HomeMy WebLinkAboutCOM2008-00104 Final Gold Label - COM Permit / Conditions - 10/14/2008 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
COMMERCIAL BUILDING PERMIT COM2008-00104
OWNER: LESTER KRUEGER RECEIVED: 9/2/2008
CONTRACTOR: LICENSE: EXP: ISSUED:
SITE ADDRESS: 23770 NE STATE ROUTE 3 BELFAIR EXPIRES:
PARCEL NUMBER: 123294100130
LEGAL DESCRIPTION: TR 13 OF NE SE
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
Gold label 12'x56' modular for offices. NE State Rt 3 to address.
General Information Construction&Occupancy Information
No. of Units: Type of Constr.: VB
Type of Use: Insp.Area: No.of Bathrooms: 1 Occ. Group: B
Type Work: NEW Fire Dist.: 2 No. of Stories: 1 Occ. Load: 7
Valuation.-
Building Height:
Pre-Manufactured Unit Information Square Footage Information
Make: Length: Lot Size:
Model: Width: Building: 672
Year: Serial No.: Basement: Parking Spaces:
Setback Information
Shoreline&Planning Information
Front: W 175.00 Ft. Shoreline: Ft.
Rear: E 32.00 Ft. Slope: Ft. Water Body:NONE Shoreline Desig.: Not Applicable
Side 1: N 165.00 Ft. SEPA?:No Comp. Plan Desig.: Urban Growth Area
Side 2: S 11.00 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?:
COM2008-00104 Please refer to the following pages for conditions of this permit. 1 of 5
Plumbing Fixtures Mechanical Fixtures FEES
.Type Qty. Type Qty. Type By Date Amount Receipt
Total
CASE NOTES FOR
COM2008-00104
CONDITIONS FOR
COM2008-00104
1) Install 2A10BC fire extinguisher mounted no more than 60 inches above the floor.
X '1�i�
Install a knox box/key box per section 506 of the 2006 IFC. Please contact the local fire distrcit for more information and inspection.
X
2) PER TITLE 14 MASON COUNTY BUILDING CODE -CHAPTER 14.17, STANDARDS FOR FIRE APPARATUS ACCESS ROADS- 14.17.110:
A fire apparatus access road in excess of 14% grade and more than 150' to new residential or commercial structures will require an automatic fire
sprinkler system installed. Contact the Mason County Fire Marshal at(360) 427-9670, extension 273, for further information.
x q ''
3) 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 t"
4) This project is approved subject to the following requirements:
1) Provide at least one accessible building entrance.
2) Provide at least one accessible route from an accessible building entrance to primary function area.
3) Post accessible signage where required, including parking, and entrance.
4) Provide at least one accessible parking space in accordance to approved standards.
X
5) A compaction report shall be provided where structures are placed on fill.
X
COM2008-00104 2 of 5
6) 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 be c d and collected by the Mason County
Building Department prior to any further inspections being performed or approvals granted. X
7) 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 6L
8) 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 US R OCCUPANCY WOULD
RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x
9) Provisions for surface/subsurface drainage control must be implemented with new construction or development on site and MUST NOT adversely
impact adjacent parcels. Under the requirements of Mason County Stormwater Ordinance, either private ditches and drains will meet requirements
of the stormwater ordinance or prior approval will be granted to use an existing utility and drainage easement dedicated for that specific purpose.
For further information regarding this ordinance and the REQUIREMENT to obtain an ACCESS PERMIT for the installation/construction of a
driveway or access connecting from a Mason County Road, Contact the Mason County Public Works Department prior to construction at Ext 450.
For any construction which is proposed to be located within 25' of a Mason County road right of way, it is suggested to contact that office to review
future planned work which may affect your project.
X
10) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilation and Indoor Air
Quality Code (VIA Building/Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction.
11) 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 CountyQuilding Inspector shall be made prior to requesting additional inspections.
X MIT
12) All property lines shall be clearly identified at the time of foundation inspection. 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-com plian 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 h9lger have prevented action from being taken. No more than one extension may be granted.
X
15) Recyclable materials & Solid Waste Storage: Space shall be provided for the storage of recycled materials and solid waste. The storage area
shall be designe^meet the needs of the occupancy, efficiency of pick-up, and shall be available to occupants and
haulers.X w041
16) Glendon drianfield must have operation and maintenance inspection within the six months of final occupancy.
