HomeMy WebLinkAboutBLD2022-00139 Garage Addition - BLD Permit / Conditions - 2/2/2022 MASON COUNTY COMMUNITY SERVICES Permit No.
PERMIT ASSISTANCE CENTER:
` •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
W.Alder Street,Shelton,WA 98584
% nNOX275-4467.
)427.9670 exL 3W•Fax.,(360)27-7798 Phone
IF E B 0 2 2022
Phone Elma:(")482-5269
• i
-� BUILDING PERMIT APPLICATION 615 W. Alder Street
y PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: j
', NAME: 11-1 NAME: CjC'kA_ 1.-LC
l MAILING ADDRESS: I MAILING ADDRESS: v fln J /of, 1
l CITY: S VCVr1k STATE:_ZIP: CTTY: S�-t l-tt- STATE: W k ZIP:
( PHONE#1: "L0 fe j'7 Ol q A 4) PHONE360 41'7.5 0S7- CELL:I 10 790 Irt
PHONE#2: ZoA 17 7-3 6 EMAIL:06%A nn tr S C'_ [p++�co�11�. nc•
EMAIL: rl L&I REG#!In[)N At CL-CI'kCICIJEXP.
PRMARY CONTACT: OWNER❑ CONTRACTOR[K OTHER❑
NAME be\r`if EMAIL tJtia AWN-%-e/-, a C-nA—d'g1 "
MAILING ADDR S 0 CITY t STATE W Ar ZIP IJ
PHONE -L L`� CELL'Zh�T I I-I
PARCEL INFORMATION:
j PARCEL NUMBER(12 Digit Number) 1�- 1 S 0 C��7U ZONING «5 I �CncQ.
LEGAL DESCRIPTION Abbreviated)L,r 70 y Ir kwtSk-Lt IN'-AA. FIRE DISTRICT F'�S�Mh
SITE ADDRESS b f 12 14-1 J, CITY 'S I\2 I+"
DIRECTIONS TO SITE ADDRESS "CY54�+aC
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO
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 T,%, ALTERATION❑ REPAIR❑ OTHER ❑
' USE OF STRUCTURE(Residence,Garage.Cononercial Bldg.Etc.) SF P
' IS USE: PRIMARY A SEASONAL❑ NUMBER OF BEDROOMS 'Z— NUMBER OF BATHROOMS 9
HEATED STRUCTURE? YES(whale Bldg)% YES(Pants)ofB/dg)❑ NO
i DESCRIBE WORKgak S :'��ky alk—,3K'Ci1e& 41 sr-p—
i SOUARE FOOTAGE:(pr,,mse+e-siving) '
IST FLOOR —sq.ft. 2ND FLOOR `� sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
I DECK_ sq.ft. COVERED DECK, _sq.ft. STORAGE sq.ft. OTHER sq.ft.
l GARAGE 5I sq.fL 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
i ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC❑ SEWER' -- / NEW❑ EXISTING
i PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form i
PERIMETERIFOUNDATION DRAINS PROPOSED? YES NO[] EXISTING SQ.Fr.
! EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
I OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by
i signature below.I declare that 1 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
irepresentative,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
I days or if construction work is suspended for a period of 180 days.
i
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 CODE14.08.42)
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSINOTES/CONDITIONS
BUILDING DEPARTMENT J'R- 3-23-2
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
I
ti
MASON COUNTY COMMUNITY SERVICES Permit No:'Z"2OZZ-061I `I
PERMIT ASSISTANCE CENTER:
•BUILDING •PLANNING •FIRE MARSHAL RECEIVED
615 W.Alder St-Shelton, WA 985
www.co.mason.wa.us n G
Phone Shelton: (360)427-9670 ext. 35 - ax:�3b�4 7 s FEB 0 2 2022
Phone Be/fair(360)275-4467- Phone Elma:(360)482-5269
PLUMBING & MECHANICAL PERMIT APPLICATION 5 W. Alder Street
OWNER INFORMAT N: _ CONTRACTOR INFORMATION:
NAME: &c.r I n 1 NAME: lffi o In to I nS+YLk,- o n
MAILING ADDRESQA I MAILING ADDRESS:
CITY: STATE: ZIP: CITY: STATE: ZIP:
1 S`PHONE: PHONE: CELL:
2°d PHONE: EMAIL :
EMAIL: L&I REG# EXP.
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number): ;1,1 19 56 -- OOOQ'-� Zoning:
LEGAL DESCRIPTION (Abbrevt t d):
SITE ADDRESS: E • C� CITY: _ eA
DIRECTIONS TO SITE ADDRESS:
TYPE OF JOB:
NEW=ADD=ALT=REPAIR=OTHER=USE OF BUILDING
LOCATION OF FIXTURES/UNITS- 1 IT FLOOR=2ND FLOOR=BASEMENT=GARAGED OTHERO
PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS
Tyne of Fixture No. of Fixtures Fees Fuel Type:Electric=LPG=Natural Gas=Ductless=
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heat Pump
Showers Spot Vent Fan
Water Heater I Mown Propane Tank
Clothes Washer Gas Outlets
Kitchen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood
Hose bibs Dryer Vent
Other tp—J t- -A5"1� Solar Panel
Other
Base Fee Base Fee
TOTAL PLUMBING TOTAL MECHANICAL
OWNER acknowledge 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 construction work is suspended for a period of 180 days. PROOF
OF CONTINUATION OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS
WILL INVALIDATE THE APPLICATION.
X
Signature of Owner Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT �12 3'Z3-
PLANNING DEPARTMENT
FIRE MARSHAL
Rev:1/27/2016 JBN