HomeMy WebLinkAboutBLD2008-00318 Replace Bridge - BLD Application - 3/20/2008 WIP,
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MASON COUNTY PERMIT NO.
0C. Ati BUILDING PERMIT APPLICATION
V # 1 )"Y1 I 1 V! 426 W. Cedar- P.O. Box 186, Shelton, WA98584
Shelton (360) 427-9670 - Belfair (360) 275-4467 - Elma (360) 482-5269
On the web www.co.mason.wa.us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner Company Name
Mailing Address !1/0-'1Z 4 Mailing Address
City State Zip Code 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 INFORMATION - Connect to New Septic— Existing Septic
Connect to Water System —Name of Water System
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No Fire District
Legal Description
Site Address (Please include street name, street number and city)
Directions to site
Will timber be cut and sold in parcel preparation?Yes/No
Is property within 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 PRIMARY RESIDENCE E] SEASONAL 0
Use of Building Describe Work &�,, ,
No. of Bedrooms No. of Bathrooms Square Footage- 1 st Floor —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 Serial No. No. of Bedrooms No. of Bathrooms
Type of Heat Purchase Price $ Replacement Unit? Yes/ No
Installer Name Certification No.
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 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
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 permitlapplication 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 OFA PROGRESS INSPECTION.INACT)VITYOF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
X Date:
Owner/Owners Representative_/Contractor .(indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT' Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Fire Marshal
FEES
Building Permit Fee Site Ins pec ion
Plan Review Fee EH Review Fee
Plumbing & Base Fee Planninq Review Fee
Mechanical & Base fee Other
Wood / Gas/ Pellet Stove Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
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TOPOGRAP!iY PROFILE:
I j 7� p, c Direction: Scale Approval: for offroa uca
Building Perrr1lt number,. RL D�c)o -OCR 3Lp !/ I�! gujlding:
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Owner/Appiicant:AO"6;I A.A��M IWIZ7 Date of Planning:
Parcel Number. 3 — 0O0 'f 0 application: Env. Health:
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ATTAcj-nVENTS
1. Load Capacity from Rick Franklin Corporation
2.prc)flle and Plan View
3. Bridge Side View
4. Bridge End View
5, Bridge Top View
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[?o. BOX 3+G8 Lebanon. Q { )
101 InduBtriai W$y, 31C.• 258-6444
FLAT CARS . , . . . . . . . .
THE BE
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44' $7,000 I, 414'6'x 9'6' Flat Steel Deck (No Curbs) Wpa�y buty
48' "54.800 i j ` 48'x$'Wood neck 50,004#Load Capacity
53' ",000 DRGW Series i 53'•x 10'6". 147,OW# Load Capacity
UPSeries 53,x 10'6" 140,0WIt Load Capacity
165,000# Load Cspacl
58' $1 o,D00 DWC Set}es � 5 x.8' R'8" tY .
F SOIL tWes 56'x 1T 184,900#Load Capacity
60, $10,000 ATSF Series 60'x 10,6" Load Capacity
BN Series i 60 x 10'6" 150,00U#Load Capacity
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69' $15,000 AkT�F Series 89 x 916' Flat Steed Dock (No C_ur /J
uP15®ries 89 x V6' (With Curbs) 125,000# Load Capac
&5w Conic rWo Abu mean s 2'x 2'x 11' 6,320#1 Each
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MAY 2 2008
TO: GLORA ROGERS
REGION SIX OFFICE
48 DEVONSIIIRE ROAD
MONTFSANA WA- . 98 563
FRONY: DOUG NEYRART
:315 , .,CA ST
SEAT TLE WA. 98101
I II AVE ENCLOSE TIJE 1`OLLOWING.
SITE PLAN
LOAD CAPACITY FROM RICK, FRANIILIN CORP,
PROFILE O1,' BRIDGE
BRIDGE, SIDE VIEW
BRIDGE, END V'EA W
BI:ZII:)CTI?, TOP VIEW
SIN('
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