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Home My WebLink AboutCOM2009-00042 Guest Lodge - COM Application - 4/21/2009 MASQN COUNTY PERMIT N OM Harmony Hill East Cabin � BUILDING PERMIT APPLICATION ' 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 Harmony Hill Retreat Center Company Name T.B.D. Mailing Address 7362 East S.R. 106 Mailing Address City Union State Wa Zip Code 98562 City State Zip Code Phone 360-898-2363 Other Ph. Phone Other Ph. Lien/Title Holder Chuck Hammond Contractor Reg. # Exp. E mail address Eric@HarmonyHill.org E Mail Address Drivers Lic.# DOB Driver Lic.# DOB SEPTIC/WATER SYSTEM INFORMATION - Connect to New Se in X Existing Septic Connect to Water System X Name of Water System Private— Hill of Union Well Water System Name of Water System PARCEL INFORMATION- 12 Digit Parcel No 32233 44 00040 Fire District Legal Description West 1/2 of Gov. Lot 1 Sec 33 Township 22 N. Rajive t3,W`Willamette Mer. Site Address(Please include street name, street number and city) 73M S. 106,Union Directions to site 1/4 mile East of Alderbrook Lodge. Will timber be cut and sold in parcel preparation? Yes No Is property within 200' of Saltwater x Lake Riv Cree Pond Wetland Seasonal Runoff —Stream—^ Slo r luffs > 15% X Is this permit submittal the result of a Stop Work Noti recti otice or other enforcement action?YesJNo TYPE OF JOB - New X Add Alt Repair ILOth PRIMARY R SIDENCE ❑ SEASONAL ❑ Use of Building Guest Lodge DescrA 5 -� No. of Bedrooms 3 No. of Bathrooms uare ge- 1 st Floor 825 sf 2nd Floor 480 sf 3rd Floor — Basement — DeCove d Deck 213 sf Other Sq. ft. Garage Attached De rport Attached Detached MANUFACTURED HOME INFORMATIO N4<ke Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Pri Replacement Unit? Yes/No Installer Name Appb Certification No. 01MVER/BUILDER Acknowledges subm' ion o urat rmation may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. tare that I the o own legal representative,or the contractor.I further declare that I am entitled to receive this permit and to do thfa,p in applicatio re that I have obtained the permission from all the necessary parties. If permission is required from any ent hol r any er party in i rest regarding this application or the work proposed in the application,I have obtained permission from thply for this permit cond work proposed. The owner or agent on owners behalf,represents that the information provided is accuratants employees o son Co ty access to the above described property and structure for review and inspection. PROOF OF CONTON OF WORK IS B EA F A PROGRESS INSPECTION. X Date: If, Z ` Ow er a Representative Contractor dicate which one FOR OFFICIAL ND THIS P NT Accepted by: Date DEPARTMENTAL RE W APP ED DENIED NOTES Building Department Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee I Z 1?16Site Inspection Plan Review Fee EH Review Fee Plumbing & Base Fee 3 Planning Review Fee Mechanical & Base fee S, S•D Other Wood/Gas/Pellet Stove Fee State Fee S Violation Fee iS/D &MC, Pre-Paid at Submittal Valuation $ 453 SUM 74 TOTAL FEES ` PERMIT NO.___ Harmony Hill East Cabin MASON COUNTY PLUMBING/MECHANICAL PERMIT APPLICATION 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 Harmony Hill Retreat Center Company Name I.B.D. Mailin Address7362 East S.R. 106 Mailing Address City- Onion State La Zip Code98562 City State Zip Code Phone360-898-2363 Other Ph. Phone Other Ph. Lien/Title Holderhuck Hammond Contractor Reg. # Exp. E mail addressEric@HarmonyHill.org E Mail Address Drivers Lic. # DOB Drivers Lic.# DOB SEPTIC INFORMATION - Connect to New Septic X Existing Septic Connect to Sewer System Name of Sewer System PARCEL INFORMATION- 12 Digit Parcel No,32233 44 00040 Fire District Legal Description Vest 1/2 of Gov. Lot 1,Sec 33,Township 22,N. Range 03,W.Willamette Mer. Site Address(Please include street name, street number and city)7362 East S.R. 106, Union Directions to sitel/4 mile East of Alderbrook Lodge. Is property within 200' of Saltwater X Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or Bluffs > 15% X TYPE OF JOB - New X Add Alt Repair_ Other Use of Building Guest Bing X Location of Fixtures/Units- 1 st Floor 2nd Floor X Basement Garage Closet PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric X LPG_Natural Gas_Heat Pump_ Toilets 3 Type of Unit No. of Units Fees — Bathroom Sink — 7— Furnace Bath Tubs Heatpumps Showers Spot Vent Fan 3 Water Heater Propane Tank Clothes Washer — Gas Outlets Kithen Sinks 3 Wood/Gas/Pellet Stove Dishwasher — Kitchen Exhaust Hood Hosebibs I Dryer Vent Other Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL 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 O CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. X V -- Date: Owner(Owners Representative)/Contractor (indicate which one) _---�� FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Planning Pd Ck#_ Date Bld Pd Receipt No. DEPARTMENTAL REVIEW APPROVED DENIED NOTES Building Department Occ Group TVpe Constr. Planning Department Environmental Health Department FEES Plumbing & Base Fee Site Inspection Mechanical & Base fee UFC Plan Review Fee Wood/Gas/ Pellet Stove Fee Other Violation Fee TOTAL FEES