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Home My WebLink AboutBLD2001-01132 Cancelled Gas Piping - BLD Permit / Conditions - 2/5/2003 MASON COUNTY DEPT. OF COMMUNITY Inspection Line (360)427-7262 Phone: (360)427-9670, ext. 352 DEVELOPMENT Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Shelton, WA 98584 MECHANICAL PERMIT BLD2001-01132 OWNER: ROBERT M JORDAN CONTRACTOR: RECEIVED: 10/29/01 SITE ADDRESS: 7201 NE TAHUYA BLACKSMITH RD BELFAIR ISSUED: 10/29/01 PARCEL NUMBER: 223047790120 EXPIRES: 4/29/02 LEGAL DESCRIPTION: TR 12-A OF SURV 13/40 TR A OF SP #1792 PROJECT DESCRIPTION: DIRECTIONS TO SITE: GAS PIPING TAKE BEAR CREEK DEWATTO RD ABOUT 10 MILES WEST, TURN LEFT ON TAHUYA BLACKSMITH RD, PROPERTY ABOUT 3/4 MILE ON RIGHT. General Information Mechanical Fixtures FEES Type of Use: SF Insp. Area: Type Qty. Type By Date Amount Receipt Type of Work: MEC Fire Dist.: Gas Outlets 1 Mechanical Fee Kc lni?grni c,n Fn 1)77AR Mechanical Base Fee Kc ini9gini sus �;n F77AR Total $34.15 PERMIT NULL & VOW 13Y EXPIRATION GATE 5-D By I( v> > BLD2001-01132 Please refer to the following pages for conditions of this permit. 1 of 2 CASE NOTES FOR BLD2001-01132 CONDITIONS FOR BLD2001-01132 1) In accordance with the Uniform Building Code, all sites shall have approved numbers or addresses located 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 re-inspection fee based on rates as adopted by the jurisdiction and the Uniform Building Code will be assessed if the owner and/or contractor fail to post t e address on site prior to requesting inspections. X 2) Fuel piping shall be inspected after the installation of gas piping is complete, and before the attachment of fixtures, appliances, or shut-off valves. At the time of inspection the test pressure shall be no less than 10 psi held for no less than 15 minutes. Appliances to be attached to the fuel piping system j shall not be used til the final inspection has been performed and approved by a Mason County building inspector. 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 buildin can b occupi OWNER OR AGENT: DATE: /U BLD2001-01132 Please refer to the following pages for conditions of this permit. 2 of 2 Tg MECHANICAL MOBILE HOME tiodrr,Is Seback date R,bbon3 dat° Chas PipkV date by Fraxidatfon Watts date by Set UP INSULATION date by BGUSLAB tnstgauon Floors Final by date by date - date FIRE DEPT. FRAMING Walls date by date by date by OTIt ER PLUMBING AWc Grotk date by e by WALLBOARD NAILING D.W.V. date by date by FINAL INSPE(;;'ilON Water Line date by date by date by AA�Ll? LEI Building Permit # MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been fund: Items Listed below must be corrected to gain code compliance 7-- You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK XCall for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ❑ OK to ❑ This is not a complete inspection �? Ck� Department Date Inspector " ■ so4 Co VT F1 Mo VV T 1 T ,�� P. 0. Box 1850 4l'1 North Fifth Street Road Name: Tahuya Blacksmith Or Shelton, WA 98584 • UTILITY PERMIT el Subject to all terms, conditions and provisions written or printed below or on any part of this form. PERMISSION IS HEREBY GRANTED TO: Bob Jordan 7201 NE Address P.O. Box 345 Physical location of installation: Tahuya Blacksmith Kent, Washington 98035 Ph:(253) 852-7053 a�0q- 7 7. 70/ --� -1-n A SP (Legal Description ►when applicable) /t // �R Zla � ll YC q 4,6 0 ( dW-�1Jl� To Construct/Install : 10, 6c)ly&KT_l / Gl rj C et'S PO4 D i O F 0L f9 y, This installation is in conjunction with Mason County Road project on this road. Installations shall be in conformance with Mason County Ordinance No. 3-93, Accommodation of Utilities on County Road Right-of-Way, and to the satisfaction of the County Engineer. Traffic control shall be in conformance with the Manual on Uniform Traffic Control Devices (MUTCD). When installation disturbs the surface of the roadway, repair of said surface shall be performed as per items 11 through 14 on the Mason County Requirements for Installations and Maintenance of Underground Utilities (attached hereto). Contractor. //CScn/ CO, ROO CC—PV Add..: Piano: License No: Expires: A bond in the amount of $ N/A is required to ensure compliance with the conditions as set forth in this permit. Said bond will be held for year(s). Permittee's non-compliance to the conditions of this permit shall result in the forfeiture of all or part of the Bond (contingent upon the costs incurred by Mason County to effect