HomeMy WebLinkAboutCOM2009-00102 Cancelled Replace Pedestrian Bridge, DNR, and Special Inspection - COM Permit / Conditions - 9/29/2009 r
MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360}427-7262
Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670,ext.352
Shelton,WA 98584
COMMERCIAL BUILDING PERMIT COM2009-00102
OWNER: WA STATE DEPT. NATURAL RESOURCES RECEIVED: 9/11/2009
CONTRACTOR: LICENSE: EXP: ISSUED: 9/29/2009
SITE ADDRESS: EXPIRES: 3/29/2010
PARCEL NUMBER: 223250060000
LEGAL DESCRIPTION: SECTION EX E1/2 SE
PROJECT DESCRIPTION: DIRECTIONS TO SIT
Replace pedestrian recreational bridge (5'0"wide, 150-ft long) On Tahuya State F r st lands: ac es via Sandhill or Elfendahl Pass Rd.
across Mission Creek.
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General Information C truc on&Occupancy Information
No. f Unit Type of Constr.:
Type of Use: bridge Insp.Area: N . of Ba oo Occ. Group: U
Type of Work: NEW Fire Dist.: 2
Valuation: $ 129,900.0 No. ' s: Occ. Load:
g Height:
Pre-Manufaq,ured Unit I rmatiortSquare Footage Information
Make: Length: Lot Size: 150-ft long:
Model: Width: Building:
Year: Serial No.: Basement: Parking Spaces:
Setback Inf
Shoreline&Planning Information
Front: Ft. Shoreline: Ft.
Rear: Ft. Slope: Ft. Water Body:Mission Creek Shoreline Desig.: Urban
Side 1: Ft. SEPA?:Yes Comp. Plan Desig.: LTCFL
Side 2: Ft.
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?:
COM2009-00102 Please refer to the following pages for conditions of this permit. 1 of 5
Plumbing Fixtures Mechanical Fixtures FEES
f Type " Qty. Type Qty. Type By Date Amount Receipt
Plan Check Fee rMnn QF11/9nnQ 1.t7rr,1d R19nn9nn
Planning Review Fee r;nann Qi11 i?nnQ ,tzzn nn R1 gnnann
Building State Fee ni r. QnlignnQ 4U Fn g17nnQnn
Building Permit Fee nl r Qi91t9nnQ R1 1R1 75 C19nnQnn
Total $2,251.39
CASE NOTES FOR
COM2009-00102
CONDITIONS FOR
COM2009-00102
1) Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title
14.28.
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2) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance
Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be
obtained at 1-800-647-09 2. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to
WA state law. X P.
3) All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are not on site, Approval WILL NOT be
granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will be char ed nd collected by the Mason County
Building Department prior to any further inspections being performed or approvals granted. X _
4) In addition to the inspections required in IBC, Section 109, the owner, the engineer or architect of record acting as the owner's agent shall employ
one or more special inspectors who shall provide inspections during construction on the types of work listed under Chapter 17 and as specified by
the design professional. The special inspectors duties& responsibilities shall be as specified in Chapter 17.
Special inspection reports shall be submitted to the Mason County Building Department, PO Box 186, Shelton WA 98584 and available for
inspection. Inspection reports shall be completed and submitted to the dept. in a timely manner and shall be submitted prior to the framing and
final occupancy ipections.
5) Any changes in construction shall be reviewed by engineer of record and submitted in writing to the Mason County Building Department prior to
construction. All engineering documents are a part of the approved set of plans and must remain attached thereto. If engineering documents are
removed, approval will not be granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will be charged and
X Ilecte�by tAe Mason County Building Department prior to any further inspections being performed or approvals granted.
6) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND THE INTERNATIONAL CODE REQUIREMENTS AND
OCCUPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF USE19R CCUPANCY WOULD
RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x I
COM2009-00102 2 of 5
7) W Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely
impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements
of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose.
For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a
_driveway or access connecting from a Mason County Road,, Contact the Mason County Public Works Department prior to construction at Ext 450.
For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review
future planned work whir,M,m y affect your project.
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8) Changes to approved building plans that affect compliance to the current Mason County Regulations shall be approved prior to construction.
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9) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE
ADOPTED BUILDING CODE.
The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in
conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a
Mason County Building Inspector shall be made prior to requesting additional inspections.
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10) All property lines shall be clearly identified at the time of foundation inspection. X f • e�_ ,
11) All building permits shall have a final inspection performed and approved by the Mason County Building Department prior to permit expiration. The
failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being
non-compliant with Mason County ordinances and building regulations.
