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BLD2023-00725 - BLD CD Environmental Health Review - 6/28/2023
Mk- Permit No 1d 2O i23" 72-5 � , , MASON COUNTY ) COMMUNITY DEVELOPMENT RECEIVED Permit Assistance Center,Building,Planning t_ BUILDING PERMIT APPLICATION JUN 2 7 2023 0 z PROPERTY OWNER(INFORMATION: CONTRACTOR INborib ®IOOftider Street m co NAME:ht{�4f� I�ocaMt\ NAME: SCtC= U a N MAILING ADDRESS: 0 U Ei..1 t. S 4"--#1.PO- MAILING ADDRESS: \t-{O k O WC- 1V"-1. L\i2 w CITY:Sec,V.11.e_ STATE:LJ.i IP: rlgtti CITY:VG.ACovnrcr STATE: Wc. ZIP: CttL0$2 PHONE#1: 'ZOL-'L-Li- 3g,i PHONE: SO,-4�5- 3t4c10ELL: Sc ci 4�5-�3t19 _ PHONE#2: EMAIL: PSorb-1 \L ) c (V t \.caM z EMAIL: M t rp&.i fron�J g M4►�M L&I REG# SGCA1 L L" 2- 1 A EXP.3/iK/Z,� Z `,,,I.L PRIMARY CONTACT: OWNER It CONTRACTOR❑ `OTHER❑L_ V NAME t-\ R'c et owut\ (\ iT4\ EMAIL MI..1`�D 9rtat`.c.c.s = = MAILING ADDRESS 3(c0 t ) EQ.en 51- 3CPt� CITY k� STATEL.)a. ZIP gsttct 11'I 0 { PHONE ZC�b'ZZ�-9�fS8 CELL zv(o'U- �3FSS PARCEL INFORMATION: E PARCEL NUMBER(12 Digit Number) 32\D(o3 Sc10\\\ ZONING R2S = T LEGAL DESCRIPTION(Abbreviated) LOT \ of SP*i LU2s PM of 1 Q K-1 FIRE DISTRICT (o-? Z SITE ADDRESS SOp 1, CIeC\�.11F� \�� AC CITY URto{\ S .) DIRECTIONS TO SITE ADDRESS /1/01 cn c E /'A Qco... _. \, E• Un 1 OI\ toA YQ c.�. D � Lec-k on L- C1ct-ter Zr. "1-o\\ow kb S.d. on Le 4. r IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES® NO 0 SNOW LOAD: psf p co IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER 0 LAKE 0 RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0 Q ` TYPE OF WORK: NEW ElADDITION 0 ALTERATION 0 REPAIR❑ OTHER 0 ( ` USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) R5 S k8-enLe L� Y IS USE: PRIMARY E SEASONAL 0 NUMBER OF BEDROOMS t-4 NUMBER OF BATHROOMS 5 cl HEATED STRUCTURE? YES(Whole Bldg)® YES(Perils)of Bldg)❑ NO 0 DESCRIBE WORK 6v\\di fs,y Ne,.a-1 I.o rne._ (N r To\t c LbS! Ctrs age SOUARE FOOTAGE:(proposed)CO 1ST FLOOR sq.ft. 2ND FLOOR 30°0 sq.ft. 3RD FLOOR \' ) sq.ft. BASEMENT2I N)sq.ft. N L DECK\3$O sq.ft. COVERED DECK o sq.ft. STORAGE o sq.ft. OTHER O sq.ft. GARAGET,sq.ft. Attached❑ Detached® CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC© SEWER 0 / NEW 0 EXISTING El PLUMBING IN STRUCTURE? YES® NO 0 Ifyes.attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES® NOD EXISTING SQ.FT. 31:5 0 EXISTING BEDROOMS 0 PROPOSED BEDROOMS 4 TOTAL BEDROOMS 4 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 thus 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 it 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) X _ (4:i-2_( ,-23 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 1 $t al A tio. .-.J• FBUILDING PERMIT APPLICATION MASON COUNTY .1144 P.O. Box 186 Shelton, Washington 98584 426-5593 6, ^ a 7, e/ DATE ISSUED nj7 _ // .- 7q's9 4 Gol( O/V G X2i3, G->yzsPOC ,s, . �9?-. .t( ��,LI 11JLLE t&OMIT NO. 9�fl? S/3� -/yd'6 OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE DIRECTIONS (� n • I • f,( TO JOB SITE' ! L (✓ ea. To u N O t., rl t a .) ' LEGAL / , �a t IV '( 3 W �, 11/t J / In SEE ATTACHED SHEET) DESCR. l /dot / . - --. NAME MAIL ADDRESS [��( / CITY&STATE LICENSE NO. PHONE p CONTRACTOR G4h de N cei3 1'IG, / V 0 6, L Idf;V IAcy/� VA fit y f !Aral_ q O USE OF �i O / BUILDING r S f, 4 e n L_� Class of work:R X NEW E ADDITION D ALTERATION E REPAIR 0 MOVE El REMOVE Describe work: _ J 7 5 QJCt 1 A-S Valuation of work: S c, d PLAN CHECK FEE PERMIT FEE C^f) 9/. ? 73. .,7c41. 6 qa ?. SPECIAL CONDITIONS: BEDROOMS__ 1 DECKS , CARPORT i NOTICE BATHROOMS__ TOTAL SQ. FT:Y/7V GARAGE$ _S-47 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OFillARIE BASEMENT 1C /3-4 3 r ATTACHED$ OR AIR CONDITIONING. TOTAL SQ. FT7C-c3 FIREPLACE% a DETACHED THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR. CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER I certify that I am a currently registered contractor in WORK IS COMMENCED. the ate of Washington and I am aware of the FOR OFFICE USE ONLY 7nce requirements regulating the work for whichtrmit is issued and all work done will be incmance therewith. PERMANENT✓ SHORELINES nra,, SEASONAL : FLOODPLAIN Firm E D. NO.___ ___ __ S.E.P.A. By Special Approvals .- IN OUT YES APPROVED NO Lic. _ Date ZONING PLANNING DEPT. 1 `1 t , OWNERS AFFIDAVIT HEALTH DEPT. OK y 4t� PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL J contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for BUILDING DEPT. 17 which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT i ...L.kt..„ , / 6 AP AT) ACCEPTED BY PLAN HECK BY� APPROVED FOR ISSUANCE '�i n e�c From M as I�at�� n [� /�6.� -L i B � v PLAN CHECK VALIDdtfON frofwdst:Tmunt)b tv PERMIT VALIDATION CK. M.O. CASH MASON COUNTY PLANNING DEPARTMENT P.O.BOX 186 Shelton,Washington 98584 PLUMBING PERMIT APPLICATION IMPORTANT—Complete ALL items. Mark boxes where applicable. Name Mailing address—Number,street,city,and State Zip code Tel.No. 1. 60/WON GE,03i NG cf'U 6 S. 19o2.-A,d co�Z/EJl71 Wa 9'03,p Y' /5/4'/ Owner 2. ,./a.4711 el,�yN ILA Contractor The owner of this building and the undersigned agree to conform to all applicable laws of Mason County and Slate of Washington Signature of applicant Address Application date LEGAL DESCRIPTION Location c_ C r ! to I K .19 c 3 � yesr w, it/ Of Building NO. PLUMBING FIXTURES }I FEE WATER CLOSETS t n C BASINS it o 0 BATH TUBS 1 SHOWERS WATER HEATERS 4. G, AUTO.WASHERS ' j,e, / SINKS ‘, / 4 FLOOR DRAINS _ c DRINKING FOUNTAINS LAUNDRY TRAYS Connect to City Sewer DISH WASHER DISPOSAL URINAL J (Show Street Names & Property Lines) INDICATE LOCATION OF MAIN SHUTOFF VALVE FOR WATER. PERMIT 77 O O SKETCH IN SEPTIC TANK& DRAIN FIELD LOCATION OR SUBMIT ON OTHER SKETCH. DO NOT WRITE IN THIS SPACE — FOR OFFICE USE brined Y Permit Date pemit iaaued Permit number Receipt No. ringed From Mason C up��y RMS 6 �, �`, / 6 ���, min Masan Gni.Iniy_Q —_--- MECHANICAL PERMIT APPLICATION MASON COUNTY DEPARTMENT OF GENERAL SERVICES P. O.'BOX 186 SHELTON, WASHINGTON 98584 PHONE 206 - 426-5593 �// DATE ISSUED 6''o9 /-e�` PERMIT NO. )6-7d/� LEGAL DESC_ SEC.. TWN. NO.,RANGE 3 WEST, W.M. PLAT DIV._ LOT OWNER G O "" ''�t Gerb/n ADDRESS 'g-flO�A S. F /'Ion/ �I/`,?/t ��iI/.eV �tt- CONTRACTOR J(IO3 Gee-b;9 ADDRESS Y/ 4 Tel.7'� DIRECTIONS TO SITE: Mr' & �{u- L fG �t j Q u re �r 5',;(1 L/i e- 5'4r9P /Vert. j� F L l( J THE OWNER OF THIS BUILDING AND THE UNDERSIGNED A R. E TT CONFOR TO LL APPLICABLE LAWS OF MASON COUNTY AND THE STATE OF WASHINGTON. �-C ) (IA/ SIGNATURE OF LICANT NO BASIC FEE $ 10.00 1 Forced-air or gravity-type furnace or burner , including ducts and vents attached to such appliance up to and including 100,000 Btu/h 6 00 la Appliance over 100,000 Btu/h including ducts and vents attached 2 Floor furnace, including vent 6.00 3 Suspended heater, recessed wall heater or floor-mounted unit heater 6.00 4 Appliance vent installed and not included in