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HomeMy WebLinkAboutCOM2014-00110 Grow and Process - COM Permit / Conditions - 9/12/2014 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line (360)427-7262 PSot CoDyrt Mason County Bldg. III Phone: (360)427-9670, ext. 352 426 W. Cedar Shelton, WA 98584 IRsd COMMERCIAL BUILDING PERMIT COM2014-00110 OWNER: EVERGREEN GRO PRO LLC RECEIVED: 7/31/2014 CONTRACTOR: LICENSE: EXP: ISSUED: 9/12/2014 SITE ADDRESS: 50 W WESTFIELD CT BLDG C SHELTON EXPIRES: 3/12/2015 PARCEL NUMBER: 420022490070 LEGAL DESCRIPTION: LOT 7 OF SP#3027 PROJECT DESCRIPTION: DIRECTIONS TO SITE: TENANT IMPROVEMENTS -SHELL BLDG C, FOR 1-502 CANAPY PARK BLDG C GROW& PROCESS General Information Construction&Occupancy Information Type of Use: I-502 GROW/PROS Insp.Area: No. of Bathrooms:No. of Units: Type of Constr.: Occ. Group: Type of Work: TRA Fire Dist.: Valuation: $ 162,987.32 No. of Stories: Exit Design. Load: 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:na Shoreline Desig.: Not Applicable Side 1: Ft. SEPA?:No Comp. Plan Desig.: Urban Growth Area 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?: COM2014-00110 Please refer to the following pages for conditions of this permit. Page 1 of 9 Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Lavatories 1 Ventilation Fan 1 Plan Check Fee rInnnn 7/';l/9nla aR7R 9F, g19nl dnn Water Closets (Toilets) 1 IFC Plan Check Fee MARA 7/11/9n1A ad37 W; S19n1Ann Planning Review Fee MARA 7/11/9n1d a�;n nn g19n1Ann EH Minor Plan Review A[P 7/'A1/9n1d a1nn nn g79nlAnn Building State Fee ni r. a/11/9nla as Rn S19nlann Building Permit Fee ni r Q/11/9nld al 'AAA RR C19nlAnn Mechanical Permit Fee ni r. 4/11/9n1a aQ nn C19nldnn Mechanical Base Fee ni r. Q/11/9n1d a9R Rn 5,19n1dnn Plumbing Permit Fee ni r a/11/9nla all An R19n1dnn Plumbing Base Fee ni r Q/11/9n1d 09A 7n Cl?nlAnn Non-Res. Energy Code ni r Q/11/9n1a 07';nn C19n1Ann Total $3,246.54 CASE NOTES FOR COM2014-00110 CONDITIONS FOR COM2014-00110 1) 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 1-800-64Z--Q@82. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X� 2) 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. X ^� 3) Approved Septic Design will need to be installed by a licensed installer and receive final approval from County Health Dept. prior to occupancy of the structure. 4) Business will be limited to no more than 4 employees, as per approved septic design from Jim Henry. Exceeding this limitation could result in over-use of the onsite septic and possible failure to the drainfield. 5) Prior to final approval, all upland areas disturbed or newly� te construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X (/r-W 6) Appro �/ ensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X COM2014-00110 Page 2 of 9 7) ,, ALL SURFACE WATER AND POTENTIAL RUNOFF WILL BE CONTROLLED ON SITE AND SHALL NOT ADVERSLY AFFECT ANY ADJACENT PROPERTIES NOR INCREASE THE VELOCITY FLOW ENTERING OR ABUTTING TO ANY STATE OR COUNTY CULVERTING/DITCHING SYSTj% gQAD WAY. X fj� 8) Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your "Approv it Ian"to ensure these structures are shown and meet the setback conditions listed. X �� 9) All means of egress doors shall be not less than 36-inches wide with a clear net opening of not less than 32-inches. Landings not less than the width of the door and not less than 44-inches measured in the direction of travel. Landings shall be provided at each door on each side with a maximum 1/2-inch threshold. Locks and latches may be permitted to prevent operation on doors on the egress side provided all of the following apply: •The locking device is readily distinguishable as locked. *A readily visible and durable sign is posted on the egress side on or adjacent to the door stating: "THIS DOOR TO REMAIN UNLOCKED WHEN THE BUILDING IS OCCUPIED." The sign shall be in letters not less than 1-inch high on a contrasting background. All egress doors shall be readily openable from the egress side without the use of a key or special knowledge or effort and shall not require tight grasping, tight pinching or twisting of the wrist to operate. (ref IBC 1008) X (&K COM2014-00110 Page 3 of 9 10,N.. FIRE FLOW MITIGATION The parcel is not provided with an approved water supply capable of supplying the required fire flow. As a result mitigation shall be required including installation of an NFPA 72 addressable fire alarm system. A separate fire-protection permit application has been approved for the fire alarm system. X LOCK BOX A key box/knox box is required to be installed