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12) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the
time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control
of the permit holor I}�ve prevented action from being taken. No more than one extension may be granted.
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13) This project is approved for 150-ft long bridge intended and designed for pedestrian traffic only. A sign shall be posted on the bridge placed in a
permanent manner stating the intended use and maximum load. Per design specifications, prepared by Boydston Engineering of Colbert, WA,
dated 8/21/2009, the design live load is 100 psf or 1000 lb concentrated load.
X C' (' -
14) Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance
Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be
obtained at 1-800-647-098 T4 person signing this condition is either the homeowner, agent for the owner or a registered contractor according to
WA state law. X (�
15) The proposed project must be consistent with all applicable policies and other provisions of the Shoreline Management Act, its rules, and the
Mason Counliy,Shoreline Master Program.
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COM2009-00102 3 of 5
16) Approved SHR2009-00007 conditions:
1. The bridge must be high enough (minimum of three feet above the 100-year flood elevation) to pass all expected debris and anticipated high
water flows from a 100-year flood.
2. All excavation materials and soils exposed to erosion by all phases of construction shall be stabilized and protected by seeding, mulching or
other effective means, both during and after construction.
3. Excess construction materials shall be removed from the shoreline area.
4. Storm water runoff shall be controlled to reduce suspended solids and other pollutants before entering the creek.
5. No further bank stabilization, such as rock, be installed on the site unless appropriate permits are obtained.
6. All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and
construction must be obtained PRIOR TO CONSTRUCTION and all conditions must be adhered to until completion of the project.
7. All facilities shall be constructed and maintained in a safe and sound condition. Abandoned or unsafe structures shall be removed or repaired
promptly by the owner.
This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied.Proof of continuation of
work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described property and ffure for eview and inspection.
OWN ER OR AGENT: — DATE: — �'-
9
COM2009-00102 4 of 5
c�
O
K CONCRETE MECHANICAL MANUFACTURED HOME D
1V
0 Date By N
cD Footings J Setbacks Gas Piping Ribbons D
o Interior Date By interior-Date By Data By —I
M
o Extencx Date By Exterior-Date B
v
ry Point Load/Isolated Footings INSULATION Date By m
Date By D�1 SLAB INSULATION By FIRE DEPARTMENT �vµ
-�
Foundation Walls Floors Date By Z
Date By Data By DECKS >
FRAMING Walls Date By C
D
Date By Date By PROPANE TANKS r—
PLUMBING Vault Date By
Date By M
Groundwork Attic OTHER Cl)0
Date By Type
Date By Date By
D.W.v DRYWALL O
Type.
Date B Int.Brace Wall Date By 0
Y
oat. By
FINAL INSPECTION c
Water Line Fire Separation O
Date By Date By Date By
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Pass or Request Inspect.
Type of Insp. Fail Date Date Donn By Comments
to 7 C'/ P-8 It Si S/�_
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MASON COUNTY
BUILDING Ill 426 W. CEDAR
SHELTON, WASHINGTON 98584
(360) 427-9670
CORRECTION NOTICE
V
Job Location
This structure has been inspected by Mason County Building Department
and the following VIOLATION of County Laws and Ordinances has been
found: Items listed below must be corrected to gain compliance Cs'9l Uri /S sl
w T s— o Ta
You are hereby notified that the above corrections shall be made
BEFORE PROCEEDING WITH ANY FURTHER WORK
❑ Call for re-inspection when corrections are made before continuing ❑ please contact our office
Make corrections, items will be checked on next inspection regarding possible structural
❑ OK to �/7C�/� ,,IT �`j �i✓ I� L-51� damage incurred by recent
it made"
❑This is not a`complete inspection disasters.This is NOT a
Date ,/42—2 e�7 Department CORRECTION NOTICE.
Inspector /9/(
Ono 10/05/2009 08: 20 5092767010 BOYDSTON ENGINEERING PAGE 01/01
■
P. 0.
10
4 4 .0 N i;'9 0
September 5, 2009
Pete Bozhinov
Bozco Construction
P. O. Box 534
Nine Mile Falls, Washington 99026
RE: New Pedestrian Bridge
Department of Natural Resources
Mason County, Washington
This letter is in response to your request to use sack concrete mix for mixing at the site for
the concrete footings and abutments.
After discussing this over the phone, we agreed if you use a high-strength concrete mix
such as Quikrete 5000, it would be acceptable to site ba"ch the concrete in a portable
mixer.
