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Home My WebLink AboutCOM2023-00014 Cellular Equipment Modification - COM Application - 2/21/2023 MASON COUNTY COMMUNITY SERVICES Permit No - 1 PERMIT ASSISTANCE CENTER: -BUILDING-PLANNING-PUBLIC HEALTH-FIRE MARSHAL E C E I V E D 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)42/-96i0 ext.352•Fax:(360)427-7798 Phone Belfair(360)275-4467-Phone Elma:(360)482-5269 FEB 21 2023 BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATI Street NAME:Green Diamond Resource Company NAME: TBD MAILING ADDRESS:215 North Third St. MAILING ADDRESS: CITY:Shelton STATE:WA ZIP:98%4 CITY: STATE: ZIP: C PHONE#1:(360)427-4733 PHONE: CELL: PHONE#2: EMAIL: EMAIL:Info@greendiamond.com L&I REG# EXP. PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER❑Authorized Rep.of Verizon v NAME John Eder,A Site Solutions Inc.Authorized Representitive of Verizon EMAIL John&4sitesolueons.com - MAILING ADDRESS 10427 205th Dr.SE CITY srwhomish STATE WA ZIP 98290 PHONE 253-278-2902 CELL 253-278-2902 PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 41914-00-00000 ZONING Long Term Commercial Forest LEGAL DESCRIPTION(Abbreviated) ENTIRE SECTION EX TR 1 S 40/130 FIRE DISTRICT Unknown SITE ADDRESS No Situs.verizon uses 1850 W.Simpson Rd. CITY Shelton Q DIRECTIONS TO SITE ADDRESS See sheet T-1 of the submitted plan set. S IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES r❑ NO❑ SNOW LOAD:N/A psf / IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all than apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION 7❑ REPAIR❑ OT-11ER•❑ Zr S., .°p USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) Unmanned telecommunications facility-175'tower and equipment building IS USE: PRIMARY El SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whale Bldg)❑ YES(Part(s1 ojBldg)❑ NO❑+ DESCRIBE WORK Eligible Facilities Request.Modify equipment at an existing wireless communication facility per the submitted plans and structural analysis. SOUARE FOOTAGE:(proposed) N/A 1 ST FLOOR 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❑ MANUFACTURED HOME INFORMATION: N/A *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: N/A SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS 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 and 1 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 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 ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) Authorized representative for the X tower owner.Verizon Wireless February 3, 2023 Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Genie McFarland From: John Eder <john@j4sitesolutions.com> Sent: Friday, February 3, 2023 4:59 PM To: Genie McFarland Subject: Building Permit Application Submittal - Verizon Modification (KAMILCHE-LS6) Attachments: Building-Permit-App_KAMILCHE-LS6.pdf,Authorized-Rep-Letter_KAMILCHE-LS6.pdf, Project-Narrative_KAMILCHE-LS6.pdf, Plan-Set_KAMILCHE-LS6.pdf, Structural- Ana lysis_KAM I LCH E-LS6.pdf Follow Up Flag: Follow up Flag Status: Flagged Caution: External Email Warning!This email has originated from outside of the Mason County Network. Do not click links or open attachments unless you recognize the sender, are expecting the email, and know the content is safe. If a link sends you to a website where you are asked to validate using your Account and Password, DO NOT DO SO! Instead, report the incident. Hi Genie, Attached is a Building Permit Application and supporting documentation for an equipment modification at an existing Verizon cell tower facility. Included are the following documents: • Building Permit Application • Verizon Authorized Representative Letter • Project Narrative (Eligible Facilities Request) • Plan Set • Structural Analysis Please pr�oide an invoice for the�plan review fees based on $25,000 valuation. Note that Special Inspections are not required, and a Structural Observation is not required per the current IBC. Please let me know if he Building Official disagrees, and please ask him to supply the applicable IBC codes tion that requires a Structural Observation. ��r� Th ks, 5 1 John er 1�1 J4 Sitetions, Inc 3' 253-278-2902 (Mobile) D iohnCabi4sitesolutions.com Y 1 s � 'a N Lin i (E)BAR GATE 1/ L(E)FOREST lA:'sD7 1i (E)CHAINLINK FENCED J4 SrM SOLUTIONS TELECOMMUNICATION f® n�...m..�s...:�.. COMPOUND (E)175.9 HIGH LATTICE TOVNER i \NC'RES, J (E)GRAVEL ACCESS ROAD WAVE Ess `1 EGR ARCHITECTURE 1133 164TH STREET SW # SUITE 202 1 NOTE' LYNNW000,wA 95067 SITE PLAN DERIVED FROM EXISTING DRAWINGS,GIB, OFFICE:(426)TII-3100 AERIAL IMAGES,AND SITE PHOTOS.NOT SUITABLE tAYQNEWWAVEARCH.COM FOR ACCURATE MEASUREMENT DATE- 1-10-23 PREPARED BY- YML APPROVED BY- JYS PARCEL# ( 41914-00-00000 SUBMITTALS NO DATEI DESCRIPTION ZONING ZONING ZONING DFL LTCF DFL 1, 1-10-23 FINAL PERMIT PROPERTY LINE 12-21-221 PREUMINARY PERMIT 7887 REGISTERED HITECT AY Y. 0 STA OF WASHNGTON I SITE I WA4-KAMILCHE (MOD.041 E—6a L-SUBS 1860 W.SIMPSON RD, SHELTON,WA 98584 SHEET TITLE OVERALL ...... SITE PLAN OVERALL SITE PLAN NORTH SHEET NUMBER NUMBER j SCALE T-300'-0. (22x34), 1• -800'-0'(11x17) // —