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HomeMy WebLinkAboutBLD2016-00441 Final Detached Garage - BLD Permit / Conditions - 12/16/2016 ' — Inspection Line(3bU)42/-/Lli1 ��6oN COU�rA MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352 Mason County 615 W Alder St Shelton, WA 98584 RESIDENTIAL BUILDING PERMIT BLD2016-00441 OWNER: MICHAEL WALLS RECEIVED: 5/18/2016 CONTRACTOR: LICENSE: EXP: ISSUED: 6/16/2016 SITE ADDRESS: 83 NE HAVEN LN TAHUYA EXPIRES: 12/16/2016 PARCEL NUMBER: 223305000070 LEGAL DESCRIPTION: HAVEN LAKE TR. 70 PROJECT DESCRIPTION: DIRECTIONS TO SITE: NEW DETACHED GARAGE ST RT 3 TO BELFAIR, L ON ST RT 300/NORTH SHORE RD, R ON BELFAIR TAHUYA RD, R ON HAVEN LAKE RD, R ON HAVEN LN TO SITE ADDRESS General Information Construction&Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: VB Type of Use: SF Insp.Area: No. of Bathrooms: Occ. Group: U Lot Size: Deck: Type of Work: ACC Fire Dist.: 2 No. of Stories: 1 Occ. Load: Building: Garage-Detached 896 Valuation: $ 39,988.48 Building Height: 19 Occ. Status: Unknown Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft. Front: S 40.0 Ft. Shoreline: Ft. Water Body: HAVEN LAKE Rear: N Ft. Slope: Ft. SEPA?: No Model: Width: Ft. Side 1: E 5.0 Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: W 5.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee GMM 5/18/2016 $ 352.79 S1201600000001 EH Minor Plan Review GMM 5/18/2016 $ 100.00 S1201600000001 Planning Review Fee GMM 5/18/2016 $205.00 S1201600000001 Building State Fee SLC 5/20/2016 $4.50 S1201600000001 Building Permit Fee SLC 5/2 012 0 1 6 $ 542.75 S1201600000001 Total $ 1,205.04 BLD2016-00441 Please refer to the following pages for conditions of this permit. Page 1 of 5 CASE NOTES FOR BLD2016-00441 CONDITIONS FOR BLD2016-00441 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 1-800-647-Q982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X hz�.. 2) 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 n1 rior to any further inspections being performed or approvals granted. X 3) Owner/Agent js yesponsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28. X / , 4) The plan �View`reck 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- 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 re of approved documents will result in failure of required building inspections. K 5) structure is approved as unheated space. To be considered unheated space the area may be provided with a heating system that does not exceed energy usage of 1 watt per sq. ft., or 3.4 Btu/h per sq. ft. A permit and approval shall be required prior to installation of any heating system. When a heating system exceeds 1 watt per sq. ft(or 3.4 btu/h per sq. ft)the heated space shall be insulated in accordance with the energy code in effect at the ti f permit application. X 4 ",_ 6) THE FOUN TION SYSTEM SHALL BE PLACED ON UNDISTURBED, FIRM-NATIVE SOIL. X BLD2016-00441 Please refer to the following pages for conditions of this permit. Page 2 of 5 7) 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 ranted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the D �! Building e prior to any further inspections being performed or approvals granted. X 8) 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. A drip edge shall f e provided at eaves and gables of shingle roofs. (IRC 2012 R905.2.8.5) X 9) 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�req'ires 5ft setback from all footing/foundations. C. No found i ins within 30ft, down gradient of drainfield/reserve area. X 10) Concr or-basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete"wo)r'k exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 11) The internat nal de 