Pie se contact me if you have any questions or if you need any additional information.
le se contact
ectfully,,,
ALA-&
80
m rn i M. oy Jr., P.E. &
le M. oy
SM B s
SMB.-sb
7093
A
ExP�iiEs 03-17-
� MASON COUNTY DEPARTMENT OF
COMMUNITY DEVELOPMENT TO BE- K
EFL,
426 West Cedar Street ♦ PO Box 186 ♦ Shelton, WA 9851,is� ! � f�V i
cy
(360)427-9670 EXT. 352 FAX(360)427-7798 HOME PAGE-www. aSQn.via I ``
Special Inspection Authorization
Project Owner /�/�o d� / /Ze -ces Building Permit Number Cps -005/—dOJfZ
PaL c e,/ Nit..+6e,_
oleo^+ ems ZL3 Z�- do -60000 Engineer/Architect of record Aoy�S 74kA b#,zv eeyrr0
In addition to the inspections required by International Building Code (IBC) Section 109, the owner or the engineer
or architect of record acting as the owner's agent shall employ one or more special inspectors who shall provide
special inspections during construction on the types of work listed under IBC Section 1704.
This form must be completed by the owner or the engineer or architect of record, prior to permit issuance, indicating
who will perform the required special inspections for this particular project. The specified special inspector(s) shall
perform the required special inspections during construction of the project, submit all inspection reports to the
Building Department and provide a final signed report stating whether the work requiring special inspection was, to
the best of the inspector's knowledge, in conformance to the approved plans and specifications and the applicable
workmanship provisions of the IBC. The following checked items require special inspection:
❑ 1. Concrete. During the taking of test specimens and placing of reinforced concrete. (IBC 1704.4)
❑ 2. Bolts installed in concrete. Prior to and during the placement of concrete around bolts when stress
increases permitted by Table 1912.2 and section 1912.5 are utilized. (IBC 1704.4)
❑ 3. Erection of precast concrete members. Periodic inspection per ACI 318: Ch 16. (IBC 1704.4)
❑ 4. Shotcrete. Continuous inspection per ACI 318: 5.9, 5.10 and IBC Chapter 19. (IBC 1704.4)
❑ 5. Reinforcing steel and prestressing steel tendons. Inspection of reinforcing steel including prestressing
tendons. (IBC 1704.4)
❑ 6. Welding of reinforcing steel. Inspection of the welding of reinforcing steel according to AWS D1.4, ACI
318: 3.5.2, and IBC 1903.5.2. (IBC 1704.4)
Na. Structural welding. Welding inspection shall be in compliance with AWS D1.1. (IBC 1704.3.1)
eU. High-strength Bolting. The installation of high-strength bolts shall be periodically inspected in accordance
with AISC LRFD Section M2.5. (IBC 1704.3.3)
❑ 9. Structural Masonry. Masonry construction shall be inspected and evaluated with the requirements of IBC
section 1704.5.
❑ 10. Soils. Inspections for fills 12 inches or greater to be performed in accordance with IBC Section 1704.7.
❑ 11. Pile foundations. Inspector to be present when pile foundations are being installed and during tests. (IBC
1704.8)
❑ 12. Pier foundations. Special inspection of pier foundations for buildings are required in seismic Zone D. (IBC
1704.9)
❑ 13. Spray-applied fire resistant materials. Inspections shall be in accordance with sections 1704.11.1
through 1704.11.5.
❑ 14. Exterior insulation finish system (EIFS). Special inspection shall be required for 4fl,EIFS systems.;;(� B
1704.12)
Continued on reverse side �t'E: -3.
❑ 15. Smoke-control system. Smoke control systems shall be tested by a special inspector per IBC Section
1704.14.
❑ 16. Special cases. Special inspection shall be required for proposed work that is, in the option of the building
official, unusual in its nature such as alternative methods and material of construction, unusual design applications,
and materials and systems required to be installed in accordance with additional manufacturer's instructions that
prescribe requirements not contained in the IBC or referenced standards.
❑ Installation of structural epoxies ❑ Installation of"high-load shear panels"
❑ Structural Observation (IBC1709) ❑Other:
Special Inspector Selection:
The special inspection agency and special inspector shall be registered by the Washington Association of Building
Officials (WABO)for the particular type of construction or operation requiring special inspection. Such inspector(s)
shall be selected by the owner or the owner's agent and approved by the Building Official prior to issuance of the
building permit. The owner's agent shall not be acting as, or employed by the special inspection agency or the
contractor for this project.
