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Home My WebLink AboutBLD98-00857 Change of Use Library to Offices - BLD Permit / Conditions - 3/5/2003 MASON COUNTY PERMIT ASSISTANCE CENTER Phone: �ss0)427 966�0,ext.352 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 f,y Shelton, WA 98584 i RESIDENTIAL BUILDING PERMIT BLD98-00857 OWNER: MARY THELER COMMUNITY CENTER CONTRACTOR: PACIFIC MOBILE LEASING RECEIVED: 08/27/1998 SITE ADDRESS: 23601 NE STATE ROUTE 3 BELFAIR ISSUED: 05/25/2000 PARCEL NUMBER: 123294300000 EXPIRES: 11/25/2000 LEGAL DESCRIPTION: SW SE PROJECT DESCRIPTION: DIRECTIONS TO SITE:' wl r CHANGE OF USE FROM LIBRARY TO OFFICES (TWO MODULARS= LOCATED NEXT TO OLD BELFAIR POST OFFICE P` 1RAT��N ONE BUSINESS) )LP tz,,-P 0 0� BY General Information Construction &Occupancy Information Sq a Footage Information No. of Bedrooms: 0 Type of Constr.: 5N Type of Use: COM Insp.Area: 1 No. of Bathrooms: 2 Occ. Group: B Lot Size:O Deck: 0 Type of Work: NEW Fire Dist.: 2 No. of Stories: 0 Occ. Load: 28 Building:2,808 0 Valuation: Buil Ing Height: 0 Occ. Status: Basement:0 Manufactured Home Information Setback Information Shoreline&Planning Information j Make Length: 0 Ft. Front: E 120.0 Ft. Shoreline: 60.0 Ft. Water Body: I :. Rear: W 33.0 Ft. Slope: Ft. SEPA?: No Model: Width: 0 Ft. Side 1: S 80.0 Ft. Shoreline Desig.: Year: Serial No.: 11 Side 2: N 5.0 Ft. Com . Plan Desi .: Plumbing Fixtures Mechanical Fixtures FEES Type QtV. Type Qty, Type By Date Amount Receipt Building plan check* KW $42.00 48115 Building State Fee TMJ $4.50 1268 UFC Plan Check TMJ $21.00 1268 Change of Use TMJ $42.00 1268 Total $109.50 BLD98-00857 Please refer to the following pages for conditions of this permit. 1 of 3 MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 P, IJ U t (3 $Nj (a p FF F-I (vi I -'r, FOR INSPECTIONS CALL 427-9670 BETWEEN 5pto AND Sam 11,27-7262 B1_D98-08,157 PAR-EL : 1.213294300000 LAT a DIV . (31-Ka LOT - JOB ADDRE-SS . 2,3601 NF STATE ROUTE 3 6 E L FA 1 11-1 mfkmlT OWNER , MA TtIELER COM.4,UNITY CENTER 275-0373 per AV ExplRAT10" I VJIULL CCMTRACTOR . PA MOBILEAEASING 22565'39 LEGAL : SP 8E o GATE CLASS' OF WORK . :NEW 0 P,ATH 2 ME ANOW-11 D Y rt BA T F REMPI TYPE A14MIT BY nm umpfl TYPE OF USE — :CON, STOR I E S 0 Occup I GRIC110F, . B 13LD(A . HEI ('s11-IT . 0 OT-t J.PICK 1 42.00 KR 0g1?7l53 48115' TYPE OF CONS T . 5'N F I R F P I_A c E IS, . w . 0 1,11IFF 4 4.60 TW 19/07198 IRWAIR 01 C C U p 1'.ci A D 28 WK)0 WS T 0 V E S . . , 0 F I III t 21.00 Til M07198 G E I FA 1P. 113)VAIWE LIL LIN PARKING SPACES, : (0) OJOY S2.00 TW 10107/93 9ELFAIR I N,3 P E C,"I 10 N A Fl,E A s I SHORELINE? . . . . ; Y 174TAI. 108.50 VA1.1,111-ATI011, SE TSACKS-- TO I LE74"S . . . . . . . . . A 2 F UEL TYP)E8-------'---- MOBILE HOME— FRONT E 12/0 1 01f t BATH BASINS . — : 2 ; /ELE/ 0-3 1-1 p 0 R F A 113 . .W 33 10-ft BATH TUBS . . . . . . : 0 315 HP . 0 MODEL S I DE ( I .s 80 .0ft S 110 114 F 118 1 . . . . . .. . . 11 '0 FORN 'I 00K F)T Ll 0, 15--30 HP , V) MA r F SIDE (2 ) J4 5 Of It WATE13 HEATEERS . . . . i I F C?R 111 10;0 K 133-I'Ll 0 3 0---5 0 HP . 