HomeMy WebLinkAboutBLD97-0537 Final Mobile Home - BLD Permit / Conditions - 7/13/1997 --------------------------------------------------
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
0 E N C4 V" E=: 11 m I T f.Ofi INSPECTIONS (:AL.L_ 427--9610
BETWEEN Spin .AND 8a3m 427-7262
BLD97--O637 P ARCE L :2233 t 5OOOO 37 PLAT :COPLO D I V : BLK : LOT :
JOB ADDRESS : NF 90 CREEK VIEW pL TA4UYA
OWNER : DEAN ORR 275--6010
CON1 RACTOR : VAN St YKE CONSTRUCTION 8 76•-5283
LEGAL. c COLLINS LAKE 1t TO 11
CLASS OF WORK , . +NEW BFDR c 2 .E:ATH : 2 JIYPE ANOUI17 BY DATE RECEIPT TYPI AMOUNT BY DATE RECEIPil
TYPE OF USF . . . . :MH '>TOR I ES . . . . . . . : 1
OCCUP . GROJP . . :7 BLDG . HF 1 GHT . . : 0 .Oft NNOF t 155.66 KS 06111197 8 f
TYPE OF CONS'T . . c? FIREPLACESS . . . . c 0 Siff 1 4.50 K° 86tI1191 0 I
OCCUP . LOAD . . . . c 0 WOODSTOVES . . . . : 0 f00 1 2t+.00 IS 161 t 1197 0
DWfLI_ .UNITS . . . . : 0 PARKING SPACFSc 0
INSPECTION AREA : 1 SHOREL I NF7 . . . N Ir+TAt: 195.56 VAtUtATION: 52b0$
amass.'�s.Est+szszsz�ts¢stx.�sra�aaacrzrz=.s�z: ..�msasnc6:ms:ss.�t:aCst:Tcesxsaa:cm-c:...:.ss�ss�
SETBACKS- ------ --- TOILETS. . . . . . . . . . : 0 FUEL TYFFS-.._-..._.__ ._--_ BOILERS/COMP---.-- MOBILE HOME i
FRONT —S 15O .0f't BATH BASINS . . . . 0 . 0-3 HP . : 0
REAR . . . .N 15 .Oft BATH TUBS . . . . . . . . : 0 3-15 HP . : 0 MODEL. :LIBERTY
SIDE ( I ) .E 300 , Oft SHOWERS . . . . : . . . . . ; 0 FURN < 100K 1370 : 0 15-3+0 H'P . : 0 MAKE . _-__._
SIDE (2 ) .W 15 .Oft WATER HEATERS . . . . ., O FURN >-1O0K BTU : 0 30-50 HP . : 0 KR284628
SHRL I NE . 0 .Oft C1 OTHE'S WASHERS . . : 0 FURN - FLOOR — : 0 '_0-4 HP . : 0 -.YEAR-
AREA -_._.__..__...._-.__-___._ KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . . 0 96
LOT ' IZI_ . . . FLOOR DRAINS . . . . . 0 VENT SYSTEMS . . . . 0 EVAP COOLERS : 0 LUNG T11144 ,
BUILDING - - 0sf DRINKING FOUNT . , 0 VENT FANS . . . . . . c 0 HOODS . . . . . . . .. 0 WIDTH . :26
BASEMENT . . . c Osf L.AIINnRY TRAYS . . . . . 0 DOMF; . INCIN :rl` SERlALIt-
DECKS. . . . . . : 06f DISHWASHERS . . .. . . . : 0 A i R . HANDL I NG' ON i TS- - COMML . I NC 1 N :f4c 091.3O
GAPICARP :? 09f CARE; DISPOSALS . . . : 0 1O000 otm . : 0 REI.00/REPAIR : 0
AT/DT . :? URINALS . . . . . . . . . . : 0 10000 oft . : 0 OTHER UNITS . : 0
M15C PLM FIXTURES : 0 GAS OUTLETS . : 0
ia:zaas amcs:_.--m¢�ssscmcraTac:as:s�.r�t+-•+�oe::t.%imr�s�. _ za�n:�z� .�cm-�s.ma_-r.�:�s�:.-z::-ac.ass::.ves•-r.+zr��su�a-.ss:�:as-.s�m4<a+c-.-asaz�r�s:zraarr=sa�rsaa:—•-ar�ez:n-_.:.a
PNOJECT OESCA1PilON;N0611F
PROJECT LOCATION:BELFAIR TAHUYA RD, R16HY INTO Cott INS LAKE, follow TO m 1XVIEN PL !1IGHI1GO TO VERY END OF CUI Of SAC. STRAIGHT AHEAD, VAN StYKF
CONSTRUCTION SIGN.
