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HomeMy WebLinkAboutBLD2006-02140 Final Garage/Storage - BLD Permit / Conditions - 8/28/2007 1 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 r Shelton, WA 98584 -or RESIDENTIAL BUILDING PERMIT BLD2006-02140 OWNER: JOYCE STRATTON RECEIVED: 12/21/2006 CONTRACTOR: LICENSE: EXP: ISSUED: 2/15/2007 SITE ADDRESS: 182 NE LAKE DR TAHUYA EXPIRES: 8/15/2007 PARCEL NUMBER: 223305000175 LEGAL DESCRIPTION: HAVEN LAKE TR. 175 PROJECT DESCRIPTION: DIRECTIONS TO SITE: CONSTRUCT GARAGE/STORAGE NORTH SHORE TO BELFAIR TAHUYA RIGHT 4 MI. TO HAVEN WAY, RIGHT 1.5 MI TO HAVE LAKE DRIVE LEFT, 3/4M1 TO TAH. BLACK. RIGHT 2/10 TO LAKE DR. RIGHT 2/10 TO 182 ON THE RIGHT. General Information Construction &Occupancy Information Square Footage Information No. of Bedrooms: Type of Constr.: V-B 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: 2 Occ. Load: Building: Garage-Detached 576 Valuation: Building Height: 24 Occ. Status: Basement: Manufactured Home Information Setback Information Shoreline& Planning Information Make: Length: Ft. Front: W 49.0 Ft. Shoreline: 127.0 Ft. Water Body: HAVEN LAKE SEPA?: No Rear: E 127.0 Ft. Slope: Ft. Model: Width: Ft. Side 1: N 5.0 Ft. Shoreline Desig.: Urban Year: Serial No.: Side 2: S 5.0 Ft. Comp. Plan Desig.: Rural Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee CMH 12/21/200 $217.91 B12006000 Planning Review Fee CMH 12/21/200 $155.00 612006000 Address Fee BLJ 12/27/200 $140.00 S12007-01 Building State Fee RTB 12/27/200 $4.50 612007000 Building Permit Fee RTB 12/27/200 $335.25 B12007000 EH Plan Review TW 1/4/2007 $35.00 612007000 Total $887.66 BLD2006-02140 Please referto the following pages for conditions of this permit. 1 of 5 ,17) , Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. x�� 18) 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 ,(�' 19) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "AWrooved Site Plan"to ensure these structures are shown and meet the setback conditions listed. �� 20) Owner/builder assumes all responsibility if drainfield/reserve area is encumbered. X 21) This parcel is located in a smoke management zone. Please contact a fire warden at (360) 427-9670 ext. 459 for further information. 22) Water quality is not to be degraded to the detriment of the aquatic environment as a result of this project. 23) Prior to final approval, 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[ 24) The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules, and the Mason County Shoreline Master Program.X 25) Approved per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X Q- 26) Tcel is located in a smoke management zone. Please contact a fire warden at (360) 427-9670 ext. 459 for further information. 27) A Road Access Permit or Approval must be granted by the Mason County Department of Public Works. For more information contact Public Works, at (360) 427-9670, ext. 450. The building permit will not be"finaled" until the permit holder can show proof that the access permit from Public Works has be n "finaI d" and approved. X BLD2006-02140 Please referto the following pages for conditions of this permit. 4 of 5 8) Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). X 9) This structure is limited to U-occupancy use only (private garages, carports, sheds, and agricultural buildings.) Any other use will be in violation of the Xteygattiional codes and Mason County Regulations unless a "Change of Use" permit is applied for, reviewed and approved. 10) 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 per�itrevocation. 11) 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 pro ct. XS 12) All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County XrdW' n e or regulation, must be reviewed and approved by Mason County prior to construction. 13) 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 Ins ctor shall be made prior to requesting additional inspections. X 14) All property lines shall be clearly identified at the time of foundation inspection. X_2S 15) 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 ordinances and building regulations. X 16) 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'R,5 BLD2006-02140 Please refer to the following pages for conditions of this permit. 