HomeMy WebLinkAboutBLD94-0082 Concrete Tank - BLD Permit / Conditions - 11/5/1997 1
MASON COUNTY
PERMIT
Mason County Bldg. III 426 W. Cedar NULL g VOID BY EXPIRATION
P.O. Box 186 Shelton, Washington 98584 DATE BY
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CONCRETE MECHANICAL MOBILE HOME
Footings-Setback date by Ribbons
date — /`/ — 9 c( by Gas Piping date b
Foundation Walls date by Set Up
date — Z& --5 by L INSULATION date by
BG/SLAB Insulation Final
Floors
date by date by date by
FRAMING Walls FIRE DEPT.
date by date by date by
PLUMBING Attic OTHER
Groundwork date b
date by y
D.W.V. WALLBOARD NAILING
date by date by
Water Line FINAL INSPECTION
date by date by date by
I
MASON COUNTY
Mason County Bldg. III 426 W. Cedar
P.O. Box 186 Shelton, Washington 98584
Permit No.
MASON COUNTY
BUILDING PERMIT APPLICATION 0 ��
426 W. Cedar/P.O. Box 186, Shelton, WA 98584 427-9670/1-800-562-5628
PLEASE PRINT _
#1 Owner .1 E5 F►E4,p ( Q Phone#
Site Address 5F—#T';E JDi21YE OFFI1n=&wCxEEKT1C017 Fire District#
City OEJ—FA)Q i Wig St \)-� Zip gR52R
Directions to Job Site WiE. . QLjr Or- IRTa.►..g )jr- 0ty No,�l}OJP,Ci�Lui,D 1�►S�o,J
G
-t- To
Owner Mailing Address R. C) - :apx 159
City T?a>E=1, A 12 St zipq
Lien/Title Holder
Address
City St Zip
#2 Contractor Name irl a-a cus: C. Contractor Reg#CeSF 11 - 22800
Address �,{ ��_)_ Expiration Date/ 0 9
City St Zip-15o Phone#_1 �7 �
#3 If septic is located on project site, include records.
Connect to Septic? Public Water Supply Well
Connect to Sewer System? Name of System
(If residential, proof of potable water is required)
#4 Parcel No. I'Z330 - 33 - 9002.
Legal Description Tit. 13 C-rovr Lor 4, 7—w-3 OF SSA. ��02�� P'rN. T2�}
#5 Building Square Footage: (existing/proposed)
1st FI / 2nd FI / 3rd FI / Loft /
Basement / Deck / #bedrooms / #bathrooms /
Garage / Carport / (Circle:Attached or Detached?)
Other sq. ft. /
#6 Use of building Warr-¢. arot r=TANk Describe work 3o.0oo QyaL.
�?F�„ c.,v n� CnwI��TP L t�slz—SNs i� 17i�i- �q�°-�°'►►J x � � � sc R � �}_
#7 Type of Job: New Add Alt Repair Cabe r
2
#8 MOBILE/MANUFACTURED HOME INFORMATION t 4
Model Year Make Model D
Length Width Serial No. BAN 2 4 1994
# Bedrooms # Bathrooms Type of Heat
Purchase Price$ —A TH SERVIC,�-
#9 Indicate by circling the applicable source if any water is on or adjacent to subject property:
River Pond Creek Stream Wetland Lake Marsh Saltwater Seasonal Runoff Other
Show following on the site plan
Lot Dimensions Flood Zones
Existing Structures Fences
Structure Setbacks Driveways
Water Lines Shorelines
Drainage Plan Topography
Septic Systems Wells
Proposed Improvements Easements
Name of Flanking Street Indicate Directional by (N, S, E, W)
Name of Fronting Street in relation to plot plan
APPLICANT TO DRAW SITE PLAN BELOW
SEE 14TTAc�}�,D D�tis1�G$
APPLICANT TO DRAW TOPOGRAPHY PROFILE BELOW
Plumbing Fixtures ($3 each) Fee Mechanical Fixtures ($6 each)
No. Toilets CIRCLE FUEL TYPE: Gas, Electric,
Bath Basins Heatpump, Other
Bath Tubs No. Units Fees
Showers Furn BTU
_Hot Water Htr Heatpumps
Laundry Washer _ Vent Systems
Sinks _ Spot Vent Fans
Floor Drains No. Boilers/Compressors
Laundry Basins HP
Dishwasher No. Air Handling
_Disposal cfm#
_Urinals No. Fire Protection Systems
Other _ Auto. Fire Alarm Sys 50.00
Fixed Fire Supp. Sys 50.00
Permit Basic Fee 15.00 Auto Fire Sprink Sys 25.00
TOTAL PLUMBING $ No. Other
Gas Outlets
Wood, Gas, Pellet Stove
NOTICE: THIS PERMIT BECOMES NULL AND VOID IF
WORK OR CONSTRUCTION AUTHORIZED IS NOT COM-
MENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR Permit Basic Fee 15.00
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD TOTAL MECHANICAL $
OF 180 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. PROOF OF CONTINUATION OF WORK IS BY
MEANS OF A PROGRESS INSPECTION.