X i'Nt ILi
COM2008-00104 3 of 5
17) The modular structure is approved for placement provided the structure is properly labeled and approved for use as an office, "B" occupancy and
installed in accordance to manufacturer specifications including seismic restraints for structures located in a seismic zone D-2.
18) All Best Management Practices must be strictly adhered to throughout proposed development. X
19) Prior to final approval, all upland areas disturbed or newly created by construction activities shall be seeded, vegetated or given an equivalent type
of erosion protection (silt fencing or straw matting). X tim
20) Temporary erosion control measures must be implemented to prevent water quality d�eQradation of adjacent waters or wetlands. Silt fencing must
be installed and maintained until upland vegetation has become established. X 1lb 0
21) Approved par,,dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure.
X i. ;
22) All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and
construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. X
This permit becomes null and void if work or construction authorized is not commenced within 180 days,or if construction or work is suspended for a period of 180 days at any time after work is
commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of
work is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees of Mason County access to
the above described property and s ructur for eview and inspection. ,t
OWNER OR AGENT: DATE:
COM2008-00104 4 of 5
1/26/2017
Case Activity Listing 3:03:47PM
Case#: COM2008-00104
Parcel#: 123294100130
Not Description: Gold label 12'x56' modular for offices.
Assigned Done
Activity Description Date 1 Date 2 Date 3 Hold Disp To By Updated Updated By
COMA010 Application Received 9/2/2008 None DONE KS 9/2/2008 KS
COMB210 Water Adequacy 9/2/2008 9/5/2008 None DONE AMH 9/5/2008 AMH
DOH indicates that Belfair Water Dist.# 1 is adequate for this additional connection.
COMB200 Environmental Health Review 9/2/2008 9/11/2008 None DONE ADR 9/11/2008 ADR
See condition
COMB009 Fire Marshal Review 9/2/2008 9/10/2008 None DONE LAW 9/11/2008 DLC
COMB110 Building Plan Review 9/2/2008 9/11/2008 None DONE DLC DLC 9/11/2008 DLC
LMOR for M Rutter: Need foundation system info&plans for exiting system-do 9/4/2008
COMB155 Letter of Incompleteness 9/18/2008 None DONE JMS 9/18/2008 JMS
The proposed building site was inspected on Wednesday 09/17/08 to check for possible critical areas.According to both my field inspection and information contained in PAR2007-00045 meeting notes there
is a Type F stream on the parcel.According to the MCRO 17.01.110 a Type F stream requires a 150 ft buffer and a 15 ft.bilding setback.From my site inspection it was determined that the proposed
development site is within the stream buffer/building setback.In order to reduce this buffer the applicants will have to follow the criteria set forth in Section D.3.of the MCRO 17.01.100(Fish and Wildlife
Habitat Conservation Area).
As part of this criteria they will need to go before the Hearing Examiner(HEX)for the requested Variance,submit an Habitat Management Plan and they may also be required to apply for an MEP(Mason
Environmental Permit).During my site inspection is was noted that the applicant maybe have room on the parcel to adjust the proposed building site to remain out of both the stream buffer and building
setback area. Please feel free to contact me concerning the information provided in this letter and or to set up a site appointment to go over the submitted site plan.
Thank you.
Jim Scholz
360-427-9670 Ext.294
COMA910 Meeting 9/19/2008 None DONE JMS 9/19/2008 JMS
09/19/08-Met with applicant's agent on site to discuss proposed development regarding 165 buffer/building setback from Type F stream.Agent will submit revisied site plan showing placement of new
development(Modular Building and Ramp)outside of 165 buffer and building setback areas.Modular building will be placed along south property line per discussion.JMS
COMA800 Plot Plan Revision Received 9/22/2008 None DONE TW 9/22/2008 TW
due to stream setback
Page 1 of 2 Casenctivity..rpt
1/26/2017
Case Activity Listing 3:03:47PM
Case #: COM2008-00104
P10
Parcel #: 123294100130
Description: Gold label 12'x56' modular for offices.
Assigned Done
Activity Description Date I Date 2 Date 3 Hold Disp To By Updated Updated By
COMB130 Planning Review 9/16/2008 9/22/2008 None DONE JMS JMS 9/22/2008 JMS
Planning review Complete.
Received revisied site plan indicating that new development is out of stream buffer and building setback per discussion with applicant's agent.No other issues.
Waiting on reivised site plan per discussion.
Site inspected on 09/17/08 to check for possible critical areas.According to both my field inspection and information contained in PAR2007-00045 meeting notes there is a Type F stream on the parcel.
According to the MCRO 17.01.110 a Type F stream requires a 150 ft buffer and a 15 ft.bilding setback.From my site inspection it was determined that the proposed development site is within the stream
bufferbuilding setback.Will be sending out letter of incompleteness to applicants-JMS.
COMA100 Approved for Issuance 9/24/2008 None DONE CMH 9/24/2008 CMH
COMA540 Print Inspection Card 9/24/2008 None DONE KKK 9/24/2008 KKK
COMA510 Reprint Commerical Permit 9/24/2008 None DONE KKK 9/24/2008 KKK
Issued permit with P.O.
COMC157 Final Inspection-Failed 10/2/2008 10/3/2008 None FAIL TFR 10/7/2008 KDM
1)POST ADDRESS#MIN 6"TALL X 1"WIDE AND PLACE ON CONTRASTING BACKGROUND
2)INSTALL ADA SIGNAGE
3)INSTALL KNOX BOX
****OK TO TEMP OCC 180 DAYS****
COMC155 Final Inspection-Passed 10/13/2008 10/14/2008 None DONE TFR 10/15/2008 TW
Page 2 of 2 CaseActivity_rpt
r
o
K CONCRETE MECHANICAL MANUFACTURED HOME C
p
0o Footing Date B y m
1 Setbacks Gas Piping Ribbons u7
o Interior Date By interior-Date By Date By m
DA Extero( Date By Exterior-Date By
Set-up �
Point Load 1 Isolated Footings INSULATION Date By m
BG!SLAB INSULATION Cn
Date By Data By FIRE DEPARTMENT m
Foundation Walls Floors Date By
Date By Data By DECKS
FRAMING Walls Date By
Date By Data By PROPANE TANKS
PLUMBING Vault Date By
Date By OTHER
Groundwork Attic
Date By pate By
Type.
Dale By
D.W.V DRYWALL Type. 0
int Brace Wall Date By 0
Date By Date By FINAL INSPECTION �
IN)
Water Line Fire Separation p
Date By Date By Data /41> 5/•.G� By C
Pass or Request Inspect.
Type of Insp. Fail Date Date Dane By Comments
i✓rf - bf1 L e-3 T" S 4-1—f
,'I-SS o,c3 le--/ ir-8
Cri
s i
oN-STATE MASON COUNTY
o P� A o N DEPARTMENT OF COMMUNITY DEVELOPMENT
N
Planning Division
?; o Y P O Box 279, Shelton, WA 98584
(360)427-9670
1864
NOTIFICATION OF INCOMPLETE APPLICATION
September 18, 2008
LESTER KRUEGER
14241 E STATE RT 106
BELFAIR WA 98528
Parcel No.: 123294100130
Proiect Description: Gold label 12'x56' modular for offices.
Dear Applicant:
You have submitted a permit application (case no. COM2008-00104) for proposed construction or
development in the county. Upon review of your application, I have determined that the contents
of the application are incomplete or do not provide enough detail for review.
Therefore, review of your application will not proceed until the necessary information is provided
(see the comment section of this letter for details.) Once the information is submitted and the
application is complete, I will continue to process your application accordingly. If the additional
information is not provided to the County within 180 days of this request, the application shall
expire and no further action on the proposed development shall take place.
Please contact me at (360) 427-9670, ext. 294 if you have questions.
Sincerely,
James Scholz
Land Use Planner
Mason County Planning Department
9/18/2008 Page 1 of 2 COM2008-00104
I
NOTIFICATION OF INCOMPLETE APPLICATION
9/18/2008 Case No.: COM2008-00104
Comments:
The proposed building site was inspected on Wednesday 09/17/08 to check for possible critical
areas. According to both my field inspection and information contained in PAR2007-00045 meeting
notes there is a Type F stream on the parcel. According to the MCRO 17.01 .110 a Type F stream
requires a 150 ft buffer and a 15 ft. bilding setback. From my site inspection it was determined that
the proposed development site is within the stream buffer/building setback. In order to reduce this
buffer the applicants will have to follow the criteria set forth in Section D.3. of the MCRO 17.01.100
(Fish and Wildlife Habitat Conservation Area).
As part of this criteria they will need to go before the Hearing Examiner (HEX) for the requested
Variance, submit an Habitat Management Plan and they may also be required to apply for an MEP
(Mason Environmental Permit). During my site inspection is was noted that the applicant maybe
have room on the parcel to adjust the proposed building site to remain out of both the stream
buffer and building setback area. Please feel free to contact me concerning the information
provided in this letter and or to set up a site appointment to go over the submitted site plan.
Thank you.
Jim Scholz
360-427-9670 Ext. 294
9/18/2008 Page 2 of 2 COM2008-00104
NameLiSTA!:�-L y D10 BLD#
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 1 of 2)
Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is
made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface 2.
'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development
including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not
part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment..
'-Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas,
concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the
natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces.
To Calculate Impervious Surfaces Please Complete This Table
Surface Type Length X Width = Area *All dimensions in feet
Buildings ~6 X 7 _ 7? ' �}�
X = Measurements for buildings are taken at the
X - perimeter of the farthest projections(example:
eaves/gutters)
X Driveways X
X - Length of drive begins at the right of way
X =
Parking Areas X =
X = Any paved, gravel or packed area per definition
above table
X =
i Patios/Walks X =
X = Any paved, gravel or packed area per definition
above table
X =
Others X =
X = tf the total impervious velo area,of the proposed site
x = depment 14.9reater than'2000 square.fest e
Small Parcel Stonnwater Site Plan is Required
Total Impervious Surface Area(sum of all areas)
If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below.
Based Upon the information you have provided a Stormwater Site Play:IS NOT required for this development activity.
Owner/Builder/Agent 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,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
de cribe property for review and inspection as may be required.
Owner/Agent/Contractor(circle one)Date: 2 (}
If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign
the information provided on page 2 of 2.
Page 1 of 2
k
NamcLwe� Q&rtj L Kii q6&e ' Parcel# 12 �3 2 y q I aol 3d BLDO
Mason County
Department of Community Development
Small Parcel Stormwater Management Application/Worksheet (page 2 of 2)
Based Upon the information you have provided a Stormfvater Site Plan IS Required for this development activity.
Title 14, Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater
Management in this jurisdiction. A complete copy of the ordinance can be found on the Mason County website:
httu//www.co.mason.wa--us/code/commissioners/index.htin
Please follow the links to"Title 14,Chapter 14.48 Stormwater Management".
Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan
(Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document
entitled "Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist
you in preparing the necessary information and plans for Public Works to review and approve. Per Department of
Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in
their entirety AND no part of the stormwater system adversely affects any septic system(see Environmental Health
information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval.
A design by a registered professional may be required for more complex sites.
*These details are found in the document Managing Stonn Drainage on Small Lots, The Small Parcel Stonnwater Site Plan
on the pages that begin with"Handout"
PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE
A) ,!� The relevant details from Managing Storm Drainage on Small Lots, The Sntall Parcel Stornrn,ater Site Plan will be installed
in their entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel.
B) An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the
system will be located as not to adversely affect any septic systems on this,or any other,parcel.
If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works
Department can provide additional instructions,guidance and examples. (Section 14.48.130) contact Public works at:
Phone: (360)-427-9670 EXT.450
Mail: P 0 Box 1850, Shelton WA 98584
Physical:415 N 6th St, Shelton WA 98584
If this development has,or will have, a septic/drainfield system you may need to contact Mason County Division of
Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or
any other,parcel.You may also wish to consult with the septic design professional involved with the project. Mason
County Division of Environmental Health can be reached at:
Phone: (360)-427-9670 EXT.352
Mail: P 0 Box 1666, Shelton WA 98584
Physical:426 W Cedar St, Shelton WA 98584
A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met
prior to a request for final inspection of the building permit.