3 of 5 CASE NOTES FOR BLD2006-02140 CONDITIONS FOR BLD2006-02140 1) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X 65 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 Dep�artment prior to any further inspections being performed or approvals granted. X 'y J�? 3) In accordance with international codes and Title 14, Mason County Building Code, "Standards for Fire Apparatus Access Roads," all new structures that require an address shall have approved numbers or addresses located at the beginning of long driveways when the address is not clearly visible from the access road. The numbers shall also be plainly visible and legible from the street or road fronting the property and shall contrast with their background. 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 international codes will be assessed if the owner and/or contractor fail to post the address on site prior to requesting Xspgct�ns. 1.� 4) 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 approved documents will result in failure of required building inspections. X (S5 5) This structure is approved as un-heated space. If at any time this building is to be used for anything other than what it is approved for, a change of use pe i shall be applied for, reviewed and approved prior to the change. 6) THE FOUNDATION SYSTEM SHALL BE PLACED ON UNDISTURBED, NATIVE SOIL. Z 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 granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Xyjldiiinng Department prior to any further inspections being performed or approvals granted. BLD2006-02140 Please referto the following pages for conditions of this permit. 2 of 5 1 This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is ' commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied.Proof of continuation of work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described pro erty d tructu for rviw""''and in p ction. OWNERORAGENT: /�Jlil DATE: BLD2006-02140 Please referto the following pages for conditions of this permit. 5 of 5 Cn o CQNCRETE MECHANICAL MANUFACTURED HOME o Date By rn Footings/Setbacks Gas Piping Ribbons oN Interior Date 9 By Interior-Date By Date By o Exterior Date, —Z�� By r Exterior-Date By Set-up Z Point Load/Isola Footings INSULATION Date By BG/SLAB INSULATION Q Date By Data By FIRE DEPARTMENT n Foundation Wall Floors Date By m Date By Data By DECKS FRAMINJ Walls Date By Date 78,f(� By A4e Data By PROPANE TANKS PLUMBING vault 'l 1 Date By Date By OTHER Groundwork Atti Data By Date By Type:Date By D.W.V DRYWALL Type: Int Brace Wall Date By Gate By W Date By FINAL INSPECTION Cl) Water Line Fire Seperation C Date By Date By DateJ2:aLQ_7 By O m OD Pass or Request Inspect. CD Type of Insp. Fail Date Date Done By Comments sv O in 7 Iq D 7 Aar, y4�( �•M,s #meta N e !WSVtA4_- R4437 4 rly-0 F.1*10L aE -_see_ /777—, V <' 0 CM ` r pR FRp gpks > f ' `' O✓Fcr/NryF �R MFgs• •�' i U � ` of ry VR U. ryF Fsr Fo �,, p 5 $pN cc tl� .gyp P s .'. � t S � w LN wo ow - f h .gob Request To Revise An Approved PIan Permit Number: BLD200 ' Name Parcel Number. Phone Number da me Project Address � n E- L,n QLL� Mailing Address me ( G I s_©i 911 E — Please provide a complete,detailed description of the proposed revisions to the approved plans: na fick_, Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes Are the approved site plans included? 1 No XYes No Are the revisions clearly and accurately identified on the plans or addendum? Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? �Yes ❑ No If Yes, Has the engineer or architect approved this revision? 