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HomeMy WebLinkAboutPAR2014-00039 Cancelled - PAR Application r f COMMUNITY DEVELOPMENT ENVIRONMENTAL HEALTH REVIEW Mason County Public Health Official use only 415 N.6th Street Permit Number: T)"2L1"I':� PO Box 1666 Shelton,WA 98584 Date Received: Shelton:(360)427-9670, Ext.400 Amount Received Belfair.(360)275-4467 Ext.400 Elma: (360)482-5269 Ext.400 Receipt Number Fax (360)427-7787 Applicant Information Type of Review Applicant V-01ZZ� A . wooer Date zA- 4. 0 Building Permit Mailing AddressVn 'ik;C %,4tn?P 0 New 0 Replacement Af 1vw1 \,,t+. 9oc,2A 0 Commercial Building Permit City 3bo State Zip G New 0 Replacement Daytime Phone�� Other Phone 8�°y �40p 992`l 0 Building/Commercial Permit Revision ,� �— O Tenant Review (p/ I� � 14 E-Mail Addres�o r, = �K pre-Application 3;00 P M Parcel Information 12-Digit Parcel Number 2JoS't-43—tea Site Address Z3r2l,0 E-.Q-3 n%e- ant& SSA Sure[Number Sired Name City Type of Job �Q / Please submit a scaled plot plan Describe work to1 �myt, cang2ni" showing all existing and proposed building, on-site sewage system, Number of Bedrooms and well. W`rLj, "'".a w"i+ oT V5T%N6G rAA On-site Sewage Information . Water System Information 0 On-Site Septic System 0 New 0 Existing Plumbing in structure? 0 Yes )(No 0 Sewer Name of Sewer System If yes: Using an existing on-site septic system will require a current please submit a completed Water maintenance report and a Record Drawing (Asbuilt). Documents Adequacy Form. for both of these requirements may be on file with Mason County Public Health. Other requirements may apply. JAp li Ire Date — 2 \4•- Official use only Departmental Review Approved I Denied Notes Water Adequacy On-site Sewage System Tenant Review Revision 7 PAR 20 I Lk oc0c DATE PRE-APPLICATION CONFERENCE REQUEST FORM The purpose of the pre-submission conference is to identify and/or eliminate as many potential problems as possible in order for the project to be processed without delay. Representatives for the Fire Marshal's Office, Building Department, Environmental Health, Planning, and Public Works Departments may attend the meeting to discuss rules and regulations applicable to the proposed project. Topics covered during the meeting will include the comprehensive plan, shoreline program, zoning, availability of sewer and potable water, development concepts, building construction, fire protection and life safety concerns of the proposed project. The pre-submission conference will be most informative when you provide accurate and detailed information on the Pre-Application Conference Application Form and the site plan.Applications will be accepted when all information is received and deemed complete. Pre-Application Conferences are held every Wednesday and last up to one hour. To schedule a meeting complete the applications and return with 10 copies of the detailed site plan,by 3:00 PM on the Wednesday two weeks prior to the proposed meeting. 1. Pre-Application/Dept.of Community Dev. 2.Environmental Health 426 W Cedar Street/PO Box 279 415 N 5`h /PO Box 1666 Shelton,WA 98584 Shelton, WA 98584 360.427.9670 ext. 352 360.427.9670 ext. 400 Check amount: $255.00 Check amount: $150.00 BOTH CHECKS MADE PAYABLE: MASON COUNTY TREASURER Applicant: S �� Site Plan Name: Submit 6 copies Mailing Addres Q. \ 24' Include the_following information Daytime Telepho e:3bo 80 k 5 l3 ax: aot z Zrlrl 5 0\9 ❑ Indicate Scale and North Arrow Email address: c- ❑ Property line dimensions,easements, and right-of-ways. Representative: Name: �pC j, �_ ❑ The location of all existing and proposed structures.Include square Mailing Address: Q 3 bt N L.L SS footage of existing and proposed structures. Daytime Telephone: O `� � 9 ❑ Setback distance,in feet from all Email address: C property lines and structures. Parcel 12 digits)l')32q - © ❑ Existing and proposed road access to and from the site. Descrip ro Include: 1) Sq Mwompog an oms(i.e., El sites office,warehouse,restaurant,storage,etc),3)Occuply,classification per ❑ Location of on-site sewage tanks and drainfields. IBC, Section 302.1,and construction type. 4)Provide two sets pfPI PS,if ❑ Location of drinking water supply. available.Use separate sheet if necessary Include location on the proposed site and surrounding parcels. ❑ Steep bluffs,wetlands,streams,and bodies of water IL-4 l Y V's "C—V —� Location of� ants and emergency lqi a access roadv,'t including grade. ace and storm w'Aerruu-d4f4utes. Has the project been discussed during a previous Pre-Application Conference: If yes,please indicate date. lA O Will the building have employees? If yes, how many? What is the water availability of the proposed project? If there is an existing well, what is the name of the system?Tl, What is planned for the on-site sewage system? If you are proposing a new on-site system provide detail on the required site plan. y i c. �o�A.0 � � \c C—_D \,.a NAN ---ePt\C. ADDITIONAL INFORMATION.