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HomeMy WebLinkAboutBLD98-0649 Final Mobile Home - BLD Permit / Conditions - 11/16/1998 MASON COUNTY Mason County Bldg, III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 E1 U 1 L. t_ I N C:; PE R M I T FOR INSPECTIONS GALL. 42 f--9670 bFTWFEN 5pm AND Sam 427--7262 BLD98-0649 P:ARCEI_ :223315200058 PLAT :COPL0 DIV . BLK : LOT : 58 JOB ADDRESS ; 171 NE CULL I NS LAKE DR TAHUYA OWNER : ABRAHAM RUTL_EDGE 275-8080 CONTRACTOR L. FGAL : COU INS LAKF 13 NLK: IOT: 58 ...r�_a�:�^:•.::swr�:�.:��sr-��-csvt���.•ss�c�zr :^r..>:a-r+.-ra>:�rta�r-..sa--urax�z=��<.-_.:.xr:i CLASS OF WORK . . :NEW BEDR : 2 .BATH : 2 ITTYYPf AMOUNT 6Y DATE RECEIPT TYPE AMOUNT RY DATE RfCfiPTI TYPE OF USE . . . . :Mt1 STORIES.. . . . . . . i f r .:� -t. - �. ._ •_ =r .m _ = . OCCUP . GROUP . . : ? BL LAG . HEIGHT — :. 0 ,0f t �PLCK S 175.#,0 Xf 06130/98 47529 TYPE OF CONST . . : ? F IRFPLACES . . . . : 0 MHOf 1 175.00 NJP 00167198 47954 OCCUP . LOAD . . . . . A WOODSTOVES . . . . : 0 STFE 1 4.SO NJP 08101198 47954 DWEL_L. .IIN ITS . . . . : 0 PARKING SPACES : 0 MCP 1 ^,5.00 NJP 081#7198 47954 INSPECTION AREA : 1 SHORFL INF? . . . . :N ITOTAL: 404.50 VALULATION: Isi :*:rc.�c.:::-.r.:.:�—•••s..::��e�zacs�c.:a-msr_rr.Wzx-s�•sri^Faac�-.-.,:.a-::^�x�s:a�-rac�s,cr:z�^cac;�^:..::tea�r,�a• a. SFT8ACKS_ .--.-_._.-..._- __.._. TOILETS . . . . . . . .. , . ; 0 FUEL TYPES---...__-------- BOIL.ERS/COMP--- -•- MOBILE HOME-- FRONT . . :F 33 .Oft BATH BASINS , _ . . : 0 0- 3 Hp' : 0 REAR . . . .W 100 .Oft BATH TUBS _ . . . . . : 0 3-15 IlP . : 0 MODEL :L IBEPTY SIDE ( 1 ) .N 41 .Oft SHOWERS . . . . . . . . : . : 0 F ORN < 100K I TD . 0 15--30 HP a . 0 -MAKE.-_-- -.- SIDE ( 2 ) .S 34 .Oft WATER HEATERS . . . . : 0 FURN >-100K BTU : 0 30-50 HP . : 0 KL2185647 SHRL INF . N 0 .oft CLOTHES WASHERS ., . s 0 FURN FLOOR 0 50+ HP 0 -YEAR.-... AREA _.__.___. .___.._____._ KITCHEN SINKS . . . . : 0 HEAT PUMP . . . . . . 9 0 98 LOT SIZE . . : FLOOR DRAINS . . . . . . A VFN'T SYSTEMS . . . : 0 EVAP COOLERS : 0 LENGTH :62 BUILDING . . . : 1736sf DRINKING FOUNT . .. . . 0 VENT F.ANS . . . . . . s 0 HOODS . . . . . . . : 0 WIDTH . :28 BASEMENT . , . : Os f LAUNDRY TRAYS . _ . : 0 DOME'S . I NC I N :O LCKS . . . . . . : Osf DISHWASHERS . . . . . . 0 AIR HANDLING UNITS--- COMML . I NC I N :O R/CARP :? Osf GARB DISPOSALS _- A 10000 cfm . : 0 RELOC/REPAIR : 0 ,AT/DT . :? URINALS . . . . . . . . . . . 0 a 10000 cfm . : 0 OTHER UNITS . : 0 M I `iC PL M F I XTORES : 0 GAS OUTLETS . ! 0 �^•«� '- �. .:�:amrsazraa.>scca�.ys. -^..-•sx�a.sra•,rsmx�r_�;.•�mrin::rr.�a.-m�;a ^+�zws.�zc__�.-ru.....wr._..:-....-..rcrr:crrs_.a:aWszs�....:x:x-�sxx:,._�rssr_�•�+a.�esscsa.n-�s-��a;s:_:.-:.«s::s•r»=.s�:ne.^a�:�_.-z_—n:a-�.�c:.- <�^•--- PROJf `T DESCRIPTION:110811E HOME r PIRIJECT LOCA1101108O1 RfIfAIR STATE PARK. NEST 114 MILE TO STORAGE PARK RIGHT UP HILL APPRCX 4.6 MILES TURN LEFT COLLINS LAKE TO FIRE STATION TURN RIGHT 1ST SHEET ON LEFT ICGRNER LOT) i. 11-IS kAMiT RFCONES NULI AND VOID IF NOH OR CONSTRUCTION AUTHORIZED-IS NOT COMME_NiED 111010 IS# DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDfD FOR A PERIOD OF ISeDAYS AT ANY TIME AFTER 1099 IS COMMENCED, EVIDENCE OF .CONTINDA!1A1 OF WORK IS A PROORFSS INSPECTION WITHIN THE Is# DAY PERIOD, F!NAI INSPECTION MUST 8F APYROYEI7 BEFORE P911DING CAN 8E OCCUPIED. J OWNER OR AGENT: ( DATE: Fie PROT 'rev, #1/31/91 r C0MP,L. 1 ARrF TO ATTACHED CONDITIONS IS PF01.I /RED CONCRETE MECHANICAL MOBILE HOME C p/xv, Footings-Setback date by Ribbons date by Gas Piping date by 7- Foundation Walls date by Set Up date by INSULATION date b BG/SLAB Insulation Floors Final date by date by date — /G- ?