HomeMy WebLinkAboutBLD2015-00087 Final Sign - BLD Permit / Conditions - 10/13/2015 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line (360)427-7262
Mason County Bldg. III Phone: (360)427-9670, ext. 352
426 W. Cedar
Shelton, WA 98584
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COMMERCIAL BUILDING PERMIT COM2015-00087
OWNER: GIMS PROPERTY MANAGEMENT LLC RECEIVED: 6/2/2015
CONTRACTOR: INSIGNIA SIGN INC 425-917-2109 BEST CONTACT: STEVEN THOMSON LICENSE: INSIGS1062Q, ISSUED: 7/13/2015
SITEADDRESS: 24100 NE STATE ROUTE 3 BELFAIR EXPIRES: 1/13/2016
PARCEL NUMBER: 123283290060
LEGAL DESCRIPTION: LOT: C OF SP#178 PTN TR 6 NW SW
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
SIGN PERMIT: REMOVE EXISTING 76 POLE SIGN
CABINETS & INSTALL NEW MOBIL SIGN CABINETS:
REMOVE EXISTING 76CANOPY WALL SIGNS & INSTALL 2
NEW MOBIL WALL SIGNS
General Information Construction&Occupancy Information
Type of Use: GAS STATION Insp. Area: No. of Units: Type of Constr.:No. of Bathrooms: Occ. Group:
Type of Work: SGN Fire Dist.: 2
Valuation: $ 25,000.00 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: Shoreline Desig.:
Side 1: Ft. SEPA?: Comp. Plan Desig.:
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?:
COM2015-00087 Please refer to the following pages for conditions of this permit. Page 1 of 5
Plumbing Fixtures Mechanical Fixtures FEES
Type Oty, Type Oty. Type By Date Amount Receipt
Building Permit Fee ARN 13019mr csoi 75 R??mFnn
Plan Check Fee iRN arnnnir, .t9Sd ii R99msrin
Building State Fee iRN Frnnnts se Sri R99msnn
Sign Permit Review .IRN A00n15 547n nn R77n�S(Nl -
Total $720.06
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CASE NOTES FOR
COM2015-00087
:i
CONDITIONS FOR
COM2015-00087
1) Appro er dimensions and locations on submitted site plan. Setbacks are measured from the furthest projection of the structure. is
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2) Signage proposed for this land use shall comply with the dimensional standards presented in Mason County Code M.C.0 17.03.200 to 17.03.203
gent or in Belfair UGA M.C.G. 17,34.010 to 17.34.180. -
3) lS 1
All construction and demolition debris must be removed from the shore area after project completion. Proper dip I of construction debris must
be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X '
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COM2015-00087 Page 2 of 5
4) The following special conditions should be made a part of the building permit:
1. Sign Installation: Sign installation shall be in full accordance with the plans approved by the Building& Planning Divisions of the Mason County 's
Deommunity Development. Each portion shall be securely fastened and anchored into place as indicated on the plans.
2. Address Posting: Numerals for residential and commercial building addresses shall be conspicuously displayed on a contrasting background and
shall be a minimum of 4 inches in height with a minimum stroke of 112 inch. Property addresses shall be posted prior to requesting any inspections.
If property addresses are not posted upon inspection, inspection may not be approved and a re-inspection fee may be charged and must be
collec��V the City prior to any further inspections being performed.
X
3. All Construction:All construction shall meet or exceed all local ordinances and the requirements of the 2012 International Codes as adopted by
Mason County and Washington State. Occupancy is limited to the approved and permitted classification.Any non-approved change of use or
occw could result in permit revocation and/or Code Enforcement action.
X
4, Field Correct:The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must
be in conformance with the 2012 International Codes as adopted by Mason County and Washington State.Any corrections, changes or alterations
requiEsd by a building or fire inspector shall be made prior to requesting additional inspections.