• APPLICABLE BUILDING CODES 2012 International Building Code/2009 International Residential Code 2012 International Fire Code-ANSI A 117 2012 International Mechanical Code—WAC 51-42 2012 Uniform Plumbing Code—WAC 51-56/51-47 2012 International Energy Cons.Code/Washington State Energy Code—WAC 51-11C&51-11R Mason County Ordinance Title 14 Code changes are on a 3 year cycle;effective in July of that particular year. Date of Conference: Time of Conference: M ,t Location of Conference: 426 West Cedar Street,Shelton Planner: ��f ext. CEDAR ST. MASON COUNTY Department of Community Development INSPECTION CARD and CERTIFICATE OF OCCUPANCY* PO BOX 186, 426 W Cedar ST, Shelton WA 98584 General Questions: (360) 427-9670 ext 352 Inspection Requests: (360)427-7262 Permit Number COM2011-00002 Date 02/09/2011 Issued By Project medical dispensary Site Address 23720 NE STATE ROUTE 3 BELFAIR Applicant BOB WOOD Contractor License Number Con. Phone Expiration Date Primary Code Occupancy Division Use retails Type of Construction Exit Design Load Public Works Access/Driveway Other Health Dept Septic Well Planning Dept Site Inspection Fire Marshal Fire Apparatus Access Fire Sprinkler Auto Fire Alarm Hood and Duct Other Final Building Dept Building Official: Community Development Designee Concrete Setbacks Slab Footing Perimeter Ret. Wall /Bulkhead Footing Interior Footing Decks/Porches Foundation Stem Other Rough-In Groundwork Plumbing Plumbing Groundwork Mechanical Other Groundwork Gas Pipe Gas Piping Framing Mechanical Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Nailing Interior Wall Brace Panels Fire walls Other Final Building Manuf. Home Setbacks Setup Concrete Foot/ Runners Final Other %PPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS THIS STRUCTURE MAY NOT BE USED FOR OCCUPANCY UNITL ALL APPLICABLE FINAL INSPECTIONS ARE COMPLETED )0 NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVALS ARE GIVEN. 'OST THIS CARD IN A CONSPICUOUS PLACE ON THE FRONT OF THE PREMISES CONVENIENT FOR MANNG REQUIRE NTRIES. %LL PERMITS EXPIRE 180 DAYS AFTER PERMIT ISSUANCE OR 180 DAYS AFTER LAST INSPECTION-d&IVITY IS PERFORMED. )WNER/ RESPONSIBLE INSPECTIONS ���` TO ALLING FOR FINAL CONDITIONSINSPEECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET. "RIOR e �`j14 426 ST. � . iSVAT E S or: t � AC4 , STAJil TE '• JF k r C �,� 9 a a f s C, e S. Secretary of State I, KIM WYMAN, Secretary of State of the State of Washington and custodian of its seal,hereby issue this CERTIFICATE OF FORMATION to MARI MART LLC a/an WA Limited Liability Company. Charter documents are effective on the date indicated below. Date: 12%6/2013 UBI Number: 603-355-427 STAT Given under my hand and the Seal of the State of Washington at Olympia, the State Capital Kim Wyman.Secretary of State 7 y 18 S9 Date Issued: 12/6/2013 STATE°� RESELLER PERMIT G - � 7889�0 Washington State Department of Revenue STATE OF PO Box 47476•Olympia,WA 98504-7476• 1-800-647-7706 WASHINGTON Issued to: Permit Number: A29 7776 16 603 355 427 MARI MART LLC Effective Date: 01-07-2014 3811 E STATE ROUTE 3 SHELTON WA 98584 8528 Business Activities: Expiration Date: 01-06-2016 FOOD (HEALTH) SUPPLEMENT STORES This permit can be used to purchase: • Merchandise and inventory for resale without intervening use • Ingredients, components, or chemicals used in processing new articles of tangible personal property produced for sale • Feed, seed, seedlings, fertilizer, and spray materials by a farmer • Materials and contract labor for retail/wholesale construction • Items for dual purposes (see Purchases for Dual Purposes on back) This permit cannot be used to purchase: • Items for personal or household use • Promotional items or gifts • Items used in your business that are not resold, such as office supplies, equipment, tools, and equipment rentals • Materials and contract labor for public road construction or U.S. government contracting (see Definitions on back) • Materials and contract labor for speculative building This permit is no longer valid if the business is closed. The business named on this permit acknowledges: • It is solely responsible for all purchases made under this permit • Misuse of the permit: — Subjects the business to a penalty of 50 percent of the tax due, in addition to the tax, interest, and penalties imposed (RCW 82.32.291) — May result in this permit being revoked Notes (optional): Important: The Department of Revenue may use information from sellers to verify all purchases made with this permit were qualified. 0 Reseller:Keep this original permit on file.Provide copies to sellers from which you make purchases. 42cu �'� �c'L-' , . (VI) ci r N s �L . o I rl I -__� ID - lL v � z � � .` r ILI- ol i � M Q� �r U 'r LU W G aC.iTF C.1`�',�J -Lji ll:_•�.;',-'� - r'. Sllp7 ti OVAV BY �GES `vGa:e w�� � I i!J C( Dry i . d� ttgym..., REVISIONS te Is,,,..r' - _.�,-. - `;.*: ,� _ '.'�' +, 'fie .,..�' .. ' #r+ 7'`�' ..'•.1 3+00 2+00 r i z •L KEY MAP • .> s it • f i` a Ft r • . ., �xw ., .,, . .� * 'k' � ,'�• ',ate .. ? Yt 3 •, � `{� °Sa'�..�y�,y y� .''�• . !, Q � y .>r a• �'w� .►� x ��� 4 b ,(fin `��/ 6":i 7- OWNER.STEPHAN K SIFFERMAN r' 2931 E.MASON LAKE DRIVE W a JF A • ' 3 ` J GRAPEVIEW,WA 985469546 — " y A, ,s"'! SITE ADDRESS:23710 SR 3 �� 7 vs + 'ems x `* �.. , . •+C,,x". r i �* SCALE SHEET NUMBER J. a " . ,. 4G."� REN.fAV DALE y` t. .... . , • 4-15-10 123294300270 `;"`a �+,., SIDE SEWER CONNECTION PROJECT