an appliance permit 3.00 5 Repair or alteration of, or addition to each heating appliance, refrigeration unit, cooling unit, absorption unit, or each heating, cooling, absorption, or evaporation cooling system, including installation of controls regulated by this code 6.00 6 Boiler or compressor to and including three horsepower, or each absorption system to and including 100,000 Btu/h 6.00 6a Over three horsepower to and including 15 horsepower , or each absorption system over 100,000 Btu/h and including 500,000 Btu/h 11.00 6b Over 15 horsepower to and including 30 horsepower , or each absorption system over 500,000 Btu/h to and including 1,000,000 Btu/h 15.00 6c Over 30 horsepower to and including 50 horsepower, or for each absorption system over 1,000,000 Btu/h to and including 1,750,000 Btu/h 22.50 6d Boiler or refrigeration compressor over 50 horsepower, or each absorption system over 1,750,000 Btu/h 37.50 7 Air-handling unit to and including 10,000 cubic feet per minute, including ducts attached thereto 4.50 7a Air-handling unit over 10,000 cfm 7.50 8 Evaporative cooler other than portable type 4.50 9 Ventilation fan connected to a single duct 3.00 10 Ventilation system which is not a portion of any heating or air-conditioning system authorized by a permit 4.50 11 Hood which is served by mechanical exhaust, including the ducts for such hood 4.50 12 Domestic-type incinerator 7.50 13 Commercial or industrial-type incinerator 30,00 14 For each appliance or piece of equipment regulated by this code but not classed in other appliance categories, or for which no other fee is listed in this code 4.50 15 For each gas-piping system of one to four outlets 2.00 15a For each gas-piping system of more than four outlets per outlet / (,.50 Ftc AT Pc1 (5.dp TOTAL�f("Q SPECIAL CONDITIONS Primted s rom MasonDounty DMS PEMIT VALIDATION ounty DM3 CK. MO. CASH PLOT PLAN ADDRESS CA, Lj/O 1.1 Y► 1 Ay-4°i il P. PERMIT NO. s o PI 1 (Vw J IAA . 1V� �s ° ° LEGAL / DESCRIPTIONce . T2.( LOT I BLK ADDITION D. SITE AREA Sq.Ft. AREA OF SITE OCCUPIED BY BUILDINGS . , So.Ft. u INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"-20' ARE FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) (,\ FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS.SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- T TION A"D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. 49 INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20' 1 • - O'///'.-:1.) \ i s \,cti.' , , V i \:\\ 4011IMMINIMININI . . ••• ., ,i\c, . '-- .4-- .4 . I/We certify that the proposed construction will conform to the dlmensiOns and uses shown above and that no changes will be made without first obtaining approval. 66 i, r; (.7 e hiI iIGNATURF OWNER(SI OR AUTM RIZEO REP E ENTNAME(SI OF OWNERIeI OF SITE a STRTURE(S) (PRI TI DO NOT WRITE BELOW THIS LINE F, dted From Mmty County DMS DATE Printed from Mason County DMS •NELTON FR7NTINO ••..r‘ , .Y. „ • -. ; • i • SKETCH OF PROPERTY SET UT IN ATTACHED ORDER .,.. .,. .. 1 -...-I To assist in locatinp; the premise!. It is . ot based on a survey, and the comp assumes no liability for variations, f any, in di menstons and location. acY 1 1;..' t • -:-• , e , to CO r,, ,,,3 t,Y -1-7-11, - •.c.**.... : ...t, 78 lock • I c:, /.c,/,...,, r , , I 2 e.2o • $ 89° 54 06"W /622.?.7 I , 400.00 .1 263 9 ,2 \ 584 03 ,.,.._. e „. • /-„.. s'''''Pson mon) /it, f• -- '-' .. .8 • ) 1/4) ....- 6 ,,i 0 - . i. . — i, • .