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HomeMy WebLinkAboutCOM2003-00162 Final Steel Fire Station - BLD Permit / Conditions - 4/13/2004 FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. PLEASE PRESS HARD BUILDING PERMIT APPLICATION tA M Z©o 31 DU 1 (02 426 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 INFORM ON CONTRACTOR INF RMATION Owner A4nS eH � _ �j e L�j Sr -�Z Contractor Name Maili Ad ess • O Mailing Addre s City Stat Zip Code City State[1,�,Zip Code Phone L� Other Ph. (_) Phone���?S ter Ph. Lien/Title Holder 4 Contractor Reg. Ph,l xp._6 l 1 -3- Email Address P t Email Address ' SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic V Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System PARCEL INF IO -12 'git T x Parcel VIA. / 2- / O Rre Distri Legal Description �--• ; Site Address(Please include stree name, street number and city) Di ctions to site k Will timber be cut and sold in parcel preparation. (Yes/No) AJQ Is property loc ted within 200'of 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 " Is this permit submittal the re ult of a Stop Work Notice,Correction Notice or other enforcement action? Describe Work C_o.� �. 1 o �' No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE- 1st Floor 2nrVFI_ "an 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION -Make Model Model Year Length Width Serial No. A I A No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ Replacement Unit? (Yes/No) Installer Name U 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. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT-I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT- I certify that I am currently regis- ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and of the ordinance requirements regulating the work for which this that all work will be done in conformance therewith. No changes permit is issued and all work shall be done in conformance there- shall be made without first obtaining approval. with. anges sh#ffVbqmaqe without first obtaining approval. X Date X Date FOR OFFICIAL USE BEYOND THIS POINT Accepted by Planning Pd Ck# Date Bid Pd. Reciept No. Sulkifng Department � /12 Ooc G Constr. Planning Department a► �� Environmental Health Department Public Works Department Fire Marshal VahnWn$ B LFAIR OFFICE Building Permit Fee Site inspection Pion Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical B Base Fee 06WAAdrift `Lr�•-�"' Wood/Gas/Pellet Stove Fee State Fee • Violation Fee Pre-Paid at Submittal TOTAL FEES MASON COUNTY PERMIT NO. BUILDING PERMIT'APPLICATION 426 W. Cedar- P.O. Box 1136 Shelton, WA 98584 Shelton (360)427-9670 • Belfair(360) 275-4467 • Elma(360)482-5269 On the Web www.co.mason.wa.us F ICANT INFORM ION '+ CONTRACTOR INFORMATION r Contractor Name `-t _ Nc Ad ess cs MailingAddre s,t- —St at dip Code City r Statet Zip Code Phone( ) Other Ph. ( ) Phone ) ther Ph.( ) Lien, Holder ' Contractor Reg.# Re 4 h iE ` .+++Exp. 6 1 ! /� Email Address Email Address SEIaTIC!'1ItlAELR SYSTEM INFORMATION-Connect to New Septic_e Existing Septic Connect to Sewer System = Name of Sewer System Well. 1"System ' Name of Water System PARCEL � iTION - 12 digit T x P cel'Up. / t / Q F're Distri -Z.. Legal[ we ription [ Site Ad' , (Please include stree narpe, street number and city) Di 'coons to slte a , Will timber,be cut and sold in parcel preparation. (Yes/No) WO Is property, Si;within 200' of saltwater Lake River/Creek Pond Wetland Seasonal Runoff St rea Slopes or Bluffs PERM "IDENCE El RESIDENCE TYPE& -New Add Alt Repair Other Use of Building i +� Is this pelubmitfal the result of a Stop Work Notice,Correction Notice or other enforcement actions( es/NoAlt Describle W6k et f C 4«. -t i s ! I r A No. of Sedioorns No. of Bathrooms SQUARE FOOTAGE- 1st Floor 2nd FI f1 f 3rd Floor Loft Basement Deck Other sq. ft. Garage,,, Attached Detached Carport Attached Detached MAhIUF 0,HOME INFORMATION Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat` Purchase Price$ t4 Replacement Unit?