0 S I-I R1 L 11 NE .%Y 60 .OF-t C L.0 T Ii E S WA S i-I E WS' . , ; 10 F 0 IR 11) FLOOR . . . 50-1- Hp . 0 -YFAFP.---------- AREA KITCHEN S !iNKS . . . . x 0 HEAT P$J M P . . . . . . 0 LOT SIZE . . c FL.001.1 DRA I NS 0 VENT S Y S T EIM3 0 EVAP COOLERSt 0 L E N 0 T 1-1 > .0 i31.3 11.D I N cl . 2a0.8 f OR I NK I NG 0 VENT FANS . . . . . . .. 2 HOODS . . . . . . . 03' W I DTH . 0 BASENIENT . . . 0 T LAUNDRY TRAYS . 0 DOMES I 0"Ic. 114 to S FE R I A L DECKS . . . . 08f D I SHWASHEn S . . . 0 A I R HIANDIL I NG UNI I TS-- MOM- INCIN :0 G A F?1 1-1 A R P Osf GARB D ISPOSAIA3 . 01 10000 offn . ; 0. RELOG/REPA I R 0 AT/DT . UR I MALS . . . . . . . . . . . 0 -10000 of m . ; 0 OTHER UNITS . : 0 1411SC PLM FIXTUFIFS2 0 GAS OUTLETS . t 0 pplodf-It'l DISICRIFTION.CPAINE Of I)SE (RON LICOARY TO GFFIC�F�l Hlrj WMAHS- QNE BUSIR'UMj;6 BFIF A 13 AM POSI OFFICE PROJECT RM 10 '11 19113, PERRIT RMINES Rull, AND VOID IF WqPK 04 MMUCTION AMIORIZED Hn 01 COWN41) 9111114 180 PAYS, Oft if OR un IS 51 i F(IR prmol) OF 18C DAYS AT ANY T,NF AFM, MIX tS CONIff-ACED, EVIDENCE Of P"ONTHMTM Of 1,099 IS A PMRESki 14SPE01(it"I WNIIIIN TIIE 189 DAY PERIOD, I"HIAL !NSPECTINq NUIST OF. APPROVED BEFORE 0 9ti 11161 tM'i Iff OCIMIPIED. OWMEP 0111 sl'O_pflff' rvit 63131141, 'CO"W"LIANCE TO ATTACHED CONDITIOINSS 1S REQUIRED i CONCRETE MECHANICAL MOBILE HOME Footings-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by by date by date by Walls FIRE DEPT. date by date by date by PLUMBING OTHER Groundwork Attic date by date by D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by q-7 -To► i l i v) ! t h lcry L461 QbA f52wv1Lj i Dr -r&I-Q ,)c�_1up#Mc_Lr 0+Vlzv- U Vti 0 ns� vlc� cir r J) WI) q o d y MASON COUNTY Mason County Bldg. III 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 F,,-- : MA ti -!`€iE LF1, Cf'VII<;IJN I TY GEIQTFR Page I per dimen r. asaras arld setba--Es ran <.u1.wrtil;�ted site p 'rtan ; Fany expar-ssicats Of (Ise, or rro�_Lire w i E I need added oounty rev i env . \_ �l.:?�� '�_J��c+c,.�f a } Par'k i nc_t aIta I I be � .4s•fi Tr i r, 1 (:,nt. For, 30 irorrna i park i rrc€ s,ta I I s 119 t bV 2-0) feet ) canrj 'j hand I cap park i tag stalls ( 12 .5 feet by 20 f'oet ) With SUf f i a 1 en't rrraIIOUvef i rz s 10 . Handicap q i a I I s Sha I 1 be oT a smooth sui-Faco atlevel car ramped to eretr-Nr i ot:a�i:ed olosest fo the% tiultdinq entry, and �halE be. saigned with .the Inter nation ) Symbol of Acce 3 Proposed structure or EanV port I on tfDert?of greater t i' an I0" i n lie I ght -Frow g4'a d e 7 i f,ie , atr.a5tntita € n t:11n ra rttInImLim of 5 ' sctbaok front a I property I ides . era„etttc.nts and 10 from a I I 6%4_LLLpjty sand SI a-te Road r i rEht of ways . {t. } R he €iv: , hand 1 1 ng ant! Storage oT hazartiaus or T i areiatab I e and c,nrrabr zst i bI liquid", in excess of 10 gallons is not al I owod w i th�.of the approval of he Mason County 5} Al I approved plans are requ i r• ed t o be o$r"o i to for Inspection ( llrpw�es If i n pec'i' i on Is called for and iJ i cans are: not on s 1 t-e� Approval WILL NOT i5€,1 or•ant0d . III addition, a Re— Inspect Ion "tee in the amount of per hciur 0 i n i rim-ri 'i hour ; w i I I be charged, and must be ou I I ected by this department prior to a.ray T€rr Cheat' Inspections, being perforined or apprc�va I granted . 