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5, Reinspection Fee:All approved plans are required to be on-site for inspection purposes, and work to be inspected shall be complete and ready
for inspection. If an inspection is called for and plans are not available on site, or the work is not ready for inspection,approval will not be granted.
In aod ,a re-inspection fee may be charged by the City prior to any further inspections being performed or approvals granted.
X
6. Permit Expiration: 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
circunces beyond the control of the permit holder have prevented action from being taken.
X CS I 1
7. Final Inspection Required: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 failure to obtain final approval prior to expiration will be documented in the legal
property records on file with Mason County as being non-compliant with the County's ordinances and building regulations and may be referred to
the Catty Attorney for action.
X (51 )
'i
8. Permit Validity. IBC 105.4/IRC R105.4:The issuance or granting of a permit shall not be construed to be a permit for, or an approval of,any
violation of any of the provisions of the building code, or any other code or ordinance of Mason County. Permits presuming to give authority to
violate or cancel the provisions of the building code or other ordinances of the jurisdiction shall not be valid.The issuance of a permit based on
construction documents and other data shall not prevent the building official from requiring correction of errors in the construction documents and
other data. The building official is also authorized to prevent occupancy or use of a structure where in violation of this code or of any other
ordin of this jurisdiction.
X� 1 }
9. Electrical Permit Required.The electrical system shall be installed under a separate electrical permit issued by the Washington State
Department of Labor& Industries(L&I). Electrical"final"inspections must be approved by L&I prior to requesting a building final.
COM2015-00087 Page 3 of 5
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10.Sales Taxes:This work is being done in Mason County. All sales tax for materials delivered to,or work performed in the County shall be
sourced to Mason County. Prior to final approval,a completed supplier/sub-contractor list may be requested by Mason County to identify suppliers
that de ered materials to the project site, and sub-contractors who performed work on the site.
x
5) All other necessary permits from Mason County,Washington State and/or Federal Agencies that squired for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION.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 1-800-6 82.The person signing this condition is either the homeowner,agent for the owner or a registered contractor according to
WA state law. 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 worm is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
P MIT APPL CATION OF 180 DAYS WILL INVALID : LICATION.
Signatur �qe Date
i
OWNER - REPRESENTATIVE - CONTRACTOR 1
Print Name �AQ (Circle one to indicate) J
COM2015-00087 Page 4 of 5
o
N CONCRETE MECHANICAL MANUFACTURED HOME
to Footings J Setbacks Gas Piping Ribbons
o Interior Date By interior-Date By bate By X
o O
00 et-up Exterior Date By Exterior-Date B S m
Point Load!Isolated Footings INSULATION Date By M
BG!SLAB INSULATION FIRE DEPARTMENT
Date By Data By
Foundation Walls Floors Date By 3
Date By Data By DECKS D
FRAMING Wails Date By O
r'lle By Date By PROPANE TANKS 3
PLUMBING vault Date By M
Date By Z
OTHER —i
Groundwork Atdc
Type= r
Uatt� By Date By Date ay
D.w.V DRYWALL Type- O
B Int Brace Wall Date By 0
y
Date By FINAL INSPECTION N
Water Line Fire Seperatlort o
Late By Date By Date 613 /6— By T
O
CD
Pass or Request Inspect.
Type of Insp. Fail Date Date Dane By Comments 4
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ONVERSION PROJECT t
&obil CRey-,/nnra8�n18
PHYSICAL ADDRESS:
325 Burnett Ave North
Renton, WA 98057
SIGN LEGEND t � r� MAILING ADDRESS:
- ;:� PO BOX 2849
+�. Renton,WA 98056
' OFFICE: (425)917-2109
n FAX: (425) 917-2109
® NEW Mobil Pole Sp :
. .,,
� � GC SE: INSIGSI062QZ
ELEC LICENSE:**PAGE 2** •6' ' `,•` .� � S INSIGSI055J5
41
low
s� = NEW Mobil Wall Signs: CUSTOMER:
**PAGES 3 &4** i t F ;' Randy's Shortstop
■
®i = NEW Canopy LED Accent Lighting: `
PAGES :OVER �� ,°,e,
Mobll
MASON COUNTY DCD PLANNING �� '�
SITE PLAN REQUIRED TO BE ON SITI 0 AL
CHANGES PUqBJECTTOAPPROVAL 1 r ,. P `
Date f
l '
R CEIVED �''
