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HomeMy WebLinkAboutCOM2002-00086 TENANT IMPROVEMENTS Restaurant - COM Permit / Conditions - 8/20/2002 CONCRETE MECHANICAL MANUFACTURED HOME N o Footings I Setbacks Date By Ribbons No Date By Gas Piping Date By C) Foundation Walls Date B y j,/Z Set-up co Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DEPT Date - -e.,2 By 712 .. Date /U-)150 _,-9'L. By 7'/I Date 1 /4 -t23 By S PLUMBING Attic OTH R Groundwork Date By Date By WALLBOARD NAILING D.W.V. Date /cam. 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L L Contractor Name ti L)bLAt4& Oct 1:r X - Maili.4 Address .d 07c Mail* Add ss City State Zip Code City 4 1,0 State Zip Code Phoned er Ph.(_ Ph. Z Lien/Title Holder Contractor Reg. # Other Ph.0 Address Expiration SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Na e of S er System Well Water System Name of Water System Ih 1 n� PARCEL INFORMA ON-12 di it Tax Parcel No. 12-3 5 / Z / D D 2. ;Fire DistrictLegal Description Site Address(Please include street name street num er and city) v DirectiQr�s to site Ll G ��-03 Willti..55mber be cut and sold in parcel preparation? (Yes/No) A Is your property within 200' of the following: Body of Water (Name)_A­01 a Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE❑ TYPE OF JOB New Add Alt Repair Other Use of Building. Mar,%A Describe Work �=� a, 'r 2-M P.-0 U C L."e.&1TS No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conform ce therewith. No changes shall be made without approval. first obtaining approva X Date X Date V FOR OFFICIAL USE BEYOND THIS OINT Accepted by Date Submittal Amount Due Receipt No. pEPAR?MN ' RE11+' - APPROVE© DEIVtIwD <;: Ci3AlT?:Il'Ia31�i Cfi?:pE >:>:::>:<:::>::>: Building Department Occ Group--,- Type Constr. Planning Department Environmental Health Department o Public Works Department l Fire Marshal i Valuation $ ES k�E Building Permit Fee Site Inspection. Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical& Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES tom 7,w avb & PERMIT NO.: BLD MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA-98584 Shelton 360 427-9670 'Belfair 360 275-4467 Elma 360 82-5269 Seattle 2Q6 64-6968 APPILIC114tiT INFORM(! TION} CONTRACTOR INFORMATION Owner r+tA/"1 r"r'o L+ L - Contractor Name a 7 t%� Oar Maili Ad ss OX Maili Acid r ss )c City jrA 1 State , Zip Code 110 City Rve 10 State Zip.Code Ph. �7 Other Ph. Phone(` Q) �.� er Ph.( 1 ( ) 'Lien/Title Holder Contractor Reg. # ' Address Expiration__/ / SEPTIC/WATER SYSTEM.INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Nan3.e of er System Well - Water System Name of Water System AC �'✓" of 3 --=-�` PARCEL INFORM ON-12 di i Tax Parcel No. / I top fire.District Legal Description /' '�' + r't '� Site Address(Please include stree name street numb rand city) ` Direct!05 sit ek C cF.pS Wilt timber be cut and sold in parcel preparation? (Yes/No)� /Q Is your property within 200'of the following: Body of Water(Name) � ,� Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE I] TYPE OF ,SOB New Add Alt Repair Other Use of Building �,,� aL� Describe Work l�j c+�*� "1" i�+-o U c v"e ►I y J No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attac d . Deta,cfhed ,Carport Attached Detached MOBILE HOME INFORMATI -Ma Model ` .� •+• Model Year Length Width Se 6a o. - No. of Brooms No. of Bathrooms at Purchase Price $ Replacement Unit?