6 } € MRSUANT To '1 994 t. N I F01110 BUILDING CODE , ALL SITES PVIUST IIA%IF A1''i'"iir;,r` ED NUMBERS On ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE MEET OR ROAD FRONTING THE PROPERTY . MAI•ON COUNTY`; B I €.I:i I ICI DEE'AFiWEN i IREQ t I RE S THIA T JHIS BE r;OMP I_ETEO PRIOR TO CAI-LING FOR A14Y SITE INSPECTIONS . A ICE i NSP CT I ON FEE , r3ASED ON RATES 1 W TABLE 3A OF THE 1994 UNIFORM BUILDING COC}r WILL BE ASSESSED I OWNER/CONTRACTOR FAILS TO POST ADDRESS S ON S i TE PRIOR TO IiEQU STING I NSI'UT I ON S . I MASON COUNTY Mason County Bldg. 111 426 W. Cedar P.O. Box 186 Shelton, Washington 98584 71 T:I:V:p ect I On wirVosos,,�roved, plot ,plan is requiref,'.1 to he on.-sito for iris'-' , V I T to - � i e, pprova ILL NOT be qranted . I rk I n i cat! led for and pipt 4� lan is not on - t A add i t 1 on , a 114 e- I n s p ct.)o t 10 n f e(.-� i n a(00L11`1t of $42 .00 rper hour 0,11nimum -1 hc.r(Jr ) charged and miust lie" co I I ected by th Is department prior -to any further, inspeo-tions being )perf,�!"med or approval grantecl . X vlil 1, 1,el j ,TRUC T ION MUST MEET 014 EXCFED ALL LOCAL CODES AND UBC R E-0 U;Eft.riA E-N TS A N D 0 C G U P A N 0,Y 8 ) ALL CONS tS LIMITED TO THE PERMITTED AND APP11OVED CLASSIFICATION . ANY CHANCIE OF USE OR OCCUPANCY WOULD," RESULT IN PERMIT REVOCATION . CHANGE OF USE MUST BE APPROVED PR I Or? TO CHANGE X 9) Changes to approved bul IdIng Plans, that of-Toot compf lance, to the '1991 washington Stpte Energy Code, 1991 Ventilation and Indoor Air Qua fity Code, t tie Un I form Du 1 1 d I ricj Code and or Mason Countv RX(ju I at i otis m Li st be approved by Mason County prior to C.a n s t r U 0 t i on --. f—ICL 10) CONSTRUCTION PROCESS TO BE FIEVI) REOVIRED PER MASON COUN Y B(JlLDING DEPARYmENT AND UNIFORM BUILDING CODE Od�_ U 11 ) 1 . PROV11DE A 2A 1013C "IATED FIRE EXT INGU ISHER AT EACH EX I T 12 ) The 'The lar Community Gen-ter Is responsibip for submitting a Contract with a septic gumpirig companv for pumping the holding tanks . The Masan County Environmental Health opari4ieant approved the use of holding tanks -for, bosinests with low viater use . Any change 1 n bl,2s i ryes vj 1 1 1 reqti I re approva I by th i s department . -T 05/24/2000 Conditions Associated with Case #: COM2000-00057 3:25:56 PM `, a Stat. Changed Updated Cond. By Code Title Hold Status Changed Tag Updated By 0200 Site Plan 0 Not Met 05/09/2000 SKM Approved per dimensions and setbacks on submitted site plan.X 5045 Field Correct 0 Not Me , 05/09i2000 SKM CONSTRUCTION PROCESS TO BE FIELD CORRECTED ASREQ;IREDIPER MASON COUNTY BUILDING DEPARTMENT AND UNIFORM BUILDING CODE.x 05/09/2000 SKM 5030 Changes to Approved Plans 0 . Not Met Changes to