HomeMy WebLinkAboutBLD2000-01475 Final Garage - BLD Permit / Conditions - 2/26/2001 Inspection Line (360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. 3 426 W. Cedar P.O. Box 186
J Shelton, WA 98584
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RESIDENTIAL BUILDING PERMIT BLD2000-01475
OWNER: DAVID WILLIAMS 360-372-2849
CONTRACTOR: SOUND BUILDING SYSTEM360-2997-7317 RECEIVED: 11/20/2000
SITE ADDRESS: 2001 NE BLACKSMITH DR BELFAIR ISSUED: 01/25/2001
PARCEL NUMBER: 223107600380 EXPIRES: 07/25/2001
LEGAL DESCRIPTION: TR 38 OF SURVEY 10/102 (NW SW)
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
GARAGE BEAR CREEK DEWATTO RD TO BLACKSMITH LAKE DR., FOLLOW DIRT
ROAD TO ELFT, GO TO T AND TAKE A LEFT TO 2001 BLACKSMITH LAKE
DRIVE
General Information Construction & Occupancy Information Square Footage Information
No. of Bedrooms: Type of Constr.: V-N
Type of Use: SF Insp. Area: No. of Bathrooms: Occ. Group: U-1 Lot Size: Deck:
Type of Work: ACC Fire Dist.: 2 No, of Stories: 1 Occ. Load: Building: Garage-Detached 1,080
Valuation: $20,434 Building Height: 17 Occ. Status: Basement:
Manufactured Home Information Setback Information Shoreline & Planning Information
Make Length: Ft. Front: E 20.0 Ft. Shoreline: Ft. Water Body:
Model: Width: Ft. Rear: W 725.0 Ft. Slope: Ft. SEPA?:
Shoreline Di
Side 1: S 35.0 Ft. g•:
Year: Serial No.: Side 2: N 230.0 Ft. Com . Plan Desi .:
Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Plan Check Fee KLW 11/20/200 $217.91 2058
EH Plan Review CEW 11/30/200 $25.00 55520
Building State Fee MEC 01/19/200 $4.50 55520
Building Permit Fee MEC 01/19/200 $335.25 55520
Planning Review Fee KS 01/23/200 $38.00 55520
Total $620.66
BLD2000-01475 Please refer to the following pages for conditions of this permit. 1 of 3
CASE NOTES FOR
BLD2000-01475
CONDITIONS FOR
BLD2000-01475
1) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X
2) All upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt
fencing or straw matting). X /k'L✓
3) 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 in the amount of$47.00 per hour(minimum 1 hour) will be charged and must be collected by the
Building Department prior to any further inspections being performed or approvals granted.
4) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located in such a position as to be 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 re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or
contract fail to post the address on site prior to requesting inspections.
X L J
5) The plan review check list and corrections, along with the Energy Compliance Worksheet (when applicable) 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 of approved documents will result in failure of required building
Xspectio �
6) This structure is limited to U-1 use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the Uniform
Building Code and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved.
(J
7) 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 of$47.00 per hour(minimum 1 hour) will be charged
and shall be collected by the Building Department prior to any further inspections being performed or approvals granted.
X
BLD2000-01475 Please refer to the following pages for conditions of this permit. 2 of 3
8) All construction must meet or exceed all local ordinances and the 1997 Uniform Building Code 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 revocation.
X et1_1
• 9) Proposed structure or any portion thereof greater than 30" in height from grade line, must maintain a minimum of 5' setback from all property lines,
_ easements and 10' from all County and State Road right of ways. X___F f,=
10) Proposed structure or portions thereof=Ln,_)
' ction over 30" in height from grade line, must maintain a 5' separation distance between adjacent
structures and that furthest projection.
11) All changes to "approved" building plans that effect compliance with the Uniform Codes as amended and adopted, or any other Mason County
ordinance or regulation, must be reviewed and approved by Mason County prior to construction.
X l�
12) The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance
with the Uniform Codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building .