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. Ro ds are required to meet the minimum Mason County Fire Marshal standards for Fire Apparatus Access Roads up to the point where such roads rct with a county maintained public road or to another fire apparatus access road which connects to a county maintained public road. X 12) The use, handling and storage of hazard+�Ir ials or flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X 13) This structur.7is limited to U-occupancy only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the internatio ode nd Mason County Regulations unless a"Change of Use" permit is applied for, reviewed and approved. X / 14) 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 and' I be-tollected by the Building Department prior to any further inspections being performed or approvals granted. X 15) All construction must eet 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. c/ X BLD2016-00441 Please refer to the following pages for conditions of this permit. Page 3 of 5 16) The placement of buildings and structures on or adjacent to slopes steeper than one unit vertical in three units horizontal (33.3% slopes) shall conform to the International Residential Code Section R403.1.7 for descending or ascending slopes. Alternate setbacks may be approved subject to approval of the building official based upon the investigation and recommendations of a qualified engineer licensed in the State,of Washington. Such an investigation•shaII include consideration of material, height of slope, slope gradient, load intensity, and erosion charact is cs of slope material. X 17) Proposed stru Cur (s) must maintain a minimum of a 5' setback from all property lines, easements and 25' from all County and State Road right of ways. Setbacks sured from the furthest projection of the structure. X 18) All changes to"ap rove building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or reg must be reviewed and approved by Mason County prior to construction. X 19) 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's 7 II Jlbe made prior to requesting additional inspections. X v / 20) All property lines shall be clearly identified at the time of foundation inspection. X D 21) All building permits shall have a final inspection performed and approved by the M0_C66nty 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 Count dirt nces and building regulations. X / 22) All permit exp 18b 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 ekceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the permit holder have preaye to /action from being taken. No more than one extension may be granted. X 23) Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connector !a)id flashing. Install metal connectors approved for contact with the new types of pressure treated material. 24) Retaining walls needed to support a surcharge as structures, roads, or to support slopes, shall require a separate building permit and approval prior to construction of the retaining wall. X BLD2016-00441 Please refer to the following pages for conditions of this permit. Page 4 of 5 • .25) Landings a d stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Appr Rd ite P n"to ensure these structures are shown and meet the setback conditions listed. X 26) Water quality is, be degraded to the detriment of the aquatic environment as a result of this project. X ' 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 contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s) for review and inspection. This permit/application becomes null &void if work or authorized construction is not commenced within 180 days or if constructio work is s;pended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERM J PLICAT OF 80 DAYS WILL INVALIDATE THE APPLICATION. — Alki— 4�///, 2 L Sign r Date / x OWNER ;`- REPRESENTATIVE - CONTRACTOR Print ame (Circle one to indicate) BLD2016-00441 Please refer to the following pages for conditions of this permit. Page 5 of 5 co o CONCRETE MECHANICAL MANUFACTURED HOME D 0 rn tings !Setback Date By Ribbons r Gas Piping N o Interior Date By interior-Date By Date By J�lp Exterior Date ic , L By xterior-Date By Set-up Point toad t Isolated Footings INSULATION Date By D BG 1 SLAB INSULATION Date By Data By FIRE DEPARTMENT r Foundation walls Floors Date By Date By Data By DECKS FRAMING walls Date By Date By -� Data By PROPANE TANKS PLUMBING _ Vault Date By Date By OTHER Groundwork Attic Date By Date By Type. Date By D.W.V DRYWALL Type- -0 Date By Int Brace Wall Date B y W N Date By - - FINAL INSPECTION p m water Line Firs Sepenitlon IJ Date By Date By Date By C N � o Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments 0 0 a o 0.4ec A /J A c C yf6m q 0 y N v 0 PLANNING C Ell V D �4'4Y�N 1_°� PLAT MONUMENT .p (elm 1 FALLS IN FILL N®I _ E' -`�� 8 20" SEE STATUTORY WARRANTY DEED AS RECORDED AREA,NOT FOUND LOT LINES EXTEND TO THE LANE UNDER AUDITOR'S FILE NO.1800524,RECORDS OF DOCK i OF OF MASON COUNTY,WASNINGTON_ CONCRETE ORDINARY HIGH WATER B 615 . Alder Street LOCK •�`` WA HAVEN LAKE PER DECLARATION TOGETHER WITH AND 5UBJECT TO EASEMENTS, ��� }�' ON SHEET 2 THE PLAT OF RESTRICTIONS AND RESERVATIONS OF RECORD. f.-�^ N�j ALA NAYEN LAKE., FOUND JOHN50N W~G L IDIV65 fig/ BAR 4 CAP 0.56 \ ss,py T p� APPROVED z� LINE EXTENODTED SET �3p). MASON COUNTY DCD P NI BAR t CAP Ar Ill, e \ N��11'¢9'w 488, SITE PLAN REQUIRED TO BE SI APPROX.LINE o"f ON PLAIN �^ gT LA IRON .fP� 1 *Bs MEAT � r' t \ ? S CHANGES 3UBJET TO APP A4 OF ORDINARY 3�� NIGH WATER AT ;, . -VQ D v� LOT LINE FALLS S t 1 IJ UNDER MANOR ©, STONE WALL MANOR STONE R WALL All FOUND 3/4IR6N \ e /��v -."i, -5 Fkp� L FOUND HUB AND /PIPE,BENT,TTED'- �C TACK N 20'54'55"W \ VERTICAL PO51T� 1 ®� 222 FROM FOUND AND REPLACE WITH \ 4 314"IRON PIPE c, POLMAN BAR 4 CAP z a 68 SEE PLAT OF HAVEN LAKE VOLUME 4,PAGES 74 P,',Gt G� (� SEE PREVIOUS SURVEY BOOK 33,PAGE 97. .� 5 SEE PREVIOUS SURVEY BOOK 34,PAGE 37. 5 Z N •i F N 2! o n v SEE SURVEY BY DAN JOHNSON BOOK 41,PAGE 125. IRON PIPE' _ ALL RECORDS OF MASON COUNTY,WASHINOTOhL \! r��' \ 40 � � ( i� !r l Er y t b /IL /� 1< Ir�� \ CORNER 0,14 9n _ 5 IRON BAR W/PLASTIC /^�3� \ NE'LY OF \ l�%L N E' YELLOW CAP SET � p 05 IRON BAR W/PLASTIC LOT LINE YELLOW CAP SET PREVIOUSLY hry ti \ + p = FOUND AS NOTED FOUND 3/4" h \ LOT \ � C2 = FOUND CONCRETE i' IRON PIPE�` \ 72 \ 1 • 1� MONUMENT PLANNING \ C2 4 \ LOT \ FOUND 5 �� ALL SETBACKS ARE MEASURED s u- 13 \\BAR FROM THE FURTHE—ST -�� PROJECTION OF THE BUILDING 32 C FE: 1 =29-FE T \ J�j� /ct i 1\ 0\�-\20 40 � / LF$ FOUND 4 1/4"x 4 I/4"GAME ��oe„gsyOl \. \ DEPARTMENT CONCRETE MONUMENT U PMETAL 4eRa x G Q CURYZ FENCE POST AND 3"BRASS 3 NO DELTA RADIUS LENGTH DISK W/PUNCH "PROP COR. o d 11381"0.19 NORTH,0.02 WEST o GI 57'03'1," 80PJ0 79b6 0 �+ � °crscea`�9 J4° C2 12'01'56" 100-00 21PJ0 h Q /0NN LAN 5 Z0, q Lol -------------------- Z" EQUIPMENT AND PROCEDURES 2 00 O 3"TOTAL STATION W/EDM v l5-07617LL15 PROCEDURE-FIELD TRAVERSE 07-136ASG �ma AUDITOR'S CERTIFICATE SURVEYOR'S CERTIFICATE l-�'OLM "I A' LSSOCf>47ES e�U R Y�'Y PRCFESSlONAL LAND SURVEYORS FILED FOR RECORD THIS., .DAY.��-1•,?m..�5.,s1T.`: M.M TNl5 MAP CORRECTLY REPRESENTS A SURVEY MADE BY FIE OR FOR P.O.BOX 3379 0 u UNDER MY DIRECTION IN CONFORMANCE WITH THE REQUIREMENTS SHELToµ . OF THE SURVEY RECORDNG ACT AT THE REQUEST OF jy�(KS 476-1990 PHONE hnane♦�ctccom �J C�� I-^-, 1'If KS (36m1 !.......OF.NTq. T PACE. ...........AT THE REQUEST CF A"o� MIKE,UTALL$............ DUN BY DATE JOB NO. N$"= 0ANIEL F.HOLMAN...... ...................... IN RNIS UNE 2IDI5 0 6 IN JUNE,a0A?_. 5E 114,NE 114 .�. . . . SECTION 30, TOWN5WIP 23 NORTN,RAN&E 2 WEST,W.M. cHICD BY' SCALE SHEET 0ITOR CERTIFICATE NO.15653. DCH I" = 2ID' I 1 Name,Y Y 6i�. 7�F� �rilJ Parcel# p2p��jjU Gy `� r BLD# 2.6 I S O0t4 L} ■ Mason County Iv i9 L :�a U e� IC B �:1p7 ] nr1��► Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stonnwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surfacez. '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 Surface Type Length X Width = Area "All dimensions in feet Buildings X = C. Z, X = Measurements for buildings are taken at the Hois X - g 8 = - 9� perimeter of the farthest projections(example: eaves/gutters) PUrvPAVy (F X 8 = Driveways X = 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 = QS 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) 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. Acknowledg ent of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further ackno ledge the information provided is accurate and employees of Mason County are granted access to the above- des perty f vi andd,ins�pection as may be required. /� Owner/Agent/Contractor(circle one)Date: 1a 21611 fv If the T tal 1 ervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the in rmation provided on page 2 of 2. Page I of 2 4 qc i e4i� I-,A G �v be b t-1 l 7-• Name WA Parcel# as�3�^�j T>'`�i�t)�(7 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 Coun website: h"Hwww.co.mason.wa—us/code/commissioners/index.htm q Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". 1 �j 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 a°max "QU+r MASON COUNTY COMMUNITY SERVICES Permit No:J�I A ao u • 6p+4 t PERMITASSISTANCE CENTER: Recv'd. •BUILDING.PLANNING•FIRE MARSHAL 615 W.Alder St-Shelton,WA 98584 - Phone:36427-9670 ext 352 Fa :360-427-7798 httpwwwcomason.waus/comuniy dev/BUIL I last /1 r BUILDING PERMIT APPLICATION fkgOENED PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:I '1,C.h r4& U)U41 I S �- NAME: 6yR AN a MAILING ADDRESS:_ ,D: L �.3i MAIL ADDRESS:I.��t�� ��ayLc�rriG, ;K v �, ¢ CITY:5 STATE: ZIP:-Jj j CITY: STATE:_ZIh L v PHONE#1: _r &tq" PHONF ; CELL: 0 f,?n.2q PHONE#2: EMAIL I EMAIL L&I REG# ' W&P etz-(1 f-:2-z -7 CONTACT PERSON: OWNER VCONTRACTOR❑ OTHERBELOW❑ NAME: to 5 t4FO If g MAILING ADDRESS: CITY- _ STATE: ZIP: PHONE: CELL: EMAIL: PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) c 3 0 — '*D-Q6V7® ZONING '5 LEGAL DESCRIPTION(ABBREVIATED) � FIRE DISTRICT -P. SITE ADDRESS 91 V ITY r&-/O V14 DIRECTIONS TO SITE ADDRESS Q LLV /1(bi)T-FL-Z� -VA.4 .0tiAVE—Y2 LAX 15 IS PROPERTY WITHIN 200 FT: (Checxarr that apply): SALTWATER❑ LAKE K RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ IS THE PROJECT W11HM 300 FT OF SLOPE(S)GREATER THAN 14% YES❑ NO D TYPE OF WORK: NEW;g ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS *4" NUMBER OF BATHROOMS I.- A- HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part[s]of Bldg)❑ NOR DESCRIBE WORK SQUARE FOOTAGE: 1 ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft.STORAGE sq.fL OTHER sq-ft. GARAGE sq.ft. ATTACHED❑ DETACHED X CARPORT sq.ft. ATTACHED❑ DETACHED❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER OWNER 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 or owner's legal representative.I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF C TINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATI OF 180 YS WILL CAUS7 THE APPLICATION TO BE EXPIRED. MASON COUNTY CODE 14.08.42) natu of O NER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDTPIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS Intake By. Approved&Ready for Pick-Up: