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Groundwork Attic Rate By Typw Rate By Date By O.W.v DRYWALL Type: O Int Brace Wall ate By 3 Rate By Date By FINAL.INSPECTION ' N Water Line Fire Sops ration, �,�% O Data By bate. By b `-y!'` e"ato�i��5// By O CD Pass or Request Inspect. o Type of Insp. Fail Date Date Done By CommentsCA CD 0 DISCLAIMER THESE DRAWINGS WERE PRODUCED WITHOUT THE BENEFIT OF AI PROPERTY A CURRENT LAND Sprint AND SETBACKS H BE VERIFIID PRIOR TO START OFMENTS, CONSTRUCTION.TAEC DOES NOT GUARANTEE THE ACCURACY PROPERTY LINE OF SAID PROPERTY LINES.EASEMENTS,ROADS AND SETBACKS. RECEIVED I PLANS PREPARED BY: MAY 19 2017 \ I I � I ' I TechnologyAssociates I 615 1N. Alder Street \ PNW MARKET OFFICE 650 SCUTH ORCAS STREET SUITE# \ � SEATTLE,WAA 98 98108 �PQ � � R, o PROPRIETARY INFORMATION \% I ,►� \ / THE INPORAanoN corrtaNEOIN THIS SET OF DRAWINGS M PROPW ETARY 6 COWIOENUAL TO SPRINT ANY USE OR NSCLOSURE OTHER TI-N AS R REUTES TO—NT IS STRICTLY PROHIBITED \ /' PROJECT INFORMATION: ALLYN/ I z� MURPHY PLANNING gl SE72XCO32 I I 19941 E. STATE RTE 3 I I _ ALLYN,WA 98524 PARCEL NUMBER �I i y z i I r LA I V N I ;�n' r : REVISIONS SETBACKS ARE MEASURED REV DATE DESCRIPTION BY EXISTING SPRINT ECUIPMENi O n - A OG112017 ISSUED FOR BO%CD REVIEW ES (NO PROPOSED CHANGES TO �_ FROM THE FURTHEST 0 04252017 ISSUED FOR 100%CO CMB EQUIPMENT AREA(8AN?ENN�- \ PR JECTION OF THE BUILDINGAREA.FOR ENLARGED SITE � I PLAN SEE \\ --------------------- EXJSTING HOUSE RAVALAND (TYP I .) Y x x LICENSURE: IL JL * x APPROVED :f E=rWWATMTAW MA ON COUNTY DCD PLANNING 'd � S TE PLAN REQUIRED TO BE ON SITE H NGES SUBJECT TO APP OV ®w� By I Date S l� EXPIRES 1112018 SHEET TITLE: I 0 L i OVERALL SITE PLAN PROPERTY LINE _ I N SHEET NUMBER: OVERALL SITE PLAN so o �$' 30• SCALE: 1^-30'-0^(24z36) Aml (OR) 12"=30'-0"(11x17) cO"r, . MASON COUNTY COMMUNITY SERVICES Permit No• Vom Zoc 7—� }rjJ PERMITASSISTANCECEN7ER: Recv'd: •BUILDING•PLANNING•FIRE MARSHAL RECEIVED 615 W.Alder St-Shelton,WA 98584 - Phone:360-427-9670 ext.352 Fax:360-427-7798 lR• http://www.co.mason.wa.us/community dev/ i ' " l MAY 19 2017 1 k ,5pn BUILDING PERMIT APPLICATION ' SE72XCO32 W&WhAMer Street ZROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Heather Murphy NAME: TBD MAILING ADDRESS: 6522 159th Ave NE MAILING ADDRESS: CITY: Redmond STATE: WA ZIP: 98052 CITY: STATE: ZIP: PHONE#1: PHONE: CELL: PHONE#2: EMAIL: EMAIL: L&I REG# EXP. CONTACT PERSON: OWNER❑ CONTRACTOR❑ OTHER/BELOW{t NAME:TAEC/Miranda Glenn on behalf of Sprint MAILING ADDRESS: 650 South Orcas Street#R-103 CITY:Seattle STATE:WA ZIP: 98108 PHONE: CELL:(5091557-5130 EMAIL:miranda.glenn taer._net PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 12217-22-00032 ZONING RR10 LEGAL DESCRIPTION(ABBREVIATED)N 1/2 NW 1/4 EX ST R/W TR B SURVEY 9/137FIRE DISTRICT SITE ADDRESS_19941 E State Rt.3 CITY_Allyn DIRECTIONS TO SITE ADDRESS See attached drawings IS PROPERTY WITHIN 200 FT: (Check all thatappy): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14% YES❑ NOV TYPE OF WORK: NEW ❑ ADDITION ❑ ALTERATION.I REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) Telecommunications Tower IS USE: PRIMARYV SEASONAL❑ NUMBER OF BEDROOMS N/A NUMBER OF BATHROOMS N/A HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part[s]of Bldg)❑ NOV DESCRIBE WORK Replacing(3)antennas with(3)new antennas and adding(6)RRUs to existing monopole. SOUARE FOOTAGE: 1 ST FLOOR 220 sq.ft. 2ND FLOOR N/A sq.ft. 3RD FLOOR N/A sq.ft. BASEMENT N/A sq.ft. DECK N/A sq.ft. COVERED DECK NLA