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HomeMy WebLinkAboutBLD2012-00065 Final 2 Story Garage - BLD Permit / Conditions - 6/21/2012 ' 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 i� RESIDENTIAL BUILDING PERMIT BLD2012-00065 OWNER: DONNY BOCKSCH RECEIVED: 2/6/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 3/12/2012 SITE ADDRESS: 1290 ASON LAKE DR SOUTH GRAPEVIEW EXPIRES: 9/12/2012 PARCEL NUMBER: 2210 .5 046 LEGAL DESCRIPTION: MAS N LAKE ESTATES TR 46 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW 2 STORY DETACHED GARAGE WITH 2ND FLOOR BONUS ROOM ST RT 3, L ON MASON LAKE RD, L ON MASON LAKE DR SOUTH TO SITE ADDRESS ON THE RIGHT SIDE General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: VB Type of Use: SF Insp.Area: No.of Bathrooms: 1 Occ. Group: R-3/U Lot Size: Deck: 144 Type of Work: ACC Fire Dist.: 5 No. of Stories: 2 Occ. Load: Building:1,007 Garage-Attached 1,064 Valuation: $ 147,511.85 Building Height: 28 Occ.Status: Seasonal Basement: COV PORCHS 32 Manufactured Home Information Setback Information Shoreline&Planning Information Make: Length: Ft. Front: S 90.0 Ft. Shoreline: Ft. Water Body: MASON LAKE Rear: N Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: E 6.0 Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: W 20.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Water Closets (Toilets) 1 Furnace<100K 1 Plan Check Fee GMM 2/6/2012 $813.38 S1201200000001 Lavatories 2 Heat Pump 1 Planning Review Fee GMM 2/6/2012 $205.00 S1201200000001 Showers 1 Dryer Vent 1 EH Plan Review KKK 2/6/2012 $ 103.00 S6201200000001 Water Heaters 1 Ventilation Fan 3 Building State Fee LDK 2/13/2012 $4.50 S1201200000001 Clothes Washer 1 Building Permit Fee LDK 2/13/2012 $ 1,262.55 S1201200000001 Laundry Tray 1 Mechanical Permit Fee LDK 2/13/2012 $72.50 S1201200000001 Hosebibs 2 Mechanical Base Fee LDK 2/13/2012 $28.50 S1201200000001 Plumbing Permit Fee LDK 2/13/2012 $67.10 S1201200000001 Plumbing Base Fee LDK 2/13/2012 $24.70 S1201200000001 Total $2,581.23 BLD2012-00065 Please refer to the following pages for conditions of this permit. Page 1 of 6 CASE NOTES FOR BLD2012-00065 CONDITIONS FOR BLD2012-00065 1) Prior to final approval, all upland areas disturbed or newly A ted by construction activities shall be seeded, vegetated or given an equivalent type oferosion protection (silt fencing or straw matting). X 2) Approved per di ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 3) Application ac owledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Rural Residential 5. X 4) This structure has NOT been reviewed or approved as an Accessory Dwelling Unit(ADU): A second dwelling unit detached from an existing single-family dwelling for use as a completely independent or semi-independent unit with provisions for cooking, eating, sanitation and sleeping. ADUs are required to meet the requirements under Mason County Development Regul ' ns 17.03.029 and the Shoreline Master Program regulations. An approved Shoreline Substantial Development Permit would be required. X 5) By definition, propane tanks and heatpumps are structures, which must meet setback conditions. Please check your"Approved Site Plan"to ensure these structures meet the setback conditions listed. X Ap 6) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approved Site Ian"to ensure these structures are shown and meet the setback conditions listed. X 7) ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTEM OR ROAD WAY,� 8) 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 X 800-647-0982.�,person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. BLD2012-00065 Please refer to the following pages for conditions of this permit. Page 2 of 6 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 Department prio any further inspections being performed or approvals granted. X v 10) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X Ar 2 11) 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 of app�d documents will result in failure of required building inspections. X 12) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. X � 13) 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 Depaytent prior to any further inspections being performed or approvals granted. X (aA/ 14) Washington State Energy Code Compliance has been approved as follows: Heat Type: Electric