--'by FRAMING Walls FIRE DEPT. date by date by date by PLUMBING Attic OTHER Groundwork date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by Building Permit # ���` �� MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE ' Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance fie y You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection OK to ❑ This is not a complete inspection Department Date �!�x-S Inspector _ -r v ���►- ■ vU NUT Fk MUV T L-M-0 TAU 1 MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 Case No . : BLD98 -0649 For : ABRAHAM RUTLEDGE Pane : 1 1 ) Approved per dimensions and setbacks on submitted site plan . X ___.__�______._..___.___ __...... Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands . Silt fencing must be incJalled and mainta ned until upland vegetation has become established . X. 33 Proposed structure or portions thereof with an projection over 30" in height from carade line, must maintain a 5 ' se ration distance between adjacent structures and that furthest projection . X 4 ) Proposed structure or any portion thereof greater than 30" in height from grade line , must maintain a minimum of 5 ' setback from all property lines , easements and 10 ' from all County and State Road right of ways . 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 stormwate,r ordinance or prior approval will be granted to use an existing :it i l i ty avid dra i nacre easement dedicated for that spec i f i n 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 Countyy Road, Contact the Mason County Public Yorks Department prior to construction at Ext 450 . For any construction which Is proposed to be Ioc•ated 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 iecf. . x 6 1 The "se, hand 1 I ng and storage of hazardous irate:r l a i is or f I ammab fi e and combust i b 1 e liquids in excess of 10 gallons is not aliowed 'without ,the approval of the MRson County X e j�la r s h a_' MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 7 Th i s app I I oat. I on I s sub jest to Butter and Landscap I nito requirements as established under- MaS ' n County Orr,dinance 1 .03 .036 . X 8 ) PURSUANT TO 1994 UNIFORM BOII...DING CODE , ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PI_AINt_Y VISIBLF AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETE[) PRIOR TO CALLING FOR ANY SITE INSPECTIONS , A REINSPEC-( ION Fur , BASED ON RATES IN TABLE 3A OF THE 1994 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS . X 9 ) THE FOONDATION SYSTFM SHAL,L BE PLACED ON UNDISTURBED, NATIVE soil. . X 10) They approved plot plan is required to be on -site for, Inspection p11r-po5;esv If inspection is called for and plot plan Is not on site , Approval WILL NOT bi�� granted . In addition , a Re- Inspeotion