(Yes/No) Installer Na Certification No. NOTICE: THIS PERMIT BECQM LtIULL 8.VOID IF 1NORK OR CONSTRUCTION'AUTNORIZED I NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRfJCTION WORK I$SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF Of CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owneror agent on owner's behalf,represents that the informz4ion provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspec(ion of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-1 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 1 i3.27 and anti aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be.done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changesshall be made without first obtaining shall be done in conform a therewith. No changes shall be made without approval. first obtainin approval X Date. X Date .,. FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. 3 .............. Buildlrlg Dip ent "OCC Grou Type Constr. Planning Department Environmental Health Department Public Works Department i Fire Marshal Valuation$_ f r Building 11,1111, RMW Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee - Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid'at Submittal ( ) x � � ys'� �� � '��• � � x� ' � ��� .TOTAL FEES f - Zcoa- PERMIT NO.: BLD Amp .. MASON.COUNTY BUILDING PERMIT APPLICATION 426 W.CedadP.O.Box 186,Shalt60,WA 88584 Shelton. 360 427-9670 Belfair 360 275-446T Elma 340 82-5269 Seattle 206 64-68M8 APPLICA T INFOR TION-� L CONTRACTOR INFORMATION tt Owner .*'# +'"`' �'� - Contractor Name " �t w J L, ID*r Maili A Maili s A d s City, @ A Al 12 State Zip Code City ► l State Zip Code. Phone .V er Ph.( ) Ph. F: (a"F: Other Ph.( Lien/Title Holder Contractor Reg.# ` Add resisExpiration SEPTICMATER 5YSTEM INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Na of�S ` er System Well Water System Name of Water System' / + +" ' 't`✓" PARCEL INFORM" ON,t2 di 't Tax;Parcel No. / / 0 Fire Di rict Legal Descriptiotl 10, -5,14 4r•t ` Site Address(Pt6ase include stre nam,epstreet numb r and city) ANNEW Directi�ar�s it �'i'fr 7 Will timber be cot and sold in parcel preparation? (Yes/No)� Q Is your property within 200' of the following: Body of Water(Name Saltwater Lake River/Creek Pond Wetland Seasonal Runoft Stream Slopes or Bluffs PERMANENTFO ENCE O` SEASONAL RESIDENCE❑ - TYPE OF JOB, 'New Add Alt Repair Other Use of Building � Describe Work p►. �t' ..L ir*"I /�r'C tJ! IFS t +t"►S No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE-1st Floor 2nd Floor 3rd Floor Loft Basement Deck_ Other sq. ft. T Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATIJ -Mako Model Model Year „�.,.yW Length Width Se6al�,No. No. of Bedrooms: No. of Bathrooms Type of Heat Purchase Price $ Replacement Unit ?(Yes/No) Installer Na' Certification No.. NOTICE: THIS � RMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT`,COMMENCED WITHIN 180 DAYSOR IF CONSTRUCTIO .wORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180"DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above'described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I'certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify,that I am currently registered as a Contractor Registration.Law.RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work, conformance therewith. No changes shall be made without first obtaining shall be done in conform a therewith. No changes shall be made without approval. first obtainin approve Date X Date FOR OFFICIAL USE BEYOND THIS POINT . Accepted by Date Submittal Amount Due Receipt No. MO .. .. :R...1:VI t t .tiff .� ..isRr,F.T.111,�:!l1: :(_::iiii. ...... ... .I .NIEI .. Building Department Occ Group . Type Constr. Planning Department qr P OO Environmental Health Department Public Works Department Fire Marshal Valuation $ RJ R x s:.. MIES 6,., . ... Building Permit Fee Site Inspection Plan Review Fee EH Review Fee' Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid;at Submittal ( ) TOTALFEES 'M 1 PERMIT NO.: MASON COUNTY PLUMIBING/MECHANICAL PERMIT APPLICATION 420 W:.0 r .O.Box 186,Sheltcfn,WA 98584 Shelton 60 427.867p f3elfair 75�14ti7 C-ima' -5269 Seattle 06 64-6968 PPL NT INFORMATION CONTRACTOR INFORMATION 1;1Owner a -�e r-*i:.f Contractor Name �" p�tr+ +✓01f+,S a ...LrtJl Mailing A 'less ; Mailing Address - - F City' State_,_ Zip Code, City State Zip Code Phone( ) Other Ph.