Owner/Builder/Agent 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,owner's legal representative,or the contractor.I
further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above-
described property for review and inspection as may be required. p `,
Owner/Agent/Contractor(circle one)Date:i �I
Page 2 of 2
MASON COUNTY PERMIT NC� ,�'
PERMIT APPLICATION
BUILDING P n
426 W. Cedar- P.O. Box 186, Shelton, WA 98584
Shelton (360) 427-9670 • Belfair (360) 275-4467 - Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION t� CONTRACTOR INFORMATION
Owner L ES TER�'t%E77r L I IIJEMS Company Name
Mailing Address E•SgIreguZ
Mailing Address
City A`L8V.& State Zip Code 2 -&' City State Zip Code
Phone Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# DOB Drivers Lic.# DOB
SEPTIC /WATER SYSTEM NFORMATION - Connect to New Septic Existing Septic
Connect to Water System . Name of Water System 6&,G"
Well - Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. 72 r77W7335736 Fire District
Legal Description
Site Address (Please include street name, street number and city) 776 IV& S
Directions to site
Will timber be cut and sold in parcel pre ation?Yes/ o -
Is property wit in 200' of Saltwater Lake River/Creek Pond
Wetland_ Seasonal Runoff Stream Slopes or Bluffs 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No
TYPE OF JOB - New Add Alt Repair Other PRIMARYADWARM"141246-5"M
SIDENC ❑ SEASONA ❑
Use of Building �1c.CS Describe Work �'Y
No. of Bedrooms, No. of Bathrooms Square Footage- 1st Floor 6 2nd Floor
3rd Floor Basement Deck Covered Deck Other Sq. ft.
Garage Attached Detached Carport Attached Detached
MANUFACTURED HOME INFORMATION - Make Model Year
Length�Width /2/ Serial No.�U'21TAA% Late r No. of Bedrooms No. of Bathrooms —/
j Type of Heat 10t4TPUMA2 Purchase Price $ Replacement Unit? Ygs/Q
i
Installer Name Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may re6ult 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 the contractor. I further declare
that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all
the necessary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work
proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or
j agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to-the above
described property and structure for review and inspection. This permit/application becomes null & void if'W0ork or authorized construction is
not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF OONTINUATION OF WORK IS BY
MEANS OF PROGRESS INSPE TION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
I Date: (5 9�
Owner/Ofvners Representative/ ontractor (indicate which one) {
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Dat
DEPARTMENTAL ,REVIEW APPROVED DENIED NOTES
BuildingDepartm ht �'//
Planning Department opw '� )
Environmental Health Department LL� (�
Fire Marshal -/b-4y
FEES
Building Permit Fee Site Inspection
F 00
Plan Review Fee 40EH Review Fee
Plumbing & Base Fee 11r Planning Review Fee
Mechanical & Base fee Other aped
Wood /Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
Paa*fi"cMob1*1e �, 12x56 - Office/Restroom
Mobile & Modular Buildings
Qualified as a small business set-a-side Guaranteed customer satisfaction!
�� tc� T C5 E�lc O F,c;E
r
Why Pacific Mobile )DIP
FOR INFORMATION CALL:
• 20 years of proven • Large inventory of mobile
industry experience offices and storage units
Chehalis,WA 800-225-6539 for immediate delivery
• Largest locally owned Z
Seattle,WA 877-225-5298 supplier of mobile offices • High security window
Pasco,WA 800-660-7174 bars & deadbolts, if needed
Portland, OR 888-434-0224 • Six branch offices
throughout the West Coast • Relocatable wall systems
Boise, ID 208-853-5442
Modesto, CA 800-441-8603 • Guaranteed 24-hour • Wide range of furniture
service response time for lease
Floorplans will vary according to model, size
• Clean & well
and specifications.
maintained fleet
Iequest To Revise An'Approved Plan
Permit Number: BLD2009) O104 Name
Parcel Number_foZ 3�� -�}�-QbQ Phone Number daytime O
Project Address Mailing Address
12 - 34
Please provide a complete detailed description of the propo ed revisions to the approved plans:
Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No
Are the approved site plans included? ❑ 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 ❑ 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
Additional Information:
Applicant's signature Date:
Office Use Only G1VZ)(k* S 4- ���� Received by:
Date Sent Assigned To Approved By Date
Original Valuation: $
Additional Valuation: $
❑ P. Sq.Ft. x$ $
9 Sq.Ft. x$ $
Total New Valuation $
P W TAdditional Fees:
Additional Planning Dept. $
Additional Plan Review $
Additional Conditions/Comments: Additional Building Permit $
Additional Plumbing $
Additional Mechanical $
Additional E.H. Dept. $
Other $
Total Amount Due: $
Amount To Be Paid Up-Front$
T56
D Vif� vIr Zo ao
j �P�yG �v •�° S �T.
