HomeMy WebLinkAboutMIS94-0080 Propane - MIS Permit / Conditions - 3/1/1994 MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
M 3E S C E L L A M E O U S P E F2 M 1E T FOR INSPECTIONS CALL 427-9670
MIS94-0080 PARCEL : 123197500010 PLAT : DIV : BLK : LOT :
JOB ADDRESS : NE 1171 SAND HILL RD BELFAIR
APPLICANT : PRINCE OF PEACE 275-6374 275-8760
OWNER : PRINCE OF PEACE 275-6374 275-8760
LEGAL : TA 1 OF SUAV 16/95 FS 15111:A
PROJECT DESCRIPTION :
500 GALLON PROPANE TANK
PROJECT LOCATION :
FROM BELFAIR WEST ON NORTH SHORE ROAD . HWY 300 TURN RIGHT ON SAND HILL ROAD , NORTH 1/2 MILE,
PAST SAND HILL ELEMENTARY SCHOOL 1 /8 MILE TO FIRST DRIVEWAY ON LEFT
PROJECT NOTES :
TYPE: AMOUNT BY DATE RECEIPT
MCFE $ 12 . 00 KS 02 /24 /94 0
I` MCBS $ 15 . 00 KS 02 /24 /94 0
94
TOTAL : 27 . 00 OWNER OR AGENT DATE
MIS_PRMT, rev: 04/01/92 COMPLIANCE TO ATTACHED CONDITIONS IS
REQUIRED
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
1 . Tank is to be 10 feet from any buidling , public way or property line.
2 . If the tank is exposed to probable vehicular damage , provide
protective bollards .
3 . All weeds , grass , brush , trash and other combustible material
shall be kept a minimum of 10 feet away from LP containers .
,>,—X
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
• P.O. Box 186 Shelton, Washington 98584
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Case No . : MIS94-0080
For : PRINCE OF PEACE
Page : 1
1) PURSUANT TO 1991 UNIFORM BUILDING CODE , SECTION 305 (C ) AND SECTION 513 , ALL SITES MUST
HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE
AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY . MASON COUNTY BUILDING
DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS . A
REINSPECTION FEE , BASED ON RATES IN TABLE 3A OF THE 1991 UNIFORM BUILDING CODE WILL BE
ASSESSED IF OWNER /CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
INSPECTIONS .
X
2) � The owner shall have available on site for inspection by Mason County , a report
indicating the name and license number of the installer , the amount of pressure at the
time of testing and the length of test time . This report shall be signed by the person
conducting the
test .
X
If t e tank size is between 125 and 500 gallons you must follow these guidelines :
19 7 5-60010 t 06611
Permit Nog)-� 1 —ojV
`! MASON COUNTY
E BUILDING PERMIT APPLICATION
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASF4fdit' ._ =!"1 VICES -- -- - -- --
#1 Owner P06 C,C ot- QEAC.G CATW'OL%L G1+UQCA _Phone # 715- S7 60 OZ Z'►,S '){506'
Site Address N E It'll $AKO 1♦4(.L QO A G Fire District# Z.
City 5E4X:FN Q St VV A . Zip 9 ES S 28
Directions to Job Site >FAam &LgAi r-S 614 RQ9PA S l+GgC QGAO -t4WI 34D _
-N,Q A R k G 14 T dot S 14,10 N 1I LL QM0 ¢ `!z Nn+c.E' I PAS T S +tL
t-LCIoG►LTw S GAooL Va we To air 0gi yt
Owner Mailing Address 15 O X 611
City 6 ELFA l k St WA Zip Z 8
Lien/Title Holder or.W 0�11'ce4:' [JF 'S CA r T L6
Address 9 10 M-4030W IT
City 54NMW St WA zip
#2 Contractor Name EFrAP1Qt6A.S OP 13R&fAM7Ctl4.J Contractor Reg 41145>191A 0k/m?
Address 88W 13 STATE 4WY 3 S-W Expiration Date / 10 / 3(0
City PORT OecukQfl St Wo Zip 9 3 Phone # 06 G74 Z 3CZ,
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. 315 7%T OO O 1O 0'00
Legal Description P01V7fb4a1C SYVQ want.a~ 5&�Ttoa 13 TOWR9" U 9. 12Ag�<E I
RffFt,Q&W-(& k3uu.0tr46 Pt4MV• 92- 10 47 Faa C14vt"
#5 Building Square Footage: (existing/proposed)
1 st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / # bedrooms / #bathrooms /
Garage / Carport / (Circle: Attached or Detached?)
Other sq. ft. /
#6 Use of building C4V (:W Describe work
#AwTA1Lp,T1a#4 OP Sao GALLON P2006t4E m4ie
#7 Type of Job: New_ Add Alt Repair Other
#8 MOBILE/MANUFACTURED HOME INFORMATION
Model Year Make Model
Length Width Serial No.
# Bedrooms # Bathrooms Type of Heat
Purchase Price $
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements Indicate Directional by (N, S, E, W)
Name of Flanking Street
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
6�G►�T.Ar�
5 oo CAL• t� c 1+vQcti
f�Ro PR�t
Y
MIA
vats S004 rt0.00
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
500
peop k , 6
�i
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No._Toilets CIRCLE FUEL TYPE:Electric,
Bath Basins Heatpump, Other
Bath Tubs No. Units Fees
Showers _ Furn BTU
Hot Water Htr Heatpumps
_Laundry Washer Vent Systems
Sinks Spot Vent Fans
_Floor Drains No. Boilers/Compressors
_Laundry Basins HP
Dishwasher No. Air Handling Units
_Disposal _ cfm#
Urinals No. Fire Protection Systems
Other _ Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet Stove
s Soo &A 004901-
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF `Af#<
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD
OF 180 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. PROOF OF CONTINUATION OF WORK IS BY
MEANS OF A PROGRESS INSPECTION.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OFTHE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEPARTMENT.
X OWNER V X BY
DATE FC 6 7-3 g f DATE
FOR OFFICIAL USE ONLY: Accepted by: Date:
Cz5 �� 3
DEPARTMENTAL REVIEW t ,5
�sz
FOR OFFICE USE ONLY 3 2
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review
Occupancy Group: Type of Const:
Fire Marshal: -tq�
ZI
Other:
Special Conditions: FEES
Building Permit
Plan Check
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee
Other t'n C. F G-7' Z "
Other ► vi c- t3 'S
Building Valuation: TOTAL FEE 7 "�
15J4
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