11 Yes 0 No Is a stamped and signed approval included with this request? ❑ Yes ❑ No fNote:No structural ct_�anees to it"designed"plan will be anoroved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes No If Yes, Is a revised site plan,.With all new setback dimensions included with this request? _ Adtii 'oval Information: C ❑ Yes ❑ No n r Applicant's signature Date: — © -7, otf�We Only _ Received by lii�� Date Sent Ami nod To Amoved By Date B. Original Valuation: $ g-) Additional Valuation: $ • Sq.Ft. z$ $ Sq.Ft. z$ S F:H• Total New Valuation $ P.W. ✓� Additional Fees: Additional Planning Dept. $ New Setbacks: Front / Rear Additional Plan Review $ / Additional Building Permit $ Sidel_ / Side2 / Additional Plumbing $ Additional Conditions/Comments: Additional Mechanical $ Additional E.H.Dept. $ Other $ Total Amount Due: $ Amount To Be Paid Up-Front$ 7ak iuiWl Revisw SP4 v2zlo 1 Job: (U2-U/) misc. / S I HH I I UN THIS OWG. PREPARED FROM COMPUTER INPUT (LORDS & OIMENSIONS)SUBMITTED BY TRUSS MFR Top chord 2x4 HF SS :T2, T3 2x1O OF-L SS: 90 mph wind 15.00 Ft mean hgt, ASCE 7-98, CLOSED bldg Located anywhere in Bot chord 2.10 DF-L SS :62 2x4 HF SS: roof, CAT If, EXP C, wind TC OL-4.2 psF, wind BC OL-5.t�] psF. Webs 2x4 HF Stud Collar-tie braced with continuous lateral bracing at 24" OC. or rigid ceiling. Member design & uplifts based on MWFRS and C&C. BC attic room Floor loading: LL - 40.00 psF: OL - 10.00 psF: From 6-0-0 to Deflection meets L/240 live and L/180 total load. 18-0-0. f — 12 12' 4X1 R) I` ZI 4 O ° 12B2 T3 — 4X14 N 4X7 CASR) -� DO X 12 (R) (� 4X7 11 !"1 24 ' --� M[ f--6' s�'� 6'7- + 6' ---- —6' i O S 9.5..2 � -9'5..2 �-6' — — 12 wim 6' s1# s1 Rv=1988# U=195# W=5"8 Rv=1988# U=195# W=5"8 LEFT RAKE = 1 '5" RIGHT RAKE = 1 '5" LEFT JIG = 17'3"6 RIGHT JIG = 17'3"6 DESC. = STRATTON SEO = 16549 PLT. TYP. -WAVE IBC/TP12002(STD) c /RT-1.00(I.25)i1O( D) OTY= 1 TOTAL= 1 REV. 7.22. 1122.01 SCALE =0. 1250 **WARNING** TRUSSES REQURE EXTREME CARE IN FABRICATING HANDLING SHIPPING INSTALLING A I ND BRACING. REFER TO HB-91 (HANDLING INSTALLING AND GRACING) IUBLISHEO 6Y TPI (TRUSS TC L L 25.0 PR& REF PLATE INSTITUTE, 583 O'ONOFRIO OR SUITE 200 MADISON, WI. 537193 FOR SAFETY PRACTICES PROPERLY ATPRIOR TO STRUCTURALFORMING THESE N .PANELS ANDNBOT OMLESS TCHORDSSHALL HAVE A PROPERLY CHORD ATTACHED RIGI ts SHALL HAVE TC DL 7-Op DATE 02-28-2DD7 CEILING. **IMPORTANT** FURNISH A COPY OF THIS DESIGN TO THE INSTALLATION CONTRACTOR. ALPINE ENGINEERED PRODUCTS, INC. SHALL NOT BE RESPONSIBLE FOR ANY DEVIATION FROM THIS BC O L 10-0 PR& D R W G DESIGN: ANY FAILURE TO BUILD THE TRUSSES IN CONFORMANCE WITH TPI: OR FABRICATING - HRNOLING, SHIPPING, INSTALLING AND BRACING OF TRUSSES. DESIGN CONFORMS WITH APPLICABLE BC L L 0•0 PROVISIONS OF NOS (NATIONAL DESIGN SPECIFICATION PUBLISHED BY THE AMERICAN FOREST AND PAPER ASSOCIATION) AND TPI. ALPINE CONNECTORS ARE MADE OF 2OGA ASTM A653 GR4O GALV. STEEL TOT.LD. 42.0 0/A LEN. 24 EXCEPT AS NOTED. APPLY CONNECTORS TO EACH FACE OF TRUSS AND UNLESS OTHERWISE LOCATED 0 THIS DESIGN POSITION CONNECTORS PER DRAWINGS 160 A-Z. THE SEAL ON THIS DRAWING INDICATESOUR.F A C. 1 . 1 5 ACCEPTANCE bF PROFESSIONAL ENGINEERING RESPONSIBILITY SOLELY FOR THE TRUSS COMPONENT DESIGN SHOWN. THE SUITABILITY AND USE OF THIS COMPONENT FOR ANY PARTICULAR BUILDING IIS THE RESPONSIBILITY F THE BUILDING DESIGNER, PT L-1995 SECTION 2. SPACING 24.0" TYPE ATIC Yy f ! _ I f M " y t f, ? t a i t y {r r F S � r a FF w ,r 1110 i f /t 5 �'99jyp77p77 n � `� � ti j f: .ny r �r, �,. �_4 __ ,. :.:_ ,rn •�, ,�, . .,, ,.,,.�... � .�'` .,.'.�- '.tom= „t� : ti � -- _ - •u r.:.: .., . >M,.,., � ;, �.. �`K.�,#t h^,zc �'t �'� w�:..K �5 �.;'`"u` �.w�,,m ,�^�o-�' :;C` r�' e z 0 H cz U O J F� 2 4 ' m O SITAIRS Roof Plane Sheathing Area = 956 sq . Ft Goble Sheathing Area = 309 sq . Pt Total Sheathing Area = 1265 sp . Ft N Fascia Material = 126 linear F`t �D Valley Flashing Material = 0 linear Ft o c� N Ridge Cap Material = 26 linear Ft � Hip Ridge Material = 0 linear Ft Total Material Cost : S 0 . 00 w Total Labor Cost : S 0 . 00 m 0 m 0 - Em f® 2 4 ' �{ r m O w Z CD H co Lu JOB NO: ` 02-07 PAGE NO: 1 OF 1 I���IINSUIWa N° 1 9 7 5 0 (360)275-0455 T% ORDER REQUEST Tax(360)275-047 A Division of PLC Enterprises,Inc. NAMEZ+f G �% C' JOB NAME ADDRESS DELIVERY ADDRESS PHONE c f PHONE DATE TRUSSES NEEDED LOCA;N(LEGAL DYSC$IPTION) )EAR CUSTOMER As of this date the following order of trusses and components has been ntered as shown below. Unless we are notified of any discrepancies within 48 hours, we ,T aC is �yyJJ--e rill proceed with production.As trusses are unique for each situation,return or cancellation teyoad that time is not allowed without permission. QTY PITCH SPAN OVHG CUT TRUSS TYPE PRICE TOTAL r r Men SPECIAL INSTRUCTIONS on nquent BARN NG:BACK CHARGES VALL NOT BE ACCEPTED REGARDLESS%10th,not 10th,OA.C.F.O.B.PLATE LINE OR SITE PER OF FCAU T,WITHOUT PRIOT,PROVIDING R NOTIMATION By USTOMERVATHIN 48 HOURSND INVESTIGATED G IS ACCESSIBLE.DRIVER IS SOLE JUDGE OF ACCESSIBILTY.1.5%�BY Pennhur month wllaa TTntta.NO i EXCEPTIONS.amounts PAYMENT ARRANGMENTS SIGNATURE WARMING:DO NOT CUT OR OTHERWISE ALTER TRUSSES BEFORE CONSULTING WITH MANUFACTURER,PROPERLY BRACE TRUSSES I AW TPI-BWT 78 MASON COUNTY PERMIT NO. 