.0. lisy
Cb
�• ��� - - •�• ' Pao -� ° \
4,6
fps Fl41°
'LANNINC
MASO,� CD=U.< D
;E TO BE ON SITE ,`�
I SITE ACT To APPROVAL P
Of
By
// �?• Eric Knopf •••.
GRAPHIC CALE •••••••• s.......
40 0 20 40 80 ' 180 EXPIRIES 10/T
SEPTIC SYSTEM DESIGN FOR: — INDIGO PEVi510,6 PATE: Y
( IN FEET ) JACK J0• ayff- DESIGN
1 inch = 40 ft
BAR GRAPH ABOVE IS 5" IN LENGTH P.O. Box 163 I _
TAX NO: 12329-4 1-00130 POULSBO, WASHINGTON 98370
ADNST SCALE ACCORDINGLY 360-779-5233. 360-779-3528 FAX
CDC
VN 123z� y IGC� 13 �
RECENE,D
SEP 19 20M
MASON COUNTY
51-r~ (�1 ✓ XVJ 9Z9£-6LL-09£ '££Z9-6LL-09£ vioNicin000v awns isfirav
OL£96 N019NIHSVM '08SlflOd 00100-1i�-6,70JI -ON Xl1 j-�,L 3Aj�'j NE[ ag Sj HAOSV HdV2I� ZIVH
£9l X08 'O'd
NOISIQ j;c ot�� qo i i
A :Mva "151AM4 OOIQNI — :80J NOIS_10 w31SAS OIld3S
80/ti'L/O1 S31aldX3 - 091 OB 0� Oz p oy
.a3,�su...o.•...........
as�oo�s - 3'IVa �IHd��II)
jdoX u3
• p
6 /
/ 1. V, P. 6�
tN
e:
co
P
�c—-— •�• ���
�! � %i �H� SAX ----•..---
9NINNVId /
m --71A g/ 1 0
GA�.
pR0? SANK
� i \
N
0 w E 8
�Ptoe�Of F(10 gE P
5100132
Eric Kno f "°•
L C SE D SIG ER /
A L \ \
EXPIRIES 10114108 %' gU\` R\ 0�j°I \ \
03
N
mc
MtALfVD w
APTV0 2007
•. „, r
\ d \�
r
P
PARS �-
Q
N0�
IV
�
,q d cT
a d d a a d 1
4< 4
ad d 1 do 1
Al
F0-0 Qa d�1 1 ✓ J
R PHIC SCALE
20 0 10 20 40 80
Will iii!"
SEPTIC SYSTEM DESIGN FOR: INDIGO REV1510N5 PATE: PY
DESIGN
( IN FEET ) IFACN JOjffjmoj -
INC.
sG
1 inch = 20 ft
BAR GRAPH ABOVE IS 5" IN LENGTH P.O. BOX 163
ADJUST SCALE ACCORDINGLY TAX Ng 12329-4 1-00 1 30 POULSBO, WASHINGTON 98370 9f-ETI OF 5f!n6
360-779-5233, 360-779-3528 FAX
HOLDING TANKS CROSS-SECTION CONTROL 1. LOCATE PANEL WITHIN VIEW OF THE SEPTIC TANK.
NDI G 0 DESIGN INC. 36 0-779-5233 PANEL 2. MOTOR CONTACTORS MAKE A THUMPING NOISE THEREFORE, AVOID
o MOUNTING CONTROL PANEL ON AN EXTERIOR WALL OF LIVING AREAS.
° J. POSITION PANEL IN THE SHADE IF POSSIBLE. TEMPERATURE
EXTREMES CAN CAUSE INCONSISTENT PERFORMANCE OF ELECTRICAL
COMPONENTS.
4. CHECK LOCAL AND STATE REGULATIONS FOR PROPER PLACEMENT
OF PANELS.