Inspector shall be made prior to requesting additional inspections.
X-
13) All property lines shall be clearly identified at the time of foundation inspection. X 1A /
14) 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
X n-compliantt with County ordinances and building regulations.
1
15) 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 prevented action from being taken. No more than one extension may be granted.
X w
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.
OWNER AGE DATE:
BLD2000-01475 Please refer to the following pages for conditions of this permit. 3 of 3
CONCRETE MECHANICAL MOBILE HOME
Foo;..igs-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
,oundwork
date b date by
W V WALLBOARD NAILING
D.date by date by
Water Line FINAL INSPECTION
date by date �j �� .j bye date by
p4 d ,V%5
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Blot
e/ac k smith Lake v v-
...rr r ••.y,«,:.r n ry �1'1�::<f.S':7?r r Y'•YY^• %:SYirr'/fr..i.`J/YC:r'i?">Y::F.'!r!..C;?Y/Jry;
'�� :�%z:.i145`�cyh•¢<�. ;� >: 'fiY�J`.��.;.� ,..r.,�✓.Y �..,:aS�'•`,.�:u:�:ir���S'....`m"�v`�J..Yf..r.r.1�.'.,r.:::.„,.Y..,?.:'si:•.: ...�,.�.J..:,..Yr.r•::�•:.,,..r.:,>...•:.:� .:fi:�.»i�
' :.. '.�1.' ' 11 1' 0^ i'. Information
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aro I Building:
r54 � �
� Occupancy: i 11 1
i..i I I l i
Deck:
Bedrooms: Type of Const: Garage: 10 go A et.,,
t f.
Bathrooms: Occupancy 1 • • Carport: 1
Stories: Occupancy Load: Cvr Porch:
1 . 1
• • - Height: Other:
/•/:q •}J� '/UA^Y:!lv� +•h '/•'/l'l!'ll •"f..S+r •lRk �•.:N�•r �./y ,�q..4Y 7L'.:' .: y.'rNry}•rty..•w:r �.{•.•:.<
h Y�S'�R:i'd�17A�r ��JNr22ESUAY:v��h5'J.3>OJ'�lY�YA'N w��4.i?lA(K:d.�n��<FN�.C//JJ�f rw�..SnYY�1FJ�� J���••.• ��:.'S..�/� -�R�2Y'?l/•.i:w i�,'LY:n�GJN s�'n.�:LY"iYnG�:rfn`- ��i:ri:
Plu
mbi 11 Mechanical:
It Water S �3
Closets: 11 1 t . . 1
�i
' Lavatories: 1 1 yXj Pump: 16
Bathtubs:
11 VentFans:
<'I 11 1
11 "t
Water Heaters:
11 i RangeHoods: 10.65
11 IttStoves: ii
G. Clothes / 5Y
1 1 �fd
;r Kitchen Sinks:
11 • <,
•
11 1 11 Propane Ta1 •
t< •7
r Dishwashers:
11 7.00 rGasOutlets 1 +
Hose Bibbs11 List gas appliances
n� r
># s Subtotal
1 •
Base Fee 20.00 Base Fee 23.50
Total Plumbing Total Mechanical
�'% r!v'•F's�YY. .'%4s�Ya3�.°�."n�.'�.visYl.�r .i%�..R'J°i x "x t c airy "F:p' „�,w a�yJ:��...'':�'.o
�gys•:�}r' f;`• w�, .`r,`%�%rs �' ���". ? 'i'.�":• `Jc �„//`Y,�JJ���� i`r.L7.5.``,`s.��"'?c'``r'�•re..:�"•t<.'s'� !�2�°Jt"..'.::; •:'s:;:.�.dY:.'�,�
Valuation:1 1 Fees:
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• =33 BuildingPermit:
t'< • 1g State Bldg
1 Covered Deck: 12.85 Mechanical + •
Carport: 12.85 Mechanical 1
11.00 F41 Plumbing Subtotal: "3
Y: Basement*• Plumbing . . 3s
Remodel <51 ' % 16.00 s¢
Remodel Feesf
9� r� << nx<.�p�rx; cq+,,',5?i,.•S„?i'.. > :�4.>..`.,,,,•,',.�.•.�z�S,�.•,,,'.,'7r,:'�,'Yr, h?'C•:;uC;dg^s.':
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ivy
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.s. .. �l•.: K %. .S .r�,. rsJ Tr �. Y`sf'r.•• J/< .Gn r !.N•.,,s�ryY� h .
