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Home My WebLink AboutCOM2008-00134 bldg a - COM Permit / Conditions - 2/24/2009 MASON COUNTY PERMIT NO. -a)(51 BUILD ING PERMIT APPLICATION t ^ 426 W. Cedar- P.O. Box 186, Shelton, WA 98584 � Shelton (360) 427-9670- Belfair (360) 275-4467 - Elma (360)482-5269 '00, On the web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION Owner Community Action Council Company Name Community Action Council Mailing Address 420 Golf Club Rd. SE Mailing Address 420 Golf Club Rd. SE City Lacey State WA Zip Code 98503 City Lacey State WA Zip Code 98503 Phone 3 6 0 43 8-110 0 Other Ph. Phone 3 6 0 4 3 8-110 0 Other Ph. Lien/Title Holder Timberland Bank- Contractor Reg. #CMMTYC*023LJ Exp.06-09-2009 E mail address E Mail Address dalel@caclmt .ora Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION -Connect to New Septic X Existing Septic Connect to Water System X Name of Water System business park' s / community Well Water System Name of Water System PARCEL INFORMATION-12 Digit Parcel No 4 2 0 0-2 2 4 0-0 0 0 0 Fire District 14 Legal Description SE NW EX SE PCL 6 OF BLA#01-7 5 S 2 7/94 Site Address(Please include street name,street number and city)4 SO Dayton-Airport Rd Lot 9 Shelton Directions to site North on SR 101 towards Hoods-port , turn left on Dayton-Airport -Rd. , o approx. 1 4 mi . , turn right into business park, Lot 9 lst lot on right) Will timber be cut and sold in parcel preparation?Yes/(No) Is property within 200'of Saltwater no Lake n River/Creek no Pond no Wetland no Seasonal Runoff no Stream no Slopes or Bluffs ) 15% no Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Y TYPE OF JOB- New X Add Alt Repair Other commercial PRIMARY RESIDENCE a SEASONAL ❑ Use of Building Storage warehouse Describe Work Bui1d 2 warehouses w/common loading dock No. of Bedrooms n a No.of Bathrooms 1 Square Footage- 1 st Floor 2 @2 4 0 0 2nd Floor n a 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make n/a 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 regarding this application or the work proposed in the application.I have obtained required from any easement holier or any other party in interest pemnissaon from to apply for This it and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is aoc ua grants emp of n county access to the above described property and structure for review and inspection. PROOF OF CO UATION OF W IS Y OAEANS OF A PROGRESS INSPECTION. Date- I f �`r O.S X n Re resentative 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 Public Works Department Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing& Base Fee t. /l1 Planning Review Fee Mechanical& Base fee 15 Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee �Cl1J C—. Pre-Paid at Submittal -- - - MASON COUNTY PERMIT NO. PLUM BING/MECHANICAL PERMIT APPLICATION 426 W.Cedar•P.O. Box 186, Shelton,WA 98584 Shelton(360)427-4b67�•Belb (360)275-4467•Elma(360)482-5269 n t e web www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFORMATION OwnerCommunity Action Council Company Name Community Action Council MailingAddress420 Golf Club Rd- SE 420 Golf Club RD SE Mailing Address City Lacey State WA Zip Code 98503 City Lacey State WA Zip Code 98503 Phone 360 4 3 8-110 0 Other Ph Phone 3 6 0 4 3 8-110 0 Other Ph. Lien/Title Holder Timberland Bank Contractor Reg. CMMTYC*0 2 3 LJ Exp 0 6-0 9-2 0 0 9 E mail address E Mail Address alel@caclmt .org Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC INFORMATION-Connect to New Septic X Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No 4 2 0 0-2 2 4 0-0 0 0 0 Fire District Legal Description SE NW EX SE PCL 6 OF BLA#01-75 S 2 7/94 Site Address(Please include street name,street number and cfty)450 Dayton-Airport Rd. Lot 9 Shelton Directions to site Hoods-port, turn left on Dayton-Airport RT. , m' n right into business park, Lot 9 (1st lot on rig t Is property within 200'of Saltwater no Lake no River/Creek no Pond no Wetland no Seasonal Runoff no Stream no Slopes or Bluffs > 15% no TYPE OF JOB-New X Add Alt Repair Other Use of Building -tnrage/warehouse Location of Fixtures/Units-1st Floor X 2nd Floor Basement Garage Closet PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Tyne of Fixture No.of Fixtures Fees Fuel Type:Electric--L LPG_Natural Gas_Heat Pump_ Toilets 1 Type of Unit No.of Units Fees Bathroom Sink —� Furnace Bath Tubs Heatpumps Showers Spot Vent Fan 1 Restroom Water Heater 1 Propane Tank Clothes Washer Gas Outlets Kithen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hosebibs 1 Dryer Vent �-- Other Other ceilina G (l in ea. warehouse) Base Fee heaters/elect) Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 t am the owner,owners legal representative,or the contractor.)further declare that I am entitled to receive this pert 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 holder or arty other party in interest regarding this application or the work proposed in the application,I have obtained permission from them t for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate of Mason arx�ess to the above described property and structure for review and inspection. PROOF OF CONTINUATI F OAK f�elf MFI A PROGRESS INSPECTION. X ` V Date:_j1,4 tr za9, /dwners ep ntative/ tract (indicate which one) FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck# Date Bid Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Grout) T Constr. Planning Department Environmental Health Department FEES Plumbing&Base Fee Site Inspection Mechanical&Base fee UFC Plan Review Fee Wood/Gas/Pellet Stove Fee I Other