TOM-77 of

Sm B?nfl?lillsw.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ruston, Washington 98407-6597 Permit NumberPhone (253) 759-3544, Fax (253) 752-3754
RST14-1312
BUILDING PERMIT APPLICATION Received 3/28/14
LAnnIiranuutozmanpn' Winn
Applicant Name: Point Ruston LLC Owner Name: Point Ruston LLC
Applicant Address: 5219 North Shirley St. Suite #100 Owner Address: 5219 North Shirley St. Suite #100
City, State, Zip: Ruston, Washington, 98407 City, State, Zip: Ruston, Washington, 98407
Phone Number: (253) 752-7083 Phone Number: (253)752-7083
E-mail Address: robert@pointruston.com E-mail Address: robert@pointruston.com

Lender's Name: Same as applicant (If Commercial):
Lender?s Address: Business Name: Same as applicant
City, State, Zip Business Owner Name:
Lender?s Phone Number: Business Phone Number:
WOW I
Contractor Company Name; Point Ruston LLC Contractor Registration#: POINTRL936CA
Contractor Address: 5219 North Shirley St. Suite #100 Contractor 602 578 303
City, State, Zip: Ruston, Washington, 98407 Is the Owner acting as his/her own general contractor?
Contractor Contact Name: Larry Hutchinson If yes, check the box: and initial the following:
phone Number: (253) 752-7083 I certify that i am exempt from the requirements of the State Contractor's
Email Address: Iarrv@pointruston_com Registration Law under RCW 18.27 and WAC 296-200A.

Site Address: 5101 Grand Loop Parcel Area: 331,302 sq. ft
Parcel Number: 0221231077, 0221231078, 0221231079, (E Existing lmpervious Surface Area: 100%
Parcel Zoning: Point Ruston MDP Proposed New lmpervious Area: 100%
I . . n_
Project Typei Full Pro'ect Descri tion: Mixed-use Square FootageommerCIa wit auxi iary commercia .
New Dwelling New Building residential Mam Floor: wt)
[3 New Garage EIAddition Second Floor:
New Deck EITenant Improvement . . Baseme t-
. Public Water Supply Private Well El 0 -
New Covered Porch Repair . . . I
.. . Publlc Sewer or Private Septic El Garage.
DAddltIon El Mechanical Only .
. Heated? No Heat  El, Gas red p0 h-
lj Remodel Plumbing Only . 0 9 r0 -
air DR Plumbing included? Yes No k.
DMezhanical Only Sign 00 Mechanical included? Yes No then ec 
'2 er:
Plumbing Only Dower Gas Included. Yes  Natural LP 
Re?Roof Occupancy Type: S-2 Pwe?ftvaluamn' I . I . I 
Fence onstru cti on Type: 1A Required. Enter antICIpated value of entlre project, including all materials and labor, Including your own.
EiomerL? Fire Sprinkled? Yes  No valuation 3 10125030000
LSiuuature'
i hereby certify that I have read and examined this application and know the same to be true and correct. . .
I also celtify that I am the owner (or owner's authorized agent) of this property and that all work shall be Permit Fees-
perforrned in accordance with all state and local laws regulating the project proposed by this application. Building plan Review Fee: 
hereby authorize representatives of the Town of Ruston to enter upon the property for inspectlon Ener 0 8, 
purposes. I understand that the granting of a permit does not presume to give the authority to violate or 9y 
cancel provisions of any State or local law regulating construction or the performance of the construction. Bu'idmg Permit Fee- 
I understand that failure to comply with such laws or the submission of inaccurate information may result WA SBCC Surcharge: 4-50
in the revocation of any permit issued pursu lcatio .
Signature of Owner
or Authorlzed Agent: 4V Total: 4.50
Printed Name: Benjamin Childs Deposn Paid: Dale;__ 

 

Balance Due Upon Issuance: 4.50

 

Date: 2/28/2014

 

 

Town of Ruston Building Permit Application Page 1 of 1