approved building plans ial Energy Code(NREC), ion Indoor Air Quality Code(VIAQ)Uniform mBuilding/Plumbing/Mechanical affect compliance to the n t Codes and/or Mason County Regulations shalltbe and approved prior to construction. X Vv`VVI - 05/09/2000 SKM 5026 Structure Setback 0 , Not Me— Structure Proposed structure or portions thereof with an projection over 30"In height from g de line,�m�u�st maintaia 6'separation distance between adjacent structures and that furthest projection.X W ` 05/09/2000— SKM 5025 Sideyard Setback 0 , Not FAet .) - Proposed structure or any portion thereof greater than 30"in height from grade line;must mafnta' a minimum of 5'setback from all property lines,easements and 19 from all County and State Road right of ways.X X 05/09/2000 SKM 5510 Property Lines <..--NR i\ll All property lines shall be clearly Identified at the time of foundation inspection.X ' ' ` «n 05/09/2000 SKM 5003 ALL CONSTRUCTION 0 r Not Me. ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND UBC REQUIREMENTS AND OCCUPANCY IS LIMITED FICATION. ANY CHANGE OF USE OR OCCUPANCY WOULD RE 0 THIN PERMIT TREVO REVOCATION. CHANGE OF ED AND APPROVED I USE MUST BE APPROVED PRIOR TO CHANGE. x �� 05l09/2000 SKM 0 (NotMe� 1012 PLOT PLAN REQUIRED ON SITE _..� The approved plot plan is required to be on-site for inspection purposes. If Inspection is called for and plot plan is not on site, Approval WILL NOT be granted. In addition,a Re-Inspection fee in the amount of$42.00 per hour(minimum 1 hour)will be charged and n%0sx^enoo�e d by this department prior to any further inspections being performed or approval granted. X 1 05/09/2000 SKM 1001 PLANS REQUIRED ON SITE 0 dot M All approved plans are required to be on-site for inspection purposes. If Inspection is called for and plans are not on site, Approvaion fee In e amount of$42.00 per hour( nimum WILL NOT tt beb ollllected by thisddition,a department prior totany furthertinspections being performed or approval l hour)will be ranted. In granted. X MIA VIA 05/09/2000 SKM 1002 POST ADDRESS 0 Not Met > PURSUANT TO 1997 UNIFORM BUILDING CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY.MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS..A REINSPECTION FEE,BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THE 1997 UNIFORM BUILDING CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POS ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X /\ 05109/2000 DLC 0001 NON-RESIDENTIAL ENERGY CODE 0 Not Met This project is approved for compliance to Non-Residential Enigy Code vAth no alterations to the existing structure affecting envelope,heating equipment(mechanical),and lighting fixtures.Alterations or repairs made to the existing structure affecting envelope,mechanical equipment,or lighting fixtures shall comply to current Non-Residential Energy Code(NREC)and will require review for energy code compliance prior to making changes. X 0046 Buffer+Landscaping Requirements 0 Lot Mel] 05/09/2000 MMS This application is subject t uffer and Landscaping requirements as established under Mason County Ordinance 1.03.036.X�� 05/10/2000 DLS 0 ($of Me 05/10/2000 DLS 0260 Fire Protection Requirements .