HomeMy WebLinkAboutCOM2017-00094 Final Change out Door - COM Permit / Conditions - 1/23/2018 0 ca
CONCRETE MECHANICAL MANUFACTURED HOME m
C311
Data By
Footings/Setbacks Gas Piping Ribbons
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CD 03
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Date B vi
y Date By FIRE DEPARTMENT __1
Foundation Wails Floors Date By 0
Data By
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PLUMBING Vault Date By
Date By
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Groundwork Attic
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Date By
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Date By ic
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FINAL INSPECTION
Water Line Fire Seperation
Date By Data By Data By -4
1
O
Pass or Request Inspect.
Type of Insp. Fail Date Gait g Done By Comments
................................
............................... ...........
(D
Inspection Line(360)427-7262
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT
9oK coDm Phone: (360)427-9670,ext.352
Mason County
615 W Alder St
Shelton, WA 98584
'R COMMERCIAL BUILDING PERMIT
COM2017-00094
OWNER: BELFAIR BAPTIST CHURCH RECEIVED: 8/10/2017
CONTRACTOR: LICENSE: EXP: ISSUED: 8/11/2017
SITE ADDRESS: 23300 NE STATE ROUTE 3 BELFAIR EXPIRES: 2/11/2018
PARCEL NUMBER: 123325000016
LEGAL DESCRIPTION: SAM B. THELER'S HOME &GAR TRS TR 7-A DOR#4656-001 f
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Change out door to assebly area
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General Information Construction&Occupancy Information
Type of Use: Assembly Insp.Area: No. of Units: Type of Constr.:
Type of Work: REP Fire Dist.: 2 No. of Bathrooms: Occ.Group:
No.of Stories: Exit Design. Load:
Valuation:
Building Height:
Pre-Manufactured Unit Information Square Footage Information
Make: Length: Lot Size:
Model: Width: Building:
Year: Serial No.: Basement: Parking Spaces:
Setback Information
Shoreline&Planning Information
Front: Ft. Shoreline: Ft.
Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.:
Side 1: Ft. SEPA?: Comp. Plan Desig.:
Side 2: Ft.
F
Fire Protection System Information
Auto Fire Alarm System?: Emergency Key Box?: Standpipe?:
Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?:
Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: i
COM2017-00094 Please refer to the following pages for conditions of this permit. Page 1 of 4
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MASON COUNTY COMMUNITY SERVICES Per No:�101'Yjl •���
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
_- - Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone
8elfair:(360)275-4467•Phone Elma:(360)482-5269
1854 ,
BUILDING PERMIT APPLICATION
PROPERTYt ^OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 11" t�` MA , NAME: �� C� g
MAILING DRESS: O (gyp MAILING ADDRE
CITY: STATE:ZIP: CITY:1� S TE: ZIP:
PHONE#1: 66 F PHONE: �. ��,�,_l 6 7 P-"�r.r'
PHONE#2: EMAIL
EMAIL: 11 L&I REG# EXP.
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHE .w C
NAME -t EMAIL
MAILING ADDRESS 1AW6 AUVW-60h FL TY r" STATE ZIP
PHON CELL,31
PARCEL INFORMATION: �q
PARCEL NUMBER(12 Digit Number) -56 `0 0 0 ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS ` ; :' ' CITY
D I
DIRECTIONS TO SITE ADRESS t �
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOV.-
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM❑
TYPE OF WORK: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)
IS USE: PRIMARY ❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE,7 YES (Whole Bldg) ❑ YES (Partfs]of Bldg) ❑ NO ❑
DESCRIBE WORK
SQUARE 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: t4 *4 COPIES OF THE FLOOR PLAN REQUIRED*
MA
KE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER❑ / NEW❑ EXISTING❑
l PLUMBING IN STRUCTURE? YES ❑ NO ❑ If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NO[] EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
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