,ox.•...,,.,C.cY!/.c: Ys. .lraH;r�.fC�G`4 d5... .✓-del.Cu„ ac:Y'nv'rk.XOS'tll:.4,,.Ss,. ...rta „GJd.•ar.,Nat:.. Y:.Y.-t.;.4.P.h•.,h..
.001 [] PLANS REQUIRED ON SITE Alf approved plam are required to be oa-alto for on putposm Ilan icopection is caged for and picas we not availaW on site,sham approval
will not be granted In addition.a te-impee6on fee in the amount of$47.00 per hour QuWamum i hour)will be charged and must be collected by the Building Department prior to any
f rather mspecb—being Performed or approvals granted
!002 POST ADDRESS In accordance with the Unaiorm Building Code,all sites sbal l have approved numbers or addresses located in such a position as to be plainly visible and legible tiwm
the scrod or road fronting the Property Mason County Building Depahamt requires that this be completed prior to can for Say Site inspections. A ire-inspection fee based on rates as
adopted by theiurisdie4on and the Uniform Building Code will be assessed ifthe owrna and/or contractor fail to post the address an site prior to requesting iaspectionf.
1003 PLAN REVIEW CORRECTIONS Ibc plan review-heck list and corrections.along with the Energy Compliance Workshod(when applicable)are part of the approved plans and
mast remain thereto. It is the responsibility of the applicant to make the corrections indicated on the plans. Once the plans are marked'APPROVMY',they shall rot be changed or altered
wdbout mAhorushon from tha Butldiag O&eial. The permit holder is responsible to retain the complete approved set of plans on site for the duration of the project Failure to comply
and/or removal of approved documents will result in failure of required building inspections.
10055 UNHEATED STRUCTURE This structure is approved w un-iested spaces If at any time this building is to be used for anything other than what it is approved for,a change of use
permit shag be applied for,reviewed and approved prior to the change.
10060 SLAB INSULATION Alf slabs within the heated space shall be insulated to a minimum R-10 for at least 24'. Monolithic slabs shall be insulated around the perimeter$our the top of
the slab to the bottom of the footing
1007❑ INTERIOR REMODELING INSULATION - All exterior wall cavities eitposed during construction or remodeling work shall be insulated 10 the full depth of the wall cavity and
imputed prior to covering
1009a0 ROOF REPLACEMENT Siuyto rafter joist we replacement shall be insulated to a mm mama of R-30 allowing for a minimum of one inch continuous vented airspec c above the
level of inwlafiom
101000 ROOF REPLACEMENT/EXPOSED DECKING Enclosed,roof systems that am exposed to the sheathing shall be insulated to a minimum R-30 and inspected prior to cover.
10120 PLOT PLAN REQUIRED ON SITE The improved"plot plan is required to be or"ite for inspection purposes. Van inspection is requested and the'approved'plat plan is act
on site,then approval will not be granted In addition,a re-inspection fee in the amount of$47.00 per hour(minimum i hour)will be ebwged and"I be collected by the Building
Departrucut Prins to any fiather insprac4ors being performed or approvah Wanted.
1006 0 COMBUSTION AIR In buildings of unusually tight constructiom,fuel-bumingl appliances(excluding waking applimas and domestic clothes dryers)shall obtain combustion av
ft.outside m accordance with the Uniform Mechanical Cade.