1111' PER10 BECONES NUII AND '4010 I'> wOR9 OR CONS11190I0N AUU01 11f8 IS NOT CONNENCEO OITHIN 181 DAYS, ON If CONSTRUCTION OR HONK IS SJSPFNDED FOR A PERIOD
OF 101 DAYS AT ANY TIME AfIER fOR1( IS CO11F10EO. EVIIENCE OF CONIINIATION.Of 101K IS A PR00BESS INSPECTION VITNIN THE 181 DAY PERIOI. FINAL 1NSPfCTI01 NUSI BE
APPROVED BEFORE BUILDING CAN Of OCCUPIED.
DINEP. oR AGENT: . DATE:
111_j1NT, rev, 13131111 COMPI I ANCF TO ATTACHED COND I T ON$ IS REQUIRED
CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date by Gas Piping date b
Foundation Walls date by Set Up
date by INSULATION date (�-�j by 1 ✓
BG/SLAB Insulation Floors Final
date by date by date �-3C� —y by �✓
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING OTHER
Groundwork Attic
date by date by
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
v-�r\ f-SS c1,
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-- -
Building Permit # MASON COUNTY
• BUILDING III 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
Job Location 90 Creed y ; c,-. �2
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: / . 0GG�..-� - - ��, ,, 90 ��-�s
Items listed below must be corrected to gain code compliance
<—I �kc)j LA-4 e-cO I-or 4-1 c- Ao e-i^s. k-,c, lie
+
4f e 40 G r e- 4r D ev
S
You are hereby notified that the above corrections shall be made BEFORE
PROCEEDING WITH ANY FURTHER WORK
�UrCall for re-inspection when corrections are made before continuing
a Make corrections, items will be checked on next inspection
aOKto
Department
Date 7— Z Inspector C -�
■ loo * NuT Mo *V THI, T A ,�
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
nn r c ca N n r n� P.O. Box 186 Shelton, Washington 98584
Case No . : BLO97-0537
Page : 1
1 ) They undersigned property owtcer is aware oie the uncertainty regarding Mason Coure+
development regulations created by the Growth Managment Hearings Board 's Order of 1
October 2 , 199 , and in consideration of Ma!-on County 's willingness to proceed with
prooes, i ng of a jp I l cat i ons which might be affected by the Under , the undersigned
property owner ereby agrees to waive any lawsuit , action , or claim for damages agaInst
Mason County which may arise out of Mason County ' s actions In acceptance processing
and/or lssur.nor of such permits or approvals (hereinafter "permitting actions" ) , which
damages are attributable to the County ' s decision- to take permitting actions despite
the ri k that chan►les to the County 's development regulat icons might later make the
Gaunt penrmlttfng actions invalid .
2 ) Tho use, hand I i ng and storage of hazardous materials or flammable and ^ombust i b i e
liquids in excess of 10 gallons is not allowed without the approval of the Mason County
Fire Marshal .
X. Ifir
3 ) Proposed structure or any portion thereof greater than 30" in height from grade line,
must maintain a minimum of 6 ' setback from all property lines , easements and 10 ' from
X 1 , w:inty and Statie, Road right of ways .