repairs, etc.). A Fee in the amount of $ N/A plus footage fees, accompanies this permit. It is the responsibility of the applicant to notify all utilities and private property owners when such property is Gable to injury or damage through the performance of the above work and the applicant shall make all necessary arrangements relative to the protection of such property and/or Utilities. No Franchise necessary. This permit subject to existing Franchise. This Permit issued contingent upon an Application for a Franchise being made to the Board of Mason County Commissioners on or before the 31st of December, 19 No work shall be done under this permit until the Permittee has communicated with the off'c of h partment of Public Works and/or received instructions from ` / , Mason County Road Supervisor. Phone No. - Dept. of Public Works: 27-9670, Ext'n: 450. This permit shall be void unless the w rk her in contemplated shall h , been completed on or before /; 19 1` DATED at Shelton, Washington, this ��6 " day of 19' Issued by: Thle: I !ak s�Ja/�c�I dam► UTILITY INSTALLATIONS Fees: $10.00 permit fee+any footage fees along R/W' $100.00 bond-bond will be held for one year after installation(this bond shall be posted by property owner,not the contractor •3 cents/ft for each foot to and including 1,000' I cent for each additional foot over 1,000'to and including 10,000' 1/2 cent for each additional foot over 10,000 feet Surface Types to Determine if Permittee shall PUSH under county road or MAY CUT surface. F = BST surface --can be cut with permission by this office I = A/C surface --Permittee shall NOT CUT surface E = GRAVEL surface--Permittee can cut with permission by this office Utilih'Installation Specifications: Legal description of property involved Where utility is being installed: Rd.,Development,etc. Type of Line being Installed Whether they are going to drill under road or cut. Utility line must be installed inside a casing and be wrapped with locate tape for road crossings. Said casing shall be a minimum of 36"below roadway surface. If more than one utility installed/spacing required between casings shown on sketch provided by this office. Casing shall extend a minimum of 2'beyond roadbed edge. Hand out is available for utility installations(specifications). Gas Line Installations: Follow Utility Specifications;also,include the following on the permit: "Gas main shall be installed per Mason County regulations and Gas Transmission&Distribution,Federal Pipeline Safety Standards(Part 192,Title 49,Code of Federal Regulations)." CULVERT INSTALLATIONS Specifications for the culvert permits are included in the permit application. Any special/additional specifications may be added by this office on an individual basis. The Bond for a regular access w/out culvert and a 12"x 20'culvert is$25.00 The Bond for a 12"x 40'to 12"x 50 culvert is$50.00($25.00 bond for each additional 25D Hand-out(sketch)is available showing side-view of installation of access culvert. MASON COUNTY Requirements for Installation and Maintenance of Underground Utilities , 1. EXCEPT IN CASE OF EMERGENCY,the permittee SHALL NOTIFY the office of the County Engineer at least two(2)days prior to commencement of work. Failure to do so may result In revocation of this and other permits. 2. The permittee is fully responsible for damage to private and/or public property resulting from his operations. This Includes any settlement occurring within one(1)year following completion of work 3. The permtittee shall maintain appropriate barricades,etc.,throughout the work area for such length of time as required for the area to firm up sufficiently to carry traffic safety. 4. Adequate warning signs of approved types shall be in use at all times during construction. State laws pertaining to Bagging and barricading shall be followed. 5. All roadside ditches shall be restored and shall include but not be limited to restoration of vegetation by sodding or seeding and shall be left in a clean condition. 6. All road shoulders shall be restored. This includes the placing of crushed stone surfacing as required to restore to original or equal condition. 7. Driveway approaches shall be repaired to original or equal condition. 8. Road crossings shall be pushed or bored wherever possible. The County Engineer may make exceptions to this requirement to allow for field conditions. 