sq.ft.STORAGE N/A sq.ft. OTHER N/A sq.ft. GARAGE N/A sq.ft. ATTACHED❑ DETACHED❑ CARPORT N/A sq.ft. ATTACHED❑ DETACHED❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REOUIRED MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner or owner's legal representative.I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permittapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPOCATION.OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) 5Z�Z/7— Signature of OWNER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT - PLANNING DEPARTMENT FIRE MARSHAL PERMIT SPECIALISTS Intake By: Approved&Ready for Pick-Up: Amanda Nations Subject: FW: Sprint From:Ariane Paysse [mailto:ArianeP@co.mason.wa.us] Sent:Wednesday, February 22, 2017 4:31 PM To:Amanda Nations<amanda.nations @taec.net> Subject: Re: Sprint Hello Amanda, Only a building permit would be required for this type of work. For the bid of$20,000 the permit cost would run $864.56. Please let me know if there are any further questions. Ariane M. Paysse, Permit Technician Mason County Community Services Permit Assistance Center 615 W Alder St. Shelton, WA. 98584-0186 (360) 427-9670 Ext 355 >>> Amanda Nations <amanda.nations@taec.net> 2/21/2017 2:52 PM >>> Hi Ariane, Sprint plans to modify an existing wireless facility located). The planned modification consists of swapping panel antennas and adding/swapping radios on an existing tower. Would you please provide a fee estimate for the required commercial building permit based on a $20,000 project valuation? Also,would you be able to advise if a separate land use permit is required in addition to the building permit or direct me to the correct contact for this inquiry? Thanks for your help! Thank you, Amanda Nations I Sr. Real Estate Specialist iTAEC I amanda.nations@taec.net 1 206-778-1548 617 8Ih Ave South I Seattle, WA 98104 1 �1 BUILDING REcEIPJ�b MAY 19 2017 March 7, 2017 615 W. Alder Street Re: Sprint Cell Site Maintenance Subject: Technology Associates EC Inc. (TAEC) —Authorized Consultant to Sprint To Whom It May Concern: This letter serves to notify you that Sprint has retained the services of TAEC as approved agents to negotiate real estate, construction terms, conditions, permitting, and pricing on behalf of Sprint. We value our landlord relationships and thank you for your time and consideration. Best Regards, Teryle Wiegel Project Manager, Sprint #MoveForward Technology 1 May 9,2017 Mason County Community Services Permit Assistance Center 615 W Alder Street Shelton, WA 98584 RE:Sprint SE72XCO32 Allyn/Murphy Dear Reviewing Parties: Sprint is proposing to modify an existing wireless facility collocated on a monopole at 19941 E State Route I The proposed modification includes the replacement of(3)panel antennas and addition of(6)new remote radio units. All new and replacement equipment will be attached to existing antenna mounts and no increase to the height or footprint of the existing facility shall result from the proposed modification. The following review is being requested at this time: • Building Permit The following items are included as part of the application package: • Building Permit Application Form • Construction drawings(3) • Structural Letter(2) • Lease Agreement Copy(redacted) • fees Please feel free to contact me directly at(509)557-5130 or miranda.glenn@taec.net should you have any questions or require additional information in order to complete your review. Sincerely, f / 6Lz Miranda Glenn Return Address: Nextel Communications 1750 112m Avenue