Name of Special Inspector or Agency: /Type of Inspection: Registration Number:
Nq TC .1�;SCt/ 51 QZ 74-)
Authorization: I hereby state that I am the legal owner of the project property, or that I am the legal owner's agent
who is not employed by a special inspection agency or contractor associated with this project. In addition, I agree
to comply with the special inspection requirements established by Chapter 17 of the International Building Code as
adop d by Mason County. J -�
Signature V Printed Name ❑Owner YAgent Da e
THESE PLANS MUST BE
ON TfI.E.10B SITE
FOR WSPECTION
PURPOSE OF SPECIAL INSPECTION
Special inspection is the monitoring of materials and workmanship which are critical to the integrity of the building
structure to assure that the approved plans and specifications are being followed and that relevant codes are being
observed. Special inspections are in addition to those conducted by the county building inspector and by the
engineer or architect of record. Special inspectors furnish inspection at all times that their presence is required by
the code, the plans and specifications, and the enforcing jurisdiction. Good communication between the special
inspector and the designer, contractor, and building department is essential.
DUTIES AND RESPONSIBILITIES OF THE SPECIAL INSPECTOR:
Special inspectors are individuals with highly developed, specialized skills who observe those critical building or
structural features which they are qualified to inspect. Duties of special inspectors and/or inspection agencies
include the following:
1. General Requirements
Special inspectors shall review approved plans and specifications for special inspection requirements.
Special inspectors shall comply with the special inspection requirements of the enforcing jurisdiction.
2. Signify Presence at Job Site
Special inspectors should notify contractor personnel and the enforcing jurisdiction of their presence and
responsibilities at the job site.
3. Observe All Work for Which They Are Responsible
Special inspectors shall inspect all work and perform or observe all tests requiring inspection and testing for
conformance with the building-department-approved (stamped) drawings, specifications and applicable
provisions of the code.
4. Notification of Discrepancies
Special inspectors shall bring all nonconforming items to the immediate attention of the contractor. If any
such item is not resolved in a timely manner or is about to be incorporated in the work, the engineer or
architect of record and the building official should be notified immediately by telephone or in person, and
the item noted in the special inspector's written report. The special inspector shall write a separate report
to be posted at the job site regarding noted discrepancies which should contain, as a minimum, the
following information about each nonconforming item:
• Description and exact location,
• Reference to applicable detail of approved plans/specifications,
• Name and title of each individual notified and method of notification, and
• Resolution or corrective action.
5. Reports
A. Inspection reports
The special inspector should complete written inspection reports for each inspection visit and provide the
reports on a timely basis determined by the building official. The special inspector or inspection agency
shall furnish these reports directly to the building official, engineer or architect of record, and others as
designated. These reports should be organized on a daily format and may be submitted weekly at the
option of the building official. In these reports, special inspectors should:
• Describe inspections and tests made with applicable locations;
• List all nonconforming items;
• Indicate how nonconforming items were resolved;
• List unresolved items, parties notified, and time and method of notification; and
• Itemize changes authorized by the architect/engineer of record and approved by the building department,
if not included in the nonconformance items.
B. Final reports
Special inspectors or inspection agencies shall submit a final, signed report to the building department
stating that all items requiring special inspection and testing were fulfilled and reported and, to the best of
their knowledge, in conformance with the approved design drawings, specifications, approved change
orders and the applicable provisions of the code. Items not in conformance, unresolved items or any
discrepancies in inspection coverage (i.e., missed inspections, periodic inspections when continuous was
required, etc.) should be specifically itemized in this report.
DUTIES AND RESPONSIBILITIES OF THE CONTRACTOR:
The contractor's duties include responsibility for notifying the special inspector or agency regarding individual
inspections required by the Building Department, or required by the International Building Code, Chapter 17.
Adequate notice shall be provided so that the special inspector shall have appropriate access to the approved
plans at the job site prior to the required inspection. The contractor shall not perform any work that requires special
inspection without the special inspector present. Completion of this form, and the performance of special
inspections does not relieve the contractor's responsibility to schedule required inspections by the Mason County
Building Department prior to concealing any work.
DUTIES AND RESPONSIBILITIES OF THE ENGINEER OR ARCHITECT OF RECORD:
The engineer or architect of record is responsible for identifying which special inspections are necessary,
developing a schedule of required special inspections, and assisting the owner in the selection of the special
inspector. The engineer or architect or record shall review the special inspection reports to determine that all
required special inspections have been performed and that all discrepancies (if any) have been resolved.