9. All service crossing shall be encased in approved conduits or casings and wrapped with locate tape. 10. No more than 500 feet of ditch shall be open at any one time,unless otherwise stipulated on the permit 11. All road crossing cuts shall be backfilled with clean gravely material to within six(6)inches of the surface,then tilled with 5/8" or 314"crushed stone,or cold mix asphalt surfacing compacted to 92%+,unless otherwise stipulated on the permit 12. All trenches located within the roadway prism(includes embanlunent slopes)shall be backfiilled with gravel borrow material. Backfill shall be applied in no greater than 8"lifts and compacted to a minimum compaction of 92%+of optimum density based on a pre-submitted and approved Proctor or Rice density test of the backfill material provided to the County prior to asphalt cutting and removal.A record of compaction achieved will be required at the completion of the open cut backfill operation providing evidence that the required compaction standard has been achieved. 13. Unsuitable materials shall not be placed upon a cut slope. Disposal on an embanlanent slope may be permissible. 14. Any roadway surface disturbed by the construction shall be repaired as soon as possible. All pavement crossing patches shall be angled,using asphalt cement concrete,Class"B"paving mix(compacted to 92%+of optimum density)so that two tires do not hit at the same time,creating a bump. 15. Any major change in plans from those submitted for permit purposes will void this permit and will require resubmission for a new permit 16. Minimum cover requirements are as follows: Ditch Line Roadway&Shoulder Crossings Underground Power Cable 36 inches 30 inches Underground Telephone Cable 30 inches 30 inches Gas Lines 30 inches 30 inches Water Lines 36 inches 30 inches 17. Pernittee shall contact the Department of Public Works'office prior to commencement of work (Ph:(206)427-9670, Ext'n.450). UTILITY DAMAGE IS COSTLY CALL BEFORE YOU DIG !! *** 1-800-424-5555 10/29/2001 11:52 FAX 360 427 7798 MASON CO PERMIT CTR 2002 FORM MUST QE COMPLETED IN INK PERMIT NO.: PLEASE PREI+IS HARD MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 99584 Shelton(360)427.9670 Belfair 380 275-4467 Elma 360 482-5269 Seattle 206 464-6968 APPLICANT INFORMATION CONTRACTOR INFORMATION Owner I -, �Tll i-JaI Contractor Name Chuck Ca C "4-N Mailing Address q15 ,41 w� f Mailing Address 3z15-lto "� u e. < E City Kest f S 4 state u, Zip Code i h-c, :5 i City S Lk n>'A-le r State t.' Zip Code 'i ' i Phone( R5 Z--70 3Other Ph.L ==)----- Ph.( z 5 3 9Q-145A- Other Ph.(Z5 q3 i -aysK Llen/Title Holder A)o L E iContractor Reg.# ,.`)art- Sn- L-o—w Address Expiration I SEPTIC IN ORMATION-Connect to New Septic Existing Septic Connect to Sewer System Narne of Sewer System PARCEL IMFORMATI ON-12 digit Tax Parcel No_ 2 Z 3 0 1 -1 6 Fire District Legal Description Site Addresls(Please include street name, street number and.city) '71c % NfE. -Fa6 - c, V Directions t site — ` t I — r — A 1 IJ — 2Y t� I 1'l r 1,C - `�-i r I c"k Is your property within 200'of the following: Body of Water(Name) Z-a c. E►'i c.ksc n Saltwater Lake _River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs TYPE OF JOB New Add Alt Repair Other Use of Building Location ofFixtures/Units 1st Floor i end Floor Basement Garage Closet ■ .n_ ■ n PLUMBING FIXTURES(Show Number of each) MECHANICAL UNITS Fuel Type: Electric TVm of Fixture No. of Fixtures Fees LPG Natural Gas Heatpump Toilet Type of Unit No. of Units Fees Bath Basins Furnace Bath Tubs Heatpumps Showers Vent Fans Water Heater Propane Tank Laundry W3her Gas Outlets Sinks Wood/Gas/Pellet Stove Dishwasher Direct Vent? Other Other -S eipX 14�0 Other I other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICA rs A FLOOR PLAN AND PLOT PLAN MAY BE REQUIRED DEPENDING ON THE TYPE OF FIXTURE/UNIT. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUC'floN 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 p rovlded 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 registereu 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 Ipr whlch 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[herewith. No changes shall be made without first obtaining shall be done In conformance therewith. No changes shall be made without approval, first obtaining appr I. � 1 X Pate Date FOR OFFICIAL USE BEYOND THIS POINT Accepted 6y Date—Submittal Amount Due Receipt No. Building .':'bElr+lrt�7tt+IGt+1:Tr�L�1ltEW" :..,:'>, rJ.. •:t3>r'I '.CON tT E.. partment /VUT OaEK CO4,ti1- IE PE(c'A'1'[. p Type Constr. IA�k LX Planning Department i Other