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HomeMy WebLinkAboutMIS95-0064 Classroom Display Bldg - BLD Permit / Conditions - 1/30/1995 �'RT 10 MIS O v`0 u R �AQ�%PEIT TY ISC NEOUS APPLICATION 0 426 W. Ceder/P.d.box 1%, Shelton, WA 98584. 427-9670 �xh PLEASE PRINT GG #1 Owner dr f� Ala Coo) ' Phone#6 C Fire District# Z Site Address 7-4=/tom 6.,f 2287/ ,' 3 City /�� '- Mail Address P o. 6o City St WA Zip '1 $S2N Applicant/Lf/)A 1-h c. Phone ?c'G �-ZY- 07-J- Applicant Address 220.21' It?,,-,*le V,;,i _D . .S. fu./' .2,0/ City ©cs /L101 ne3 St 1-14 Zip Directions to Site: 9.1 wa.. 3 �� C��/��%, Lt/cs� 0±7��ocss� Parcel No. 12332 - �S'0 - O r� Legal Description r•` 3� ft.,^r r�� f GA. �Ia #3 Indicate by circling the applicable source if any water is on or adjacent tote property site: saltwater lake river creek stream pond etland seasonal runoff marsh other #4 Project Start Date U_Gn _ FdC Project Completion Date 0-11nt 9S #5 Use of Buildiing Describe proposed construction 'Depending upon the type of permit,a floor plan and plot plan may be required. 'This permit is valid for 180 days from the date of issuance. OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED CON- MENTS OF THE CONTRACTORS REGISTRATION LAW TRACTOR IN THE STATE OF WASHINGTON AND I AM RCW 18.27, AND AM AWARE OF THE MASON COUNTY AWARE OF THE ORDINANCE REQUIREMENTS REGULAT- ORDINANCE REQUIREMENTS FOR WHICH THIS PERMIT ING THE WORK FOR WHICH THE PERMIT IS ISSUED AND IS ISSUED AND THAT ALL WORK DONE WILL BE IN CON- ALL WORK DONE WILL BE IN CONFORMANCE THERE- FORMANCE THEREWITH.NO CHANGES SHALL BE MADE WITH. NO CHANGES SHALL BE MADE WITHOUT FIRST WITHOUT FIRSTOBTAINING APPROVAL FROM THE BUILD- OBTAINING APPROVAL FROM THE BUILDING DEPART- ING DEPARTMENT. MENT. X OWNER X BY DATE DATE Show following on the site plan Lot Dimensions Flood Zones Existing Structures Fences Structure Setbacks Wells Water Lines Shorelines Drainage Plan Easements Septic Systems .Name of Fronting Street Indicate directional by Proposed Improvements Name of Flanking Street N, S, E, W etc. PLOT PLAN AREA l*11A USI=t►Cf~Y:Amp ly::. .. ... DEPARTMENTAL REVIEW FOR OFFICIAL USE ONLY Planning r APP COND APP HOLD - :>3 z(Y(K Building Fire Marshal Other Special Conditions Fees Permit Fee $ o Plan Check Other Other State Building Fee r 5- TOTAL DUE $ �(� GENERALC ES TING LAB ORATO7 IES, INC. 18970 Third Avenue NE,P.O. Box 1586,Poulsbo, Washington 98370 ORIGINAL " January 5, 1994 " Project Number: B8189 Rice Fergus Architects 264 Fourth Street Bremerton, WA 98310 ATM Mr. Steve Rice RE: Pile Driving Inspection Report Hood Canal Wetlands Project, Belfair, Washington Dear Mr. Rice: Attached are the pile driving records for three plastic piles driven at the above project site in the vicinity of station 12+00, identified as an "Emergency Vehicle Turn-Out." All three piles were driven in accordance with the specification documents provided, with the exception of the following: • Cushion Blocks were not used • Hammer Weight - 15001bs. not 3000 as required The bearing value (6 tons) determination was calculated using the following formula: P = 2Y;H S + 1.0 I r P = bearing capacity (6 tons) W = weight of hammer (1500 lbs.) H - height of free fall (10 ft.) Each pile was carefully positioned and lightly driven (3' to 4' hammer drop) to approx- imately 10' penetration before 10' drops were started. All piles were driven a minimum of 10' below grade (tip elev. -3') and a minimum of 8 blows per foot were recorded at final tip elevation. "r If we can be of further assistance on this project, please do not hesitate to call us at (206) 779-9196. Sincerely, G ES LABORATORIES, INC. /esild . Hart ent JRH/jp Enclosure Quality Assurance for Nonh%wt Commwdon rouLM a0Q 999-91% 7 JAN M ante at wubm8ton �. Department of Community Development i Fire Plot cboo Setviow Dlv wn a 1 :, Life Safety Unit �0 [/ 4317&h Ave..S.B. Laory,WA.9a50-83w poo 03-MO or 1.80NUM138 CONTRACTOR'S MATERIAL i TEST CERTIFICATE FOR ABOVE GROUND PIPING 'irRocEOURE tpo„••i•oM et .at. iaP•c�io• MW W@w •NO M end•b M•ee•treoW,wp sm"d«nad oftse•d M as ownWo npe•••tetk AMrel•e1• lnea be aonee+• eed MtM i•1I b a•iwe•nd«•eesaeetera/ an JW A e•nieoM• andl M Aa•d e•I aed dyad M r•Pne•�Iniwa coon~~ s i I Mr awwA*a•MnrWm ewer• and eaene•br. R is aee•raNeed Mn Oww npe•retwow•e arora4ee it so w?Pra udi a.T eYi•eCrM sow"" r ow arwr osswie.P� «arr..a eewplr�n aPpwbs e•Ilwr+hr'• "� «Ioed er�iaaow. Q PWINTY NAM RO AD u 1. A � _ 1 PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS ❑YES ❑NO EOUPMENT USED M APPROVED )R:�EES ❑NO F NO. MATE DEVIATIONS Z. OF CONTROL VALVES AND CAE AND MAMTEM MS ANCE OF T NEW EOUIPMENT? OYES NO NT F NO.EXPLAM ;INSTRUCTIONS NAvE coprs oF APPROFFMAN 081WEIKOM AND CARE AND WWMUWM CWWS AND#jFPA I ❑YES ANo INEEEN LEFT am►REMISES? F NO.EXPLAIN s• .LOCATION ¢ OF SYSTEM 4. MAKE IIOOEL tMYN CO RE -TnT MTWO URE SPRINKLERS L s, AND PFE CONFatNs To ANDIIRD YE8 ❑NO f17TINGS PTTSI3S oolFowl TO ANDAD ONO IF NO.EXrLAw s- *AAM DEVICE s1AtMRRI IRE 1M1 TO OPERATE INNOI IOW VM THE EIAIIE MOOSL GIRL fEC. T .. T SW HALVE OLOA �K! sKt0E1 SWEAL NO. sY1KE rODEI Son"NO. Ir-3o2- 1 Tw To TIT► VATER AN WN POsfr TINE WATER MARM � "M IRST PIPE PIssMRE 10 S 010 ME N R§ PROKRIv MN sEc �sI PIN PsI UK am vas No OW PIPE OPERATING AN TEST .Win O.O.D. F NO. WWLAW L�Y� am �. !�s» MwA� •fwern OPERATION ❑PNEUMATIC ❑ELECTRIC O NYORMILIC 8. XIDDEPIPMIG SUPERVISED DETECTING MEDIA SUPERVISED ❑YES ❑NO ❑ S ❑N I DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS O YES `O NO a THERE AN ACCESSIBLE FACILITY INEAM CIRCUIT FOR TESTING r NO.EXPLAIN ON O YES ❑NO DOES EACH CIRCUIT OPERATE note EACH CIRCUIT SIAXIMUM TIME TO MAKE MODEL LOSS ALAOM 40PERATE VALVE IIELEASE OPERATE-RELEASE HYDROSTATIC: Nywastaft Msts shallow wesde st not leas than 200 ON(1&6 brs)for Ma hem of 60 pet(3.4 ban)above static Oessrs, akessa oI 150 pia (10.2 ban)for hww►Mrs.DiMrnatal dY couper wawa , IF ehell be let open Ostw-Mat b protean damage.AN taborspnsnd PWM leskat>•shah be stopped. TEST FLUSHING: FkM tin reverse nle ewai wnM w clear es wdieated try�e eowelieww of foralSn taMrlel le st.I.o-*Ms r Qatar.tool►u hYanr is and blowr�otle. DESCRIPTION Flush at Moire no lean than 400 GPM(1614 L/ata)for 4-mch pipe.SW GPM(2271 Litwin)for(Flesh pipe.750 GPM NOW Litwin)for•-inch pipe. 1000 GPM (3785 Limm)Ior rweM flips.UM GPM(5676 Lima)for 0 weh pipe and 2000 GPM C7670 LIstw)for/2•Yah pipe.When supply cannot produce wwwated now rates.obtaw tasumaww available. PNEUMATIC. Establish 40 psi(2.7 bars)air presssM sad measure drop wMwieJw a11aN set ascend 1-11 pill(0.1 ban)in 24 hors.Teat prasswre tanks at normal water laws,asd ar presMrn and measure air pressure drop-- weh slab not eaeeaa I•%pa(0.1 ban)w 24 hors. 9. ALL PIPING HYDROSTATICALLY TESTED AT 7CLIV-PSI FOR M RS. IF NO.STATE REASON DRY PO4W PNEUMATICALLY TESTED ❑YES EQUIPMENT OPERATES PROPERLY Q ❑NO READING OF GAGE LOCH NEAR WATER SUPPLY TEST PIPE: RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE TESTS oRAINI TEST STATIC PRESSURE: PSI P81 Underground mame and lead in connections fs ayslaM rissra embsd-*fora eonwsefl- Mods b aptiMtlr Npleg- VERIFIED BY COPY OF THE U FORM NO. NO. ❑YES OT*ER EXPLAIN ❑NO I FLUSHED BY P INSTALLER OF UNDERGROUND ❑YES ❑NO SPRINI10. NUMBER USED LOCATIONS NUMBER REL40VED BLANK TESTING GASKETS 11. WELDING IPM YES ❑NO .. IF YES . t DO YOU C&TIFY AS THE SPRINIMER CONTRACTOR"'AT'WELDNG PROCEDURES COMPLY WITH 71E REOUIREMENTS OF AT LEAST AWS 010.6.LEVEL M-2 ', S ❑NO r E WELDING 00 YOU CERTIFY THAT THE WELONG WAS PERFORMED BY WELDERS OWWFED IN COMPLIANCE I P fE1 ❑NO WITH THE REOUIREMENTS OF AT LEAST AWS OfQg. LEVEL AR-3 DO YOU CERTIFY THAT WELDING WAS CARRIED OUT if OOMpumm WITH A DOCUMENTED DUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE RETRIEVED. THAT OPE7N 138 N PIPING:ARE �--f SMOOTH. THAT SLAG AND OIN TTER WELDING RESIDUE ARE REMOVED. AND TWIT THE MTERNAL $ Y D NOT DIAMETERS OF PIPING ARE NOT PENETRATED �. IL HYDRAULIC kAWPLATE PROVIDED � if 160. EXPLAIN - DATA OYES ❑NO NAMEPLATE 1a. DATE LEFT IN SERVICE WITH ALL CONTROL VALVES REMARKS a ' AME OF SP 'TOR ,.. f �1�n�T onJ TESTS WITNEssED my FOR PROPERTY OWNER f ► TITLE DATE SIGNATURES COKWP=OR DATE -u. /41YIA N ADDRIONAL exPLANATIM AND NOTES I jWASHINGTON STATE FIRE MARSHAL'S OFFICE FIRE SPRINKLER ADVISORY r.� 09NTRACTORS MATERIAL&TEST REPORT FOR UNDERGROUND PIPING PROCEDURE upon ewnpldlon d wok YrpeMlon srd tede eheN a nhede by dr eonbeelofe wpreeehtdM sM wisheeeed by an ewnafe wpwewtaftw AM Mods shill be wr*d d and"em bh In tehhAee owe tenbaetors pwm-m onany bww the pb. A owlfletb MUN be Mbd mt and WWwd by balh wpreeenrAaa Copin"be pwg for apprabq suammim&anew and aDnttm ar.M b urdaMeed the owns t mpre nWW's Mpnduw 1n ro-W pwludimw mEy dolm tp i wt oonln/a�a for/rally wwiwK`pow�wwWrArehip,a1W we bD ooffgiy wllh tpp oft tuCiw/✓�wacWkn Weft a biro eedbrneea PROPERTY NAM / r,} F(C. ��E LIYV/ /A LM r-"T I V G em, "ATE ; — 7-f5 'PROPERTY ADDRESS G�i - L ACCEPTED YAP HONING AUT S(NAME) PLANS ADDRESS, S.(2.. LK 112 WA INSTALLATION CONFORMS TO ACCEPTED PLANS + S H NO EOUIPMENT USED IS APPROVED YES NO F NO,EXPLAIN DEVIATIONS WAS PERSON IN CHARGE OF FIRE EOUIPMENT BEEN INSTRUCTED AS TO LOCATION ES U NO OF CONTROL VALVE AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO,EXPLAIN i'iij�i •� F �' . INSTRUCTIONS HAVE COPIES OF THE APPROPRIATE INSTRUCTIONS AND CARE AND MAINTENANCE CHARTS YES NO BEEN LEFT ON PREMISES? F NO,EXPLAIN LOCATION SUPPLIES BUILDINGS PIPE TYPES AND CLASS P�AaS?l G �D D JouNr PIPE CONFORMS TO STANDARD4MYES NO UNDERGROUND IF CONFORM TO � .� S NO PIPES F NO.EXPLAIN •, 01 AND � � JOINTS D JOINTS NEEDING OR N YES NO ACCORDANCE WITH f t'� 6TAiNDA1RD F NO.EXPLAFLUSHING IN (� i Flow tfr wqubed hsfe wd 1"i •• ro rndwW ti budtp btpt d ahabb such on hydmnb and dowels Fowh d Rowe nol lei dhsn Mi0 f1PM fer fwNnah plpe.14t011PM for 104=h pipe,and lbm a'M far U-imh pps. VAw whppV---phedhpe TAT llydhaMsae NMI \ d tor8opllabwAdbw �pIn sa d ttlo pd br two DESCRIPTION LEAMLfirs pipe bld nMh nbbw prllfal tdbbEbry;b—Mat w no btbtp d"10"*A w mwt of bompt Now ' ig*"drf no a>taW!p pw Ihoha pw t00 1M balapeshdl M dlssbhMd aw d1 pbhr l owh Istlslp opal.at a bw port to kohm"on w"be smadwed UrAmod oty anal wrde.7M an a Mr d aaarsde beam"specfbd aba wry be bweoed by 10 as Mr Im ww dwedw per how far each wdd NOW rW biM ft Ilw bd pMtn.l dy brwl hydMM w bdod wMh fw whin hwW apw%ao/It Iydtallb aw Urdu pweeuw.an addfiorW 6 at pw whMsMe bdrp b prmMed br*wh%*Uri. NEW UNDERGROUND PIPING FLUSHED ACCORDING TO AJ STANDARD YES U NO BY(COMPANY) "OX Ft aE V'EN77I0A/ F NO,EXPLAIN FLUSHING WAS 013TAINED T TYPE OF OPENING FLUSHING W PUBLIC WATER ❑TANK OR RESERVOIR '❑FINE PUMP HYDRANT BUTT ❑OPEN PIPE TESTS LEAD-INS FLUSHED ACCORDING TO �ANO]VIR�D/ YES NO BY(COMPANY) F NO,EXPLAIN jjQW' I FLUSHING FLOW WAS OBTAINED !"ROUGH WHAT TYPE OF OPENING PUBLIC WATER ❑TANK OR RESERVOIR ❑FIRE PUMP JKXCONN.TO FLANGE 3 SPIGOT ❑ OPEN PIPE ' I 958 (OVER) ALL NEW UNDERGROUND PIPING HYDROSTATICALLY TESTED AT JOINTS COVERED HYDROSTATIC 2 PS1 FOR HOURS DYESNC TEST ' TOTALAMOUNT OFIEAKAGE MEASURED �S HOURS LEAKAGE TEST ALLOWABLE LFJIKAGE �g -- HOURS L HYDRANTS Q OYES ❑NO WATER CONTROL VALVES LEFT WIDE OPEN MIXES UNO CONTROL IF NO,STATE REASON VALVES JE EADS FIRE DEPARTMENT CONNECTIONS AND HYDRANTS INTERCHANGEABLE OYES ONO SE OF FIRE DEPARTMENT ANSWERING ALARM W �'REMARKSNUMIN�ICi CONTRACTOR CONTaffiWUYMSTub IS NESSED BY SIGNATURES ERTY OWNER ) TRLE DATE9 DATE 1 N ) I T LEDATEJ44 THE TION HEREIN IS TRUE AND THAT THIS bfFJr'iKLERSYSTEM WAS INSTALLED W ANcE WITH RCW is-m AND THE RULES ADOPTED BY THE WASHINGTON ADMINISTRATIVE CODE AS ADMINISTERED BY CERTIFICATIONTHE FIRE MARSHAL. Fred O. Ziemke E OFF wiMe of�RIFId►TE of ooMPerENcr MOLDER Ott oa 7vPq �ONI1nJFE OF CERTScMTE of COMPE IRCY HOLIM TE REGISTRATION OJ1TE yes IMCK AND Norma Wo 0.2m 604"1 I, 1 I I f - r 1. ti 1• �S. PERt1FICATION .This is to certify that this automatic sprinkler system has been installed in accordance with the standards adopted by the Washington State Fire Marshal and N.F.P.A. Standard 13. Name of Firm --- _ Mailing Address Name TRW Date (Swisw.N FYw o"ww) WHEN ALL APPLICABLE ITEMS THROUGH-15 HAVE SEEN COMPLETED THIS ORIGINAL FORM SHALL BE RETURNED TO THE STATE FIRE MARSHAL'S OFFICE 16. CONFIRMATION OF S-LeAKLER SYSTEM INSTALLATION RW Name Title PN11M 4� Date 41/o V� I! LN FA. rw nprwMulM Acceptable: ❑YES ❑NO 1 1'6 17. COMMENTS: i ADDITIONAL.EXPLANATION.AND NOTES i M tea.• �` i i zt .r V 'v "n 19 a s.. C ;r 1 M -f 01) -n -4 Mo I w O M lu o — Q o -i o -[ 0 -C C C C W z- r 0 0 > c' m36fi a I -4 -4 G) z > o ! 2 r- o o r- M q rn o m o Z -4 _ - - -4 M c*) (n co — r- j I z 2 rn > A At co (a 0 4000 CA ,e N I — � o o ca MMin0 r� C War - z ~ zS '. ca" i Ica rr m j ' ww w ww rn ~ Qo -+ t� ca r .4 > 0 0 Q c _ O` or CD W � n w> CD co 0�Q 0 0 � O I > n — C G)p cl p, C) Z ` M O, Q > C 0 iPt M co .. { IM J to m i > - -€ m cn m I � 4 f CONCRETE OJT '—�'T ^' tr ECHANICAL - MOBILE HOME Footings-Setback 2— —SS date by Ribbons date by Gas Piping (late b Foundation Walls date by let Up date by INSULATION date by BG/SLAB Insulation Floors I=inal FRAMING te by date by date by Walls FIRE DEPT. date by date b (late b PLUMBING Attic y OTHER ' Groundwork date b u `"—(- � date b y D.W.V. 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