4��
5. ENSURE THAT ACCESS TO THE PANEL IS NOT OBSTRUCTED.
4 X MIN 3'
CONDUIT FROM TREATED MAX 4'
PUMP TANK POST
FINISHED GRADE APFR—, �T
+� F s 1
MC HEALTH MPT
CONTINUOUS CONDUIT NOV 0 6 2007
Q• 5100132 TO PUMP TANK RISER
Eric Knopf •• .•
LC NS D SIGNER F4'-10'
EXPIRES 10-14-08
/a-1•$-7
PVC Splice Box with
CONDUIT EXTENDED Cord Grips
TO CONTROL PANEL
TANK ALERT FLOAT
AND FLOAT TREE
24'PVC RISER(TYPICAL 3 PL) FINISHED GRADE MUST SLOPE AWAY FROM UDS 24-PVC RISER MPICAL 3 PL) 24•PVC RISER(TYPICAL 3 PL)
FINISHED GRADE MUST SLOPE AWAY FROM LIDS OREN00 LIDS MUST BE USED ORENCO LIDS MUST BE USED CRENCO LOS MUST BE USED
FINISHED GRADE FINISHED GRADE FINISHED GRADE
6" 6" 6"
MIN. MIN. MIN.
11...., • LA �' • • 'd �' d • J 'd d
`m;p Floe O
120 gal/day/bedr
PVC 3D34 OR BETTER EMERGENCY STORAGE EMERGENCY STORAGE EMERGENCY STORAGE
.SLOPE O 1/4'PER FOOT
:es CIe mt Requimmmte)
a
DESIGNER d, DESIGNER d.
MUST APPROVE ANY MUST APPROVE ANY
SUBSTITUTIONS SUBST11UTIONS
:. DESIGNER
MUST APPROVE ANY
.a .d SUBSTITUTIONS •4
1125 GALLON SEPTIC TANK 1125 GALLON SEPTIC TANK 1125 GALLON SEPTIC TANK
SOME SEPTIC TANKS MAY HAVE ONE RISER SOME SEPTIC TANKS MAY HAVE ONE RISER SOME SEPTIC TANKS MAY HAVE ONE RISER
OVER BOTH COMPARTMENTS WHICH IS ACCEPTABLE OVER BOTH COMPARTMENTS WHICH IS ACCEPTABLE OVER BOTH COMPARTMENTS WHICEIIS ACCEPTABLE
AS LONG AS THERE IS A CAST IN PLACE RISER AND UD AS LONG AS THERE IS A CAST IN PLACE RISER AND UD v AS LONG AS THERE IS A CAST IN PLACE RISER AND UD
OVER THE OUTLET TEE TO ACCESS OUTLET FILTER OVER THE OUTLET TEE TO ACCESS OUTLET FILTER OVER THE OUTLET TEE TO ACCESS OUTLET FILTER
. . .
NOTE �•` NOTE �' NOTE:
TANK SHALL BE CLEANED A TANK SHALL BE CLEANED TANK SHALL BE CLEANED
OF ALL DEBRIS FOLLOWING OF ALL DEBRIS FOLLOWING ' OF ALL DEBRIS FOLLOM
INSTALLATION INSTALLATION INSTALLATION
.• .-.
8o 8o 8o 80 8o 8o CV,8o�8o<>p 8o�80�80 8o go .�8o. •.8O• 80 8o �80�8oCV,So�8o�80 80 80 A.
8o 80 8o �8o�8o�8o�8o�8o
B o- �8 a $ a B a 6" Gravel BOSe`0 o. e o. 4 O• 0 o- B 0. �8 0. cg o. B o- B a ce o- 1 a 6" Gravel Basel - 6 - * o- � a B o � a � o- B o. B a c8 a B a 6" Gravel Base g o, � tr 4
0900 oSoo 0900 090o oSoo oSoo oSo� oSo oSoo oSo� oSo� 0900 0900 oS0o 0900 osoo 0900 090 080 080 oSoa 090 0900 oSoo 0soo oSoo oSoa 090o OSo� 090a o90e oso, 090,
GRAVEL NECESSARY ONLY IF TANK HOLE HAS BEEN OVER EXCAVATED
SEPTIC SYSTEM DESIGN FOR: = INDIGO PEV1510N5 PATE: �Y
JACK JO OX DESIGN Nc S�A�E:
P.O. BOX 163
TAX NO: 1 2329-41 -001 30 POULSBO, WASHINGTON 983705f1EET5
360-779-5233, 360-779-3528 FAX