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HomeMy WebLinkAboutCOM2012-00101 Pharmacy Addition - COM Permit / Conditions - 9/11/2012 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 COM2012-00101 OWNER: SAFEWAY RECEIVED: 9/11/2012 CONTRACTOR: IN STORE SERVICES INC 1.206.682.3934 LICENSE: INSTOS1169JZ EXP: 4/1/2014 ISSUED: SITE ADDRESS: 23961 NE STATE ROUTE 3 SUITE A BELFAIR EXPIRES: PARCEL NUMBER: 123294100010 LEGAL DESCRIPTION: PCL 3 OF BLA#98-58 PTN NE SE SURVEY 32/67 PROJECT DESCRIPTION: DIRECTIONS TO SITE: ADDITION OF 50 SF ROOM INSIDE PHARMACY FOLLOW ST RT 3 TO BELFAIR, SAFEWAY IS LOCATED ON THE LEFT SIDE General Information Construction &Occupancy Information No. of Units: Type of Constr.: Type of Use: GROCERY STORE Insp. Area: No. of Bathrooms: Occ. Group: Type of Work: ALT Fire Dist.: 2 Valuation: $ 20,000.00 No. of Stories: Exit Design. Load: Building Height: Pre-Manufactured Unit Information Square Footage Information Make: Length: Lot Size: Model: Width: Building: Year: Serial No.: Basement: Parking Spaces: Setback Information Shoreline& Planning Information Front: Ft. Shoreline: Ft. Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.: Side 1: Ft. SEPA?: Comp. Plan Desig.. 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?: COM2012-00101 Please refer to the following pages for conditions of this permit. Page 1 of 4 IPlumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. type By Date Amount Receipt Total CASE NOTES FOR COM2012-00101 CONDITIONS FOR COM2012-00101 1) Approved per dimensions and configuration on submitted floor plan changes within the existing store structure. X A4 2) Application acknowledges that the structure is only permitted for a use consistent with the current zoning of the parcel.Zoning is Mixed Use MU X zone in Belfair UGA. r 3) All sprinkler modifacations must be done in accordance,,with NFPA13 and is subject to field corrections as deemed necessary by the Mason County Fire inspecto X �r All fire alarm modifacations must be done in accordance with NFPA72 and is subject to field corrections as deemed necessary by the Mason County fire inspector. X dq One 2A10BC fire extinguisher is required in the area mounted no more than 60 inches above the floor and with a maximum travel distance of 75 ft in any direction. X 4) 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 A4t' 5) 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 charged and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted.X M C 6) 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 /tif COM2012-00101 Page 2 of 4 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 I 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 by the Mason County Building Department prior to any further inspections being performed or approvals granted. I ` x 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 O.F USE OR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x /V 9) Changes to approved building plans that affect compliance to the current Washington State Energy Code(WSEC), ventilation requirements), Building/Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. X /"l L 10) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENTAND 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 County Building Inspector shall be made prior to requesting additional inspections. X ; 11) 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-compliant with Mason County ordinances and building regulations. X M 12) 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 holder have prevented action from being taken. No more than one extension may be granted. X M�_ 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 yaaccess to the above described property and structure for review and inspection. OWNER OR AGENT: �'/r:��iu%�d� �� DATE: II, (yL �-✓1 S J1�6� SS'�-✓fc-t'y T�`fC COM2012-00101 Page 3 of 4 r cl Z STOCKROOM I Lo O NEW 1 1— M o ELECTRICAL ROOM N Z Lu W o [1000 _ C�r J CONSULTI ❑ O � H (8'-1 x I V-0) I--� Q bl MEA U) U) FREEZER I BOX B25 114 Q z _ Q BOOM (a a x T-0;- I W N L _ _ T ® Q W -- " -- ----QQ L7LT-- ------------ ---- F 2 HARMACY / C�l (e'-0 x G'-3') m ORK AREA / WAITING r — 3'4° AREA _---- PHARMACY r - - -__------- W z N co< II - ou ( 0-- -- ---- ---- - - -- - O w ,�. O (R)BLOOD O X PRESSURE APPROVED MACHINE — MASON COUNTY DCD PLANWNG O SITE PLAN REQUIRED TO BE ON SITE CHANG S SUDJECT TO APPROVAL By e APPROVED L -cr� 0- z 10 z 10\z FINAL z z \Z \Z m � � /I Vill I A 71 /1 Vi A 6 r STOCKROOM ~ z 1 16 Lo O NEW q ELECTRICAL N V co W ROOM Z ~ TB W J Ej ❑ ry ^ cr i CONSULTI O V J W (B'-l"x 11'0) Q MEA FREEZER BOX 07 BOX W OO 125 �j z RE ROOM A E T CD (8 o"x 7'-0)�' I 1 1 L1 W _I I El __j N L - - T - - --- - - L.L W (N)SECURITY PHARMACY ® U) GATE WORK AREA WAITING © 119 AREA L� / o / - PHARMACY N / I I / 0 bz — -- ---- ---- — -- -- / / z VJ j C) L _ X X W APPROVED � MASON COUNTY DCD PLANNING SIT PLAN REQUIRED TO BE(IN SITE CI­IAf BJECT TO AP HOVAL BY 7 Date-1 ` t Z 4 v 