HomeMy WebLinkAboutCOM2015-00035 Change in Tenant - COM Permit / Conditions - 3/31/2015 Inspection Line(360)427-7262
8 ;A MASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Phone: (360)427-9670, ext. 352
Mason County Bldg. III
426 W. Cedar
Shelton, WA 98584
1854
COMMERCIAL BUILDING PERMIT COM2015-00035
OWNER: DAVITA INC RECEIVED: 2/12/2015
CONTRACTOR: LICENSE: EXP: ISSUED: 3/31/2015
SITE ADDRESS: 23961 NE STATE ROUTE 3 SUITE B BELFAIR EXPIRES: 9/30/2015
PARCEL NUMBER: 123294190021
LEGAL DESCRIPTION: TR 2-A OF NE SE LOT: 1 OF SP#2929
PROJECT DESCRIPTION: DIRECTIONS TO SITE:
CHANGE IN TENANT&COMMERCIAL PERMIT FOR FOLLOW ST RT 3 TO BELFAIR, SMALLER OFFICE LOCATED NEXT TO
DIALYSIS CLINIC, SAFEWAY, FAR CORNER, SAFEWAY IS SUITE A, THIS WILL BE SUITE B
General Information Construction&Occupancy Information
No. of Units: Type of Constr.:
Type of Use: DIALYSIS OFFICE Insp.Area: No. of Bathrooms: 3 Occ. Group: B
Type of Work: NEW Fire Dist.: 2
Valuation: $ 281,351.84 No.of Stories: 1 Exit Design. Load: 44
Building Height:
Pre-Manufactured Unit Information Square Footage Information
Make: Length: Lot Size:
Model: Width: Building: 4,592 :
Year: Serial No.: Basement: Parking Spaces:
Setback Information
Shoreline 8 Planning Information
Front: Ft. Shoreline: Ft.
Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.: Not Applicable
Side 1: Ft. SEPA?:No 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?:
COM20 15-00035 g
Please refer to the following pages for conditions of this permit. Page 1 of 9
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Plumbing Fixtures Mechanical Fixtures FEES
Type Qty. Type Qty. Type By Date Amount Receipt
Floor Drain 2 Furnace<100K 4 Plan Check Fee moon 911919n1ri R1 1Q';AR v,19n1.,;nn
Floor Sink 1 Heat Pump 5 IFC Plan Check Fee r.mu 911919n1R (tr,Q7 7Q s1,niRnn
Kitchen Sink 12 Ventilation Fan 3 EH Minor Plan Review (,noon 911919n1R alnn nn g1gn1Rnn
Lavatories 8 Planning Review Fee moon 9i19i9n1R (tRAn nn g1gn1rnn
Water Closets (Toilets) 3 Planning Review Fee moon 9i19/9n1R ituRn nn G1gn1s;nn
Water Heaters 1 Non-Res.Energy Code ni r. gi1Qi9n1R IR7,4 nn G1gn1Fnn
Building State Fee rn r. Ra sn gign1.x;nn
Building Permit Fee ni r. A/1Q/gn1F sq n1q QF -q1gn1Fnn
Mechanical Permit Fee ni r. i/1Qign1R TiQ1 gn Rign1Rnn
Mechanical Base Fee ni r i/1Qign1.x; 0.9R Fn G1gn1rnn
Plumbing Base Fee ni r Ri1Qign1.j; 4�'?a 7n g1gn1snn
Plumbing Permit Fee rn r. 14/1Q/9n1R A9';d Qn glgn1Fnn
ADJUST--Plan Check Fe. ni r: il1Q/gnl.F a119 RA oignirmn
ADJUST—IFC Plan Checl ni r Ai1Qnn1.z; 4tx;a dq q1?n1Fnn
Total $5,292.38
CASE NOTES FOR
COM2015-00035
CONDITIONS FOR
COM2015-00035
COM2015-00035 Page 2 of 9
1) This project is approved for compliance to the 2012 International Energy Conservation Code/Washington State Energy Code (IECC/WSEC);
components shall be installed as follows:
ENVELOPE: In accrodance with the component performance located no sheet G1.1-
Roof Deck : Not less than R-35 insulation
Wall insulation:
Existing CMU walls not less than 1.5-inches rigid polystyrene insulation (R7.5).
Existing framed walls exposted duting insulation not less than R-15 in 2x4 walls and R-21 in 2x6 walls
Slab insulation: Existing as installed.
Fenestration, including new storefront windows U-.47 or less except one at 12 sq.ft U-.27 or less
New doors: U-.28 or less, . Solar heat gain coefficient(SHGC) 0.28 or better.
LIGHTING SYSTEMS:
Interior lighting shall be installed in accordance with the 2012 International Energy Conservation Code as amended by Washington State
(IECC/WSEC), Section C405 and as presented on Sheet E0.2.
Controls shall be installed in accordance with C405.2 including occupancy sensors in employee lounge, private offices,janitorial closet, restrooms,
and other areas 300 sq. ft or less enclosed by walls. Occupancy sensors shall be installed to automatically turn off lights within 30-minutes of all
occupants leaving the space and shall be manual on or shall be controlled to automatically turn the lighting on to not more than 50% power. Full
automatic on may be installed in restrooms and as otherwise allowed in the exception associated with Section C405.2.2.2.
Daylight zones shall be switched separately from non-daylight zones in accordance with C405.2.2.3.
Compliance to lighting installation and controls shall be verified in the commissioning plan and final report.
MECHANICAL SYSTEM.
Refer to sheet M0.2-confirm seer ratings in accordance with compliance information provided: All roof top fixtures shall be provided with
economizers in accordance with C403.3.1.
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COM2015-00035 Page 3 of 9
2) SYSTEMS COMMISSIONING
A commissioning plan shall be developed by the registered design professional in accordance with Section C408.1.1 of the 2012 International
Energy Con servation/Washington State Energy Code (IECC/WSEC). Provide the commissioning plan prior to or during the framing inspection of
this project. The plan shall be sealed and signed by the design professional.
Prior to obtaining final occupancy approval the registered design professional shall provide evidence of systems commissioning and completion in
accordance with the 2012 International Energy Conservation/Washington State Energy Code (IECC/WSEC)Section C408.
Copies of all documentation shall be given to Mason County Department of Community Development prior requesting the final occupancy
inspection and shall include commissioning of the building mechanical system (C403), service water heating systems(C404), electrical power and
lighting systems (C405).
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3) 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 USE OR OCCUPANCY WOULD RESULT IN PERMIT
REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x
4) Changes to approved building plans that affect compliance to the current Washington State Energy Code(WSEC), ventilationrequirements),
Buildir)g�Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction.
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5) All construction and demolition debris must be removed from the shore area after project completion. Proper disposal of construction debris must
be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X
6) The demolition and disposal of debris must meet the regulations of Mason County and Olympic Region Clean Air Agency(ORCAA).
It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos containing materials have
been identified and removed from the area to be demolished. Work shall not commence on an asbestos project or demolition project unless the
owner or operator has obtained written approval from ORCCA.2490 B Limited Lane NW, Olympia WA 98502, 360.586.1044/800.422.5623
www.orcaa.org
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7) 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
collected Mason County County Building Department prior to any further inspections being performed or approvals granted.
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8) 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 C�ty Building Inspector shall be made prior to requesting additional inspections.
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COM2015-00035 Page 4 of 9
9) 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-co p I'iant with Mason County ordinances and building regulations.
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10) SUBJECT TO INSPECTION BY FIRE MARSHAL
The structure is subject to inspection by the Mason County Fire Marshal. All corrections deemed necessary by the Fire Marshal, to assure the
minimum fire and life safety requirements as adopted by Mason County and Washington State may be required.
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EXISTING FIRE ALARM OR FIRE SPRINKLER SYSTEM:
A separate fire protection permit shall be required to address modifications to the existing structure and the existing fire alarm and sprinkler
systems.
Plans shall addressing modifications, must be submitted with the required application form and shall demonstrate that the existing systems, or
modifications, are designed to operate in accordance with NFPA13 and NFPA 58.