(Yes/No) Install el,Ne Certification No. NOTICE; IIfiY11T BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180,[lA1i $TRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER THE WItfCtiliI1MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. THE 01MNEIR: I ON OWNER'S BEHALF,REPRESENTS THAT THE INFORMATION PROVIDED IS ACCURATE AND GRANTS emPLO .Y ' 1 'Il sign COUNTY ACCESS TO THE ABOVE DESCRIBED PROPERTY AND STRUCTURES FOR REVIEW AND INSPII< "EMI$ PROJECT. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESUL' � 1#�I'WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: ti OWNER AFFII ri1T-I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT- I certify that I am currently regis- ment offfte i;tor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that)am aware of the on requirements for which this permit is issued and of the ordinance requirements regulating the work`for'which this that all viorlrvnil(b"one in conformance therewith. No changes permit is issued and all work shall be done in conformance there- shall be"made without first obtaining approval. with. hanges s ade without first obtaining opproval. X Date X Date D FOR OFFICIAL USE BEYOND THIS POINT , Accepted by Planning Pd Ck# Date Bid Pd. Reciept No. t g` Occ GroTynA Constr. Planningk artment77 ` • . ,7 Environmental Health Department Public Wbrka D;part►nent Er 201.13 Fire Marshal" . Val6atlorf$ ', IRELFAlf OFFICE Building " 'Fee Site Inspection -a 7 Plan Review Fee EH Review Fee Plumbing&Bso Fee Planning Review Fee Mechanical Bass Fee Other Wood/Gas%Pellet Stove Fee State fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES FORM MUST BE COMPLETED IN INK PERMIT NO.: PLEASE PRESS HARD MASON COUNTY PLUMBING/MECHANICAL gPERyyMITg gAPPLICATION Shelton(360µ2 C-96 0 BeifaP(360g�TMElma(360N82.5269 APPLICANT INFORMATION CONTRACTOR INF RMATION Owner i Contractor Name t M S/VCt Maiil AdqWss Mailin Add xv .2-1 City. State["..,Zip Code City State Zip Code Phone( ) Other Ph.( Ph.(2fih ) Other Ph. Lien/Title Holder Contractor Reg.# Address Expiration SEPTIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL'INFORMATION-12 digit Tax Parcel No. CFlire District Legal Site Addraw(Please include str, name eet number and c ) Dloons to site Is your property within 200'of the following:Body of Water(Name) Saltwater Lake River/Creek Pond Wetland YeS Seasonal Runoff Stream Slopes or Bluffs i i TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1 st Floor 2nd Floor Basement Garage Closet PWMWNG FDf,TURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric M=of EW ure No.of Fixtures Faes LPG Natural Gas Heatpump TOOM Type.of Unit No.of Units Fees Batlllroom Sink lFumace Bath Tubs Hempumps Showers Spot Vent Fan 1 Water Heater Propane Tank Clothes Washer Gas Outlets Kkchen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs 22 Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. 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-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 herewith. No changes shall be made without approval. first o proval. X Date X Date / FOR OFFICIAL USE BEYOND THIS POINT Accepted by Date Submittal Amount Due Receipt No. }•.Y y(�y��"(f�,��:}�::::?:3/.�i1��1►i:•ii:i::::i:;:i:::i::'.i::i}i�ii`:`::�::ti:i::i�::i::S::::i:ii:�.•.• Building Department Occ Group Type Constr. Planning Department 2003 Other BELFAIR OFFICE ht her : •::::::::::::::::::.:::. t...:...::::.::::::::::.::.::::::.:::. ::::.:::.;.:i•:•:.::•::::. ..:r.:::.:: ...•. •::;.:::i •::::::::::::.}}v::::::::,.:..::::rr::,.::::. ...... ;............ .......... ............ :...... t............. ...... r r............. t .....:......: .!/,..............n.....:..... .2...... . ........ ...w::.. . ................t.....f............... .. . . : r. t.r...:..............k}Y:•}:•}:•::wti•Y:4:.Yv::.v.v:::::...........t.... .... :r::...