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HomeMy WebLinkAboutCOM2017-00098 Cancelled Dock, Ramp - COM Permit / Conditions - 3/3/2021 lroii QOU MASON COUN rY COMMUNITY SERVICES -ASSISTANCE CENTER: ' 'PERMIl � - Q00I b .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED 615 W.Alder Street,Shelton,WA 08584 — - Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7796 Phone Belfair.(360)275-4467•Phone Elma:(360)482-5269 JUN 2 9 2017 85 BUILDING PERMIT APPLICATION 615 W.Akkw SkoMi PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: ?0Q4- o("" `^��°K"1 �` �I ^�� NAME: MAILING ADDRESS: P o G O _ MAILING ADDRESS: CITY: STATE: tr✓k ZIP: 5-' CITY: STATE: ZIP: PHONE#1: 4-7,�j'"' ,"t D- 6 S- Z PHONE: CELL: PHONE#2: EMAIL : _ EMAIL: Pd t.l"6)E 6 AA l?W I sn"A-I�, L&I REG# EXP. PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER(d NAME 6 f-1`L" Ir-'I At-)V#rt-`7 EMAIL C)t' F tit E. i �`-�� �Y✓► MAILING ADDRESS 0 ST- 644,AAA2 S CITY -r C wt STATE WA-- ZIP 9 Pi 4 PHONE CELL 7_5r PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number). 100 a, 1 - l0960D ZONING LEGAL DESCRIPTION(Abbreviated) &OA S WtX-0 A 4 t_\�I P!b C t 4'y. FIRE DISTRICT SITE ADDRESS t) AIL ��11�(� (C%�-I` (,00( I-A{�0 CITY DIRECTIONS TO SITE ADDRESS L0t RPrAXII) "f 0 FA Its. H&6?10W d IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESM NO ❑ IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER[g LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW'[ ADDITION❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc. Ir L/O NT4 06 I'0(41 65,6-'" '"; IS USE: PRIMARY M SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Part[,]of Bldg) ❑ NO 9 DESCRIBE WORK F'LOA11t,JIS XV�, A Lauo'1 r; SOUARE FOOTAGE: (propose+existing) 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.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH _ WIDTH BEDROOMS BATHS , SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES ❑ NO'g Ifyes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NOW EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS 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 and 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 constru tion work is suspended for a period of 180 days. P NTINUATION OF WORK ON THIS PERM Y MEANS OF INSPECTION. INACTIVITY OF THIS P MIT APPLICATION OF 180 DAYS OF MORE WILL CADS E APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42 corn OWNER Must be i ned b the OWNE Date DEPARTMENTAL REVIEW . PROVED DATE ATE DENIED D TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH ooUr'• MASON COUNTY COMMUNITY SERVICES F, PERMI7 ASSISTANCE CENTER: Pcrttxit No: orn O •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL Q EC l 615 W.Alder Street,Shelton,WA 98584 1 Phone Shelton:(36U)427-9670 ext.352•Fax:(360)427-7798 Phone JUN 2 9 20V Belfair.(360)275-4467•Phone Elma:(360)482-5269 854 615 W. Alder Street BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: ?00,,T- O(- r<aV -► VVI CX--) NAME: MAILING ADDRESS: P o e MAILING ADDRESS: CITY: (.P V "V t tMV,) STATE: vAR ZIP: C1 CITY: STATE: ZIP: —- PHONE#1: Z.S'-' t'e,I C9- 6 5`57 PHONE: CELL: PHONE#2: EMAIL : EMAIL: Qd tt,1 0(- 6 VA N)I LW e, 9 Wt A-@L< f e-U-ti L&I REG# EXP. PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER(d NAME EMAIL i CyE' r -t?, f.. `f�� • MAILING ADDRESS (c?01 T" CITY t�1 C m STATE WA-- 4:t_ ZIP � 2- PHONE 25-3-i) PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number). 1 c7L (O"j y 1 - 009C0 ZONING LEGAL DESCRIPTION(Abbreviated) A\U4 y- lob 1 FIRE DISTRICT SITE ADDRESS 2)5- „ 6 MMEP 4,oCe P-O W CITY l& 5V(Qy DIRECTIO�NSS*TOSIT,E•ADDR/E�SS JJJ©nl' i;1p.� �s(���`Ci`�1 iCA� �t'�t"Y' Y�t�F�t') � `f"t3 r-A-let. � Ai6i.rS'!.Y`Yt IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESM NO ❑ IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER[K LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW*g ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc. �" AC`T-!Pa 'C G1 r° f ►i�t IS USE: PRIMARY V SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Part(s/of Bldg) ❑ NO DESCRIBE WORK PtOA"''106 I>, Vf4 P�IsUM - SOUARE FOOTAGE: (propose+existing) 1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq. ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRE,ll* MAKE MODEL YEAR LENGTH_ WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW ❑ EXISTING❑ PLUMBING IN STRUCTURE? YES ❑ NO'M Ifyes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NOV EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS 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 and 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 permillapplication 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 CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) X ` 6) 1-7- Signature of OWNER(Must be sinned by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT ,j3 f& FIRE MARSHAL PUBLIC HEALTH Jam" Attachment D Schedule of Value 10/15/2017 r SCHEDULE OF VALUES LISTING FOR GRAPEVIEW FLOATING DOCK @ Port of Grapeview Grapeview, WA CONTRACTOR, Marine Floats Corporations The following listing shall be used by the Contractor for a Schedule of Values required to be attached to the Proposal. 1- Design $ 3,400.00 1.1 Contractor's Engineered Design Drawings 1.2 Contractor's Shop Drawings 1.3 Contractor's Calculations 2-On Site Work 2.1 Cast-in-Place Concrete Sidewalk $ 6.565.00 2.2 Concrete Reinforcement $ 3,375.00 2.3 Cast-in-Place Concrete Platform/ Bulkhead $2a 0s4.00 2.4 Platform Guardrails $ 2,700.00 On-Site Work Total $ 40,724.00 3-Gangway $ 23,327.00 4-Floating Dock & Accessories $ 65,440.00 5 —Steel Pilings with Caps. $ 39,792.00 Floating Dock Total $ 172,683.00 End 5/30/2017