in accordance with the 2012 International Fire Code Section 506. Please contact the local fire district for more information and to discuss inspections for installation of the lock box system. X FIRE EXTINGUISHERS: Install 2A10BC fire extinguishers throughout the building in accordance with chapter 9 of the 2012 International Fire code. The fire extinguishers shall be installed such that the extingishers are located not more than a travel distance of 75 feet in any direction and mounted no more than 60 inches above floor to the top of the unit. At least one extinguisher is required on every level or floor. X INTERIOR FINISHES: All interior wall and ceiling finishes shall be in compliance with chapter 8 of the 2012 International Fire code. All rooms shall have a finish of a minimum ofa class C with a flame spread index of 76-200 and smoke development index 0-450. X (//W COM2014-00110 Page 4 of 9 11) ACCESS TO BUILDING The site and buildings shall be accessible to persons with physical disabilities in accordance with ICC A117.1. Accessible routes within the site shall be provided in accordance with IBC Section 1104 and not less than 60% of all entrances shall be accessible. PARKING: Accessible parking spaces shall be located on the shortest accessible route of travel form adjacent parking to an accessible entrance in accordance the 2012 International Building Code Section 1106. Spaces shall be constructed in accordance with Section 1101.2/ICC A117.1. Accessible parking spaces shall be provided in accordance with Table 1106.1 as follows: 1 to 25 total parking spaces requires not less than one accessible parking space 26 to 50 total parking spaces requires not less than two accessible parking spaces Construction and design shall be completed in accordance with ICC All 7.1, Section 502. Accessible parking spaces shall be located on the shortest accessible route of travel from adjacent parking to an accessible building entrance. Car parking shall be not less than 96-inches wide and access aisles not less than 60-inches wide shall be properly marked. Parking surfaces shall be firm, stable, and slip resistant material and shall not be steeper than 1:48. Accessible parking spaces shall be clearly identified by signs containing the International Symbol of Accessibility placed not less than 60-inches above ground surface, measured from the bottom of the sign. X AI �L,� 12) Storage racks greater than 69"and up to 8'0" in height shall be installed in accordance to manufacturer specifications for seismic attachment. When seismic attachment is not provided by the manufacturer an engineered design and attachment details shall be required. Installation specifications or engineer's design shall be available during inspections performed by the Mason County Building Department. Storage racks greater than 8-ft in height shall require an engineer's design addressing seismic conditions and attachment. In addition, storage racks 8-ft tall or more shall require special inspection performed by the design professional or an approved representative. The special inspection report and engineered design shall be provided to the Mason County Building Department for approval prior to the final occupancy inspection. COM2014-00110 Page 5 of 9 13) , 2012 IECC/WSEC COMPLIANCE: This project is approved for compliance to the 2012 International Energy Conservation Code/Washington State Energy Code (IECC/WSEC); components shall be installed as follows: ENVELOPE: Prescriptive Using Table C402.2 Roof/attic: Min. R-49 Slab insulation R-10 or better installed in around the entire perimeter from the top of the slab edge to the bottom of the footing. Fenestration including doors and windows, including store door(s) shall have a U-Factor as follows-fixed/non operable windows .30 and skylights U-0.50 or less. Solar heat gain coefficient(SHGC) 0.40 or better except skylights SHGC 0.35 or better. OTHER DOORS: Other than entry doors U-0.37 or less and roll-up or sliding doors min. R-4.75. ELECTRICAL POWER AND LIGHTING SYSTEMS - DEFERRED SUBMITTAL Permanently installed lighting not associated with task lighting for plant growth or maintenance shall require compliance to the 2012 International Energy Conservation Code as amended by Washington State (IECC/WSEC). Provide compliance forms available from Northwest Energy Efficiency Council on their website at: http://www.neec.net/energy-codes. Compliance documents shall be submitted and approved prior to the framing inspection of this project. MECHANICAL SYSTEMS - DEFERRED SUBMITTAL Permanently installed mechanical systems including heating systems, cooling systems, service water heating, and fans, shall require compliance to the 2012 International Energy Conservation Code as amended by Washington State (IECC/WSEC). Provide compliance forms available from Northwest Energy Efficiency Council on their website at: http://www.neec.net/energy-codes. COMPLIANCE INFORMATION SHALL BE SUBMITTED TO THE MASON COUNTY BUILDING DEPARTMENT AND APPROVAL OBTAINED BEFORE THE FRAMING INSPECTION. THE FRAMING INSPECTION WILL NOT BE APPROVED UNTIL DEFERRED SUBMITTAL DOCUMENTS ARE APPROVED AND ISSUED BY THE MASON COUNTY BUILDING DEPARTMENT. X 14) Exits and exit access doors shall be marked by an approved exit sign readily visible from any direction of egress travel. Signs shall mark the direction of egress travel to clearly indicate the direction of travel in cases where the exit or path of egress travel is not immediately visible to the occupants. All intervening doors shall be marked by exit signs. Exit signage shall be electrically powered and labeled in accordance with UL924 and illuminated at all times. In the event of power outage exit signs shall be provided with an emergency power system provided from storage batteries or other approved system such that the signs will remain illuminated for not less than 90-minutes. (ref IBC Section 1006 and 1011) X_ Aw 15) One unisex rrees�troom, accessible to persons with disabilities, is allowed provided the total occupant load is 15-persons or less. COM2014-00110 Page 6 of 9 16) 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 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 17) 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 b har d and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X 18) 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. Commercial structures shall have building numbers or letters posted as follows: 50-ft or less from road not less than 6-inch high and at least 3/4-inch stroke 50-ft up to 100 -ft from the road not less than 12-inch high and at least 1-1/2"stroke X Clz_� 19) All Material Safety Data Sheets (MSDS) for all hazardous materials used within the facility shaJI be placed in a notebook and permanently located in a conspicuous location inside the building near the main entrance. (IFC Chapter 50)X 20) The use, handling and storage of hazardous materialgior flammable and combustible liquids in excess of 10 gallons is not allowed without the approval of the Mason County Fire Marshal. X ` 21) 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 USE OR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x 22) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilation requirements), Buildin lurr,}aing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. X �'" 23) 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 CA ing Inspector shall be made prior to requesting additional inspections. X 24) 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 n unty ordinances and building regulations. X 25) 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 Xa the permit hold e prevented action from being taken. No more than one extension may be granted. COM2014-00110 Page 7 of 9 26), Recyclable materials & Solid Waste Storage: Space shall be provided for the storage of recycled materials and solid waste. The storage area shall be design t the needs of the occupancy, efficiency of pick-up, and shall be available to occupants and haulers 27) Provide a list of materials that will be used and stored within the structure along with anticipated quantities and where the material will be stored prior to the framing inspection of this project. Provide the information to the Mason County Building Department for review and approval . The information is needed in order to verify that the storage of materials does not constitute a physical or health hazard in quantities in excess of those all d wi in the control area. X 28) This permit is approved to complete tenant improvements within an existing shell structure for the purpose of growing and processing recreational marijuana in accordance with 1-502. Oil extraction will not be performed within the structure. A separate permit and approval shall be required to add extraction processing within the structure. X 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 contractor. 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 authorized agent 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 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 OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. ) ��2 ��Z `,//,;�//g Signature Date r)q'91-JX i`9LLS OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) COM2014-00110 Page 8 of 9 CONCRETE MECHANICAL MANUFACTURED HOME m O Date 101,gj" By LA IL— _N Footings /Setbacks Gas Piping Ribbons o Interior Date By interior-Date By bate _ By o Exterior Date By Exterior-Date By Set-up m INSULATION Point Load/Isolated Footings Date By BG 1 SLAB INSULATION _..._ ,. _. .... Date By Data By FIRE DEPARTMENT 0 Foundation Walls Floors Date By Date By Data By DECKS ---- X O FRAMING walls Date By r Date a l—If By Data By PROPANE TANKS n PLUM I G vault Date By Date By OTHER Groundwork Attic Type: Date By Date By Date By o.w.v DRYWALL Type- 0 Date I p H 1y Byt.Oh Int Brace Wall Date __. By Dale By N Water Line Fire Separation FINAL INSPECTION Co� Date it/12,3jlli By bO)b Date By Date ZC) t115� By CD Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments c Ww P.<64 �uSS 9 2rT I tact L-i3y-- �'`/```'�tsi�►. Pis hr� 6•1 101? r o 3 /y L40t All 'Iu^ c f,-oe^ �t;� wUttiz I t'�os _A n L Jim -� 0 0 Fermi# 1 f I C) MASON COUNTY BUILDING I/I 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location !z 6 ) ay 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 com liance l). Al( �.w►h -za Lv P �'� .c cc U ✓s 64 -3Y ::PIX .-r" ei&4 n1t%o.,6nt� r . You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK itil 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 damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOT Date lohdd Department CORRECTION NOTICE. Inspector jzbiL, ■ ,0* 4 N* ,#T ' 01* A* ' ' THI T,6,= * -w IH 0011 0 Permit# " ��^ MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE ��c 'g(� � Job Location sO W V� 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 oe lqtet. -^PN4✓V- 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 nex inspection regarding possible structural OK to Of Nil t( Y 11,4,C � ([W t�, damage incurred by recent "natural1man made" ❑ This is not a complete inspection disasters.This is NOT a Date 101C4'%vl Department 01- CORRECTION NOTICE. Inspector W 1C f m'JT THPh, T"ivm * qff Permit# 6f IN 116 MASON COUNTY , BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location `y W .e,j 6.,-( yam-, This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been folund:-\ f� Items listed below must be corrected to gain compliance t Pe 14r� .i �U You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK 11 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 t0 damage incurred by recent This is not a complete inspection ),- ( isa disasters. made" ® 1 P p 1 disasters.This is NOT a Date �o u Department �L CORRECTION NOTICE. Inspector D* N* ,0T P il* AI4 ' ' THI , TAwr Permit# I'� I ID MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 60 /j /VicS-(fidd This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been fo nd: Items listed below must be corrected to gain com liance *rl a t,►Gl L.��ta�l� re s 2 , � � T L►�s ,�.. Tom, �,w�«.� �r►I a 1�/► ►/LG�S 'ti�s•, ►�+tic r G 11v�.rc� �. 7 , 7� ►� r f iLl 1r LG1 �/u-� d1 4►1 S °-� cy+ l! r► „1 roc -� s, P,i- �S t c.ZC� I v►-2 1, %l� Ytc. of to � -tt r �t, --� /vim- �a ti� ��z ►"✓+�-.s '?�r� lleA Loo 4k (zlo-tz— lodes es- ",, I 1 GcS Si r toed � 1'�, c- ,)l ,vc.► z.,. -re ►l ?. ;�trr�7�- t,-t 1� � ,S_ AMaFr-et" hereby no i ied that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK Call for re-inspection when corrections are made before continuing LI please contact our office ❑ Make corrections, items will be checke on next inspection regarding possible structural �?�,,•t �� �,,r �vK damage incurred by recent "natural/man made" ❑This is not a complete inspection disasters.This is NOTa Date Department 131.,0 CORRECTION NOTICE. Inspector L lot v* 4 N* VT i InI O ' ' THI , T,&F- t~Ar hay MASON COUNTY PERMIT NO. 06rn 20A -00110 DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 Mason County Bldg. III,426 West Cedar Street (360)275- 467 Belfair ext. 352 . ! I r �xsa Shelton,WA 98584 (360)482-5269 Elma ext. 352 V u BUILDING PERMIT APPLICATION OWNER INFORMATI � � CONTRACTOR INFORMATION: NAME: C&*)b 0 V V6,kL— NAME: - - C L n--V1 MAILING ADDRES MAILING ADDRESS: 1 6 5e. 40; . 1JN 5c, CITY: STATE: ZIP: CITY: L STATE:y^%/ZIP: q gs13 PHONE: CELLrj PHONE: T CELL: EMAIL: EMAIL : ,euj i A k�- k 5 Y �41 l u E n FJ 3 OI �0 L&I REG# N ctc l' 3`�D$Lim EXP. L/ PARCEL INFO TION: r-185Co- 3La 6 a8o Ll OS5 PARCEL NUMBER(12 DIGIT NUMBER) AZ�02-2M OO-70 FIRE DISTRICT LEGAL DESCRIPTION(ARR EVi CITY TF,D)- r.� SITE ADDRESS_ �jA) - { _ DIRECTIONS TO SITE ADDRESS IS PROPERTY WITHIN 200 FT: SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑ DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES NO TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATIONS REPAIR❑ OTHER ❑ USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) IS USE: PRIMARY❑ S) SONAL ❑( NUMBER OF BEDROOMS ER OF BATHROOMS DESCRIBE WORK ci r f e� S UARE FOOTA �CtS�►►� 'fpri►ti'�" 1 ST FLOOR L s .ft. 2ND FLOOR s .fL 3RD FLOOR fL BASEMENT s .q q sq q ft. DECK sq. fL COVERED DECK sq.fL STORAGE sq.fL OTHER sq.fL GARAGE sq.ft. ATTACHED ❑ DETACHED ❑ CARPORT sq. fL ATTACHED ❑ DETACHED ❑ N ANUF ORMATION: ;4 COPIES OF THE FLOOR PLAN MODEL YEAR LENGTH IDTH BEDROOMS BA NUMBER 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 contractor. I further deciare 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 authorized agent 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 permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if constru ion work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF IN ON. IN TIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDAT THE APPLICATION. x 7 3Gr % ignature of, ppli Date X L'un, t `l- tr OWNER/ REPRESENTATIVE /CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW AP ROVED DATE DENIED DATE TAGS/NOTES/COn�IFIONS BUILDING DEPARTMENT - PLAN ING DEPARTMENT FIRE MARSHAL MASON COUNTY PERMIT NO. no 2oI L4 - wI io DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL _ WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 _ Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext.352 18g4 PO Box 279, Shelton,WA 98584 (360)482-5269 Elma ext.352 PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFOBAI 4TION: NAME:_ �(J Pro L,C� NAME: �S MAILING ADD SS: MAILING ADDRESS: I( k S C CTTY: STATE: ZIP: CITY: ( STATE: u)h. ZIP: 9 9 S'13 PHONE: CELL: PHONE: Vo —7,eA ELL: EMAIL. — ZU0. 2e!n.-d8 5 EMAIL : L&I REG# MP-066312S L EXP. r/ PARCEL INFORMATION:PARCEL NUMBER(12 DIGIT NUMBER): 4Z Do 1-2 4 q 1 ©C-7 o LEGAL DESCRIPTION(ABBREVIATED): r SITE ADDRESS:_ a CITY: DIRECTIONS TO SITE ADDREss: TYPE OF JOB NEW ADD ALLT x REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES INfr§--I"FLOOR 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas—Ductless— Toilets 1 Tvae of Unit No.of Units Fees Bathroom Sink ( Furnace Bath Tubs Heat Pump Showers Spot Vent Fan Water Heater 1 Propane Tank Clothes Washer Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hose bibs Dryer Vent Other Solar Panel Other Base Fee 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 I am the owner,owners legal representative,or contractor. 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 authorized agent 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 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 OF INSPECTION. INACTIVITY OF THIS PERMI PPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. XAcs— — i ature o Applicant Date X Owner/Owners Representative/Contractor � r �� � indicate which one Print Name (indicate ) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Request To Revise An Approved Plan Permit Number: BLD (4m;?4N - 60(r U Name P f. Gt-o piqt) Parcel Number 4-boo-L - - Phone Number daytime ( 3G ) ) �p Project Address Sl , a� �; �` Mailing Address j t[.d� 61 lease provide a complete, detailed descriptign of the proposed revisions to th ppro-led plans: c� Are two sets of the revised plans or addendum indicating the changes included? Yes ❑ No Are the approved site plans included? -Ff Yes ❑ No Are the revisions clearly and accurately identified on the plans or addendum? Yes ❑ No Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes _V'No If Yes, Has the engineer or architect approved this revision? ❑ Yes ❑ No Is a stamped and signed approval included with this request? ❑ Yes ❑ No (Note:No structural changes to a"designed"plan will be approved without the written consent of the engineer and/or architect of record.) Does the proposed revision modify the footprint or location of the structure? ❑ Yes (No If Yes, Is a revised site plan, with all new setback dimensions included with this request? ❑ Yes ❑ No AdditionalInformatio C�z - 1 (111 Applicant's signature Date: 3� Office Use Only Received by: el Date Sent Assigned To Approved By Date Original Valuation: $16 Ajq �z•J� B• l� L.� 1 Additional Valu n: $ l Sq.Ft. x$ / / $ $ al New Valuati $ 7Td d . ❑ P.W. A ' tonal arming Dept. $ o� A ditiona Ian Review $ O Addition onditions/Co m'� tl'f�:�� Additio Building Permit $ .�t� 8 /3 46 � D� A nal Plumbing $ 0 D A ditional Mechanical $ Additional E. H.Dept. $ ODY her $ Thal Amount Due: $ //Amount To Be Paid Up-Front$