DUTIES AND RESPONSIBILITIES OF THE PROJECT OWNER:
The project owner, or the engineer or architect of record acting as the owner's agent, is responsible for the funding
of all required special inspection activities in accordance with International Building Code Section 1704.
IzE ;l..A MUST BE
ON Taf : 3 c I iE
FOR li`'SPEUTION
< MASON COUNTY DEPARTMENT OF
COMMUNITY DEVELOPMENT
426 West Cedar Street ♦ PO Box 186 ♦ Shelton, WA 98584
(360)427-9670 EXT. 352 FAX (360) 427-7798 HOME PAGE—www.co.mason.wa.us
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Special inspection policy R sP� TioN
Scope:
To ensure compliance with all provisions of Local, State and International Building Codes in addition to
all jurisdictional policies.
Responsible Party:
The owner or registered design professional acting as the owners agent is responsible to obtain, and have
pre-approved by the jurisdiction, any and all Special Inspection Agencies and/or persons employed by
such.
Policy:
Mason County allows two methods in which compliance may be obtained. Please read the following
options carefully when choosing your method of compliance and special inspection agency:
Pption I: Registration with WABO (Washington Association of Building Officials)
The WABO registration gives the jurisdiction the assurance that the individual and or
agency has met certain criteria and that the criteria is maintained.
See WWW.WABO.ORG for listing of approved individuals or agencies.
❑Option II: Mason County will approve an individual or company, to perform inspections upon
demonstration of competence-for the particular type of construction or operation requiring
special inspection. As proof of competence the individual or company will need to
conform to all of the following criteria and provide supporting documentation.
A.)Provide the name of the individual that will perform the particular type of
inspection along with documents demonstrating competency including copies of
all certifications and registration numbers pertinent to the inspection type.
Examples: (ICC, ICBO,NICET, AWS)
WA. State licensed Structural/Civil Engineers or Architects may also be accepted.
B.) When laboratory testing and field inspection equipment will be required provide
details of specific tests,the quality of the system,procedures to ensure test are
performed properly and all policies for recording, reviewing and performing
such test. An equipment log must be maintained and available for review. All calibration
maintenance records must be traceable to the National bureau of Standards, calibrations must be
performed frequently as set up per the standards.
C.)When all required information has been submitted staff will review documentation and approve
the acceptability of the special inspection competency or request additional information as
deemed necessary.
Authorization Form:
After selecting option I or II please complete the "Special Inspection Authorization" form and submit it
to Mason County for initial review.
Approved By: Mark Core Date: 10-02-07
FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT NO. �,�Ylol1 -
PLEASE PRESS HARD BUILDING PERMIT APPLICATION Q�
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
APPLICA1,4T INFORMATI N I CONTRACTOR IN.FPRMATION -' .
Owner Q'�� ompany Name Zr>'� V1 �1G�T T ir-n
Mailing Address KI Mailing Address
City StatkJ x'-_Zip Co, Stat Zip Co
Phone Other Ph. Phon Other Ph. 0
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic. # DOB Drivers Lic.# DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existing Septic
Connect to Water System Name of Water System
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. — _ Fire District
Legal Description
Site Address (Please include street name, street number and city)
Directions to site
Will timber be cut and sold in parcel preparation?Yes/No
Is property within 200' of Saltwater Lake River/ Creek Pond
Wetland Seasonal Runoff Stream Slopes or Bluffs /o
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair r PRIMARY RESID NCE ❑ SEASONAL ❑
Use of Building Describe Work
No. of Bedrooms, No. of Bathrooms Square Footage- 1st FI or 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq. ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length Width Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price$ Replacement Unit? Yes/ No
Installer Name Certification No.
OWNER /BUILDER Acknowledges 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, owners legal representative, or the contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all
the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work
proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or
agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above
described property and structure for review and inspection. This permit/application 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 OFAPROGREssAsPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 PAYS WILL INVALIDATE THE APPLICATION.
X / � Date: O
Own!ne22frs epresentativp/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Fire Marshal
FEES
Building Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing & Base Fee Planning Review Fee
Mechanical & Base fee Other
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
Mission Creek Trail Bridge
Plan View and Cross-Sections
Scale: 1" = 60'
Ordinary High Water Line
I \_ Stream Cross-section
—_——— Stationing
1 - 0+00
I
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I ———0+54
APPROVED
TBM#1 is a Blaze in root collar / -- e MASON C'U" I NTY DCD PLANN I^I G
of NW side of 20"DBF /
Douglas-fir / __ SITE P N REQUIRED Tn 9E ON SITE
/ - 1+04 CHA ES BJECT TU Ac'PROV^.L
/ BY Date
1+60
L
Thalweg / 2+14
m
x
x
STATE OF WASHINGTON Project Name Project No. Bid Opening E
Mission Creek Trail Bridge DNR 09-E03 2:00 p.m.
Department of Natural Resources
Engineering Division
Project Manager Location
Bid Proposal—Summary Recording Sheet Bill Heymann Mason County
B o n d Proposal Trench Addendum
NAME OF FIRM BB/CC Signed Safety #1 Base Bid Amount
---- --P7r-AS_rAe-- -s-oAnt,-;- tfi2G. to1�
3
- -- - .�K- -- -C
3
--- - ---- --- --- -- - -- ------ --- - - -- -- -
6
ENGINEER'S ESTIMATE $175,000.02
7Recorder's Signature Proposa Reader's Signatt
I
STATE OF WASHINGTON PUBLIC WORKS CONTRACT ~'
DEPARTMENT OF NATURAL RESOURCES
5
ENGINEERING DIVISION
i
s
CONTRACT NO. DNR 09-E03
PROJECT: MISSION CREEK TRAIL BRIDGE
i
THIS CONTRACT, is entered into between the STATE OF WASHINGTON,DEPARTMENT OF
NATURAL RESOURCES,ENGINEERING DIVISION,P. 0. Box 47030,Olympia, WA 98504-7030,
hereinafter called the Owner,and BOZCO CONSTRUCTION, 20660 W. Southbank Rd,Nine Mile Falls,
WA,99026,hereinafter called the Contractor,existing under and by virtue of the laws of Washington and
authorized to do business in the State of Washington.
WITNESSETH: That in consideration of the terms and conditions contained herein the parties hereto
covenant and agree as follows:
1. The Contractor agrees to furnish all material, labor,tools,equipment,apparatus,facilities,etc.,
necessary to perform and complete the above-entitled project.
2. The Contractor agrees to complete the project in accordance with and in the manner described in
the Form of Proposal,General Conditions, Special Conditions, and Specifications and Drawings,
together with all amendments,modifications,supplements and addenda issued by the Owner.
These documents, along with this contract, shall be collectively referred to as the Contract .
Documents and are by this reference incorporated herein and made part hereof. The Contractor '
further agrees to perform any changes in the work in accord with the Contract Documents.
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3. The Owner agrees to employ,and does employ,the Contractor to provide the materials and to do
and cause to be done the above-described project and to complete and finish the same in accord
with the Contract Documents. The Owner further agrees to pay the Contractor pursuant to the
Payment Schedule(Attachment"A")at the time, in the manner,and upon the conditions provided
for in the Contract Documents.
4. The Contractor agrees that the covenants contained in the Contract Documents shall bind its j
successors and assigns.' }
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5. The work to be performed under this contract shall be completed by October 31,2009. The
Contractor further agrees that, from the compensation otherwise to be paid,the Owner may retain
the sum of ONE HUNDRED DOLLARS($100.00)for each calendar day thereafter that the work
remains uncompleted, which sum is agreed upon as the liquidated damages which the Owner will I
sustain in case of the failure of the Contractor to complete the work at the time stipulated,and this i
i
sum is not to be construed as in any sense a penalty.
6. It is further provided that no liability shall attach to the Owner by reason of entering into this G.
contract, except as expressly provided herein.
IN WITNESS WHEREOF,the parties have executed this instrument on the day and year below written.
BOZCO CONSTRUCTION
By: Pry
Title: (9-U 7 I!�
Dated: 06 — � r>t
State Contractor's License No.
BOZCOC*91000 r
Fed.Tax.I.D.No. 91-2190377
U.B.I.No. 602-294-43 5
e-mail address: bozco@a centurytel.net
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STATE OF WASHINGTON
Y
DEPARTMENT OF NATURAL RESOURCES
APPROVED AS TO FORM ONLY
This flay of 2009 x
.v
Assistant Attorney General '7
By:
ClaySpfaVe
Depu pervisor,Uplands
Dated:
� `�7� f
a
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ATTACHMENT A
PAYMENT SCHEDULE
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LUMP SUM ITEMS
LUMP SUM ITEM I. Mobilization and Demobilization. _$ 6,500.00
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LUMP SUM ITEM 2. Provide and Install trail Bridge. _$ 123,400.00
TRENCH SAFETY ITEM =$ 0.00
TOTAL PROJECT BASE BID =$129,900.00
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