-_ RATED, EXIT DOOR.EXTINGUI HERS MUST E TAGGED BEA EXTINGUISHER ADJACENT C TERIOR A LICENSED FIRE EXT INGUISHER SHER IINSTAL ERAND H EX N PLACE AT THE TIME OF OCCUPANCY. Page 1 of 2 05/24/2000 Conditions Associated with Case #: COM2000-00057 3:25:59 PM Cond. Stat. Changed Updated Code Title Hold Status Changed By Tag Updated By 0210 Parking 0 Not Met 05%10/2000 AHB 05/10/2000 AHB Parking shall be sufficient for 9 normal parking stalls(9 feet by 20 feet)and 1 handicap parking stall(12.5 feet by 20 feet)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 a signed with the International Symbol of Access. Buffer screening from adjacent properties by owner is required. X "15,'1 L1,1 Page 2 of 2 CONCRETE MECHANICAL MOBILE HOME Fooghgs-Setback date by Ribbons date by Gas Piping date b Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date by date by PLUMBING Arc date by OTHER Groundwork date by date b D.W.V. WALLBOARD NAILING date by date by Water Line FINAL INSPECTION date by date by date by I �n -IbQrIF:Cs - Aq LLAM TO �Fl _ x x I ,T I Al Cl 4 RAVE L N . FAIR KfNU LO-r i FT ToTA4- 3 `� a ^ sTa-+.�-s N • . N O N 41 ;r.. 12 13 14 15 16 17 18 19lip 20 s i Page No. 1 CASE HISTORY FOR CASE NO.: BLD96-0719 MARY THELER COMMUNITY CENTER NE23601 STATE ROUTE 3 BELFAIR 02/24/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By - ------------------------------ -------- -------- -------- --------------------------------------- ---- --- -------- --- BLDA010 Application received / / / / 06/14/96 06/14/96 KW BLDA100 Approved For Issuance / / / / 08/05/96 DONE TW 08/06/96 TW BLDA500 (F) Issue building permit / / / / 08/06/96 DONE TW 08/06/96 TW BLDB009 Fire Marshal Review 07/19/96 / / 07/22/96 DONE DLS 07/22/96 DLS BLDB110 Structural Plan Review 07/10/96 / / 07/19/96 TEMPORARY STRUCTURE ONLY DONE MJB 07/19/96 MJB MUST MEET HANDICAP ACCESS BLDB120 WSEC Compliance Review 07/22/96 / / 07/22/96 MOVED BLDG, NOALTERATIONS MOVD DC 07/22/96 DLC BLDB130 Planning Review 06/26/96 / / 07/10/96 DID PRE-APPLICATION INSPECTION IN MARCH DONE AHB 07/10/96 AHB 1996. AHB BLDB134 RLC Checklist Review / / / / 07/10/96 WETLAND AND STREAM RESOURCES ON SITE; DONE AHB 07/10/96 AHB AREA OF EXISTING PARKING LOT. AHB BLDB135 Addressing / / / / 06/28/96 DONE GMM 06/28/96 GM BLDB200 Environmental Health Review 06/14/96 / / 06/26/96 Need approved design. psd HOLD PSD 06/26/96 PSD BLDB200 Environmental Health Review 08/05/96 / / 08/05/96 approved for holding tanks only. DONE JWT 08/05/96 JWT BLDB210 Water Adequacy 06/14/96 / / 06/26/96 Belfair water is adquate. psd DONE PSD 06/26/96 PSD BLDC155 Final inspection 08/16/96 08/19/96 08/19/96 ONLY PART OF THE CORRECTIONS WERE DONE FAIL LW 08/19/96 LAW FROM THE LAST LIST.. ~ \ BLDC210 MH Final inspection 08/14/96 08/16/96 08/16/96 CORRECTIONS: FAIL LW 08/16/96 LAW �nJy 1. MINIMUM LANDING SIZE FOR HANDICAP IS 44X60 INCHES. 