•:..f .t.t .,.r.:.N..::.r....:.:...... ...... ....f.Y......r..tr: +c .... v:.f.}};}.ft:.:•::;•;•;.........., ,r........ . .....n....t. n...r ..v............................Y.........4. ..:nv.:t .. r:.. :.v...:::::nv:::::.....,.,....}...n.xr.4. .....l........i..:C i,... .....................�................................... .v. .r.}w::::::4:::......;......... n•f rr.:i:}..n.:n:v::::w:.:............. ........... ............................. ........................t........ ... ...tt�•. .v::: n..t x+.w:{^:it•} Yii... .... :..........r...................:. .•.v}} tt v....t..............................v:.•....fx::::.v......:m:rw::..........................v::::•:::•::i'rr::',r`},..::::::::.4..:.•: r....... .r.vv::::::.v:::::.::::::::::::::::.. 4 : ..... :::::\t l....•Y............::::....hii4:4:4:•Y:w:::.v::::........::::::::::::..... v.S:n 4:'tx::t:::n:::•:•:w.v:::::::::::::vv:::.....rmit Fee SiteInspection lan Review Fee UFC Plan Review Fee lumbing&Base Fee Other echanical&Base Fee Other WoodlGas/Peilet Stove Fee Pre-Paid at Submittal ( ) violation Fee TOTAL FEES MASON ,,QOUNTY PERMIT NO. BUILDING PERMIT APPLICATION E }1 {; >�" r- i C y 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.eo.mason.wa.us APPLICANT INFORMATION .. CONTRACTOR INFORMATION Owner Mc LL S c c c �- r r e f S r R �., Contractor Name S-t fl h S t Mailing Address. � . �' :mac.S VV-Ji Mailing Addre s f-.C, 4k x 16/ City I Stat ' Zip Code 7 City t'e WA r,* StateLGIA Zip Code'" �. .Phone(_) Other Ph. ( ) Phone " 7 ther Ph. ( ) /Title Holder Contractor Reg. # "+-� a,� 1�khail Address Email Address -► r r t S9PTIC/WATER SYSTEM INFORMATION -Connect to New Septic_ Ir Existing Septic Connect to Sewer System Name of Sewer System Well Water System Name of Water System � 4 r + PARCEL INFORMATION - 12 igit T x Parcel No. / Z / C Q . Fire Distript Legal Description �`� Site Address(Please include stree name, street number and city) Dictions to site /. > -I s ,r ,f � a t-► Will timber be cut and sold in parcel preparation? (Yes/No) Is property loc ted within 200' of saltwater Lake River/Creek Pond Wetland Seasonal Runoff Strear>� `. Slopes or Bluffs PERMANENT RESIDENCE ❑ SEASONAL RESIDENCE TYPE OF JOB-New Add Alt Repair Other Use of Building F i rf r,A-". " Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? es/No),A&L Work �=$ I'i �,4+,,t ! C c�,_ S r�-.� c.-� t.�7 wS No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE- 1 st Floor 2nd FI 6f 1 j 1 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION-Make Model Model Year Length Width Serial No.' 17A 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. OWNERIBUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT-I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT- I certify that I am currently regis- ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and of the ordinance requirements regulating the work for'which this that all work will be done in conformance therewith. No changes permit is issued and all work shall be done in conformance there- shall be made without first obtaining approval. with. Kin changes sh90 ade without first obtaining approval X Date X - Date 2 C FOR OFFICIAL USE BEYOND THIS POINT Accepted by Planning Pd Ck# Date Bid Pd. Reciept No. Building Department �. a . Occ Group Type Constr. Planning Department x' Environmental Health Department C I Public Works Department Fire Marshal BELFAIR OF_;ICE Valuation$ Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical 8 Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES MASON COUNTY PERMIT NO. BUILDING PERMIT APPLICATION tAM Zou3- vv I (p2 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 INFORM ION CONTRACTOR INF RMATION Owner 0, r Contractor Name ZIVG . i Mailip Ad ess G o Z"� Mail Addre s x City t4 Stat Zip Code City /- Statet�Zip Code Phone( Other Ph. ( Phone 16 1% th I cam) 7 er Ph. ( ) C Lien/Title Holder Contractor Reg. 5 eP;1L1 *txp. Email Address IV. Email Address •fi q SEPTIC/WATER SYSTEM INFORMATION-Connect to New Septic)i _Existing Septic F Connect to Sewer System Name of Sewer System Well Water System Name of Water Systemickee 4 H ✓-A PARCEL INFOR ATION - 12 dialt T x P cel / L / O F're D"st i Legal Description l� U �L q ,Site Address (Please include stree name, street number and city) I DI ctions to site 0/` e - / r 1 aH I Will timber be cut and sold in parcel preparation?(Yes/No) WQ I Is property oc ted within 200'of saltwater Lake River/Creek Pond Wetland OX Seasonal Runoff Strea Slopes or Bluffs PERMANENT RESIDENCE ❑ SEASONAL RESIDENCE TYPE OF JOB- New Add Alt Repair Other Use of Building ire jm;R&I Is this permit submittal the rggssult of a Stop Work Notice,Correction Notice or other enforcement action?( es/N Describe Work 11 - -CC 1 C oM Sr.-- 4f 10"7 I-e -f r o No. of Bedrooms No. of Bathrooms SQUARE FOOTAGE- 1st Floor 2nd FI 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION -Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Price$ A I a 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. OWNER/BUILDER ACKNOWLEDGES SUBMISSION OF INACCURATE INFORMATION MAY RESULT IN A STOP WORK ORDER OR PERMIT REVOCATION.ACKNOWLEDGEMENT OF SUCH IS BY SIGNATURE BELOW: OWNER AFFIDAVIT-I certify that I am exempt from the require- CONTRACTOR'S AFFIDAVIT- I certify that I am currently regis- ment of the Contractor Registration Law RCW 18.27 and am aware tered as a contractor in the State of Washington and thatl am aware of the,ordinance requirements for which this permit is issued and of the ordinance requirements regulating the work for which this that all work-will be done in conformance therewith. No changes permit is issued and all work shall be done in conformance there- shall be made without first obtaining approval. with. anges shdITI5bjrnaje without first obtaining approval. X Date X Date _43 /Z 0 I FOR OFFICIAL USE BEYOND THIS POINT Accepted by Planning Pd 'Ck# : Date _ Bid Pd. Reciept No. ki I , Building Department Occ GroupConstr. /D 0 AI/— c Planning Department `T Environmental Health Department PAR d Public Works Department 71 Fire Marshal OFF Valuation$ 14,34 5 alb. IN Building Permit Fee U� — Site Inspection,,,.,.. w Plan Review Fe -&l 7 EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee1 Other 3. Wood/Gas/Pellet Stove Fee State Fee Violation Fee Os F Pre-Paid at Submittal o ) •, :, TOTAL FEES < PERMIT NO.: MASON bONTY PLUM9ING/MECHAN164L PERMIT APPLICATION 426 W.Cedar/P.O.Box 186, 86 Shelf ,'VITA 98584 Shelton(360)427-9�74 Belfair(360)�76 Elma(S60)482-5269 b #PPLICANT INFORMATION CONTRACTOR INFORMATION ,.'..^ Owner i Contractor Name Mailing Ad ess Mailing Addr Cit)rj A ate Zip Code City State , in Code Phone( ) thLt Ph.( Ph.(�,�� Other Ph.(� Len/Ti$ 'Holder ContractorReg.# Address Expiration / �T SEF TIC INFORMATION-Connect to New Septic Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION-12 digit Tax Parcel No. 1,7— p'/ nn in& Fire District_ 2. Legal Desorfoon 11` "' Ske Address(Please include str name reet number and ) Dir 'ons to site .1 Is your property within 200'of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland S Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location of Fixtures/Units 1st Floor 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric Txpili bf Fixture No.of Fixtures Fees LPG Natural Gas Heatpump Toilets t Type.of Unit No.of Units Em Bathroom Sink _� Furnace Batts Tubs lHeatpumps Showers Spot Vent Fan / Water Heater Propane Tank Cklthes Washer - Gas Outlets Kften Sinks Wood/Gas/Pellet Stove,*; Dishwasher Kitchen Exhaust Hood Hosebibs Z Dryer Vent Other Other ' Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURrz/UNIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 18#bAYS OR IF s CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS C MENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,r sents that the .1 Information provided is accurate and grants employees of Mason County access to the above described property and sJawa s 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 cegistered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I af the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this peued and all woconformance therewith. No changes shall be made without first obtaining shall be done in conforma therewith. No chanbe made withoutapproval. first ob . pprovalX Date X te FOR OFFICIAL USE BEYOND THIS POINT. Accepted by Date Submittal Amount Due Recei No. Building Department Occ Group Type Constr. Planning Department f Other Other ............... ::.....................................v.. .................:.........%?.. .....,. ....:.........:::. :..........::::rev ... .2rj::}v:::�:t:., ::v.... :}'r'::v::::::::...•. ...............:::v::::::.:•.........................................:::v:::::::::::..n:................................................. F.;...;{.:w::;......•......::::::n'$:w:::•}:•i}}}:ii;•}:i•}}:•:ti•}:•:ti•}:....... ........:::::$.: ::::::.....:...........:v.:. Permit Fee Site Inspection w Plan Review Fee UFC Plan Review Fee Plumbing&Base Fee Other , Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee Pre-Paid at Submittal Violation Fee TOTAL FEES i MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Planning Division P O Banc 27%Sharon,WA 98584 boy (360)4274670 tpN► NOTIFICATION OF INCOMPLETE APPLICATION October 03, 2003 MASON COUNTY FIRE DIST#2 . PO BOAC 277 BELFAIR WA 98528 Parcel No.: 123052290001 Project Description: CONSTRUCT ALL STEEL CONSTRUCTION FIRE STATION - FOR FIRE TRUCK STORAGE. Dear Applicant: You have submitted a permit application-(case no. COM2003-00162)for proposed construction or development In the county. Upon review of your application, I have determined that the contents of the application are incomplete or do not provide enough detail for review. Therefore, review of your application-will not proceed until the necessary information is provided (see the comment section of this letter for details.) Once the information is subrrutted and the application is complete, I will continue to process your application accordingly. if the additional information Is not provided to the County within 180 days of this request, the application shall expire and no further action on the proposed development shall take place. Please contact me at (360)427-9670, ext. 577 if you have questions. S' R kM Land Use PI&va Mason Counepartment 10/3/2003 1 of 2 COM2003-00162 NOTIFICATION OF INCOMPLETE APPLICATION 10/3/2003 Case No.: COM2003-00162 Comm nts: A preliminary review of the site plan Indicates that the proposed fire station will be W from a Category III wetland. The Wetlands chapter of the Mason County Resource Ordinance requires a 66 setback from Category III wetlands. Based:upon the submitted site plan it appears that the site will;support a W revision to meet wetland setbacks. A revised site plan showing the correct setback Is all that Is required to continue review of the proposal Please contact me If you require clarification of this issue. 10/3/2003 2 of 2 COM2003-00162 Request To Revise An Approved Plan c-01vt.Zpo3-00 Ito Z° �-- Permit Number: BLD200 - Name Parcel Number / AO ;5( Phone Number Project Address Mailing Address Please provide a complete, detailed description of the proposed revisions to the approved plans: c5 Are the site building plans, approved by Mason County, _ included with this application? 0 Yes P'No Are two sets of the revised plans or addendum indicating the changes included? P'Yes 0 No Are the revisions clearly and accurately identified on the plans or addendum? l9'fes 0 No Does the plan contain an engineer's or architect's lateral or vertical analysis? 0 Yes M40 If Yes, Has the engineer or architect approved this revision? 0 Yes ff No Is a stamped and signed approval included with this request? 