HomeMy WebLinkAboutCOM2002-00110 Final Tenant Improvement - COM Permit / Conditions - 10/2/2002 MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line(360)427-7262
Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670,ext.352
Shelton, WA 98584 /;:/
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COMMERCIAL BUILDING PERMIT COM2002-00110
OWNER: LAWRENCE LYON MD, FAMILY DOCTOR PLCC RECEIVED: 7/29/2002
CONTRACTOR: LICENSE: EXP: ISSUED: 9/19/2002
SITE ADDRESS: 23460 NE STATE ROUTE 3 SUITE B BELFAIR EXPIRES: 3/19/2003
PARCEL NUMBER: 123294390280
LEGAL DESCRIPTION: TR 28 OF SW SE TR 3 OF SP#1331 PCL 2 OF BLA#99-74
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
TENANTIMPROVEMENT
General Information Construction &Occupancy Information
Type of Use: Medical Insp.Area: No.of Units: Type of Constr.: V-N
Type of Work: REM Fire Dist.: 2 No.of Bathrooms: Occ. Group: B
Valuation: No.of Stories: 1 Occ. Load: 9
Building Height: 16
Pre-Manufactured Unit Information Square Footage Information
Make: Length: Lot Size:
Model: Width:
Building: 1,200
Year: Serial No.: Basement: 1,200 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?:
E
y COM2002-00110 Please refer to the following pages for conditions of this permit.
1 of 4
Plumbing Fixtures Mechanical Fixtures FEES
N Type Qty, Type Qty, Typo 6y Date Amount Reeelpt
p_ w Tenant Review Fee TW 719Q17nn9 St ti nn knnlo
c Building Mats Fee Mr, 71anM91n'? s t sn AnA29
I� UFC Plan Check Fee SAS svt 17W xgu;fin Ann?,;
Planning RevlewFee RAM n+Pnnro sas nn sru,7?
Total $209.00
CASE NOTES FOR
COM2002-00110
vrl/1G� ��L CONDITIONS FOR v� r1t/�•/1 �C{1w� Ccc(
.COM2002.00110 J "
Ali approved plans are required to be on-site for inspection purposIds, If Inspection is called for end plans are not
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on site,Approval WILL NOT be granted. In addition,a Re-Inspection fee in the amount of$62.30 per hour
(mi lmum 1 hour)will be charged and must be collected by this department prior to any further Inspections being �COhd`x9 9r
rformed or approval granted, X (�✓ O /f/O
PURSUANT TO 1997 UNIFORM BUILDING CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR a`s c)� Oat
ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE S
0 STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY BUILDING DEPARTMENT REQUIRES �iq�ai///� z�/
THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS, A REINSPECTION FEE, T 4 a a//
BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THE 1997 UNIFORM BUILDING CODE WILL
BE ASSESSED IF OWNERICONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING
3 VNSPECTIONS,X 6
The approved plot plan is required to be on-site for Inspectlon purposes. If inspection Is called for and plot plan is
03
to not on site,Approval WILL NOT be granted. In addition,a Re-Inspection fee In the amount of$52.30 per hour
(minimum 1 hour)will be charged and must be collected by this department prior to any further inspections being
erformed or approval granted. X
Changes to approved building plans that affect compliance to the current non-residential Energy Code(NREC),
m ventilation and Indoor Air Quatity Code(VIAQ)Uniform Bulldtng/Plumbing/Mechanical Codes and/or Mason
�ounty Regulations shall be approved prior to construction.X
ILE 1/ CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING
/DEPARTMENT AND UNIFORM BUILDING CODE.x
o N '✓ All building permits shall have a final Inspection performed and approved by the Mason County Building
-', --Departmant-prior-to-parmit-explration—T-he-fa.11uratwequesLa-hnaUnspection or to obtain a proval will be
N o� documented In the legal property records on file wlth Mason County as being non-compliant with Mason County
o N ordinances and building regu ations.
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a COM2002-00110
rn 2 of 4
�'VNeecl to have 1 (one)2A108C fire extinguisher by the exit.
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Contractor registratlon laws are governed under RPW 18,27 and enforced by the WA State Dept of Labor and
o Industries,Contractor Compliance Division.There are potentlal 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
This permit becomes null and void if world orconstructlon authofued Is not commenced within 180 days,or If construction or work Is suspended for a period of 180 days at any Uma after work Is
commenced, Evldence of mntin arut of work Is a progress inspectionwithin the 180 day pedod. Final inspection must be approved before building can be oocupied.
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N CONCRETE MECHANICAL MANUFACTURED HOME
o Footings / Setbacks Date By Ribbons
bN Date By Gas Piping Date By
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Foundation Walls Date B y Set-up
o Date By INSULATION Date By
B G / Slab Insulation Floors Final
D ate B y Date B y Date B y
FRAMING Walls FIRE DEPT
Date By Date By Date By
PLUMBING Attic OTHER
Groundwork Date By
Date By WALLBOARD NAILING
D.W.V. Date By
Date By FINAL INSPECTION
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RECEIVED
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-9.2 •FT�. . . .� . r 1- . E3• F�.. f . �. . : r, � , ---- AND SEPTIC TAKIk:
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'LXISTII�( > 30' EA"' \`\
IF — 95(0
_._ CONSTROCT 12" BY 4" I iK;H
.ASPHALT BERM TO DIRECT DRY
ATCH BASIN.
RECEIVED
,JUL 2 4 2002
426 W: CEDAR ST: s r ( \ f I �R A �. L_
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,f�?1Va3D 'M 9Zt? Case number:
Name .
;,, , 71 1�`, Mason County
TENANT IMPROVEMENT APPLICATION
0 n'13038 Tenant Change
Complete the Tenant Review Application and return with a floor plan.site plan,septic pumpers report,septic records and
$111.00 fee to the Mason County Department of General Services, P.O. Box 186,Shelton,WA 98584. During the evaluation of Ten
Review Application staff members from the Building, Fire Marshal, Environmental Health, Planning, and Public Works offices will identi
compliance requirements. This application is Intended for tenant change only. If construction or remodeling Is proposed a separate
building permit will be required. Upon approval the permit will be issued to the applicant and permit fees due will be collected. After the
permit is issued a site inspection can be scheduled by calling (360)427-7262. Upon satisfactory inspection a Certificate of Occupancy
will be issued and must be posted in a conspicuous place on the premises.
Date: _ 2 L( 32 Assessor's Parcel Number: 32ct 3^ c3 g0
Legal Des ription: S Q� o,{{ c 'A .c�vne4 ACl .tX)
Building Site Address: 2 `3 Lf-(, o S o, 3 f�-e U ksuA
�Y
Method of sewage disposal: Septic OSewer- name of district:
Water source: O Well O Community Well V Public System, name of system: L
PEOPLE and FIRMS INVOLVED IN THE PROJECT
Name of property owner: V /4 L_ C LL0��
Mailing address: Pei 3 (1 17* r A ( r— l-i A Qg S-2
Day phone:3(,,,o_Z4�5--c 3S Contact Person: Ai IMessage phone: S
Name of applicant: Avv(ZC-'vLC L`io�l t M ( L 0 oTa Y?_ L
Mailing address: -q '� ^ C
Day phone-.253_ (,,G y3(Contact person: LA2�LC' o.J Message phone:
Name of Tenant: (.-6QU\Q t- U CC_ L,1--(,3N r) _A Al I Lcf 0(-CTbrL LL L
Mailing address: Sq
oAj
Day phone: Contact person: Message phone:
PROJECT INFORMATION
Proposed business name:(_AUt, (. _�orJ �M(L� � � j l�C
Proposed use: �GnICAL O ^/cam Number of employees:
Previous business name: N,cNF
Previous use: SIC C�
INFORMATION A1B9Mf STRUCTURE
Check one: ODetached single level/single tenant single level/multi tenant
O Multi level/single tenant O Multi level/multi tenant
Age of structure: Is structure Curren occupied? If not occupied, how long has it been vacant?
Circle o0e: Y_eV s mos.
List square footage for each floor level
Basement: First: AV I Mezzanine: Second: Third:
Is the structur eated? Type heating fuel: Ci e:
Circle one: No lectri Liquid Propane Natural Gas Oil
Type of heat: Circle one: Furnace eat Pump) Electric baseboard or wall mount Radiant
Will there be any c anges to the following? Circle yes or no, if applicable:
Floor lay-out: Yes o Lighting: Yes (g�) Heating: Yes
Exterior Finishes: Yes Interior Finishes Yes /iq-OD Parking: Yes
Number of restrooms provided: Number of fixtures in each
Is structure handicap accessible? Circle one No
Is the structure equipped with a fire sprinkler system? Yes N Fire alarm system? Yes
Return this application with:
1) Floor Plan (5 sets), 2) Site Plan (5 sets), 3) Pumpers Report and septic records and 4 111 ee
1) Floor Plan(5 sets): Include existing walls,proposed walls,and walls that will be removed.
• Draw the floor plan to scale, '/;'= 1 foot min. Use of rooms
• Room Dimensions • Location of all exits and windows(include dimensions)
• Location of plumbing and mechanical fixtures 4 Interior doors with swing radius
2) Site Plan(5 sets): Note scale used
• Property lines, easements, & right of ways • Location of all existing structures&dimensions
• Distance, in feet,from property line&structures • Landscape buffer yards
• On-site sewage tanks and drainfields, &rese location
• Surface&stormwater run-off routes location areas(number&arrangement
• Location of fire hydrants&vehicle access roads • Slope of property
3) Septic records pumpers report and JUL 2 4 2002
4 6 � C���p C�C,,�
4) Fee: $111.00 Intake fee will be collected w ei►sub►fillTec7:'� §Atonal fees will be collected when the permit is issued,
including required state fee, and may also include Environmental Health and Planning Department fees.
Office Use Only
Accepted by:4zy
Date-7/ '
Submittal Amount$ Receipt number
Pre-Application Review Departmental Review
Env. Health IjZt Uzi Env. Health
Planning Planning
Public Works Public Works
Fire Marshal Fire Marshal
Buildin Building
NREC NREC
Pre Application required? (circle one) Yes No
Building Permit required? (circle one) Yes No Engineering Required? (circle one) Yes No
Occupancy Classification: Occupancy Change? (circle one) Yes No
Occupancy classification change from to
Type of construction
Occupant load calculated: persons. Existing occupant load design persons.
Fee Schedule