JUN o 2 2015 400 �;;° ����---� - � ,- ;:" PAGE: 1 of 5
426 W. CEDAR ST.
s
PROJECT ADDRESS:
24100 NE State Route 3
.• — ice.
PLANNING A�., Belfair, WA 98528
DATE: 05/15/15
-" CONTACT: Steven Thomson
Steven@insigniosign.com
PARCEL#: 12328-32-90060
h --- ISI JOB#: 15-6615
} �a ZONE: GC
+ , '� ,•' This is an original design and drawing created for
the exclusive use of the customer. Until transfer by
sale,all rights are reserved and it is only to be used
+ A by customer in connection with this project. It is not
to be reproduced in any manner without the
express written approval of Insignia Sign,Inc.
Construction or permitting conditions may cause a
A, change in dimensions or specifications.
s r Due to the printing process,colors may vary.
Mvb'11
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MobilPHYSICAL ADDRESS:
12-1/2"CABINET� - 325 Burnett Ave North
Renton, WA 98057
MAILING ADDRESS:
■ �•�- PO BOX 2849�
• Renton, WA 98056
OFFICE: (425) 917-2109
bi
M ,MO
FAX: (425) 917-2109
C."NERRow GC LICENSE: INSIGS1062QZ
ELEC LICENSE: INSIGS1055JS
' ' CUSTOMER:
AWI
F- 7_ • • • Mart Randy's Shortstop
LEAS N rp...K... • I� - ,� gyp.... 3.0-YC 70�1 Mobi
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PAGE: 2 Or 5
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PROJECT ADDRESS:
SCOPE 0 F WORK 24100 N E State Route 3
�I I 11
* Remove 8L discard existing 76 sign cabinets: Belfair, WA 98528
Moball * Install &wire new Mobil sign cabinets on existing poles using grade 5 bolts �4tota/percabinet}. DATE: 05/15/15
v
Prep & paint existing steel poles to Mobil white:
CONTACT: Steven Thomson
'� ,i * Total Sign Square Footage = 58.36 (23.18NfTRfDU(T10N): S CONTACT.
Thomson
* Total Sign Height = 23'-0" (NO CHAN6f)
* Total Sign Setback = (NO006f): PARCEL#: 12328-32-90060
ISI JOB#: 15-6615
' ZONE: GC
• • •
FEDERAL This is an original design and drawing created for
ALL ELECTRiCALCOMPONENTS TOBEU.L-LISTED, the exclusive use of the customer. Until transfer by
SIGN TD BE 111.1-LISTED APPROVED AND MARKED PER N.E.C.6OD4. sale,all rights are reserved and it is only to be used
/ AND SHALL MEET M.E.C.STANDARDS ALL TO RE HEATH
ELECTRICALLY GROUNDED PER N.E.C.250, b customer in connection with this ro ect. It is not
ALL POWER SUPPLIES TO BE FUSED PER U.L.48,28.2.1 y p
Underwriters GROUNDING AND BONDING PER NE.C.260-60.-92:64,-•6. to be reproduced in any manner without the
Lahorat0neS Inc. SIGN TO MEET N E C AND U L 48 SIGN COMPANY express written approval of Insignia Sign,Inc.
STANDARDS FOR ELECTRICAL SIGNS.
ELECTRIC SIGN GROUNDING&BONDING www.FederalHeath.com Construction or permitting conditions may cause a
AS PER N.E.C.zsaeo&NEC 000-7 specifications.
P
change in dimensions or s
_ 1251 Washington St.Suite 245 Grafton,WI 53024 g
Phone(262)377-2975 Fax(262)377-3193 Due to the printing process,colors may vary.
MW
Mobil
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sue► "4�,W
48'-0'CANOPY LENGTH PHYSICAL ADDRESS:
CANOPY FASCIA SOFT=irt.00 ® q 325 Burnett Ave North
Irso
Renton, WA 98057
MAILING ADDRESS:
Mo PO BOX 2849
Renton, WA 98056
-- -- - OFFICE: (425) 917-2109
FAX: (425) 917-2109
6 ,�6 GC LICENSE: INSIGS1062QZ
ELEC LICENSE: INSIGS1055JS
& SCOPE OF WORK CUSTOMER:
s ® ® Rand 's Shortstop
p
* Remove&discard existing 76 canopy sign:
* Install new 24"LED illuminated blue fascia: '
* Install new 24"x82"LED illuminated Mobil wall sign:
Wire new LED illuminated blue fascia&Mobile wall sign to existing electrical:
*Total Sign Square Footage = 13.67
*Total Sign Weight = 5# per letter:
Mobil A a 1 PAGE: 3 of 5
it.
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PROJECT ADDRESS:
48' CANOPYSOFT LENGTH b� t ^I
L
SIGNSIGN (ANGPY FASCIA
SOFT-192 00
24100 N E State Route 3
Belfair, WA 98528
bil --
------- ---
- DATE: 05/15/15
14'6' ' 16'
CONTACT. Steven Thomson
' Steven@insigniasign.com
®&®i SCOPE OF WORK PARCEL#: 12328-32-90060
* Remove&discard existing 76 canopy sign: ISI JOB#: 15-6615
* Install new 24"LED illuminated blue fascia: ZONE: GC
* Install new 24"x82"LED Illuminated Mobil wall sign: This is an original design and drawing created for
A=6 *Wire new LED illuminated blue fascia&Mobile wall sign to existing electrical: the exclusive use of the customer. Until transfer by
... ��� sale,all rights are reserved and it is only to be used
j I by customer in connection with this project. It is not
*Total Sign Square Footage = 13.67 to be reproduced in any manner without the
* express written approval of Insignia Sign, Inc.
Total g Weight= 5 per letter. con se ja
Sign ei ht # e Construction or permitting conditions may cause
change in dimensions or specifications.
Due to the printing process, colors may vary.
Mobi
sue► � �
PHYSICAL ADDRESS:
325 Burnett Ave North
-----------T---------r-------
----T, Renton, WA 98057
MAILING ADDRESS:
I I I I
I I I I
I I 1 I
I I I I
U.L. APPROV. METAL PO BOX 2849
TRANSFORMER BOX Renton, WA 98056
r--------y ; ; OFFICE: (425) 917-2109
FAX: (425) 917-2109
1 I I I
I I I I
#10 @ 11/2"x3"SQUARE DRIVE ; ; , GC LICENSE: INSIGS1062QZ
SCREWS(6 TOTAL PER LETTER) ELEC LICENSE: INSIGS1055JS
fill
I I I I
I I I 1
6" :1 i i i PS12-60 POWER
SUPPLY CUSTOMER:
Randy's Shortstop
II II
II II 1
1 I I I
ILLUMINATION VIEW
I I I
■
i ----------
Mobi
II it I I I 1
II i I I I I
I 1 I
11 : Ili
11 I I I 1 1 1
1 I I I
II II I � I I
II I
I I I I I
I
I j I I I
1
1 I 1 1 1
I I I 1 1
WHITE SLOAN APOLLO LEDS i
(6 LEDS PER FOOT)
I 7 II I I I I
I II I I
SEI CONDUIT I ; PAGE: 4 of 5
� II BETW.TW. JUNCTION BOXES
i ;
TO,POWER SUPPLY BOX
1 II i I I
II I I
I
PROJECT ADDRESS:
-——— 2X4 JUNCTION BOXES
�� AT REAR EA LETTER
82 SIGN - -� --- 24100 NE State Route 3
-
1
Belfair, WA 98528
1 1 III i I I I
Xz"SEALTITE CONDUIT SEALTITE CONDUIT TO DATE: 05/15/15
PROVIDED BY INSTALLER ADJACENT LETTER
■ V� i ALL ELEC. CONNECTIONS
Z II I
I p I 1 1
CONTACT. Steven Thomson
II 1 I I
Lon
II I I I I
° Steven@insigniasign.com
`V lo I I SECTION VI EW PARCEL#: 12328-32-90060
ISI JOB#: 15-6615
ZONE: GC
NOTES & SPECIFICATIONS:
This is an original design and drawing created for
the exclusive use of the customer. Until transfer by
ILLUMINATED USING SLOAN APOLLO LEDS sale,all rights are reserved and it is only to be used
by customer in connection with this project. It is not
to be reproduced in any manner without the
(1) SLOAN MOD-60W POWER SUPPLY @ 1 AMP (MAX.) express written approval of Insignia Sign, Inc.
Construction or permitting conditions may cause a
change in dimensions or specifications.
Due to the printing process,colors may vary.
V
Mobil I� l 'i��S'.n 4;S 22.. ,��,��,�
PHYSICAL ADDRESS:
I',-rcaovrLIENO 325 Burnett Ave North
CAIROFWSQ9 140.00 Renton, WA 98057
MAILING ADDRESS:
PO BOX 2849
Renton, WA 98056
i OFFICE: (425) 917-2109
FAX: (425) 917-2109
GC LICENSE: INSIGS1062QZ
• ELEC LICENSE: INSIGS1055JS
1
2 CUSTOMER:
Randy's Shortstop
Mobil Mobil
M 0
s � �
0 0
Mob PAGE: 5oF5
t PROJECT ADDRESS:
Won FMMSOF 11.0 ' 24100 NE State Route 3
- Belfair, WA 98528
DATE: 05/15/15
CONTACT: Steven Thomson
Steven@insigniasign.com
®i SCOPE OF WORK. PARCEL#: 12328-32-90060
M"" MoW
� ' Remove&discard existing Texaco canopy sign:
ISI JOB#: 15-6615
' Install new 24"LED illuminated blue fascia: ZONE: GC
`Wire new LED IIIUfrllnoted blue faS(10 t0 existing electrical: This is an original design and drawing created for
r' the exclusive use of the customer. Until transfer by
sale,all rights are reserved and it is only to be used
_ by customer in connection with this project. It is not
to be reproduced in any manner without the
express written approval of Insignia Sign,Inc.
Co nstructlon or permitting conditions may cause a
change in dimensions or specifications.
Due to the printing process,colors may vary.
CODEPRO;
July 9, 2015
Mason County DCD
Barbara A. Adkins, Director
426 West Cedar Street
Shelton, WA 98584
Re: Building Permit# COM2015-00087, 24100 NE State Route 3
Dear Ms. Adkins,
The construction plans for the Sign replacement from 76 to Mobil at 24100 NE St. Hwy
3, have been reviewed for compliance with the 2012 International Building Code, the
2012 International Mechanical Code, the 2012 Uniform Plumbing Code, and the 2012
Washington State Energy Code, as adopted by the State of Washington, as well as any
locally adopted amendments to the codes.
The construction plans have been found to be in substantial compliance with the
adopted codes, and provided the special conditions identified below are incorporated
into the building permit, we recommend approval of the construction documents in
accordance with IBC Sections 107.3.1.
The following special conditions should be made a part of the building permit:
1. Sign Installation: Sign installation shall be in full accordance with the plans
approved by the Building & Planning Divisions of the Mason County Department
of Community Development. Each portion shall be securely fastened and
anchored into place as indicated on the plans.
2. Address Posting: Numerals for residential and commercial building addresses
shall be conspicuously displayed on a contrasting background and shall be a
minimum of 4 inches in height with a minimum stroke of 1/2 inch. Property
addresses shall be posted prior to requesting any inspections. If property
addresses are not posted upon inspection, inspection may not be approved and
a re-inspection fee may be charged and must be collected by the City prior to any
further inspections being performed.
3. All Construction: All construction shall meet or exceed all local ordinances and
the requirements of the 2012 International Codes as adopted by Mason County
and Washington State. Occupancy is limited to the approved and permitted
classification. Any non-approved change of use or occupancy could result in
permit revocation and/or Code Enforcement action.
4. Field Correct: The construction of the permitted project is subject to inspections
by the Mason County Building Department. All construction must be in
conformance with the 2012 International Codes as adopted by Mason County
and Washington State. Any corrections, changes or alterations required by a
building or fire inspector shall be made prior to requesting additional inspections.
Cudepm tic Page I of 2 P.O.Box 185
Allyn,WA 98524
CodeProsWA.com
5. Reinspection Fee: All approved plans are required to be on-site for inspection
purposes, and work to be inspected shall be complete and ready for inspection. If
an inspection is called for and plans are not available on site, or the work is not
ready for inspection, approval will not be granted. In addition, a re-inspection fee
may be charged by the City prior to any further inspections being performed or
approvals granted.
6. Permit Expiration: 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.
7. Final Inspection Required: 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 failure to obtain final
approval prior to expiration will be documented in the legal property records on
file with Mason County as being non-compliant with the County's ordinances and
building regulations and may be referred to the County Attorney for action.
8. Permit Validity: IBC 105.4/IRC R105.4: The issuance or granting of a permit
shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the building code, or any other code or ordinance of Mason
County. Permits presuming to give authority to violate or cancel the provisions of
the building code or other ordinances of the jurisdiction shall not be valid. The
issuance of a permit based on construction documents and other data shall not
prevent the building official from requiring correction of errors in the construction
documents and other data. The building official is also authorized to prevent
occupancy or use of a structure where in violation of this code or of any other
ordinances of this jurisdiction.
9. Electrical Permit Required. The electrical system shall be installed under a
separate electrical permit issued by the Washington State Department of Labor &
Industries (L&I). Electrical "final" inspections must be approved by L&I prior to
requesting a building final.
10.Sales Taxes: This work is being done in Mason County. All sales tax for
materials delivered to, or work performed in the County shall be sourced to
Mason County. Prior to final approval, a completed supplier/sub-contractor list
may be requested by Mason County to identify suppliers that delivered materials
to the project site, and sub-contractors who performed work on the site.
It has been our pleasure to work with you on this project with our mutual desire for
safety in the built environment. If you have questions or concerns, please contact
CodePros at 360-801-0543, or contact me directly at mbarth _codeproswa.com .
SS/incerely.
Michael J arth, M.C.P.
Building Code Consultant
Codt OM LLC
cafile
Codfflm UC Page 2 of 2, P.O.Box 185
Allyn,WA 98524
CodeProsWA.com
fig" & Re-/�►agi�►g
RECEIVED
JUN 0 2 2015
Moboll 42
6 W. CEDAR ST.
Project Name: Mobil Re-Image Project:
Addresses: 24100 NE State Route 3, Belfair WA 98528
Date: 05118115
Department of Community Development,
Enclosed is a permit application & 4 sets of drawings to replace 1 existing 76 pole
sign & 2 existing 76 wall signs with new Mobile signs
Also, enclosed is check for the initial permitting fees but if additional fees are
required please call our office @ (425)917-2109 for credit card information OR we
can mail another check as required.
Please let me know of any questions or concerns. O
Thank you,
Steven Thomson
Insignia Sign, Inc.