NE,Suite C-100 Bellevue,Washington 98004 ATIN: Systems Development Manager MASTER FILE Site No. 1 ORIGINAL Category Site ae �tiy/lr�-� J AMENDMENT NO.2 TO COMMUNICATIONS SrPE LEASE AGREEAUNT Lessor: John W.Murphy Trust Lessee. Nextel West Corp.,a Delaware corporation, dba Nextel Communications Nextel Reference Number WA0168-1 Allyn Murphy This Amendment No. 2 (this "Amendment") is attached to and made a part of the Communications Site Lease Agreement (the "Agreement") dated October 31, 1997, as amended by that certain Amendment No. 1 to Communications Site Lease Agreement dated March 18, 1999 by and between Nextel West Corp., a Delaware corporation, dba Nextel Communications (herein called "Lessee"), and John W. Murphy Trust (herein called "Lessor"). The terms in this Amendment shall have the same meaning as in the Agreement. In case of any inconsistencies between the terms and conditions contained in the Agreement and the terms and conditions contained herein, the terms and conditions herein shall control. Except as set forth below, all provisions of the Agreement remain unchanged and in full force and effect. NOW, THEREFORE, in consideration of the mutual covenants contained herein and for other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: 1. That Paragraph 4. Option to Lease:Term of Lease of the A&eement is hereby deleted in its entirety and replaced with the following paragraph: 4.Qvtlon to lease:Term of Lease.Lessor grants to Lessee an option(the"Option")to lease the Premises, provided Lessee delivers to Lessor written notice that the lease shall continence the latter of the date of the notice or a date certain specified in the notice("Commencement Date"),which date shall be not later than August 1, 2000 (the "Expiration Date"). Upon a failure to deliver such notice on or before the Expiration Date,this Agreement shall stand terminated. As consieration for the Option, Lessee shall pay the sum of for each six (6) month period(or fractional part therEo—q,trom the date of this Agreement to the Commencement Date. The term of the Lease shall be five (5)years commencing on the Commencement Date and terminating on the fifth (5th)anniversary of the Commencement Date(the "Term") unless otherwise terminated as provided in Paragraph I0.Lessee shall have the right to extend the Term for five (5) successive five(5)year periods(the"Renewal Terms")on the Same terms and conditions as set forth herein. This Agreement shall automatically be extended for each successive Renewal Term unless Lessee notifies Lessor of its intention not to renew prior to commencement of the succeeding Renewal Term. 2. That paragraph 5. Rent of the Agreement is hereby deleted in its entirety and replace with paragraph 5(a). • (a) Within fifteen(15) days of the Commencement Date and on the fast day of each month therafter, Lessee shall pay to Lessor as rent per month("Rent"). Rent for any fractional month at the beginning or at the end of the Term or Renewal Term shall be prorated. Rent shall be payable to Lessor at 1717 150" Avenue SE, #24, Bellevue, WA 98007; Attention: John Murphy. 3. 'lliat paragraph 6. Facilities, Utilities: Access.