10, 0 0 Kz z IL-A m � w o Planner: Grace 6AMan ebecca RECETVED MASON COUNTY PLANNING INTAKE CHECKLIST ccp 1 12012 Owners Name: - (,cf,pU Date: 1 DAR ST. Commercial : yes no Project: Site Plan: ❑ North Arrow ❑ Property Dimensions: x Irregular Shape ? y no ❑ Streets and Driveways shown ❑ Road Frontage Name: ❑ All Existing Structures Shown with setbacks and use. ❑ Well Location, Septic and Drain-field show with setbacks s ❑ Identified Surface water(streams,ponds, shoreline,wetlands,n al/historic drainage, defined drainage) ❑ Topography (slopes) ❑ Minimum Structure Setbacks (direction/setbac F: / R: / Sl / S2 / ❑ Utility and Drainage Easements: ye no (if yes enter condition 45022) ❑ Other Easements ❑ Accessory Appurtenances: opane tank Heat pump ❑ Does site plan show land' at all exits ? ❑ Variance applied for: es no P ng space allotted: yes no ❑ County Access Pe t Needed (add condition#0 0) ' ❑ State Access P .t needed (add condition 90020 ❑ Standard P . g conditions: 45019 and 4700❑ any impediments -- Are th e ediments (dogs/gates) that may strict a cess to yo�� s P ❑ If s, do we need appointment? yes no ❑ Is site clearly marked? Address Name Other -- ALLYNB F SBELTON Rural LAND DESIGNATIONS J GC J PF J R-1 J R-1P RC 1 J RR 2.5 J AGRICULTURAL J POs J J R-2 J R-1R JJRC2 J RR 5 J LTCFL J BI C-CI J R-3 J RI J RC 3 J RR 10 J 0-HOLDING J HC J LTA J R-5 J RT J RAW J 15 20 J TRIBAL J T J MU J R-10 J RT/RTC J RNR J J BP J vc J RAC Critical Areas: (streams, o s,shoreline,wetlands &steep slopes) Shoreline Designation: X N/A ❑ Urban ❑ Rural ❑ Conservancy ❑ Natural Water Body: SEPA: yes �no o yes no o MapAquifer Rechge: ye no �"Flo�odPlain: ap# Tags/Cases: RLC/SPI: ' 6 year Reforestation: yes Eagle Nest Tag: yes t Other/North Bay Sewer: ye no MASON COUNTY PERMIT NO.I 101M A- W 10 l BUILDING PERMIT APPLICATION AlAft, 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 CONTRACTOR INFORMATION Owner Safeway Company Name In Store Services,Inc. Mailing Address 1371 Oakland Blvd Mailing Address 625 S Lander St nu WA 98134 City walt Creek State �A Zip Code 98416 City Seattle State Zip Code Phone Other Ph. Phone 206-682-3934 Other Ph. Lien/Title Holder Contractor Reg. # INSTOS1169JZ Exp. 4/1/2014 E Mail Address mlavell@storeservices.net 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 Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No 123294100010 Fire District Legal Description Safeway Retail Grocery Store Site Address (Please include street name, street number and city)Safeway,23961 NE State Route 3,Suite A,Be air 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 Yes Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Grocery Store Describe Work Addili,of 50sf room inside pmrr ary No. of Bedrooms ° No. of Bathrooms a Square Footage- 1 st Floor 50 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 V 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. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. Lo X Michael LavellA Date 6.1 4.,2 Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THISt POINT Accepted b Date DEPARTMENTAL REVIEW A P VED DENIED NOTES Building Department /— Planning Department Environmental Health Department Public Works Department — Fire Marshal /� — 2— `--' FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbinq & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES .ctver MASON COUNTY PERMIT NO.I 16M l�' DO 10 BUILDING PERMIT APPLICATION 74114t. wry 201� 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 r.,r t^FQAR 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 Safeway Company Name In Store Services,Inc. Mailing Address 625 s Lander St ,371 Oakland Blvd Mailing Address City Walnu Lan r-r.k State r-" Zip Code �°� City Seattle State Zip Code 96,34 Other Ph. Phone 206b62-393a Other Ph. PhoneExp. anrzola Contractor Reg. # INSTOS1161JZ Lien/Title Holder mlavell@storeseMi s.net 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 Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No 123294100010 Fire District Legal Description Safeway Retail Grocery Store Site Address(Please include street name, street number and city)Safeway,2396,NE State Route 3,Suite&Belfair 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 Alty-- Repair Other PRIMARY RESIDENCE ❑ SEASONAL ❑ Use of Building Grocery Sloe Describe Work Addbm of5°sfroom inside pha—y No. of Bedrooms ° No. of Bathrooms ° Square Footage- 1 st Floor 50 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 V 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. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. Ma�p�ounss nun-�.p�e mn.wrs X Michael Lavell o.A,>aw�>o-,a Date'6.,a.,2 Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted b Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Planning Department i Y Environmental Health Department Public Works Department — Fire Marshal FEES Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/ Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES