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Home My WebLink AboutBLD2018-00908 - BLD Permit / Conditions - 11/7/2018 MASON COUNTY COMMUNITY SERVICES Permit No: .�I Lo- PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352-Fax:(360)427-7798 Phone Belfair.(360)275-4467-Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:, "t-C,c✓�ir_� NAME• -IYI.Q. MAILING ADDRESS: ► r 0 11 MAILING ADDRESS: ' CITY: i+0r STATEiIJ�, ZIP: CITY: STATE ZIP: - PHONE#1: (-3(g()1A0-((KE PHONE:( D-1f3l CELL: PHONE#2: EMAIL: ;s�f� I?�fn nw EMAIL: n 1{J�.LQ?'Y� L&I REG# EXP. PRIMARY CONTACT: WNER❑ CONTRACTOR OTHER El NAME ►'IYI EMAIL i u I i p lzi me f)W C.CCU f t MAILING DDR SS n CITY L-ave STATE}' ZIP l PHONE — CELL ') PARCEL INFORMATION: ii7-��,��(,,^� PARCEL NUMBER(12 Digit Number) 4/-t OF3 "' �V _ZONING rr LEGAL DESCRIPTION(Abbreviated) F Lt.IZV-e IRE LD�IST/RICT SITE ADDRESS U 0 �I t 1 S Q /0 b C f- CITY S/ k- OIT,r DIRECTIONS TO SITE ADDRESS J f w- 3 IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO K IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ ��jREppPAIPX OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) &run C—/ IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS__NUMBER OF BATHROOMS HEATED STRUCTURE? YES(WholeB1d4 YES(Part(s)ofBldg)❑ NO❑ DESCRIBE WORK 60 SQUARE FOOTAGE:(propose+existing) 1ST FLOOR) ZS.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. nC DECK L-1- )ft{' CO RED DECK (t O sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached< Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED H INFORMATION: * PIES OF THE FLOOR PLAN REQUIRED* MAKE MO AR LENGTH WIDTH BEDR BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC] SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES-If NO❑ Ifyes attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ 4 NO[] I EXISTING SQ.FT. EXISTING BEDROOMS—�L— PROPOSED BEDROOMS �f— 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 I 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 permittapplication 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 EXP ED.(MASON COUNTY CODE 14.08.42) X lf' ignature of OWNER( ust be signed by the OWNER) Date DEPARTMENTAL REVIEW. APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT to-zo-i PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES V"D Building,Planning,Environmental Health,Community Health Physical and Mailing Address: 615 WAIder St., Bldg 8, Shelton, WA 98584 Shelton Phone: (360)427-9670 ext 352 -* Fax (360)427-7798 eet PLUMBING & MECHANICAL PERMIT APPLICATION Permit#: A cool e-0090g, OWNER INFORMATION: CONTRACTOR INFORMATION: ' :NAME: Li- 0- — i t - - I NAME: Ii�nlq f j' i�mboyl MAILING� DR� 11115 Vol f-0 U_A 1'(1 MAILING qDRESS: akfm Ki vinov Wd 3e-, CITY:. r) STATE:R-)Q ZIr'.qL.1rLq CITY: 11a(PLA AT tip: 1,11 PHONE: PHONE: CELL: 2nd PHONE: EMAIL: EMAIL: L&I REG#J I MCM LP)tp q 9 11 EXP.062 PARCEL INFORMATION: PARCEL NUMBER (12 Digit Number). o�— Zoning: LEGAL DESCRIPTION (Abbreviated): AE SITE ADDRESSIi/ It i-tibs,boeo (Jbap CITY:- 7:5kL 1 'tV t` DIRECTIONS TO SITE ADDRESS: TYPE OF JOB/WORK: NEW ADD— ALT REPAIR Y1 OTHER USE OF BUILDING— PLUMBING FIXTURES MECHANICAL UNITS Electric in-wall heaters(nofee) Type of Fixture No. of Fixtures Fuel Type Fees Type of Unit No. of Units Fuel Type Fees Toilet(s) Furnace [E/G/LPG] Bathroom Sink(s) Heat Pump I [E/G/LPG] Bath Tub(s) 0 Ductless H.P. [E/G/LPG] Shower(s) Spot Vent Fan Water Heater(s) [E/G/LPG] Propane Tank _gal.] Clothes Washer(s) [E/G/LPG] Gas Outlet(s) Kitchen Sink(s) 1 Heat Stove [E/G/LPG/W] Dishwasher(s) Kitchen Exhaust Hood I Hose bib(s) Dryer Vent Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee Final Inspection Fee Final Inspection 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 contractor. I 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 authorized agent 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 constr ction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF ,INSPECTION.INACTIVITY THIS P RMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. . I b X Slignaturuf AP "i int Date X U. e4 Owner/Owners Representative/Contractor , i a=b Print Name (Circle one) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS • Building J7L_ • Fire Marshal • Permit Tech (OTC permit only) i,�ev-3/091`1017 MASON COUNTY Shelton (360)427-9670 ext. 352 `~ '• DEPARTMENT OF COMMUNITY SERVICES Belfair(360)275-4467 ' Mason County Bldg. 8, 615 W. Alder Street Elma(360)482-5269 s Shelton, WA 98584 www.co.mason.wa.us REQUEST FOR BUILDING PERMIT EXPEDITION Date: Permit No.: ��' � ' ��D16- Name: t��11� 1`��' y✓� ' Mailing Address: �� ®C �� =a �1G 1S VV Parcel Number:quor Site Address: S1� I�un Request due to: ❑ Medical Hardship ❑' ire Damage El Other }� Explanation of Hardship: W Ihi l �� /� Must include supporting documents.This may be a letter from a doctor, insurance claim report, report of fire damage from appropriate fire district representative or other relevant documentation. I (WE) understand the intention of this form to determine and document justification for expedition of a building permit to alter or reconstruct a structur he above named property. Signature Owner/Agent: OFFICIAL USE ONLY Request: Approved ❑ Denied Date:"�4 Request denied for the following reasons: Signature: Director of Community Services D— N N A si �ra 38'-4- 25'(E) W-4-(E) N 1 a 2668 8.4-(E) 10-4- 11.1. 4' T-7- II'-7- O � � � � U3 m a CJ pm R $g Zl m 7668 7668 UJI ju A i V N y m � n91 I m SF m ,r A a m p 0 �1 F 1 � >z o x � 1868 g13' 3 1- =a no m=� < m MRM z old. 7K oil ��Q 1�XX> `o Z O "q ♦® Z Cl IX o HMO AM 4 p iaTlA 3 �. A z J m - - 0 5 4- W 'Willm — O r 0 Kg ci g1468 i& J 7668 O � 6040 EGFRE88 (E)8'-4- (E)30' rp.eww. s-x uma » 2" Floor Pon/IN SWUM Structural Engineer A Reconstruction Plan for: Prime NW Construction Precise Engineering I Si 1113 Sleater Kinney RD SE Wa Lacey,WA 98503 1011 Mellen street Centralia,Wa.98531 Ph.36o-73 3 3 75 A-2 �o 5 61 Hillsbrough Ct.Shelton,We. Ess, 1D M 1D °°m0y T:\20160127-Drawings 2\Additions\Prime NW Construction\Sigo-61 W Hillsbrough Ct\Sigo-61 W Hillsbrough Ct 3.dwg,10/25/2018 11:42:27 AM,Adobe PDF