(d)of the Agreement is hereby deleted in its entirety and replace with paragraph 6(d): d. Lessee shall maintain the existing.div1 access roadways set froth on Exhibit B from the nearest public roadway to the Premises in a manner sufficient to allow Lessee access to the premises at all times under normal weather conditions. Lessee shall be responsible for maintaining and repairing such roadway,at its sole expense, except for any damage caused by Lessor's, and lessor's agents',guests' and invitees',use of such roadway. IN WITNESS WHEREOF,the parties have caused this Amendment to be executed on this ^day of 1 W9. LESSEE; LESSOR Nextel West Corp.,a Delaware corporation, John W.Murphy Tnrst dba Nextel Communications By: By: Mark B.Nelson Heather Murphy Title: Vice President Title: Trustee Date: �/ —! Date:_-- JO _7 7 ACKNOWLEDGMENTS ALL SIGNATURES MUST BE ACKNOWLEDGED STATE OF Washington } II// ) ss. MUNTY OF Cam( V12r-- On this Zo day of , I personally appeared before me Mark B. Nelson to me known to be the Vice Presldjnt, Nextel West orp., of the corporation that executed the within and foregoing instrument,and acknowledged said instrument to be the free and voluntary act and dad of said corporation,for the uses and purposes therein mentioned,and on oath stated that she was authorized to execute said instrument and that the sea]affixed(if any)is the corporate seal of said corporation. f'` =;; �C+��4Y' • iN tary Public' and for State of Washington � �+ f_•l r� = r - �,`•G i- ' !� Name Printed i i My appointment expires IA/ It State of Washington ) } ss. County of Vi On Q day of U{�j , 19�,personally appeared before me t-}�[�✓ jit�1 wy 7 `t to me known to be the_ _�� of the th executed the within and foregoing instrument, and acknowledged said instrument to be the ee and voluntary act and deed of said corporation,for the uses and purposes therein mentioned,and on oath stated that ,) was authorized to execute said instrument and that the seal affixed (if any)is the corporate seal of said corporation. S 1 t t ary Publi and for State of Washington 0• 1 < cSl{?lY , �/ ►►► Q - Z Name Printed i �G �O ZO �,/• n t �t► ..t My appointment expires: ► s+ S Qp,= - r III OF W ASNO Mason County Community Services Building Division SPECIAL INSPECTION & 615 IN Alder Street Shelton, WA 98584 TESTING AGREEMENT 360.427.9670 ext. 352 www.co.mason.wo.us (All references are per the 2015International Building Code) Project Name: _Sprint/Murphy Project Address: _19941 E State Route 3,Allyn (SE72XC032) Building Permit Number: _COM2017-00055 Date Issued: BEFORE A PERMIT CAN BE ISSUED: The registered Design Professional in responsible charge shall fill out the Agreement and include the name and address of the company or inspector. Two(2) copies of this form are to be submitted to the County prior to the issuance of a building permit. If changes are made as to who will perform the special inspections a new form shall be submitted and turned into the Building Permits&Inspections Division for approval. STATEMENT OF SPECIAL INSPECTIONS: In addition to this Agreement, a "Statement of Special Inspections" shall be provided per IBC 1704.3. This Statement shall be made as part of the approved plans, and be placed in a conspicuous location,such as the first page of the construction plans or the first page of the structural sheets. SPECIAL INSPECTORS: All special inspectors shall be approved by the Building Division prior to performing any duties. The special inspector shall provide proof of certification as a special inspector for each inspection item and be licensed by the State of Washington. SPECIAL INSPECTION REPORTS: Special inspection reports are to meet the requirements of IBC 1704.2.4. Copies of each report are to be sent to the address listed in the letterhead noting the Project Address and Permit Number. A final report shall be submitted stating that all special