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PORTABLE FIRE EXTINGUISHERS:
Fire extinguishers are required for this occupancy. Minimum rating of 2-A:10-B:C required. Fire extinguisher shall be located along a path of egress
and spaced such that not more than 75 feet of travel distance exists between any point inside the building and an extinguisher. Extinguishers shall
be located not higher than 5 feet above the finished floor. Indoor fire extinguisher cabinets shall not be equipped with locks. Extinguishers shall
have a service tag verifying they have been serviced by a professional extinguisher company. If extinguisher is recently purchased, the tag inside
the box may be affixed to the extinguisher with "NEW"and the date of purchase.
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11) The use, handling and storage of hazardous materials or flammable and combustible liquids in excess of 10 gallons is not allowed without the
approval of the Mason County Fire Marshal. X [[��
COM2015-00035 Page 5 of 9
12) All interior wall and ceiling finishes shall be in compliance with chapter 8 of the 2012 International Fire code (IFC). All rooms shall have a finish of a
minimum of a class C with a flame spread index of 76-200 and smoke development index 0-450.
Restrooms shall be provided with finish material in accordance with the 2012 International Building Code (IBC), Section 1210. Toilet, bathing and
shower room floor finish shall have a smooth, hard, nonabsorbent surface. Walls and intersections of walls and floors shall have a smooth, hard
nonabsorbent vertical base that extends not less than 4-inches up onto the walls. Walls within 2-feet of sinks, urinals, and water closets shall have
a smooth, hard nonabsorbent surface not less than 4-ft above the floor.
Accessories such as grab bars, towel bars, towel bars, paper dispensers, and soap dishes provided on or within walls shall be installed and sealed
to protect structural elements from moisture.
Water closet fixtures shall be set no closer than 15-inches from its center to any side wall and the clear space in front shall be not less than
21-inches. Urinals shall be not less than 12-inches from its center to any side wall or partition. (UPC 402.5)
The number of plumbing fixtures shall be provided in the number required in IBC Chapter 29 and in accordance with the occupant load calculated
in Chapter 10.
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13) Information provided specifies that hazardous materials, defined in the 2012 International Fire Code (IFC) as chemicals or substances which are
physical hazards or health hazards, will not be stored or used in the tenant space.
When used or stored, all Data Sheets related to the hazardous materials used within the facility shall be placed in a notebook and permanently
located in a conspicuous location inside the building near the main entrance. (IFC Chapter 50)
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14) Provided parking shall be sufficient for 12 standard parking stalls (9 feet by 20 feet) and 2 handicap parking stalls (12.5 feet by 20 feet)adjacent to
clinic access points with sufficient maneuvering aisles. Handicap stalls shall be of a smooth surface at level or ramped to entry, located closest to
the building entry and shall be signed with the International Symbol of Access. Screening from adjacent residential properties to the north is
required. X ,�/
15) 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
X the permi h9Jd�r have prevented action from being taken. No more than one extension may be granted.
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16) 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 charged and collected by the Mason County
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Building Department prior to any further inspections being performed or approvals granted. X
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COM2015-00035 Page 6 of 9
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17) 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.
Commercial structure mile point number or unit designation posting requirements:
50 feet or less setback shall post a 6 inch minimum with a 3/inch stroke.
50 feet or more setback shall post a 12 inch minimum with a 1 %2 inch stroke.
Designating unit on a building will be no less than 6 inches in height with minimum 3/inch stroke.
Designating unit on a door will be no less than 4 inches in height with minimum '/inch stroke 100 foot setback or less shall post 18 inch minimum
with 2 inch stroke.
100 foot setback or greater shall post 24 inch minimum with 3 inch stroke.
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18) 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 1-800-64& The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to
WA state law. X
19) 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
generally; or in E3elfair UGA M.C.C. 17.34.010 to 17.34.180.
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20) Approved per dimensions and setbacks on included site plan aerial of the Belfair Center. Setbacks are measured from the furthest projection of the
structure.X 0v
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21) Recyclable materials &Solid Waste Storage: Space shall be provided for the storage of recycled materials and solid waste. The storage area
shall be designed t meet the needs of the occupancy, efficiency of pick-up, and shall be available to occupants and
haulers.X -2-
22) Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel. Zoning is Belfair UGA
General Corcail zone.
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23) Suspension Systems for acoustical lay-in ceilings shall be installed in accordance with manufacturer specifications and in accordance with NW
Wall &Ceiling Bureau (NWCB), Bulletin 401, Suspended Ceilings. Ceiling areas shall be divided into areas 2500 square feet or less by full height
partition walls or other similar system to create seismic separation joints.
Schedule an inspection with Mason County building department before ceiling tiles are installed, to verify that the suspended ceiling system is
installed in accordance with specifications for structures located in Seismic Design category D2 and NWCB Bulletin 401.
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COM2015-00035 Page 7 of 9
24) All exit doors shall comply provisions of Section 1008 of the 2012 International Bulding Code.
Doors shall be equipped with approved lever hardware and be readily openable from the egress side without the use of a key or special knowledge
or effort including tight grasping, tight pinching or twisting of the wrist to operate.
Means of egress shall be illuminated by artificial lighting during the entire time a building is occupied so that the paths of exit travel are always
visible and available of evacuation of the occupants during emergencies. Exits and exit access doors shall be marked by an approved exit sign
readily visible from any direction of egress travel. All exit signs shall be internally or externally illuminated at all times and equipped with to ensure
continued illumination for duration of at least 90-minutes. Egress doors shall be readily distinguishable from the adjacent construction and finishes
such that the doors are easily recognizable as doors. Egress doors shall be side-hinged unless specifically exempted in the International Building
Code, Section 1008.1.2.
Unlatching of any door leaf shall not require more than one operation. Manually operated flush bolt or surface bolts are not approved.
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25) Drinking fountains shall be required in number specified in accordance with Chapter 29 of the 2012 International Building Code when the occupant
load exceeds 30.
The medical procedure provided by this tenant requires that patients be provided with specific liquid intake. To maintain patient safety, in lieu of
providing drinking fountain(s), the tenant has agreed to provide drinking water to staff and visitors that accompany patients during treatment.
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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 INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
ffwm', - a I/ MAk 15
Signature /� �� II'' Date
EI)SGiYd(/ OWNER - REPRESENTATIVE - CONTRACTOR
Print Name (Circle one to indicate)
COM2015-00035 Page 8 of 9
�f MASON COUNTY t Permit No: 2016 " 000
k, DEPARTMENT OF COMMUNITY DEVELOPMENT
` BUILDING•PLANNING•FIRE MARSHAL (360)427-9670 Shelton ext.352
Y http://www.co.mason.wa.us/communi de v/ (360)275-4467 Belfair ext.352
- you 426 W Cedar Street,Shelton WA 98584 (360)482-5269 Elma ext.352 -A I�n
`3:< ixsa
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: DaUta,Inc—Kri* ideto NAME: TBD
MAILING ADDRESS: 32275 32nd Ave.S. MAILING ADDRESS:
CITY:Federal Way STATE: We ZIP: 98001 CITY: STATE: ZIP:
PHONE: CELL:253-60M191 PHONE: CELL:
EMAIL: Ms0n.videto@davita.com EMAIL:
L&I REG# EXP.
CONTACT: OWNER❑ CONTRACTOR❑ BELOW Q✓
NAME: Randall Dover,kchbect MAILING ADDRESS: 4121 HillsborD Rd.Ste.303
CITY:Nashville STATE: INZIP: MTF PHONE:615-251-3388 CELL: 61R28-7619
EMEII,: a over.net
PARCEL INFORMATION: /� /1
PARCEL NUMBER(12 DIGIT NUMBER) �, — f 1 00610FIRE DISTRICT
LEGAL DESCRIPTION(ABBREVIATED):
SITEADDRESS 23961NE teR0A3,X%'gS CITY bellair
DIRECTIONS T STTE ADDR�EESS
nn0cte ro 4PFoc tYLj
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 Q REPAIR❑ OTHER ❑
USE OF STRUCTURE(REsiDENcE,GARAGE ETC.) Dialysis Cfnic