5000 U-1 USE ONLY This structure a limited to U-1 use only(private garages,tarpons,sheds,and agricultural buildings.)Any other use will be in violation of the Uniform Building Code
and Mason County Regulations unless a•Ch&W of Use permit is applied for.reviewed and approved
SW I 0 SPECIAL INSPECTION 1997 UBC Chapter 17,Section 1701. In addition to the impectimus required by UBC Section 103.the caner or the engineer or architect of mcard acting
a the owners agent shall employ one or mane special inspectors who shall provide inspections during construction an the types of work listed undo UBC Section 1701.5. The special
inspectors'duties dt responsibilities shelf be as specified in 1701.2 and 17013.
5002 ENGINEERING OR ARCHITECTURE Arty chanQac m proposed eanstrvdion shall be reviewed by the eogam=ar archit a of record and submmed to writing to the Mason
County Building Department prior to comtruutioa AD engineering emdtor architectural documents;am a part of the approved set of plain and shall remain—died Owego. lt'doc ments are
removed,approval will tad be granted In additim a re-inspection fro of t47.00 per how(minimum I hour)will be charged and shall be collected by the Building Department prior to any
f udw impactions being performed or approvals granted
5003 ALL CONSTRUCTION Alf construction mast meet or eueed all local ordinances and the 1997 Uniform Budding Code requirements as adopted and amended by Mason County
and the State of Washington. Occupancy is limited to the approved and permitted classification. Any nonapproved change of ash or occupancy would result in Permit revocation.
S00440 WSEC RESIDENTIAL HEATING EQUIPMENT Installation of beating equipmcot m single family residences"and the requirements of the 1991 WSEC. ibe flhmso s to
be installed shelf not attend 150%of the heating design load or prescriptive requ imments of Chaptaer 9. Furnace efficiency shag be.78 AFUE or higher. Ducts shell be taped sealed and
meebanicagy feat mad witb a minimum of 3 fatiteera per iowL Duda shag be mulaard to R4.
5025�SIDEYARD SETBACK Proposed structure:or any portion thereof greater than 30"in height from grade line.lin must maintain a minimum of 5'setback from all property liens,easements and 10'from all Comity and State road right of ways.
5036 STRUCTURE SETBACK Proposed structure or portions thereof with•projection over 30"in height fioan grade line must maintain a 5'separation distance between adjacent
//`\ and that furthest projection
5030 CHANGES TO APPROVED PLANS All changes to-approved"building plans that egret compliance with the Uniform Codes as amended and adoptcck or any other Mason
��_��_"""��-,,{�{ County ordinance or regulation,must be reviewed and approved by Mason County prior to construction.
spl FIELD CORRECT The construction ofthe permitted project is subject to inspections by the Mason County Building Department All construction must be in conformance with the
r� Uniform Codes ns amended and adopted by Mason County. Any corrections.changes or alterations required by a Mason County Building Inspector shall be made prior to requesting
additional impactions.
5080 0 PROPANE TANK LESS THAN 125 GALLONS All propane tarts must be installed in accordance with the Uniform Fire Code and all applicable Mason county ordinance.
Alf Propane tanks filled on site must be located a minimum of 10'from any possible source of ignition(electrical ou d ts.electrical f xtums.compressors,etc),mechanical system air intake
(direct vent appliance.ventilation air intake,etc),and/or any Greeds.Bask brush,trash or any other similar combustible materials Propane tanks less than 125 gallons must also be located a
minimum of 5'from any building opening(foundation vernts.windows,doors etc),property line or easement, if a propane tank a c pm ed to probable vehicular damagy protective bollards
mat be installed
5085 0 PROPANE TANK,125-500 GALLONS AD propane tanks must be installed in accordance with the Uniform Fire Code and all applicable Mason Canty ordinances. All
Propane tanks between 125 and 500 gallons must be located a minimum of 10,fromo any building,property line,public way,possible source of ignition(electrical outlets.elexUial 5tdures,
compressor L etcl and/or any weeds,grass,brush.trash or any other similar combustible materials. If a propane tank is closed to probable vehicular damage,protective bollards must be
installed
S090 0 PROPANE TANK All propane tanks must be installed in accordance with the Uniform Fire Code and all applicable Mom County ordinances. All propane tanks must meet the
installation requirements and mimimmm setbacks as listed in the Mason County Fue Marshal's Standards for the Installation of Propane Tanks.
