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HomeMy WebLinkAboutCOM2013-00107 Add Ancillary Equipment - COM Permit / Conditions - 12/11/2013 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT inspection Line t.sbu/4zt-izbt Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670, ext. 352 Shelton, WA 98584 1� COMMERCIAL BUILDING PERMIT COM2013-00107 OWNER: S &J JOHNSON LLC RECEIVED: 10/16/2012 CONTRACTOR: WESTOWER COMMUNICATIONS 1.425.941.5941 LICENSE: WESTOC1975J8 EXP: 12/14/2014 ISSUED: 12/11/2013 SITE ADDRESS: 24901 NE STATE ROUTE 3 BELFAIR EXPIRES: 6/11/2014 PARCEL NUMBER: 123213400030 LEGAL DESCRIPTION: TR 3 OF SE SW S 28/106 PCL 1 BLA#03-14 BLA#03-14(R)AF#1779502 PROJECT DESCRIPTION: DIRECTIONS TO SITE: ADD ANCILLARY EQUIPMENT TO EXISTING ATENNA SITE. FOLLOW ST RT 3 THROUGH BELFAIR TO SITE ADDRESS ON THE LEFT ADD A SMALL PURCELL CABINET ON TOP OF EXISTING SIDE JUST BEFORE PENINSULA BLVD CABINET(WA745) General Information Construction &Occupancy Information Type of Use: CELL TOWER Insp. Area: No. of Units: Type of Constr.: No. of Bathrooms: Occ. Group: Type of Work: ALT Fire Dist.: 2 No. of Stories: Exit Design. Load: Valuation: $ 15,000.00 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.: Not Applicable Side 1: Ft. SEPA?: 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?: COM2013-00107 Please refer to the following pages for conditions of this permit. Page 1 of 5 riurnomy rixtures mecnanlcal rlxtures rtta type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee l%A1H iniirigni Bias A gigni inn Planning Review Fee nniH 1ni1signi -VAan nn gigniinn Building State Fee I A%A1 19ia»ni.i T.d x;n Signl Ann Building Permit Fee I AXA1 19iai?ni; 095i 7x; gi,niinn Total $749.06 CASE NOTES FOR COM2013-00107 CONDITIONS FOR COM2013-00107 1) Appr ed per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 2) The pfgposal shall be in full compliance with the Mason County Cell Tower Ordinance#5-98 (Revised by Ord. No. 53-04). X The design of the equipment buildings and related structures shall, to the extent possible, use ma enals, colors, textures, screening and landscaping that will blend the tower facilities to the natural setting and built environment. X 3) All construction and demolition debris must be removed from the site area after project completion. Proper di�FI of construction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X �-f 4) Project must meet or exceed standards and regulations of FAA, the FCC and any other agency of the federal government with authority to regulate towers and antennas. If such standards are changed, then the owners of the tower and antennas, governed by Mason County Ordinance No. 53-08, shall bring such tower and antennas into compliance within six (6) months of the a tive date of such standards and regulations unless a more stringent compliance schedule is mandated by the controlling federal agency. X . 5) To ensure structural integrity of the tower, the owner of the tower shall ensure that it is maintained in compliance with standards contained in the applicable Mason County Building Codes and the applicable standards for towers that are published by the Electronic Industries Assoc., as amended. If, upon inspection, the governing authority concludes that the tower fails to comply with such codes and standards and constitutes a danger to persons or property, then upon notice of being provided to owner of the tower, the owner shall have thirty days to bring such tower into compliance with such standards. If the gn r fails to bring such tower into compliance within said thirty days, the governing authority may remove such tower at the owner's expense. X 6) 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 COM2013-00107 Page 2 of 5 -7) All approved plans are required to oe on-site Tor inspection purposes. IT inspection is caiiea Tor ana plans are not on site, Hpprovai vviuL INU i De granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will Ike charged and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X �f 8) 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 J- q --rT 9) 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 inspections. X 10) 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 colt to by the Mason County Building Department prior to any further inspections being performed or approvals granted. X 11) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilation requirements), Builyliytg/Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. X �-�-+f 12) CONSTRUCTION PROCESS TO BE FIELD CORRECTEDAS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND 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 my Building Inspector shall be made prior to requesting additional inspections. X 13) 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-c pji4nt with Mason County ordinances and building regulations. X�}-� 14) 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 holder have prevented action from being taken. No more than one extension may be granted. X COM2013-00107 Page 3 of 5 bWNER/ 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 ERMIT APPLICATION F 180 DAYS L INVALIDATE THE APPLICATION. Signature Date -Ai�� OWNER - REPRESENTATIVE - CONTRACTOR Print Name (Circle one to indicate) COM2013-00107 Page 4 of 5 C) O (A N CONCRETE MECHANICAL MANUFACTURED HOME 90 Dale By L w Footings 1 Setbacks Gas Piping Ribbons L o Interior Date By tnteriRr-Dane By Date By = o Exterar Date By Exterior-Date B Set-up to INSULATION Point Load I Isolated Footings Date By 0 BG I SLAB INSULATION Z Date By Data By FIRE DEPARTMENT �- Foundation(Mails Floors Date By 0 Date By Data _ By DECKS FRAMING Walls Date By Date By Data By PROPANE TANKS PLUMBING vault Date By I'I Date — By OTHER Groundvrork Attic - -- —_ _-..__.___-. Date By Date By Type: Date By D.w.v DRYWALL Type n Int.Brace Wall O y Date By Date B Date By � K) FINAL INSPECTION O Water Line Fire Separation Date By Date By Date L( By Lo GJ I� O Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments 4 CP 0 Permit 00/07 MASON COUNTY - BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location z !!5 /Z 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 Z� 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 damage incurred by recent "naturaUman made" This is not a complete inspection disasters.This is NOT a �2 CORRECTION NOTICE. Date ���3 /� Department Inspector �� N�7T , 'Iml or w114 ' THI -b, T, J* mw MASON COUNTY DEPARTMENT OF , COMMUNITY DEVELOPMENT r 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 Special Inspection Authorization Project Owner J o`J ��eY)%m,LLCliuilding Permit Number Project Address Engineer/Architect of record 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) 7. Structural welding. Welding inspection shall be in compliance with AWS D1.1. (IBC 1704.3.1) 8. 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 all EIFS systems. (IBC 1704.12) Continued on reverse side 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: 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 adopted by Mason County. Signature Printed Name Owner Agent Date 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. Y 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.masonma.us Special inspection policy 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: ❑Option 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 H: 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 Va5bington Z(5!5oriation of 3Builbing (Officiate *Peciar ltvgpertton fteurp Certificate of Regi!aratiotl Krazan 81 Associates, Inc. Lynnwood, Washington The premise of the Washington Association of Building Officials (WABO) special inspection registration program is that the "special inspector" referred to in the State Building Code is a quality control organization with management and supervisory personnel, special inspectors and laboratory technicians, and the appropriate equipment and facilities to conduct special inspection and material testing in accordance with those standards stipulated in the State Building Code. Types of Work RC REINFORCED CONCRETE PC PRESTRESSED CONCRETE SC SHOTCRETE SM STRUCTURAL MASONRY SSB STRUCTURAL STEEL AND BOLTING SW STRUCTURAL WELDING FP SPRAY-APPLIED FIRE-RESISTIVE MATERIALS LW LATERAL WOOD CF COLD-FORMED STEEL FRAMING PA PROPRIETARY ANCHORS The agency name on this Certificate of Registration has, as prescribed in the State Building Code, demonstrated competence to the satisfaction of the building official specifying the services of a WABO registered special inspector, by qualifying for registration as an agency, as prescribed in the WABO Agency and Inspector performance Qualification Standard No.1701 for the particular type(s) of work listed above. � I January 1, 2015 o $ EXPIRATION DATE EXECUTIVE DIRECTOR ` I i RECEIVED AN 4 2014 & A S S O C I A T E S476 kardAR ST. GEOTECHNICAL ENGINEERING, . ENVIRONMENTAL ENGINEERING CONSTRUCTION TESTING & INSPECTION April 10, 2014 Project No.: 106-14066 Mason County Debbra Coker PO Box 279 Shelton, WA 98584 Permit No.: COM2013-00107 RE: Final Letter Regarding Special Testing& Inspection WA745 Belfair LTE Dear Ms Coker: In accordance with our client's request and authorization, we have performed special testing and inspection services for the above referenced project. The special inspections for this project were: Special Inspection Required Performed Structural Steel: Welding ❑ ❑ Bolting To the best of our knowledge, all work and noted deficiencies have been tested and/or inspected and have been found to be in accordance with the approved plans and specifications. If you have any questions or if we can be of further assistance, please do not hesitate to contact our office at (360) 598-2126. Nl) submitted, SSOCIATES, INC. J nson Jr. anager Poulsbo Division RGJ/cq cc With Offices Serving The Western United States 1230 Finn Hill Road NW Suite A 9 Poulsbo, Washington 98370•(360)598-2126 9 Fax: (360)598-2127 i, FIELD 9"K1 azari &Associates, Inc. REPORT NO.: 14066DFRO40114-LD Geotechnical Engineering•Environmental Engineering Construction Testing and Inspection DATE: 4/1/2014 CONTRACTOR: WESTOWER PROJECT#: 10614066 PERMIT#: COM2013-00107 PROJECT: WA745 BELFAIR INSPECTOR: Lowell Davis LOCATION: BALFAIR JURISDICTION: MASON COUNTY KA P.M.: BJ WEATHER: CLEAR TEMP: 50* Krazan inspector on site for special inspection. Structural observation was performed at existing 185' structure by visual methods from the ground. Reconfiguration of existing panel antennas and the adding of 6 new RRH units and one urge suppression unit to the existing monopole, appear to conform to approved plans, sheet RF-2 details 1,2,3 and 4. Reviewed By: ASTM Test# Equipment/Asset Number(s): To the best of my knowledge,the above WAS performed in accordance with the approved plans,specifications and regulatory requirements. Superintendent/Representative: Technician: Blank SgnatureSigPlusl Offices Serving t Western United States Lynnwood(425)485-5519 •Poulsbo(360)598-2126•Puyallup(253)939-2500 Doty Field Repon Revision 8 Effeaive 02/13/2013 m.aro�impo.ia<a onw.R«c:y�.<a t«u.a<n�.<�<orux asc mis.<p<.n,.y n«w..s.o*,c<a ut Yy tonrnmiws me w;ue+pmdevm otne c�as.as:..un eNsodea:.ms.<p.c o,ti«u:o«mp<nm oe.ew.00.naiww.esurc:ewa m n«cawoau.a<onu<c«.mna<.. lfui uaommtion u+uej<nw.ene.pri«lo CwlsuMuval.By si/ivlg Wfep«f,o«vupermraoa not scceµrtsponneiliry f«wiairy otrcWn.m<fmu n,fomia;mwb<m povia<a ey anm on vte. 1 gON-'COI!- 'n/�� `�` C•. ., ... �r rca "lf MASON COUNTY V PERMIT NO. -b6q _ DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING•PLANNING•FIRE MARSHAL WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352 I �� Mason County Bldg.111,426 West Cedar Street (360)275 4467 Belfair ext.352 1854 PO Box 279,Shelton,WA 98584 (360)482-5269 Elma ext. 352 BUILDING PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: S&' ) &Snti LLC NAME: Weslwty MAILING ADDRESS: Sb NC- PekIhS [ R(y . MAILING ADDRESS: 7S2 2 + CITY: �c��'a►;V STATE: WA ZIP: S�� TJ-Qj U CITY: Mtwttv jit,4STATE: W Z : 160140 PHONE: CELL: PHONE: 2 - y I CELL: EMAIL: EMAIL : L&I REG# JC_!SroC1 AIS 38 EXP•12 IL / PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) �� "� 00030 FIRE DISTRICT LEGAL DESCRIPTIONJ,ABBREVIATED):T( 0F_ lift PrZ I ALA ?BSo2 SITE ADDRESS j��l'�!_, c I. t�,�.� J'-- i CITY `✓ DIRECTIONS TO SITE ADDRESS S Q e rf o ( ►.SR 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 ❑ ALTERATION(, REPAIR❑ OTHER ❑ USE OF STRUCTURE(RESIDENCE,GARAGE ETC.) IS USE: PRIMARY❑ ASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS DESCRIBE WORK vt i I- h� 4 0 k SQUARE FOOTAGE: 1ST FLOOR sq. ft. 21ND 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: *4 COPIES OF THE FLOOR PLAN MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL 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 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 INSPECTI 1 T I�TY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X i n ur of scan Date X Z,tG ; l` S ,k(j ( �' r OWNER/ EP SENTAT E/CONTRACTOR Print Name (CIRCLE TO INDICATE) DEPARTMENTAL REVIEW PRO 'ED DATE DENIED DATE TAGS/NO.TES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT. FIRE MARSHAL � T{ ��11 P�' 7� LEGEND RR� ./. ECI - _ SUBJECT BOUNDARY LINE ��IJC� ! � —-—-—" —RIGHT-OF-WAY CENTERLINE ?z `` K ! / - —� _` / 1 6 2013 RIGHT-OF-WAY LINE mobility PLAI,4 1-'i� ttt ! ' / OCT1 1 J -------------ADJACENT BOUNDARY LINE SECTIONAL BREAKDOWN LINE 426 W. CEDAR ST OHP—«P OVERHEAD POWER LINE WeSTO WBR- / —UGP—OGP--UGP— BURIED POWER LINE COMMUNICATIONS y ae j BURIED GAS LINE 1„. ! 1 n _ .. a _ -- OVERHEAD TELEPHONE LINE E —uGT—uG>'--ucr—BURIED TELEPHONE LINE ! Q I [� 1' \ —W—W--W—W—BURIED WATER LINE ■ ■ ALL n..''ETBACKS ARE n E.SU -1_L-:' ) \ —s—ss—A—BURIED SANITARY SEWER PPN \ 232t 4300010 —SO—SO-50—BURIED STORM DRAIN PACIFIC TELECOM SERVICES, FROi THE FUR H ST I DITCH LINE u-C yN OFT! t!1(YJw. \ ..................................... RETANI K AWINGG WALL PROJEC I Q'POQ -VEGETATION LINE —X—X—X—X—X—CHAIN LINK FENCE —❑ a ❑ WOOD FENCE 4072 REGISTERED \ —X—X—X—X—X—BARBED WIRE/WIRE FENCE ARCHITECT TRANSFORMER FIRE HYDRANT APN I a j;( LIGHT STANDARD N GATE VALVE S 123213400030 I ) \\ ,/ © POWER VAULT ® WATER METER OAFS R' I I _ STATE OF WASHINGTON ® UTILITY BOX f� FIRE STAND PIPE EXP.02-1&15 pA6 �(� 0 UTILITY POLE 0 CATCH BASIN. TYPE I I APN A P P t e i 7��E ,2321�400030 \\ // �� @ GALS VALVE — POLE GUY WIRE ® CATCH BASIN TYPE 11 I 123219999999 T�� �( D PLANNING � 13 GAS METER BOLLARO/ 1N $ATEL_.1N REQvIRL ) r0 E BE Cif SITE (�p TELEPHONE VAULT o MAIL BOX I Q t/ o TELEPHONE RISER 234.21 SPOT ELEVATION CHANGES SUBJECT TO APPROVAL / By 1 Date // / LEGAL DESCRIPTION: I / SEC 08 TWP 32 RGE 08 RT-15)TH PTN OF NE1/4 SW1/4 LY N OF S LN OF CITY OF SEATTLE&PUO 1 R/W SUBJ TO SEATTLE CITY LIGHT ESE & PUD 1 1 , VICINITY MAP /- / F 00 EXISTING ] N RAILROAD ROW / � w 66 / OI Lu APN 1 ` �} OQF� ' \ SITE. CO 123213490080 N I \ / \IX1571NG / POND 7 C ^mil / / I `/6IING // �OP / BU /ILDINGS t o / AT&T PROPOSES TO MODIFY AN EXISTING UNMANNED TELECOMhPJNICATIONS x EXISTING SITE FACILITY BY RECONFIGURING (3) EXISTING UMTS PANEL ANTENNAS (1 PER ACCESS �� / I REVISIONS SECIUR),ADDING (6) RRH UNITS (2 PER LTE ANTENNA),AND (1) SURGE 1 / NO.I DATE I DESCRIFOON INITIAL SUPPRESSION UNIT TO AN EXISTING MONOPOLE AT&T ALSO PROPOSES TO ADD Z'�P A 07/15/13 ISSLm FOR PCO REVIEW SS (8) BATTERIES TO AN EXISTING TE40 CABINET AND (1) PURCELL CABINET STACK EXISTING OTHER / I NOTE O to/az/t3 ISSUED FOR CONSRNCfiON LEH MOUNTED TO AN EXISTING PURCELL CABINET. 1 CARRIERS SHELTER , �� / THIS IS NOT A SITE SURVEY: ALL PROPERTY BOUNDARIES, ORIENTATION OF TRUE NORTH AND EXISTING ECOLOGY / I STREET HALF WIDTHS HAVE BEEN OBTAINED FROM BLOCKS A TAX PARCEL MAP AND ARE APPROXIMATE NOT FOR CONSTRUCTION UNLESS 1 / 1 1 <0 / 123213400000 I At dI n....m�e t graundnq tn,nw, LABELED AS CONSTRUCTION SET A- + C ALL prwiG�1YARNING•taps vl 1]•b.lo�ymd�. I \ / •cALL BEFORE YOU DIG' SHEET TITLE 1-800-414-5555 SITE PLAN I 1 UIMY N011FIWM�lTFR OF WI5HXI4TON 4IAlE ` / I EXISTING / I BUILDINc� ® Ram TRUE ORTH SHEET NUMBER 24'x36" SCALE ,• 50•-0• SITE PLAN -1 11"x17" SCALE 1" 100'-0' S0 25 0 0' A THE INFORMATION CONTAINED IN THIS SET OF CONSTRUCTION DOCUMENTS IS PROPRIETARY BY NATURE ANY USE OR DISCLOSURE OTHER THAN THAT WHICH RELATES TO CARRIER SERVICES IS STRICTLY PROHIBITED. 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