* c) i • f,.;rl- :2141 4 I'' C.) /; .‘4•%.....''s.N....e.:, ., Lf ,......... (i- zz. L.! •' ,'( 1 1‘' t:-.) "-•••• . • ..,- • ,.., NI. .• ,2 5 4 060, : 'I ir C) . ,. I t i I, 4.. . •N\Ni, ______•_ .___,..'.c•6 A.4.e.l.f/r P..ns.' //.• -*''i-s—'-- ,. ',/- -ii I ";II.'.v'.j''.•, i,.,.,•ik,, • 1'i•kx41 cp...\ -....•.64V), ft\i N 4 4 P4-,(•-•,`-2\,•I?7 1 • I• c 4 I89°54 - / N/ 1 , .- ' ." .4:s,,--'\,.\,•‘\"0\c....1 .-..,.. •0.\61C••/•."•.r,t\:107i..K\5-.•N N•,-,N•.,...\, ,- / ‘ 1/ " 4-4-N., 1:t • N 8S°53'.4 " ' • . 03 < . --•''•• N... • J .. .I I I /6/.9? 300.1 CO .71-1 , ........... • t I' . 6-'.. . 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Floor 1 uar.Footage 205 Owner GFRBENG, DrirArin Phone 432-1486 Dist. 6-27-84 95R(16 SF 199ri !Sepia vallay Zip 98038 Contractor C.nrdnn aorhtng Phone Address Zip Plan Check Approved by EEP Shoreline by WSJ Typo Applicant's plot plan approved as to setback reeulrements, by Legal Description: Lot 1 6-21-3 Direction to project sit.: HcReavy to Union Ridae. past Union Salvage. Top of hill. Fee Paid, Pion Check_P.rsit_z_PiumbInQz___INchenlcal_i_Serer Mood Stove Fireplace 2 Deck 498 Garage576 Carport Basement 1503 Loft Main Floor Second Story Inspections:_ aA -Approved; D-Disapproved; BY -By; DIE -Date rA D BY DTE A D BY DYE 11 FOl11DATiON: Compacted Fill _- — Fireplace footing Forms ✓ Anchor bolts _ _ Foundet ion rail &weber re" Pier spacing _ _ — _ Basement rail &rotor _ _ Vents t crawl spece Retaining cell t rebar — — _ Soli-rood ci — — —_ III FRAMING, Floor Blocking Girders posts —_ Bridging _ - Joists size d grads Sub floor type tttl Span — _. Grade I Nailing Malls Material Grade - _ _ Bracing — Enter for siding — — Ceiling height Nailing — — _• Roof _ _ VICN° Approved trusses _ Purr legs,Clips Rafters _ -- Purl logs Cathedral Valley rafters �+ r Beers Sheathing Span — Flashing Q�. �_ -� Blocking _- _ Weather *pal lrattin.��,///_ c / Fire-stops / Malls t callings Stoner cells _ _ _ Furnace duets _ Dropped callings Hain-- - le • uggldal boo— — Roof Ma HolesPlugged Flrred-out calls - — Others Stairs Riser t Treed —- — — _ Headroom Width — _— Han Ste lr Jacks _— __ t Lend logs drails — — — V • • • Printed From Mason County DMS Printed from Mason County DMS Inspect Ions: •A - Approved: D-Disapproved; By -By; DTE -Date •A D By DIE A D BY DIE • F lrePlace — — No. of flues"—— — -- Construction — — -- '�-- For: Flashing — — — -- SoffIts — — $oftlt Vents — — -- Exposed — — Ridge Vent — Closed — -- -- Cathedral — — — -- Windows A Doors — -- Header Span — — -- Impact protection (fe — — — e Insulation — --Openings — — —. "— Caulkinga — — — Sill Height — — --- Attic — — Access — — — Veatlletlor. — — — -- IV PLI1hhING -- Pipe Runs Roof vents A Jacks -- _— — Bathroom Fact I. Traps '—' -- Handicap Fact I. Cltan tuts 7e i r-ree.(J Hot rater Pressure Valve • Mechanical — —Fans-Kitchen Beth CI. Dryer Vent — — 8 — — -- -- Stove vent — — _ -- Furnace I Ducts — — -- -- insulation — — Floors Cel — '� -- Ester for Doors Cal I ing — — -- V INTERIOR COVER — -- Finished Walls Finished Floors — — -- Type Type Nailing — — Decks Balconies A Lofts Structural $uD• — — -- Guardrails — — -- • ForeForr Protection — — Smoke Detector — — Doors — — — Wood Stove — -- Flr.uelis &Ceiling — — Final A Occupancy Approved. Dote _ By: • REMARKS: • II III E NULL&lO1D BY CXDtRA�1nN IV By v pYtT! --- l • • • • • • • • • Printed From Mason County DMS Printed from Mason County DMS