Enclosures
'MourrQ :
PHYSICAUSHIPPING ADDRESS: OFFICE: (425)917-2109 MAILING ADDRESS:
325 Burnett Ave North FAX: (425)917-0153 PO BOX 2849
Renton, WA 98057 EMAIL: STEVEN@INSIGNIASIGN.COM Renton, WA 98056
9Ism
MASON COUNTY Permit No: a - UDoDEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING.PLANNING.FIRE MARSHAL (360)427-9670 Shelton ext.352
http://www.co.mason.wa-us/community dev/ (360)275-4467 Belfair ext.352
426 W Cedar Street,Shelton WA 98584 (360)482-5269 Elma ext.35
v`TE
BUILDING PERMIT APPLICATION
11 N 0 2 2015
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:GIMS Property Management LLC NAME: Insignia Sign Inc. 't 2 6 !. CEDAR S T.
MAILING ADDRESS: 7115 Muirkirk Ln SW MAILING ADDRESS: PO BOX 2849
CITY: Port Orchard STATE: WA ZIP: 98367 CITY: Renton STATE: WA ZIP: 98056
PHONE: CELL: PHONE:(425)917-2109 CELL:
EMAIL: EMAIL: steven(EDinsianiasicin.com
L&I REG# INSIGS1062QZ EXP. 02/19/1
CONTACT: OWNER❑ CONTRACTORX BELOW❑
NAME: Insignia Sign Inc. MAILING ADDRESS: PO BOX 2849 ' D'
CITY: Renton STATE: WA ZIP: 98056 PHONE: (425)917-2109 CELL:
NG
EMAIL: stevenna insigniasign.com
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) 12328-32-90060 FIRE DISTRICT
LEGAL DESCRIPTION(ABBREVIATED): LOT:C OF SP#178 PTN TR 6 NW SW
SITE ADDRESS_24100 NE State Route 3 CITYBelfair.WA 98528
DIRECTIONS TO SITE ADDRESS Parcel located South of Cokelet Ln
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 X
TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATIONX REPAIR❑ OTHER ❑
USE OF STRLTCTiTRE(REsIDFNcE.GARAGE FTC.) Gas Station
IS LTSE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
DESCRIBE WRLOILK ® Remove existing 76 pole sign cabinets&install new Mobil sign cobinets:
IIWIIIII Remove existina 76 canopy wall '
gns&install 2 new Mobil wall sgns
SOUARE FOOTAGE:
Gas Canopy
1ST FLOOR_JUL__sq.ft. 2ND FLOOR sq.fr. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.fL COVERED DECK sq.ft.STORAGE sq.fL OTHER sq.fL
GARAGE sq.ft ATTACHED❑ DETACHED❑ CARPORT sq.ft. ATTACHED❑ DETACHED❑
MANUFAC HOl > TFORMATIO •4 COPIES OF THE FLOOR PLAN RE UIRED
MAKE MO Y LE- H
WID ROOMS BATHS AL NUMBER
OWNER acknowledges that 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 or owner's legal representative.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 legal
representative,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 permitlapplication becomes null&void if
work or authorized construction is not commenced within ISO 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 CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42)
x a'iewe*t 47400ao" 05/18/15
Signature of OWNER Date
DEPARTMENTAL REVIEW APPROVE D,4TE DENIED DATE TAGSINOTES/CONDITIONS
BUILDING DEPARTMENT 7 Q ) fl
PLANNING DEPARTMENT
FIRE MARSHAL
FEES TOTAL VALUATION:
BUILDING PERMIT FEE FIRE ACCESS AND GRADE
PLAN REVIEW .jj GEO-TECH REVIEW
PLUMBING&BASE FEE STORMWATER REVIEW
MECHANICAL&BASE FEE TOTAL FEES
WOOD/GAS/PELLET STOVE VIOLATION INVESTIGATION FEE
PLANNING REVIEW FEE VIOLATION FEE