^r a�mc { Di xSM@L k0m JJLTI AFC To HlQM= OI r yr VMD-1-.=r FVM0 JI AX V ' 2 vv ANVC r1c Or-m WALL TYN Be W.TV. 3 Mi �! Vmm1 CDC rrrG M.r j{I k � m OF FMM VWT Am rsl CMtY m L!JQ FEG O WVL 37ACL J ML V=IDS K MOW Foal APO TH�DOaR,LAB:r Alm TIM Tp I!Lr AT ra►VALU A W TYPICAL CROSS SECTION m a m vv•t'r r A V4'=1'-0' a"r m 'Am 4/1/97 ANC m 1 STORY CROSS SECTION ADAIR HOMES, INC. SINCE 1969 Oregon Contractors#000593 Washington Contractors#ADAIRH'262RZ April 22, 1998 BEAVERTON OFFICE Mason County Building Dept 1111 S.W.170th PO Box 186 APR 2 %%. 1998 BEAVERTON,OR 97006-4299 Shelton WA 98584 SALES(503)645-3547 > CONST(503)645-1156 jR11T �SSISTbICE CENTER FAX(503)645-5986 Dear Official, BEND OFFICE 63309 NELS ANDERSON RD. Please find enclosed a building permit application for Leslie Hamilton. She BEND,OR 97701-5743 will be building a 1702 Sqft home at 171 NE Trudeau Mt Rd, Belfair. SALES(541)382-4068 CONST(541)382-6924 Enclosed are two sets of blueprints, strip map to site, plot plan, approved FAX(541)382-8989 septic design, water avalability information, energy form and wattsun OLYMPIA OFFICE report. 2303 93RD AVE.S.W. If I have forgotten anything or if your requirements have changed, pleaseOLYMPIA,WA 98512-9156 SALES(360)352-8571 notify me at (360) 352-7641. CONST(360)352-7641 FAX(360)943-0701 Thank you very much for your time and assistance. BUSINESS CENTER 56/�"G6f 1111 S.W.170th BEAVERTON,OR 97006-4299 Carol Schmidt (503)645-4730 Administrative Assistant FAX(503)645-9715 Adair Homes Inc. L4 /� ADAIR HOMES, INC. SINCE 1969 Oregon Contractors #000593 • Washington Contractors#ADAIRH"262RZ April 27, 1998 BEAVERTON OFFICE Mason County Building Dept 1111 S.W.170th PO Box 186 BEAVERTON,OR 97006-4299 Shelton WA 98584 SALES(503)645-3547 CONST(503)645-1156 FAX(503)645-5986 Dear Debra, BEND OFFICE 63309 NELS ANDERSON RD. Please find enclosed the typical cross section for the Leslie Hamilton's BEND,OR 97701-5743 project located at 171 NE Trudeau Mt Rd, Belfair. SALES(541)382-4068 CONST(541)382-6924 If I have forgotten anything or if your requirements have changed, please FAX(541)382-8989 notify me at (360) 352-7641. OLYMPIA OFFICE Thank you very much for your time and assistance. 2303 93RD AVE.S.W. SALES 3 0) 52-8579156 �� ( SALES(360)352-8571 CONST(360)352-7641 FAX(360)943-0701 Carol Schmidt Administrative Assistant BUSINESS CENTER Adair Homes Inc. 1111 S.W.170th 111J� C �I BEAVERTON,OR 97006-4299 (503)645-4730 Do- FAX(503)645-9715 '�p�2 9 v Mason Count Bldg. Permit No.BL - Y , BUILDING DEPARTMENT Date: • idp P.O. Box 186, Shelton, Washington 98584 (360) 427-9670 ext. 355 INSULATION CERTIFICATE � I hereby certify that insulation has been installed in the project constructed at 171 NE. TRUDEAU MTN.RD, BELFAIR ,WASH. 98528 in conformance with the requirements of the 1994 Washington State Energy Code as follows: Component Type Thickness R-Value Comments (or trade name) (material only) FLOORS-over unheated spaces MANVILLE 61-2" 19 INSET TWINED/BAFFLES WALLS MANVILLE 611' 19 POLY VAPOR BARRIOR BASEMENT WALLS N/A ROOF DECK N/A CEILINGS ® Blown ❑ Batts MANVILLE 16" 38 No. of Bags 47 Wt./Bag45 Baffles extend 6"above batts& 12"above loose-fill Area Covered 1702 sq. ft. SLAB/FOUNDATION N/A HEAT DUCTS N/A PIPING- In unheated spaces OTHER: Vapor retarder of 6 mil black polyethylene installed in the crawl space overlapped 12 inches at all joints and extended to the foundation wall. YES Air leakage: weatherstripping, caulking, gasket YES Installed by Company WASHINGTON INSU'LATIONDate Certified by HERB NORQUIST Company WASHINGTON INSULATIONDate_►�����& Inspected by W ��L WS %/�"` ��� �� Date / "21 -2'k This card is to be posted in a conspicuous place on the premises. The inspector performing the final inspection will pick-up the card during the final inspection. 05/11/98 18:03 FAX 4258688928 MAIL POST 0 002/002 fi i Jy g r� too- A E ss�c,lfl`'`n LTI P M � • Permit No. (l,L►7�I� ..{� -' MASON COUNTY BUILDING PERMIT APPLICATION 426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628 PLEASE PRINT #1 wner _ Phone # eIc te Address � W � C Fire District# ity ti� _ St U Zlp 7 FF Directions Job Site "--i - I r 1� (_ > Q Owner "ddress City St Zip - Lien/Title Holder Address X City St Zip( #2 Contractor Name F) nc-, Contractor Reg # AbX(K-1 ,(�Z Address Expiration Datea!iicity St�_ZIp Phone #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) #eLegal No. �c�- C` 'SQ,Aj (� Description _ �r�--C V\J `Fie-+ Ex 5uvvz,-1 f400 #5 Building Squa,a Footage: (existing/proposed) 1st FI -/ (RO2-�nd FI / 3rd FI / Loft / Basement / Deck / #bedrooms / # bathrooms / Garage /�arport /�(Ffrel etaei�ed�) Other sq. ft. / i #6 Use of building Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION Model Year Make Model Length Width Serial No. # Bedrooms # Bathrooms Type of Heat Purchase Price $ #9 Indicate by circling the applicable source if any water Is on or adjacent to subject property: River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other Plumbing Fixtures ($3each) Fee Mechanical Fixtures ($6 each No._Toilets CIRCLE FUEL TYPE: Gas, Electric, _Bath Basins Heatpump, Other _Bath Tubs 9 Units Fees _Showers — Furn BTU _Hot Water Htr — Heatpumps _Laundry Washer — Vent Systems _Sinks — Spot Vent Fans —Floor Drains No. Boil .r. / ompressors _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 $ IL`4� 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- 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 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 OWNER X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by: DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Z41157�2 4 iM Environmental Health: Building Plan Review Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other Other DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: ---LT Building Plan Review Occupancy Group: 9-3 Type of Const:S Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check y `/ Plumbing Fee S� 7 5— Mechanical Fee z- Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection 170Z- 4-7 - 7ti 59Y Building State Fee Other C-11 _. Other DEPARTMENTAL REVIEW FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: YU- Environmental Health: Building Plan Review . i Occupancy Group: Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Radon Monitor Violation Fee Site Inspection Building State Fee Other `P Other