OWNERS AFFIDAVIT CONTRACTORS AFFIDAVIT
I CERTIFY THAT I AM EXEMPT FROM THE REQUIRE- I CERTIFY THAT I AM A CURRENTLY REGISTERED
MENTS OF THE CONTRACTORS REGISTRATION LAW CONTRACTOR IN THE STATE OF WASHINGTON AND I
RCW 18.27, AND AM AWARE OF THE MASON COUNTY AM AWARE OF THE ORDINANCE REQUIREMENTS REGU-
ORDINANCE REQUIREMENTS FOR WHICH THIS PER- LATING THE WORK FOR WHICH THE PERMIT IS ISSUED
MIT IS ISSUED AND THAT ALL WORK DONE WILL BE IN AND ALL WORK DONE WILL BE IN CONFORMANCE
CONFORMANCE THEREWITH. NO CHANGES SHALL BE THEREWITH. NO CHANGES SHALL BE MADE WITHOUT
MADE WITHOUT FIRST OBTAINING APPROVAL FROM FIRST OBTAINING APPROVAL FROM THE BUILDING
THE BUILDING DEPARTMENT. DEP RTMENT.
X OWNER X BY
DATE DATE
FOR OFFICIAL USE ONLY: Accepted by Date:
DEPARTMENTAL REVIEW
FOR OFFICE USE ONLY
Approved Cond. Hold
Approval
Planning:
Environmental Health:
Building Plan Review Plal-)'-, fnut I Inc DY) d VYtI' j�Sf
�Y1 c l r�.Q.wt►rra
Occupancy Group:m-a Type of Cons 1 -
Fire Marshal:
Other:
Special Conditions: ?Z�X- ZD �` FEES
Building Permit
Plan Check ��� � ,�`'
Plumbing Fee
Mechanical Fee
Wood/Gas/Pellet Stove
Radon Monitor
Violation Fee
Site Inspection
Building State Fee �-
Other
Other
Building Valuation: o4J /y TOTAL FEE
GARY YANDO,DIRECTOR
y�N.S TA
o P A N DEPARTMENT OF COMMUNITY DEVELOPMENT
u
z o T z PLANNING - SOLID WASTE -UTILITIES
� N Y Y BLDG. III • 426 W. CEDAR • P.O. BOX 578
1864 SHELTON, WA 98584 • (206) 427-9670
February 10, 1994
Mr. James Jesfield
PO Box 159
Belfair, WA 98528
RE: State Environmental Policy Act compliance. BLD 94-0082. Water Tank.
Dear Mr. Jesfield:
The proposed 30,000 gallon water tank is considered an underground storage and as such is not
exempt from the SEPA review process pursuant WAC 197-11-800 (2)(g) ; tanks that are less
than 10,000 gallons are exempt.
Please submit a completed environmental checklist with a check for $100.00 payable to the
Mason County Treasurer. Your building permit application is placed on hold until we receive
a completed checklist.
If you have questions regarding the information provided please contact this office at 427-9670,
ext 295.
ZRestfully,
assee, Planner
pment of Community Development
c:
B. Boehm
file
11Aw,ru.Srrc lM.n.r.s
0Hcalth �IZZUtiVEL
Division of Drinking Water LIAR 2 9 1994
INVOICE r'ALTH SERVIrr
Water Plan Review
INVOICE NUMBER
TO: Mr. Jim Jesfield 11372
P.O. Box 159 INVOICE DATE
Belfair, WA 98528 July 7, 1993
BILLING PERIOD
30 days
DATE DESCRIPTION QUANTITY COST AMOUNT
07-07-93 Water System Engineering Report Approval $350.00
Cedar View Tracts Community Water System,
ID #06151A, Mason County; Engineering
Report for System Expansion; DOH Project
#059308
r`x -�27-93
Payment due within 30 days.Interest shall accrue at 1%per month after 30 days.
Make Checks Payable to Department of Health
Return Lower Tear-off Portion to: Department of Health
P.O. Box 1099
Olympia, WA 98507-1099
--
OSTATp
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
SOUTHWEST DRINKING WATER OPERATIONS
2411 Pacific Ave. • P.O. Box 47823 • Olympia, Washington 98504-7823 • (206)664-0768
July 7, 1993
Mr. Jim Jesfield
P.O. Box 159
Belfair, Washington 98528
Subject: Cedar View Tracts Community
Water System, ID #06151 A,
Mason County; Engineering
Report for System Expansion;
DOH Project #059308
Dear Mr. Jesfield:
The project report for the above project received in this office May 12, 1993 has
been reviewed, and in accordance with the provisions of WAC 246-290 is
APPROVED. The approval issued herein is based on conformance with current
standards outlined in WAC 246-290, revised April 1993. Future changes in the
rules may be more stringent and require facility modification or corrective action.
PROVIDED that the comments outlined in the attached memorandum, dated June
9, 1993, be addressed and the information submitted along with the required
construction documents. In addition, a pre-planning conference with DOH staff is
required in order to establish an agreed-upon schedule for the completion of the
required water system plan.
The subject project being approved at this time indicates that hydropneumatic
tanks will be installed. The regulations of the Department of Labor and Industries
(RCW 70.79.080) require that all unfired pressure vessels, including
hydropneumatic tanks larger than five cubic feet (37.4 gallons) in volume, be
ASME construction.
Mr. Jim Jesfield
July 7, 1993
Page Two
Regulations establishing a schedule of fees for review of planning, engineering and
construction documents were adopted January 3, 1993 (WAC 246-290-990). An
itemized bill for $350.00 is enclosed.
Sincerely,
Elisabeth A. Raysby, P.E.
WSDOH Regional Engineer
Southwest Drinking Water Operations
EAR:clu
Enclosure
cc: Mark Tompkins, Mason County Health Department
Allen Miller, P.E.
Rich Hoey
Peter Beaton