or other than electric, Compliance Method: Prescriptive option III, Window(Max U-Factor):0.30, Skylight(Max U-Factor):0.50, Doors (Type/Max U-Factor):0.20 or less, Wall insulation R-21, Floor insulation R-30, Ceiling Insulation R-38 advanced or R-49 standard, Vault Insulation R-38, and Slab Insulation R-10. In addition the following credit from Table 9-1 shall be completed: 6 X 9 15) A permanent certificate, completed by the builder or registered design professional, shall be posted within three feet of the electrical distribution panel. The certificate shall list the predominant R-values of insulation installed in or on ceiling/roof, walls, foundation (slab, basement wall, crawlspace wall and/or floor), and ducts outside the conditioned spaces; U-factors for fenestration; and the solar heat gain coefficient(SHGC) of fenestration. Where there is more than one value for each component, the certificate shall list the value covering the largest area. The certificate shall list the type and efficiency of heating, cooling, and service water heating equipment, duct leakage rates including test conditions as specified in WSEC Section 503.10.2, and air leakage results if a blower door test was conducted. Building envelope air leakage control shall be considered acceptable when tested to have an air leakage less than 0.00030 Specific Leakage Area (SLA) when tested with a blower door at a press of 50 Pascals (0.2 inch w.g.). Testing shall occur at any time after rough in and after installation of penetrations of the building envelope, including penetrations for utilities, plumbing, electrical, ventilation, and combustion appliances and sealing thereof. The blower door test results shall be recorded on the permanent certificate required located near the electrical distribution panel. Air leakage testing is not required for additions less than 750 square feet. Reference WSEC 105.4 Certificate and 502.4.5 Building Air Leakage Testing. Compliance certificates are available online at the WSU Energy program website titled, "WSEC 2009 Certificate"and are available in %or'/sheets. The Mason County Permit Center will also have some available. I� X i it BLD2012-00065 Please refer to the following pages for conditions of this permit. Page 3 of 6 16) A minimum of 50 percent of all luminaires shall be high efficacy luminaries unless lighting compliance was approved using the options available in WSEC Section 1520 or 1530. Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on the same lot shall be high efficacy luminaries unless permanently installed outdoor luminaires are controlled by a motion sensor(s)with integral photocontrol photosensor or installed in or around swimming pools or water features. All fluorescent fixtures must be fitted with T-8 or smaller lamps (but not T-10 or T-12 lamps). Reference W 505. X 17) REQUIREMENTS FOR ROOF COVERINGS. Roof coverings shall be applied in accordance with the applicable provisions of the current code and the manufacturer's installation instructions. X t2 18) 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 ackno pledging that all components of the stormwater management system have been installed as approved on the stormwater site plan. X 19) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. A. Drainfield/ Reserve requires a 10ft setback from all footing/foundations. B. Septic tank(s) requires 5ft setback from all footing/foundations. C. No foundatiQD drains within 30ft, down gradient of drainfield/reserve area. X 20) 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 X such roads connect with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. 21) 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 X charged and shall b� llected by the Building Department prior to any further inspections being performed or approvals granted. 22) 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 revocation X BLD2012-00065 Please refer to the following pages for conditions of this permit. Page 4 of 6 23) 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. X 24) Placement of structure must comply with standards set forth per the international codes regarding descending and/or ascending slopes. X 25) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County X rdinance or retion, must be reviewed and approved by Mason County prior to construction. 