( J Other Ph.( UienlTitle.Holder Contractor Reg.# f ` Address `.. Ex iration / J F ' SEPTIC INi=ORMATION-Connect to New Septic Existitlg Septic-X—Connect to Sewer System Name of Sewer.Systerr► r � PARCEL INFORMATION-12 digit Tax Parcel;No. O L L Fire,District Z. j Legal,Description; y - Site Address(Please_include street name,street number and city) , Directions to site i j Is your propertywithin 200'of the following: Body of Water(Name) Saltwater Lake River/Creekr;�__,_ Pond Wetland Seasonal Runoff f Stream Slopes or sluff S ` TYPE OF JO8 New. Atld Alt Repairs ' Other . Use of But JC'�s-16L%A -O"t { Location Of Fixtu ces/UlxIts 1st Floor 2nd FtooL Basements Garage Closet PLUMING FIXTURES($how Number of each) MECHANICAL UNITS Fuel Type: Electric j� of Fixture No. o Fixtures ees LPG Natural Gas Heatpump 1 Toilets TV of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Z Tom- Showers - Vent Fans Water Heater _ Propane Tank Laundry Wsher das Outlets . {� Sinks Wood/Gas/Pellet Stpue Dishwasher ,`L _ Direct Vent?_ Other _ Other Other' _ Other. ' Base Fee BaFee'' TOTA(KUM8WG _ TOTAL MECHANICAL A FLOgR,PLAN ANL1 PLOT PLAN MAY BE REQUIRE ID DEPENDING ON THE TYPE OF FIXTURE/UNIT. r, o"ndt; T.HjS.PKRWT Bd�f)1G%lan 'VC0 0 ORK OR CON$TttUCTIO AUr'HWtlZED;16 NOT ftl W[r M I DAY$OR IF C TRU&"Wol fS Sfi$PEtMt1!~D OR Al N1[fdITNED FOFt A PERIOD OF 180 DAY$AT'ANIf TIIVt$ THE Wt'>fDC 1S t;OMMENC D: faR OF CONTf�Itfp►T10N OF W1►QRIC iS BY MIAN Dt=Ai>RffIFsRES$INSPEl TION. ' ' A met or agent on©weer' behaH,re reselits'that the in'lor latr provided is accurate Ivai ts• i .yeas of Mason County access to t� bove described propFerty and structures for review and inspection of this.pi4ect. Acknowkdgment•of it"is by signature below: OWNtiR AFFID viT-ieefilN that I aryl exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am cunwitly registered as a Gon3ractor Reg n laaw'RCW,i 8,27 and am ewate of the ordinance contractor in the State of Washington and that I atn aware of the ordinance. requireitrents for Whfch this perrr►R is iSSUed that an wo done in. requirements regulating the work for which this permit is Issued and all work confortnanc:e therev . No chartges s mae�kning shall lac done in conformance therewith. No changes shall be made without approval. - first ob approval. `. bate ZO r FOR OFFICIAL USE BEYOND THIS POINT Accepted by DateSubmittal Ameuxt"taus Receipt No ...{.}, .4,.v i{{{,•r.;:+•Sn+t,;;;;ny; -0} 1j�ri:{:•. 1 ::lnCf•.}�:{:y'.?:•::r{{i:}:::'{:�,;::is}iT;.`.;i {d ? \. {{S•}:}! Building 0vr•` Occ' T Constr. pianh�Department •;a . Omer ...r.-:.. ..: :• }. .:3 .'. .. '.:.::} :>.:.... .. {..::},fi :(f rr.:•?'.2:}{. :;:vrr�t?u•.{w .'• .r`.. .4:{O:{:•{:•:•.'••'>:4Y.2�•}i'::�22.'•:{;>'{,: t...rr •✓ nr:• ..'•fY•:+.: ,x..:X:../.,,. •:R,3•.+9•::: r ::;.+.,.{} .;;:.,,,..;...,. ..,t....{r}::•}:i??•:E,::}.. }iR2Y.,{.i.¢.; :.2{;.., ,r:{c• : .#r::r •a. x8 ;4{,•.,.:.:`.;• >••Yr" r:.+ ...a.{...?';r •Gr} :.�'..S •:•Y.,•., .2. ::t•:`.'•. ,:.r;.: .:u,:• .:.2.. { 4%is•i#:+N•a::�r.:{•:.,�:}.vf.�:�`>rifiy,..::,<•:?cv('• .:{i. k....:.}...5•.::;:'•} .•}�•„ .:}.. . ..�:. .. •.;;. .:v, •?{,:.: .. 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BOX SEATTLE (206)464-6968 BELFAIR WA 98528 Case No.:COM2002-00086 Parcel No.:123282390022 Dear Applicant: Your building permit cannot be approved by Mason County Environmental Health until the following are completed and turned in: Please see comments at the end of this letter. Please call me at (360)427-9670, ext. 353 if you have any questions. Sincerely, Cindy Waite Environmental Health Mason County Health Services Comments: Need letter from Richard Benson, DOH, to approve addition of restaurant. 7/1/2002 1 of 1 COM2002-00086