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 On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner ;�pV�� p=R AT�'011 Company Name Mailing Address , g._L,g i<E jig Mailing Address City 14 XQ State Ij 4 _Zip Code City State Zip Code Phone 3(po 226 614/ Other Ph. Phone Other Ph. Lien/Title Holder 71—a 6 Contractor Reg. # Exp. E mail address ?S:z ' �7 T^ t w E Mail Address Drivers Lic. # DOB Drivers Lic.# DOB SEPTIC /WATER SYSTEM INFORMATION,r/�%Connect to_I�Jew-g-eptic Existing Septic Connect to Water System Name J,* t _System Well Sewer System Viewer System PARCEL INFORMATION - 12 Digit Parcel No. ,�.Z ���- rL�+;7 a Fire District Legal Description Site Address(Please include street name, street number and city) Directions to site Will timber be cut and sold in parcel preparation?Yes o Is property within 200' of Saltwater Lake i% River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/ o TYPE OF JOB - New Add Alt Repair Other PRIMARY RESIDENCE ❑ SEASCNAL ❑ Use of Building ;:. / ,i-) Describe Work No. of Bedrooms No of Bathrooms Square Footage- 1st Floor �-7�, 2nd Floor " 3rd Floor Basement Deck Covered Deck Other Sq. ft. Garage Attached Detached v Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. I .' No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? Yes/ No Installer Name Certification No. OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. This permit/application becomes null & void if workkf�o� r,- Wytth�orized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTI41fATION OF WORK IS BY MEANS OFA PROGRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THEAPPLICATION. X Date: J 1-e?7 -4 DEC 2 1 ?nng Owner/Owners epresentative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: ate DEPARTMENTAL REVIEW APPROVED DENIED NOTES t 2 Building Department Md 6 / Planning Department Environmental Health Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee 1 7 4 / EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee - S� Violation Fee 0'6 Pre-Paid at Submittal Valuation $ TOTAL FEES PERMIT NO. Z �� MASON COUNTY 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 INFO MATION CONTRACTOR INFORMATION Owner A J7RATToIV Company Name Mailing Address2 N.� . Lb/� 2 Mailing Address City 1 4 N u y A State Wt� Zip Code 9 9 S 7 City Mate Zip Code Phone 3&p 17 5 MI Other Ph. 7 S / 7 99 6* Phone Other Ph. Lien/Title Holder A Contractor Reg.# Exp. E mail address PJ '3rkA77-0A/ON NrwCN MS�.cot, E Mail Address Drivers Lic.#C Rq H 1 © DOB 1 2 '3 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. ;� ;4 330 50 C 17 S Fire District Legal Description Site Address (Please include street name, street number and city) /SS 2. Al.E I- N/< E 7)e 14 H N Y A Directions to site Is property within 200'of Saltwater Lake 4"5 River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% TYPE OF JOB - New Add Alt Repair Other Use of Building OA'�`'� b . 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:ElectriG_ LPC-L— Natural Gas_ Heat Pump_ Toilets Type of Unit No. of Units Fees Bathroom Sink Furnace Bath Tubs Heatpumps Showers Spot Vent Fan Water Heater Propane Tank / Clothes Washer Gas Outlets 'Z» Kithen Sinks _ Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs Dryer Vent Other Other Base Fee— Base Fee TOTAL PLUMBING_ TOTAL MECHANICAL OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner,owners legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X Date: Owner/Owners Representative/Contractor (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Grou _�-"�`+ a Constr. P PlanningDepartment 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