50950 FUEL PTPIIG/GAS PIPING Fuel piping shall be inspected after the installation of gaa piping is complete.and before the attachment of ftrttmres,appliances,or shutoff valves. At
the tine of inspection the test pressure shelf be no less than 10 psi held for no lea than 15 minutes. Appliances to he attached to the fuel piping system shall not be used unit the final
urspedson has been performed and approved by a Masan County building ihsppector.
5510 , PROPERTY LINES All property Gres shall be clearly identified at the time offoundation inspection.
5600 FINAL INSPECTION REQUIRED All building permits sbaDav he.find inspection perform County area approved by the Mai Cety Building Depacnncmt prior to permit
expiration.The faihre to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being noncompliant with Mason
County ordinances and building regulations.
5610V PERMIT EXPIRATION All permits empire 190 days after permit issuance.or 180 days after the leaf inspection activity is performed The Building Official may extend the time for
action for a period not exceeding 190 days,upon the receipt of a wtiom attention request indicating that circumstances beyond the control of the permit holder ban prove ted action from.
being take No more than one cucasion may be Seated
10000 CUSTOM CONDITION
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December 18, 2000
David J. Williams
2001 NE Blacksmith Lake Dr.
Belfair, Wa. 98528
Re: BLD2000-01475
Dear applicant,
Your plan for the building permit referenced above is in the process of being reviewed.
Unfortunately, the review can not be completed until we receive all the information relevant to
the project as proposed. This letter reflects only those items that are necessary to continue the
Building Department review, and does not contain the findings of the review, or note the
corrections that may be necessary once the review is completed, nor does it address any needs of
any other county department. Please review.the following comments, then follow the re-
submittal directions that follow.
s
PLAN REVIEW REQUIREMENT COMMENTS:
The following items are needed to perform a complete plan review:
#1. Detail on end wall needed showing grade of material, hangers or post block under 2"
x 12" with nailing of blocking shown.
#2. Wall T- girts for wind not shown.
#3. We will need an accurate topographical map showing degree of slope and if the site is totally
flat at the location of the garage.
#4. The engineered plans call out for pressure treated posts to be# 1 D.F. Douglas fir is generally
not available in pressure treated, unless special ordered. If the posts are to be Hem-Fir, the
engineer must revise the plans to indicate this.
Please make the required corrections and/or clarifications and submit two sets of the plans
showing the revisions, marked on the sheets and noted with a cloud surrounding them or some
other method of distinguishing the revisions. If only affected pages are re-submitted,
arrangements should be made to remove the voided sheets and re-insert the new sheets into both
building department copies of the submitted plans. Please detail all corrections and/or revisions
in a transmittal letter, numbered in the same order as in the plan review letter to aid in a timely
re-submittal review. Please be sure to reference the BLD number noted above to identify the file
to whitLh all re-submitted documents belong. Re-submitted plans are normally reviewed within 5
working days of the receipt of proper and complete revisions in our office. If re-submittal
documents are incomplete or changes are made requiring additional review, an additional plan
review fee may be charged at the rate of$47.00 per hour.
Prior to re-submittal, please call the Plans Examining Department to make arrangements for a
meeting if one is necessary, or if you have any questions regarding this review. You may contact
me at (360) 427-9670 extension 284.
Sincerely,
Mark E. Core Building
Inspector
Mason County Building Department
Plans Examining
wp/00-01475
cc:Sound Building Systems Inc.
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NAME PAyJ W , 1 � �A ,-r.-.6- JOB W1II ;A n,5
ADDRESS Good N F. 31.,,,c-� 5,14 0 . CITY L ,
DUMP ONLY_ ROLL ONLY EITHER
CONDITIONS
SOUND BUILDING SYSTEMS
• Post Frame Building Specialists
Quality You Can Depend On
3 Residential/CommerciaUAgricultural
Carports•Garages•Sbops•Horse Barns•Arenas
Welter 1-800-932-7628
3so55HP (360)297-7317
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ALL GOOD MAPS SHOW NORTH
PERMIT NO.: BLD czml y /J
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 INFORMATION. CONTRACTOR INFORMATION
Owner 04,,14 T J&4# 1I1gtMJContractor Name Soued 8"1IdOru 5yat-CM3, Zing
Mailing Address .�oo1 E 81acksn+,'t'h Leak& Or,ve e Mailing Address JIJ38 a'affe_ran &4,h Rd d/F
City,Mailing
State_WA Zip Code 1?521 City k ,155tovr State WA Zip Code 17&JY10
Phone (,D 37.t-A811 Other Ph.(� Ph.(3 0 )Z47- 73 7 Other Ph.0
Lien/Title Holder Cook o f hm er►ca Contractor Reg. # 50u NO 8S 40.1 7NM
Address Po So y gooa ,it / o16&_ 9#06 Expirations
SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic_A _Connect to Sewer
System Name of Sewer System Well_,&_Water System Name of
Water System
PARCEL INFORMATION-12 digit Tax Parcel No. .1 2. 3 1 0 / 710 / v d 3 8 0 Fire District 2
Legal Description ��.S W % /D - AT a. SL W .
Site Address(Please include street name, street number and ity)
Directions to site 134&e Creek 1)ewaf• IPd tv Slacks n,*-k ,t.sK e, Dr. - Fells✓ d"i- road +0 1 CP1
Go fit, T 4.1) f'RIIG a Ief1' +a ADD) Blackmiy-k Lskp Dr.
Will timber be cut and sold in parcel preparation? (Yes/No)
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 Craroxiid
Describe Work Con a trua't►ova of Pole, hu;bdiq aro
No. of Bedrooms No. of Bathrooms SQUARE O TA -1st Floor 2nd Floor
3rd Floor Loft Basement Deck Other sq. ft.
Garage Lgf0 Attached Detached Carport Attached Detached
MOBILE HOME INFORMATION-Make Model 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.
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-]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 shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without
approval. first obtaining a proval j\
X Date X Date//—l�/'DO
FOR OFFI IAL USE BEYOND THIS POINT
Accepted bye �Nct � Date 11 ,.Submittal Amount Due .� •f t I Receipt No. `�
DEPARTMENTAL.IREVIEW APPROVED DENIED;' CONDITION CORE$
Building Department
Occ Group Type Constr.
Planning Department
Environmental Health Department
Public Works Department
I
Fire Marshal
Valuation $
FE: S ;:.:>;:;.:::::
Building Permit Fee Site Inspection
Plan Review Fee UFC Plan Review Fee
Plumbing & Base Fee Public Works Review Fee
Mechanical & Base Fee Other
Wood/Gas/Pellet Stove Fee Other
Violation Fee Pre-Paid at Submittal ( I t )
TOTALFEE
MASON COUNTY PROJECT SITE INFORMATION
• ''�""`. Case No.
Name L-Avosl 77 PARCEL NUMBER 2310 -71a-00 3,V0 Date
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
Names of Fronting Streets Septic System
DRAW SITE PLAN BELOW Include adjacent properties if on shoreline or within 100 feet of adjacent property line.
adjacent property line-) , I E-adjacent property line
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SAMPLE SITE PLAN
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TOPOGRAPHY PROFILE(Show a side view of property. Show slopes, cuts and fills. If possible include height and the
degree of slopes. See sample topography profile.)
SAMPLE TOPOGRAPHY PROFILE
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Signature Date