tee In he amount of $42 .00 per hour (mirlimum 1 hour ) will be charged and must be culleoted by this department prior to any further inspections being performed or- approval oranted . X 11 ) REGUiPED INSPFCTIONS ( rooting Ins ec 't tion-prior o pour , Set-tip I'n,,,;pe(,, o --tlnprJor to skirtin? Final Inspection-prior to occupancy) . I have received a co y of the General a Io n and Guidelines-Mobile a/Manufc a tured Housing Installtions 2ndout for detailed descriptions of all required inspections on my mobile/manufactured home installation , I hereby assume all responsibility for, the scheduling of these required inspections , ' It those required Inspections are not requested, Inspected and signed off (approved ) by the Inspector in 'the- prescribed order , I understand that teinspeotion fees and anhourly investAyation fee pursuant to the 1994 UBC , 'Table 3A will be assessed o in add itin to my origina permit fe.s to resolve any questionable practices or probleivis that have been discovered . I further understand that this investigation will ne sohedul6d time allows , Until resolution of any/a.11 proble s n 0 o 0 c upAnOY FinalI Inspection ) will be granted for the residence . OWNERICONTRACTOR ( Indicate wh ((,h ) .Sjqnature X MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 12 ) Al I mobi I e/manufact tired home landings or decks must Lie, I I t.1 i fl,.r e If :-upport i tig The largest landing or deck Qer-mitted without drawings or a building permit is- 120 s�q ft or less AND MUST be under 30 in height from surrounding rade . NO second story decks , or decks above 30" can be built without a permit . Any landing or dook that is 30 or more in height from walking surface to finish grade requires a Permit . Any landing or deck that has 4 or more rlsiirs, requires a handrail . 13 ) CONSTRUCTION PROCESS TO BE FIEL-I) CORRECTED AS RFOUIRED PER MASON COUNTY BUIL.DING DEPARTMENT AND UNIFORM Bk)lt..DING CODE ALVIN � ■■■YI®■YI■■n■■■mH�■■■■■■■■■■■■■■■■■■■■■n®nYl■q■■■■uN■m■■■YI■�■■■'!�7■A��s� ■u®■:�!N�■■� 'l�'■■n■■�111�■■■■■■■■■■■■■■■■■■■■miim■■■■n■■nNYt■■■■■■■■mB�N���■■■■■■■■■ ■■u■■'�'o ;�:7_9:Ti1[-����.is i■■lim��u�l�'L-LEI■■■■■■■■■nn■®NYI■■n■■■■■u■■■■■■■■■■®u■N■■■■■■■■■■ ■■■®■!<IPA■■Pi■■«■■■■IA■ilr■■■ ■rw■■■■■■■■u■■■u®u■■■■■n■■■■nm■■■■■Yt®Yi■■■■■■■■■■■■ uu■�•�■o�i!■�-u�u:�Yu•_r�■�-°��.��■■■uu■■■Yt®Y®■■■■■■um■iu■■■n®iva■■m■■■u ■■ia�■■■rltl■Y®■■wun■�•v�■■■■i■■■■■■■■o■■m®un■u■nu■iY®■■uu■wm■■■■■■■■■■u ■■m���l�;i1►_L`G'*Y�������n.��t:�■■■■■■m■■■YI■m■®■■■uu■n■■u■muu■■■mum■■■■■■■■■m ■■mio■�■■n�■m■�luw■■o■■■■■■■■■■■mn■■mom■■■■■■■n■u■au■■■u■em■■■■■■■■■■YI ■■mYva�-.�■���;��■■■■■■■■■■■■■■■mn■ua®nu■m■■uma■■■■®®®■■■u■■■■u■ ■■®c�mu n■■■A■■■■m■ROVER uu■ ®�®i®■■u■■■■■■ ■nN'�RIO■■i•■■m■mYl■n■■■■■■■■■■■■■■■■■■YI®i�nm■Nn■■■u■i>�mnn[.:i•m■■■■■■■■■■■■ ■uBFi•■■i�nmu■■■qn■m■■■■■n■■■■■■■®�■■■■n■■■� ��■���C�■��■=JC= SENSE!■�1mYi■Y�■■■m■■■■■mn■■■■■■■■■■■Y��Yi■■■n■■■■®■i>■�W�IY■f1�1■■■■■■n■■s ■l•a.; ■■■■■■■■■NYIm■■m�■Ylu■■m■■■oYBI��44�[�n`l'..�.lu■NYI■■ v rnaalr®/■■����■...--•o■■■Yln■u■a■Yo�iw■■m■■umYi■■m■s��®un■■■m ■N iin!nl m am O� ■■■I■n■■ni■�'r■■■■u■■■■■■n■■�/i>I•■■■■■■u®■■i>AYn■i>Y�i•il■■■■■■■nm n!iln�ll�i■®■■■■I■Bmn■■■ASV■■■m■■® ■YI■■■nm ■■iYlv■■■■N■■■■n ■■!i!Y■t'■®i■mn■v■GYM■■■■n■■r!