inspection and structural testing items were completed and are in conformance with the approved design drawings and specifications. Items not in conformance,unresolved items,or any discrepancies in inspection coverage(i.e.missing inspections, periodic inspections when continuous was required,etc.)shall be specifically itemized in the final report. Areas requiring special inspection: Name of Agency: Address&Contact Information ❑ Unapproved Fabricators(IBC 1704.2.5) Other than Structural Steel(IBC Table 1705.2.2) ❑ Steel floor&roof decks ❑ Welding of reinforcement ❑ Cold-formed steel Structural Steel ❑ Welding(Per NSA of AISC 360-10) ❑ Details(Per N5.7 of AISC 360-10) ❑ High-strength bolts(Per N5.6 of AISC 360-10) Concrete Construction(per IBC Table 1705.3) ❑ Reinforcement,embeds,anchors ❑ Formwork ❑ Materials ❑ Shotcrete ❑ Post-tensioned/Pre-stressed Concrete ❑ Erection of precast concrete Page 1 of 3 Mason County Community Services Building Division SPECIAL INSPECTION & 615 WAlderStreet Shelton, WA 98584 TESTING AGREEMENT 360.427.9670 ext.352 www.co.mason.wa.us Areas requiring special inspection; Name of Agency: Address&Contact Information Masonry Construction(IBC 1705.4) ❑ Prior to Construction(Article 1.15,TMS-602) ❑ As Construction Begins(Article 1.19.2,TMS-402) ❑ Prior to Grouting(Table 1.19.2,TMS-402) ❑ During Construction(PerTMS-402&TMS-602) Wood Construction ❑ High-Load Diaphragms(IBC 1705.5.1) ❑ Wood Trusses>60ft(IBC 1705.5.2) ❑ Soils(IBC Table 1705.6) ❑ Driven Deep Foundations(IBCTable 1705.7) • ❑ Cast-in-place Deep Foundations(IBC Table 1705.8) ❑ Helical Pile Foundations(IBC 1705.9) ❑ Sprayed Fire-Resistant Materials(IBC 1705.13) ❑ Mastic&Intumescent Coatings(IBC 1705.14) ❑ EIFS(IBC 1705.15) ❑ Fire-Resistant Penetrations(IBC 1705.16) ❑ Smoke Control(IBC 1705.17) ❑ Structural Steel(IBC 1705,12.1&AISC 341-10) ❑ Structural Wood(IBC 1705.12.2) Page 2 of 3 s r Mason County Community Services Building Division SPECIAL INSPECTION & 615 W Alder Street Shelton, WA 98584 TESTING AGREEMENT 360.427,9670 ext. 352 www.co.mason.wa.us ❑ Cold-formed Steel(IBC 1705.12.3) ❑ Mechanical&Electrical Components(1705.12.4) ❑ Architectural Components(IBC 1705.12.5) ❑ Storage Racks(IBC 1705.12.7) ❑ other (IBC 1705.1.1) X Structural Observations- Declaration by Architect/Engineer I, the design professional in responsible charge for this project, declare that the above listed special inspection and structural testing items are required for this project in accordance with IBC lhapter'17. Signature Date Declaration by Owner I,the Owner of the project,declare that the above listed firm(s)or individual(s)are hired by me to perform special inspections and structural testing for the project pursuant to IBC 1704.2. Digitally signed by Miranda Glenn Miranda C I e.n nDN: on=Miranda Glenn, Technology Associates 8/15/2017 1 mail=mirand nl nnaota t —US Date:2017.08.15 09:12:00-07-00, Signature Date CONTRACTOR RESPONSIBILITY: Each contractor involved with the construction of wind or seismic force-resisting systems shall comply with the requirements of IBC 1704.4. The contractor is responsible for providing the special inspector access to approved plans and contract documents at the job site. All special inspection records shall be retained at the job site by the contractor and shall be made available to the Building Department upon request. Declaration by General Contractor I, the General Contractor of the project, agree to comply with the "Contractor Responsibility' items noted above. t na Date Page 3 of 3