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS 3
DESCRIBE WORK Tenant Improvements for a Dialysis Clinic of 4,09T—sq—.ft-
SQUARE FOOTAGE:
1ST FLOOR4,091 sq.ft. 2ND 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❑
x
MANUFACTURED P11FORMATION. S OF THE FLOOR PL UIItED
MAKE LENGTH
WIDT BEDROOMS BATHS S 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 1
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 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 PERMIT
APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42)
Kristin A. Videto°'" �"""=
— -,�� -" 1/21/15
X
Signature of OWNER Date
DEPARTMENTAL REVIEW APPROVE DATE DENIED DATE TAGS/NOTES/CONDPITONS
BUILDING DEPARTMENT D
PLANNING DEPARTMENT
FIRE MARSHAL
"TEE. VATTO,TA.L
BUILDING PERMIT FEE FIRE ACCESS AND GRADE 'f
PLAN REVIEW GEO-TECH REVIEW
PLUMBING&BASE FEE STORMWATER REVIEW
MECHANICAL&BASE FEE TOTAL FEES 10 3 0 20
WOOD/GAS/PELLET STOVE VIOLATION INVESTIGATION FEE
PLANNING REVIEW FEE VIOLATION FEE I t 9 n vi. C,F-DAR ST
5011q Co
MASON COUNTY PERMIT NOGf 0
r ~ _ DEPARTMENT OF COMMUNITY DEVELOPMENT �d®�
1 •`
BUILDING•PLANNING•FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. III,426 West Cedar Street (360)275-4467 Belfair ext.352
lxsa v -- Shelton,WA 98584 (360)482-5269 Elma ext.352
PLUMBING & MECHANICAL PERMIT APPLICATION
OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: -Dew"i tG.-, / .cIG NAME:
MAILING ADDRESS: MAILING ADDRESS:
CITY: STATE: ZIP: CITY: STATE: ZIP:
PHONE: CELL: PHONE: CELL:
EMAIL: EMAIL:
L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER): /a -:r-Z 2 000
LEGAL DESCRIPTION(ABBxEVL4TED):
SITE ADDRESS: -;?\3 91 CPI CITY:
DIRECTIONS TO SITE ADDRESS: o2t�
TYPE OF JOB
NEW ADD ALT REPAIR OTHER USE OF BUILDING
LOCATION OF FIXTURES/UNITS—11T FLOOR 2NDFLOOR BASEMENT GARAGE OTHER
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Tyne of Fixture No.of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_
Toilets LS Type of Unit No.of Units Fees
Bathm=SMW 6,-,— Y-e-✓� Furnace
Bath Tubs Heat Pump _ (p
Showers Spot Vent Fan _
Water Heater Propane Tank
Ws Asher Gas Outlets
2inks Wood/Gas/Pellet Stove �p
Dishwasher 11 Kitchen Exhaust Hood
H�seil�s �Cq� Dryer Vent
Other,5l,q A5 /,21 Solar Panel (�
52P rle�y- Other 1
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
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 INSPECTION.INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X
Signature of Applicant Date
X Owner/Owners Representative/Contractor
Print Name (indicate which one)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
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Page 1 of 1
Uebbera Coker - DaVita,Inc, Dialysis clinic Belfair, WA - Bldg Dept. comment letter
From: Debbera Coker
To: rd@rdover.net
Date: 3/17/2015 5:05 PM
Subject: DaVita,Inc, Dialysis clinic Belfair,WA- Bldg Dept. comment letter
Attachments: COM2015-00035 bldg dept comment letter.doc;2012 IBC Special Inspection Authorization Form.doc;
fire_pro_sys_permit_app.pdf
A letter prepared as a result of the building department plan review is attached to this email along with referenced enclosures.
Please review the letter and respond as requested. If you have questions please let me know.
Effective March 31,20151 will be retiring from Mason County. You may contact me via email through March 27,2015. After that
please contact my replacement, Rich Balderston, at rbalderston@co.mason.wo.us for assistance.
0 66era Co4r
Mason County Building Department
Building Inspector IV
Phone: (360)427-9670 ext 510
FAX: (360)427-7798
E-Mail: DLC(@co.mason.wa.us
426 West Cedar Street
Shelton, WA 98584
" l L[59 0a,
rL-�' �e CAS �� CZ � 13�
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file:///C:/Users/Dlc/AppData/Local/Temp/XPgrpwise/55085EF6Masonmai1100170357012CA391/GW 0... 3/17/2015
APPROVED
MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
CHANGE SUBJECT TO APPROVAL
By Date�7�.��
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