� �� �i�■C��■ YI!■!!!!i ■■L'■i■!�Y■■■■Ylmu■■■n■n■■ ■��_i0■�■■nn ■ii•Y[EY®Ylm■ ii■■■f,a i!J i Ill ■■YI 10111111111111111 ■� ®mNmY ■t■■■i•_1®i ■Yimnu■n■■■nNm iia n �■Y!•��mn■■YI■ Y!■I��ilBil■_■■■■■®m■■n■n■unn■■■■Yi•� n■■RL",Te■ 'Jmn i�■■m ®■i ®®/Yli� ■■n■n■■Bmm■■■m■ u®■ I�mn N■ilulY■oi ■YI•■m•u■Yln■■■nm■i•�■E�n■ .� '�Yi■■® � u■i ®Y®i�YiA■■■Yiimu■i1■■n■■■m ���a '��■ Wiwi�"•�—�—�—�mnYl■nYln■ ■Y_I� ■n■■ ® i®i>u■ muu■umon ■i_r ■■■i ® gym■■ um■■■numm■■���nu■■■■m■ • a - su i®■m■ ■W■mu�■I�iY■®■Ylu■ ®i®■m■■ waw ■■m■■mmnnml� !a®■■�i®®■■ . NsllIllllllsE � -- �� mum �Y . ,•Z+�WiI• i�T�_.�!!.r a.. ■ lum r.�:iu ■■m --� �= �..m�■►:sr ■i>i+�.t i•�n® s mum MIlni• i i�■nm�ie� ■■�iu ® � � nu■sy►�'i11Oen■ fY■■■■YI■!�/ • m,^Is 10■■■■ � ■■ ■Y®i<`�r ■vim"zallbi ■■®■r�a■[L/m.®■mmlr_a —� ��i��°�®�.�'�■■■■■n■■NI■Ium■■�1 r�n■uni>�■N�7���Y■■m 1111111111101111■'l.■�7. �iiti■B■OmYI■■m I��N■u mR/!�i•■■ ■m■■nYl I .:■i■1•n■�■■//■vum�l ■■n■�YiG1G1 ■m■■■Yi ■■m�+r-®®r_�■i��l■n■in'�■■am■m■1 ■■ian■■■asmlan�ai• nmum �,t/„� ®!�.''���i■�j7�■■N���ii■■HaYI■■m( mn�■■�mu� �mWi1p !lfifL�Ga■ ■■ii�Yi>E!i:ii� �Si �mv ■■�� - ®war..ii■nurianmm�■Y� ®■ .. - c� ■m■nv�m■�i■ua®1 ®■� ■■s �. ' m■■n.ri■m■ir■unnmlNINE =mmmmmmin�■C ■� mpep■ ■�n■n�■® 'i•un■�■■■io® ■�IU■m iY®® ®m®■ .�u■un■■m®rli.�iso® ■®■ ■�ii Al ■® ®mna®um■an® n■oin■r�■■is■■■Yi.■� ■uuum ■i>o mr� 11011111111110111� ink -'�' ems• 00, Permit No. k6o 4 2 M I ASON 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 ner fl6RA V4 .`j T4?LE 2. P7ne# �© ite Address N 1-T OL I-11 Ns L A KF Fire District# City 7A N u Vf9 St W3.. zip R8 STS, Directio to Job Site F-L«M •$QL.Fk't- S a-c1- to f ►�� M'� 4 5-70 P-bg Q- 'P41c-K U Lt--- A . to MO-PS 4%A K, L-Q t=T- Cn L-L- 1�i s L.A le-•e.. "s T' s e o►.� _ L Q�-t- Cm�e wort Y Owner Mailing Address SA rn4e- City St Zip Lien/Title Holder Address City St Zip '' cL.Assv4S 023K-�- #2 Contractor Name C LAS6e �AtoMe5 -IKc- Contractor Reg # Address 1�)c>>C 878 Expiration Date City 5 t.7-60 St W P . Zip 9H Sa Phone# 314o0- 432+b32� #3 If septic is located on project site, include records. Connect to Septic? X _ Public Water Supply Well Connect to Sewer System? Name of System Aft, C.O LL-t tA 5 A�- (If residential, proof of potable water is required)) #4 Parcel No. 22 331-7L - OQQ 58 Legal Description LAKE 3 ( p S6 #5 Building Square Foota e_ 1 7s� 1 st FI nd FI 3rd FI Loft Basement # Bedrooms # bathrooms;, Deck Other Garage Carport (Circle: Attached or Detached?) #6 Use of building Describe work #7 Type of Job: New Add Alt Repair Other #8 MOBILE/MANUFACTURED HOME INFORMATION n h { Model Year I'M Make L13F-e Model KLZ8 56 -1 KJ" Lengthy Width Z8 Serial No. FWC•TTO" gogAo� /n # Bedrooms 2-- # Bathrooms Z Type of Heat ELec-T— Purchase Price $ S�r PDO , 1 #9 Indicate by circling the applicable source if any water is on or adjacent to subject property: River Pond Creek Stream 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 Indicate Directional by (N, S, E, W) Name of Side Street Name of Fronting Street in relation to plot plan APPLICANT TO DRAW SITE PLAN BELOW APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW 4 MASON QUILDING IPdSnMR CHANGES SUB"' _DACE Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 each) No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Units Fees Showers Furn BTU Hot Water Htr Heatpumps Laundry Washer Vent Systems Sinks _ Spot Vent Fans Floor Drains No. Boilers/Compressors Laundry Basins _ HP 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 Stove 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 16.75 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM- 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 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 BUILDING. THE BUILDING DEPARTMENT. DEPARTMENT.. C�-AX11 1 ry`ps X OWNER X BY �% DATE DATE Ip- Zq " FOR OFFICIAL USE ONLY: Accepted by: Date: DEPARTMENTAL REVIEW G�7S2GT FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: oCr. Environmental Health: Building Plan Review a C �1f1 ur7 �ti� L�� (� Aj-r VqeD moo -7 sa i 3T f Occupancy Group: -3 Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit e� Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee SO Other Other Other Building Valuation: TOTAL FEE Plumbing Fixtures ($3.35 eachl Fee Mechanical Fixtures ($6.75 each No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Units Fees Showers Furn BTU Hot Water Htr Heatpumps _Laundry Washer _ Vent Systems Sinks _ Spot Vent Fans Floor Drains No. Boilers/Compressors Laundry Basins _ HP 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 Stove 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 16.75_ WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM- 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 OFTHEORDINANCE 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 TH BUILDIN THE BUILDING DEPARTMENT. DEPARTMENT. 0 -- 1 mps X OWNER X BY • DATE DATE IQ'" Zq FOR OFFICIAL USE ONLY: Accepted by: r Date: p� 1-75-,OD DEPARTMENTAL REVIEW �7 FOR OFFICE USE ONLY Approved Cond. Hold Approval Planning: Environmental Health: Building Plan Review VA Occupancy Group: P) =� Type of Const: Fire Marshal: Other: I Special Conditions: FEES 6 Building Permit L� Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee 5z Other Other Other Building Valuation: TOTAL FEE , Plumbing Fixtures ($3.35 each) Fee Mechanical Fixtures ($6.75 each No. Toilets CIRCLE FUEL TYPE: Gas, Electric, Bath Basins Heatpump, Other Bath Tubs No. Units Fees _Showers Furn BTU _Hot Water Htr _ Heatpumps —Laundry Washer Vent Systems _Sinks _ Spot Vent Fans Floor Drains No. Boilers/Compressors _Laundry Basins _ HP 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 Stove 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 16.75 WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $ OF 180 DAYS AT ANY TIME AFTER WORK IS COM- 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 TH BUILDIN THE BUILDING DEPARTMENT. DEPARTMENT. Cc-►�xK � n'Ips X OWNER X BY DATE DATE FOR OFFICIAL USE ONLY: Accepted by: Dater DEPARTMENTAL REVIEW �7 S2cJ FOR OFFICE USE ONLY �Prov ed Cond. Hold Approval Planning: Environmental Health: Building Plan Review i&o : /oo oia 5 00 a A3 4720 Occupancy Group: R`3 Type of Const: Fire Marshal: Other: Special Conditions: FEES Building Permit �D Plan Check Plumbing Fee Mechanical Fee Wood/Gas/Pellet Stove Violation Fee Site Inspection Building State Fee SD Other L7KU• /,FLTIf Other Other Building Valuation: TOTAL FEE