0 Yes Flo (Note.No structural changes to an engineered plan will be approved without the written consent of the engineer or architect of record.) Does the proposed revision modify the footprint or location of the structure? eYYes 0 No If Yes, Is a revised site plan, drawn to scale, included with this request? —A-fes 0 No Additional Information: Applicant's signature Date: ttecaved by: _Datt:, — Dffir&I Ise Only Forv,ard to departments indicated below: Approval/Date Original Valuation: BWding S r I(q Additional Valuation: Plannin �, g9 Ft x g � 1/Zo awl �Yzt 0 sq Ft x Environmental Health f'ftll 10 Total New Valuation: Additional Fees: Public Works Additional Plan Review Additional Conditions/Commnents: Additional Building Permit Additional Plumbing Additional Mechanical Other ��- 3S•� Total Amount Due: s o rr�z a v ARno ZJ 9 i No�15t IQ Ile � Zp22 X e Al \\ t \ T Z / z \ / �• I• \\\ t tt �, G ••j 10 m 1 \ t 1 0 () •\ \ ` 1 rn _ c An Ile p ONE � N 212.93' -� �S 1 B'd SGG9-SGZ-09E •ouI guosuyor uaydsiS dTT :TO EO ET .400 Al LLr 0 u \ \ 1 = N jRF \ ., vWj a a V) � Or. --�, — o\\, Coo :a \ . Z o V6 C, 0- ai% W LLJ p 9 w °M f a r � \ (L Z d �/ a- coN N O \ CL _ wu) , ��yy Q O z 'w) \ J � % %N Z c� \ \ _• O wcn Vr- m % .09 N ,00 3 o — 2 .09 . 0 z 1 � 1 \ / z `v 1 ` \ 'o �� CN — \� do z n (n W ~ a , o O i� II g � � I w LLJ �� T- O � � QN � tn pw N �-- �`' o U.) w T' I Z Q o O � z � Z N - M W = --. oYOF- Q' Z Z LJLJ �-- Ocr- OUH O aui ¢ < 0 J �-- a b .. \ t i. 1p LU own CO anew 40 t .pin•• :j'.' \ uj law NoLL 10 �n 40 ZO t �01� Ljj 10 4v 0-2 N ! \ \ N% ` \ A -- • :0 \ 1 1 AS (l? A . • O Of Q W ug 5_ WUJ • N to ILp3LO LLI 1 O W soup z Z W O~ (� W � CLo, > � I•—O-• �� COS .................... •f. .'.�1,;1 .. . Y M•rr y,ww... �n,.,w .,y. r sY1we'ry.T).'rvf+Y•Mrr•"RT; �.. \CO , aIWWN— Od, \ \ \ M � CL 406 V \ \ a w I I Lj IL o r. ILL I x M \ loo I Ax 011 W Zcn _ \ ►C�12 of s o w ! ` i p�co 1 Ntp 1 1 ocl so � � 1 FAY I • �: \ ' . .\.. , 1 a J /ro CIV N 1 1 n Of C ,/ $ Oz t � ki �• 1 /• Ld LU LO Z Q ^O Q O WCN f . ui w d O � ZWJ Q C:� Q H........... k .... ri+#.roM'!'�!.,r. „i Jul 25 03 ll : lla GENE L. MCTEE 360 277 3003 p. 3 FROM : 'W6 W 41 O7PERAT I ONS PHONE NO. : W 677 5339 Ju 1. 25 2003 10:40faM P2 MASON COUNTY DEPARTMENT OF HEALTH SERVICES r#Wmvnvwd Health PO BOX I"OMM:fA 08584 Lt C/1I.C30)427-%70 SWAM(360)2754467 4468 Applicat owfor Pftrmination of Adequacy PART 1: AppliennWarcel Identification Name of Apptxaat Date� ._ Mauling Addma o L'? Tekpho>me 34�c�> z7.�-�G y j/ Assessor's Parcel Number'"/z 3d.r"2g' d 08 Type of Water (ekeek ORe. Ream forAgagnegn LgkwJt One): al. PubUdCcmm mky Water Sr m o or ow. � > P� 1 oomaalow u Land=a appliea&a.if so- w IadividuW water son=(an wwwo ioa),ifs*.. o Divisioa of bad to wen r of PW"I%T * Sptm =f1ce water ( SPH9� n OtlKr(explda) o Bomday 6w adlusmon io odor(esplaia) PART 2: Water System Information Complete the socbm appropciate for the type of water system bw*evaluated for adequacy: Pablo Water S,psSem Name of Water System Water Facility Inveauuy(VVFI)Nt>mabec __ a 7%g water 1.v"as leas tt'bed a Itum psaw*bbnkac hookups to dos"am system. VMM l saga. wa be dw syseeaa is abk and wtttm�b�watere to thisr as the Bmtta of the.rats sysem►w my 1 units set by sm ad local Sigoatorc of Water System Haters« Date - N�UVWTAb(JICtaYLUtrA7�AGtl.NT (>oitle_Maahb.149? 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N N ? �D N cows.CD c c o aD o 3 0 o _ s cn `` a; o cD 0CD D 1� RATE MECHANICAL MANUFACTURED HOME c Fib {Setbacks Date By, Ribbons date Gas Piping Date By Foundation Walls Date By Set-up Date By INSULATION Date B B G J Slab Insulation Floors Final Date By Date By Date By FRAMING Walls FIRE DE T D ate p By %/? Date B y K11 Date B y b&V PLUMING Attic J OTHIIR Groundwork Date W B Date/L-/L By 7- WALLBOARD NAILING D.W.V. Date - Zf B y j Date B y 74 FINAL INSPECTION Water Line Date D ate 8 y z : : :::::>: :.:,,>:.. <.:� >#.r;z; ,,..: ::.>:v....:`:` :, Date By gam, al' 16C62 � o N T w �C k//C C 0 h C