4 ) Approved per dimensions and a,etbFacks can submitted site p►ar . x �
5 ) Proposed structure or pportions thereof with an projection over 30" In height from trade
line, must maintain a 5 ' separation dietance between adjacent :structures and that
furthest projection . X
B ) PURSUANT TO 1994 UNIFORM BUILDING CODE SECTION 305(C ) AND SECTION 513, ALL SITES MUS,r
HAVE APPROVED NUMBERS OR ADDRESSES PRbVIDED IN SUCH A POSITION AS TO BF. PLAINLY VISIBLE
AND LEGIBLE FROM THE STREE'r OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING
DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO GALLING FOR ANY SITE INSPECTIONS . A
REINSPECTiON FEE , RASED ON RATES IN TABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BF
e
ASSESSED IF OWNER/e;ONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
NSPECT1014S
I_7 ) RF011 I RED I W;PECT IONS ( Foot I no I nSpRot 1 on pr i <;r I e: raear . Set up 110ZZ IeOt 10" -C)r 1111 t e,
�: ti v 4 < y
Informte It n rrr ati Gui tie I inj, b!c< Mob! le,'W'VIrtaf!iIII Pd Item I
I "o Irf�'l I I .L11 n sus landoul ror
detailed description,. iul manufactured home
i nst a l l at l on . i herwt . t ; tut l ng of the,,;e required
I ngp n oct i ons . I f these Hqu I MASON COUNTY' Inspected and b i gned
off approved) by the I t 1-t '-hat reInapect icon
fees and an hourly i nve + ;A wi 1 1 �e assessedI n acid I t i on t o my ter I-j ► it Mason County Bldg. III 426 W. Cedar ,t i eers or
roblems that have been d1s, Estigation will
er schedu I e d as time a i P.O. Box 186,Shelton, Washington 98584" cupancy ( Final
Inspection ) Witt h^ nrPnt : JI-
OWNS /CONY At i-, I , tt 1r ! Ch ? 1 r:.., t .lt t XL.
8 ) All tnobi le/manufactured home landings or, ducks must: be freestanding ( self supporting ) .
The largest I turd I ng or deck permitted without draw i r►gs or a building permit Is 36" x
36" Any landing or deck that Is 30" or more in height frow walking surface to finish
Rradee requires a guardrail . Any landing or deck that has 4 or mare risers requireR a
andra I 1 . Any landing or duck I arge r, than .36" x 36" must be permitted which regb i res
s uct ur a l drawings and a b► I l d i ng permit app 1 i cat I c+n . i s I nst a I I at I can Perm i t doe��
N include any l and i nil or leek i arge+r than then 16" x 36 size .
X ✓ � _______._._._�_ _.._______.____._._._.__.__._.
9 ) Placement of structure must comply with standards eat f ..t_h per, 114C sec , 2907
regard i nq descending arid/or ascending slopes . X __-
GARY YANDO,DIREC 07
SON.STA-F
A H DEPARTMENT OF COMMUNITY DEVELOPMENT
u =
s N PLANNING - SOLID WASTE - UTILITIES
N Y y BLDG. I • 411 N. 5"' ST. • P.O. BOX 578
SHELTON,WA 98584 • (360) 427-9670
1864
DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created
by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's
willingness to proceed with processing of applications which might be affected by that Order, the undersigned property
owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of
Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting
actions"), which damages are attributable to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations might later make the County's permitting actions invalid.
`r'`7 Cy 000&-7
0;�33 t•—S
Date (Parcel No. or Legal Description)
Pro rty owner's signature(Notarized)
(or the County may accept the signature of the owner's authorized agent upon proper proof of authorization)
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL)
STATE OF 1k)fi S N It13 G TO tJ
COUNTY OF
On this _ti_r day of l V i(U in the year dl before me MERRY L OW Notary Public,
personally appeared J e,,i ,-, �( .( '.-, --personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it.
WITNESS my hand and official seal. -For County use only -
Reviewed by applicant on
2 MERRY L QUN (Date)
Notary �gnature r�` Staff Initial:
My Co ssion Expires:
�r
I
GARY YANDO,DIRECTOI
STg
PCirFO
A o u DEPARTMENT OF CO DEVELOPMENT
�
s NZ PLANNING -SOLID WASTE - UTILITIES
0 N Y Y BLDG. I • 411 N. 5' ST. • P.O. BOX 578
�° SHELTON, WA 98584 • (360) 427-9670
1864
DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES, AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created
by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's
willingness to proceed with processing of applications which might be affected by that Order, the undersigned property
owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of
Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting
actions"),which damages are attributable to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations might later make the County's permitting actions invalid.
Date (Parcel No. or Legal Description)
Property er's signature(Notarized)
(or the County may accept the signature of the owner's authorized agent upon proper proof of authorization)
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL)
STATE OF
COUNTY OF
On this day of , in the year ,before me Notary Public,
personally appeared personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it.
WITNESS my hand and official seal. -For County use only-
Reviewed by applicant on
(Date)
Notary's signature Staff Initial:
My Commission Expires:
1�: :� - 1
05/02/1994 06: 24 876-6703 VANSLVKE CONSTRUCTIN PAGE 02
JL.L 30 197 Oe:32Rm LIBERTY HOMES P.2
I�
=%Melf LIBE, R ,�'Y I- OMIBS, INC�
Corpcurate Office
July 30, 1997
Dave Van Slyke
Van Slyke Construction
PO Box 1106
Port Orchard, WA 98366
RE: 28'-6" x 44' Liberty Multi-Section Manufactured Home
Dear Mr. Van Slyke,
I have reviewed your tie-down system for the 28'-8' x 44' mufti-section Liberty
manufactured home. Based on your drawing (copies attached), this system
consistf,of cables 8' o.c. connecting 8" x 22" x 28'-8" reinforced concrete ribbon
footing to all 1-beams in the frame.
This method of tie-down meerts the requirements for Wind Zone I assuming that
the cable and all the connections to the frame and the footing are rated for
31500 working load,
Please note It Is the responsibility of local authorities to determine if the
foundation system complies with local codes. Liberty Names Installation Manual
and local codes must be used for all other installation and set up requirements.
Sincerely,
LIBERTY HO ES, INC.
�ee Lehman
Director of Engineering
pol
attachments
1101 Eisenhower C)rive hivrth/Po Box 3s- 30*hen IN 46$27-0035 . (219) 533-0631 fex r2 s) S33 0439
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Page rlo. 1 t CASE HISTORY FOR CASE NO.: BLD97-0537
• (V
DEAN ORR
NE90 CREEK VIEW PL TAHUYA
07/16/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
------- ------------------------------ -------- -------- -------- ------/---y--��------------------------------- ---- --- -------- ---
b 1 I i rns L�ric�. I Lo+- lo7
BLDA010 Application received / / / / 05/15/97 05/15/97 KW
BLDA015 Waiver in File / / / / 05/15/97 DONE KW 05/15/97 KW
BLDA100 Approved For Issuance / / / / 06/10/97 DONE KS 06/11/97 KS
BLDA500 (F) Issue building permit / / / / 06/11/97 DONE KS 06/11/97 KS
BLDB110 Structural Plan Review 06/01/97 / / 06/03/97 DONE TLG 06/03/97 TLG
BLDB130 Planning Review 05/21/97 / / 06/01/97 SITE AT HIGHEST PART OF PROPERTY. AHB DONE AHB 06/02/97 AHB
BLDB134 RLC Review / / / / 06/01/97 TYPE 3 STREAM ALONG EAST PART OF N/A AHB 06/02/97 AHB
PROPERTY. AHB
BLDB135 Addressing 05/16/97 / / 05/19/97 DONE GMM 05/19/97 GMM
BLDB138 Planning Pre-Review 05/19/97 / / 05/21/97 DONE MMS 05/21/97 MIS
BLDB200 Environmental Health Review 05/15/97 / / 05/16/97 This is a shoreline replacment (possible HOLD PSD 05/19/97 KS
expansion) but the drainfield is greater
than 200 feet from the shoreline. There
are complete septic records. They need
to 1) pump/inspect tank and 2) identify
a reserve area on a plot plan.psd
PUMP REPORT ADDED TO THE TIN BIN.
BLDB200 Environmental Health Review 06/03/97 / / 06/10/97 pumper's report satisfactory... DONE CAJ 06/10/97 CAJ
reserve area drawn in on plot plan
BLDB210 Water Adequacy 05/15/97 / / 05/16/97 The DOH was faxed regarding the Collins DONE PSD 05/19/97 PSD
lake water system.psd
This is a replacemnt.psd
5/19/97 The water system is inadequate
per the DOH, but this is a replacement.