2. THE GRADE AT THE ENDS OF THE RAMPS NEEDS TO BE LEVEL, THE SURFACE BETWEEN THE HANDICAP STALL AND THE RAMP ENDS NEEDS TO BE HARDEN. c 3. THE BOOK SHELFS ARE OVER 5 FT. 9 I`)42 INCHES WHICH REQUIRES A 44 INCH MINIMUM CLEARANCE BETWEEN THEM. 4. PROVIDE' 1A LANDING AND STEPy$ AT REAR DOOR. I �4Y� (Li� t7 iT S. THE SET UP SPEC'S CALLS FOR 5 BLOCKS MINIMUM ALONG THE OUTER EDGE OF EACH UNIT. ONLY 4 BLOCKS IN PLACE ONE ONE OF THEM. 6. THE INSTALLATION SPEC'S COULD NOT BE READ WHERE IT TALKED ABOUT TIE DOWNS. PROVIDE NEW SPEC'S THAT CAN BE READ. C7. A FINAL FROM THE FIRE MARSHAL NEEDS E DONE. 8. INSTALL ALL SIGNS, OCCUPANT LOAD, THESE DOORS TO REMAIN OPEN, BATH ROOM SIGNS, HANDICAP PARKING ETC. 9. REMOVE THE WET INSULATION FROM UNDER X�j THE UNIT AND INSTALL INSULATION WHERE ISSING AROUND PLUMBING AND INSTALL VAPOR BARRIER. 10, FINISH INSTALLING SEPTIC AND CONNECT PLUMBING. / ice 1 � 1 lop BRUSH !1NE 1 �1 BRUSH UNE cn I CXISTINEI L�i4tNF1E�D i i1 •i s 5�ass I JL � " . .000 F I l ) I i - qx,� j6- I --�,i 000 ��. � � r / '� .fir i i . .•. . . L V,ca N"v t-KUM rit.,rr 5-06-1998 10:03AM ra� - . L � 2 3 27 - q3 -- c- 2 9 12 1201 O,a Pow{ rGt `p2b Ate/+-T1[ �3 36 v iL �op aZS /DER-Ty ?Q lZ LU A S 0 SSA N 864 SY'APA �'Bye e 4i Z7 Y-3 �. a0.51 "'0.0 y 7"1x�[�- 1 Li'�ve.ry 79�1oac��ar 2'1 x 3 z II 2FG2 5 ' Tof�� W �` 1 0 lr\ 1�YoPoSed LLL ES Q� . �rOiaClrTl� Lt'�neS Z. �' irIANGE crV USE 7 PERMIT NO.: Z " MASON COUNTY S 7 BUILDING PERMIT APPLICATION 515 f 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4467.Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner S. lauea. B. 'haler uci; Contractor Name Mailing Address P. O� Box 14415, Mailing Address City };c1 ai.r_ State WA Zip Code 98523 City State Zip Code Phone( 360 ) 275-4398' Other Ph.( ) Ph.L_J Other Ph.( ) Lien%Title Holder Same Contractor Reg. # Address Expiration%� [_SEPTJZ[WATER...SYSTEM INFORMATION-Connect to New SepticExisting Septic=Connect to Sewer stem Name of Sewer System WellWater System Name ofter System AP-1 fi'air Glatp.r Di strict PARCEL INFORMATION-12 digit Tax Parcel No. 1232943 / OWN)/ Fire District 2 Legal Description Porf_inn nfr St-17 .SF (see RTA ganerfmrlk) Site Address(Please include.street name, street number and city) 2-3601 NE State Route 3. 111fai.r. WA Directions to site- One driveway south of D. Ja°s Music - across SR 3 frOin Pei insula Credit Unto i Will timber be cut and sold in parcel preparation? (Yes/No) NU Is your property within 200' of the following: Body of Water (Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Chanpe of use/Occa Describe Work c,tA)r7' A& 86Cfac• �.� ,rr d3ee�34�S o ToTi4L a J1 98 ® ,Z7- C Ak,T i/A36cg LPw No. of Bedrooms 0 No. of Bathrooms l SQUARE FOOTAGE-1st Floor = 4 "2ncrFloor 3rd Floor Loft Basement Deck Other sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat. Purchase Price $ Replacement Unit ?(Yes/No) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance- requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without appro al. first obtaining approval. i `X� N,AA �✓l&�- U 0as Date "Y � a/00 X Date _ Ail,-, FOR OFFICIAL USE BEYOND THIS POINTAccepted by Date v�Submittal Amount Due �a` Receipt No., ........................................................ >> TNIENTAL*REV:IPW APP:RQVED ::.I�PNIED::.:.. Building Department f,; 3o_ 66,6 OccGrou -T e Constr. QCC-EAPAIv�. Planning Department Environmental Health Department Public Works Department Fire Marshal". ''Valuation $ ESX. ............ :.:::::.::::::........... p.. :......::..:.: ........... . ;:.;:.;:.>;:.;:.:;. Building Permit Fee Site Inspection Plan Review Fee UFC Plan Review Fee Plumbing& Base Fee Public Works Review Fee Mechanical & Base Fee Other Wood/Gas/Pellet Stove Fee Other Violation Fee Pre-Paid at Submittal ( ) O T T F AL EES PERMIT NO.: kits MASON COUNTY S)a7�98 MISCELLANEOUS PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98584 Shelton 360 427-9670 Belfair 360 275-4.467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner M A92 ; C'�r JS L g /a- arts 1� . C� i Contractor Name Mailing Address 0/- L4 C Mailing Address City J ��_F J�rr z Statela�A' Zip Code 9 8XZ Q City' State Zip Code Phone ,( �6 )��,� 0.1 7� Other Ph. .766 6 ),,r Ya R Ph.( ) Other Ph.( Lien/Title Holder 17 A,.� 4-. 1A J� Contractor Reg. # Address _ Expiration PARCEL INFORMATION-12 digit Tax Parcel No. ca c c, r> cl Fire District 7_ Legal Description /. 6 )=' 7—/2. A--�i 4; Site Address(includ'e street name and city _? C ® l r�'7 /�� .�_ �: �� 3d Q g'k(1 Directions to site:- / 6 4- A a Will timber be cut and sold in parcel preparation? (Yes/No) X11\ Is your property within 200' of the following: Body-of Watery Name) Saltwater Lake River/Creek Pond Wetland o1 Seasonal Runoff Stream I ' Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use'of Building _ Describe proposed.constrution o ,,lz „ro-v / , A d2,1 A ;j SHORELINE PROJECTS New Replacement Repair' Expansion F' Bulkhead Material (concrete, rock, wood, etc.) Length Height A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF PERMIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures-for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a the Contractor Registration Law RCW 18.27 and am aware of the contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work ordinance requirements regulating the work for which this permit is issued will be done in conformance therewith. No changes shall be made without and all work shall be done in conformance therewith. No changes shall first obtaining appr�al. ` be made without first obtaining approval. X?/, f.�//// ®r Date X Date FOR OFFICIAL USE BEYOND THIS POINT- Accepted byr'`�-r --� Date) - -/0 Submittal Amount Due �- � Receipt No. U / 0` DEPARTMENTAL REVIEW APPROVED DENIED CONDITION.CODES Building Department 9 Occ Grp Type of Const. - Planning Department f V Environmental Health Department ' Public Works Department Fire Marshal f, Valuation $ FEES Building Permit Fee = S.ffe-Irispecfion" Plan Review Fee �.,; :J� '— Other CtJP 47—' Z UFC Plan Review Fee O,t�ter Violation Fee Pre-Paid at Submittal O FEES o> T TAL i'..