26) 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 international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason County Building Inspector shall to made prior to requesting additional inspections. X /lafJ 27) 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 or . ances and building regulations. X 00 28) 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 preveAt.4ad action from being taken. No more than one extension may be granted. X /,tc,�/ 29) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and fishing. Install metal connectors approved for contact with the new types of pressure treated material. X 30) Retaining walls needed to support a surcharge s/�/s structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X BLD2012-00065 Please refer to the following pages for conditions of this permit. Page 5 of 6 • 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 wor is y mpf c of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason C t the above described property and structure for review and inspection. OWNER OR AGENT: DATE: BLD2012-00065 Please refer to the following pages for conditions of this permit. Page 6 of 6 r , Ir ca o CONCRETE MECHANICAL Cp MANUFACTURED HOME oData g _........_.._______----------- 0 I j Footings/Setbacks Gas Piping y / Ribbons o Interior Date By Interior-Date By Date By n o 0) Exteror Date,3� . By Exterior•Date B Set-up 3: Point Load/Isolated Footings INSULATION Date By p BG I SLAB INSULATION ----- --- O Date By Date By FIRE DEPARTMENT Z Foundation Walls Floors Date By Date. 7 `/I- By 1A�► Data ,)—2 I- 1 L Bye✓ DECKS FRAMING Walls Date By Date ^ By R Data — — Z BY l PROPANE TANKS PLUMBING vault Date i3.yV =� Date ,S-3 1 !Z BY _ OTHER Groundwork Attic A Date ,3Q—� L BytA� Type Date By Date By D..W.V DRYWALL Type- Int.Brace Wall Date By W Date BY_M Date By r CD a) FINAL INSPECTION p w Water Line Fire Separation N m Date By Date By Date ByCD O � N g Pass or Request Inspect. c Type of Insp. Fail Date Date Done By Comments rn 0 1=2z< ?-IJ-12 7 )�Z-Z CD -zz- 2 -3. 23 -1 L4 e- cJ✓ v CD z, ' "-�Sf Z CL y ° crtc PAN2 1--IS I L S' 1712- TM �oCD r; `// 4, Z-Le _.2 2.- S-221-1 c t n 3 h �F r oc,,y. r Li /L co o / (dv G r )e-4 G ^�I- a .�N1 . n�r � S lrVt G G1rL y C�O� :.! MASON LAKE APPROVED MASON u,11J,`, fY L✓%a PLANNING SITE PLAN RE0:1! "D TO BE ON WE48 CHANGES SUBJECT TO APPROVAL By - ------ - Date ,--�-vqO I a . O LOT 47 NoM MAPUeRC HEALTHOVED h E MAR 0 8 2013 N Apjj (� N y J, D/F IS TO MAINTAIN 30' FROM GARAGE. FUTURE 1500 GAL. S/T& 1800 GAL. P/T DRAIN MAY BE INSTALLED. �" � ll 4 BEDROOM EXISTING WELL DRAINFIELD TO BE ABANDONED. D/F MUST MAINTAIN i A 10'SETBACK a s i / PAR 1` � NEIGHBOR � I WELL Of Ymm G NEW WELL Q no 5�7 AYYC! / I' LOCATION E ' PAgKING XPIRES NOTE: NO VEHICULAR TRAFFIC IS 1 %b' ALLOWED ON TOP OF DRAINFIELD PIONEER DIGGING INC. CUSTOMER: ON BocKsc" SCALE 1"=39 7 D PARCEL#:22107-50-00046 TEST HOLE L• TEST HOLE 2-- SEPTIC DESIGNS DRAWING: PLOT PLAN 0"-30"GLS 0"-16"GLS • 3083 E.MASON BENSON RD. GRAPEVIEW,WA 98546 DESIGNER ROBERT PAYSSE 30"+CS 16"+GS N OFFICE-360-426-1803 FAX-360-427-2353 DRAWN BY: ALEX PAYSSE ROOTS-36" ROOTS-36" 12110 �— leb Ad --� �-' C�6 �`3 ► wo-t t R1 16H6oreS C.-o T- i P,T is ►t/r�V6 PLA I NG : 3 { IDm�n ALL SETBACKS ARE MEASURED I , S FROM THE FURTHEST 14 y i PROJECTION OF THE BUILDING 42 (A W I I LOGR'f b7•� I &),e l(3e P S C-A b►rJ d. G A..6 r rtJ Exist, �C�tn�6E/ APPROVED MASON COUNTY DCP PLANNING SITE PLAN REQUIRED T q BE ON SITE s CHANGES SUBJECT Tq APPROVAL f i By bate , l,a- &A Ut<MJF6 C) ^_ Fa 0 8 2012 �D i 426 W CEDAR S1 111 F�S�rV G1�f�� MASON COUNTY PERMIT NO.i��C{� �'- PLUMBING/MECHANICAL PERMIT APPLICATION 426 W. Cedar• P.O. Box 186,Shelton,WA 98584 Shelton (360)427-9670•Belfair(360)275-4467•Elma(360)482-5269 On the web www.co.mason.wa.us APPLICANT NFORMATION CONTRACTOR INFORMATION Owner ,1,1 T G�S,_4 o c� hill i T/'.as Company Name Mailing Add res oIr Z 3 T./A Mailing Address City ✓ State-6 ip Code l kii z City State Zip Code Phone 4 &o) 701-2otz Other Ph.�3r o) Nw2,-0104 1 Phone Other Ph. Lien/Title Holder C.6,4 s{ A a n k Contractor Reg. # Exp. E mail address , Aej-ksC-9 is C_~(_'(i+ ,vtt+- E Mail Address Drivers Lic.# l3oc.KSD 3-L S Nt. DOB 'T_(;-&G I Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic—?� Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No 2-7-to-7— '" o&0gio Fire District Legal Description /24'ferh 44 L Fs fw E Tac-- Y(o Site Address(Please include street name,street number and city) IZqQ c, (,c Dl. S . AT•r eyie-i Directions to site Is property within 200' of Saltwater Lake X River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs 1 15% TYPE OF JOB - New Add Alt Repair Other ac Use of Building 77 n --a Location of Fixtures/Units- 1 st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric_LPG—Natural Gas—Heat Pump_ Toilets ( Type of Unit No.of Units Fees Bathroom Sink — Furnace I Bath Tubs Heatpumps 1 Showers 1 Spot Vent Fan Water Heater Propane Tank Clothes Washer I Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent 1 Other UW:1.1 I Other 514{c Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 01NNER/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 frthis permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is7#,4, P mployees of Mason County access to the above described property and structure for review and inspection. PROOF O WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date:_ /Z e Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEY O D HIS POINT Accepted b . Planning Pd Ck# Date ZO Bid Pd Receipt No. DEPARTM t NTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group—Type Constr. 2 r3 it o Planning Department Environmental Health Department FEES Plumbing&Base Fee Site Inspection Mechanical &Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee Other Violation Fee TOTAL FEES Vv. Ate } MASON COUNTY PERMIT No. I�IabI�►-Obbl'�� BUILDING PERMIT APPLICATION 426 W. Cedar• P.O. Box 1 B6, Shelton,WA 985B4 Shelton(360) 427-9670•Belfair(360)275-4467•Elma (360)482-5269 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION 1. �oG1cSG� Owner f �. �o L �f Company Name cAn . c.k5 1. tu'�n, I ag air —7 b 5 Mailing Address M ng Address City ® State Oct- Tn cola R S 1 Z City State Zip Code r vvV v Phone l 3�0)'701-20 Zz Other Ph. (�L,)yq3'04q I Phone Other Ph. Lien/Title Holder C h a« 64 n Contractor Reg.# Exp. E mail address d 6oc sck,2 comcae>t,net- E Marl Address Drivers Lic.# &CKS07 3tic,N&t DOB —i a ldo Drivers Lic.# DOB SEPTIC I WATER SYSTEM INFORMATION-Connect to New Septic X E>dsting Septic Connect to Water System Name of Water System Well_ice Water System Name of Water System PARCEL INFORMATION-12 Digit Parcel No zZ t U'1— S© ., F270 (d Fire Distri Legal Description A?dteh Gute 4CALks Site Address(Please include street name,street number d city) `�� k D' 'o to site St t�+ 3., L. o n m A50 n L lrli n Will timber be cut and sold in parcel preparation?Yes No 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?Y o TYPE OF JOB -New Add Alt Repair Other ({ PRIMARY RESIDENCE,❑ SEASONAL Use of Building n° rs_— Describe Work ✓-e ' &.a {I'Ace j�Ao,-'' No.of Bedrooms —No.of Bathrooms Square Footag Floor —2nd Roor fro? r— B ent Deck Covered k er Sq.ft Garage)— Attache J�Detached Carport Attached Detached FACTURED 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/BULDER Acimowledges submission of hacazate inbrmabon may result in a slap work order or parrnit revocafion.AdmuMedgement of such is by signatxe belay.I declare that I am the owner,owners legal represent35ve,or the corrtrac o.I further declare that I am mtified in receive this permit and to do the work as proposed in the app6cahon.I declare that I have obtained the permission from all the necessary parties.tf permission is required from arry easement holder,or any other party in interest regarding this appficafion or the work proposed in the applicabon,I have obtained pemirssion from them to apply for this parrnk and conduct the work proposed. The owner or agent on owners behalf,represents that the hfoormation provided is acme and employeesofMason County a=ess to the above desmbed property and structure for review and won. PROOF OF CO OF UE4NS OF A PROGRESS W SPECTION. - X Date- r Dwne a entihs/Contractor Cinc sate which one) FOR FICIAL USE BEYOND THIS POINT Accepted b D DEPARTMENTAL REVIEW APPROVED DENIED j' NOTES Building Department 13 /L LW Planning Department 1 Environmental Health Department ,�- +0 • • • ' ' ' Public Works Department Fire Marshal FEES Builcrinq Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical &Base fee Other a a C Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation$ TOTAL FEES