Also according to Cherri Paine, the
water system is close to comliance.psd
BLDC199 Mobile Strip Footing 06/18/97 06/19/97 06/19/97 CONDITONAL APPROVAL: COND LW 06/24/97 LAW
1. RUNNERS ONLY 7 INCHES DEEP, EITHER
MAKE THEM 8 INCHES DEEP OR POUR AS IS AN
PROVIDE THE INSTALLATION SPEC'S THAT
SHOWS 7 INCHES IS OK AT THE NEXT
INSPECTION.
04/'9/1994 05:44 876-8703 VANSLYKE CONSTRUCTIN PAGE 01
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HEALTH
04/jQ/1994 05: 44 876-8703 VANSLYKE CONSTRUCTIN PAGE 02
VAN 3LYKE CONSTRUCTION
P. O. Box 1106 ��o-« 3 t-o S 7C, Sz 8^3
Port Orchard, WA 98366
76 - 9 .70 3
04/19/1994 05: 33 876-8703 _ VANSLYKE CONSTRUCTIN PAGE 01
Do
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HEALTH SERVICES
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04/16/1994 05:28 876-8703 VANSLYKE CONSTRUCTIN PAGE 01
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P. 0. pox 1106
Port Orchard, WA 98366
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JUL 14 1997
HEALTH SERVICES
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
(Calling From: Seattle 464-6968, Belfair 275-4467, Elma 482-5269)
PLEASE PRINT
#1 wn I JAR y1 �'� �10 Phone# 2 7r— GO /O
Site Address /U - l C�ee r-✓y�/ f 6o(LP Fire District#
City �a v v r� �� s ct �e� St (�(�Gt , Zip g �3 g
Direct*ons to Job Site 1 P I 4Qi,�— ,7 e� v y4 V-'4 h-6-0 r K) l t �z Lg'C&-Q �
cJ ) o
Owner Mailing Address �• Z Z
City St 4 Zip �8 zsg
Lien/Title Holder Ac
Address c r/� U aZ_
city �� a �. St Zip 8
#2 Contractor Name Gt y► 57 .me— Contractor Reg# VA-o,JSLCA 019YOS
Address P D, j� n� (06 Expiration Dated/��
City�o r-�—(� St Zip g 9 7 6� Phone# 36o
#3 If septic is located on proj7t site, include records. i
Connect to Septic? ublic Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 reel No. Z--33/
WL gal Description lam{ O G �
#5 Building Square Footage:
1st FI 2nd FI 3rd FI Loft Basement
#Bedrooms # bathrooms Deck Other
Garage Carport (Circle:Attached or Detached?)
Describe work
#6 Use of building I f" V�
#7 Type of Job: New Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year�Make L�Model�/� Z e 41g Z
Length_Width_Serial No. 2L 3 o `// q 'f(�)
#Bedrooms_,# Bathrooms Z Type of Heat :w 1,ee 7`rtL
Purchase Price$ S ZSoo 0o
#9 Indicate by circli the applicable source if any water is on or adjacent to subject property:
River Po Creek tream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Fences
Existing Structures Driveways
Structure Setbacks Shorelines
Water Lines Topography
Drainage Plan Wells
Septic Systems Easements
Proposed Improvements
Name of Side Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
i
Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 eachl
r
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
_Bath Basins V Heatpump, Other
_Bath Tubs., No. Units Fees-.
Showers Furn BTU
Hot Water Htr _ Heatpumps
Laundry Washer — Vent Syste s
Sinks — Spot,, nt Fans
Floor Drains h Q, -Boilers/Compressors
Laundry Basins lip
Dishwasher No. Air Handling Units
Disposal cfm#
Urinals No. Fire Protection Systems
Other Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 16.75 — Auto Fire Sprink Sys 35.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet ve
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF —
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 75
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD
OF 180 DAYS AT ANY TIME AFTER WORK IS COM- TOTAL MECHANICAL $
MENCED. PROOF OF CONTINUATION OF WORK IS BY
MEANS OF A PROGRESS INSPECTION.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER X BY
4
DATE DATE - - -- -7
FOR OFFICIAL USE ONLY: Accepted by: Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
E
ed Cond. Hold
/ Approval
Planning:
JA
Environmental Health:
Building Plan Review,.
-,5&r
Occupancy Group: Type of Const:
Fire Marshal:
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Violation Fee
Site Inspection
Building State Fee
Other eTAW. H 14N. C2 6, c0
11 Other
Other
Building Valuation: TOTAL FEE