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Home My WebLink AboutBLD2023-00142 Remodel - BLD Application - 2/2/2023 MASON COUNTY COMMUNITY SERVICES Permit No: PERMIT ASSISTANCE CENTER: • •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i; 615 W.Alder Street,Shelton,WA 98584 F E B 0 . "` r "r Phone Shelton:(360)427-9670 ext.352•Fax.(360)427-7798 Phone 2023 J y Belfair(360)2754467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: CQYhPa'lhp 07 Rtz Co NAME: ArGI'/CI i/44nfl' MAILIVG ADDRESS:Z G ite4filil / MAILING ADDRESS: CrrY an G,t G STATE: ZIP: A!/0 CITY: i 7Cd1 STATE: ZIP: V IV PHONE#I:_ ,3/. IX 2-611 PHONE: / S' CELL. 4Z 3 PHONE#2: EMAIL: 1'fi1u l Co EMAIL: emis 2 Be a0z. 0 2 L&I REG y XP.(�/�Z/� PRIMARY CONTACT: OWNER❑ CONTRACTOR Pf OTHER❑NAME I1 /�1 EMAIL-W&t;ffi//CCkr 67i4??7 rNQ1t'• 'Ct7 r MAILING DDRESS CITY_&Jne(J A STATE 'ZIP v PHONE Y1&,J/2.f x-63J3 CELL ICp. l�lll� PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) " coo ZONING LEGAL DESCRIPTION(Abbr vjated) FIRE DISTRICT SITE ADDRESS p� E' O�Gh71DYC/ I CITY lke/fth DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO❑ SNOW LOAD:_psf 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 X REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,commercial Bid,,Etc.) ef/GYen ey IS USE: PRIMARY❑ SEASONAL br NUMBER OF BEDROOMS NUMBER OF BATHROOMS 3 HEATED STRUCTURE?.YES((WholeBkig)�[ YES(Part/s)ojBidg)[I NO❑ �,{ A DESCRIBEWORK lG!/C,/(X/'f I'f/TIOO&I �IC-1 7•Irmtj&+ 2W, O PC` SQUARE FOOTAGE:(proposea) 1 ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.fL Attached❑ Detached❑ MANUFACTURED HOML INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUI * MAK MODEL WI TH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWERN NEW❑ EXISTING W PLUMBING IN STRUCTURE? YESJq NO❑ Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOg EXISTING SQ.FT. EXISTING BEDROOMS 4 PROPOSED BEDROOMS 6 TOTAL BEDROOMS y 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 EXPIRED.(MASON COUNTY CODE 14.08.42) X Signature of OWNER(Must be signed by the OWNER I Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT s)7L PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: PERMIT ASSISTANCE CENTER: RECEIVED •BUILDING •PLANNING •FIRE MARSHAL 615 W.Alder St-Shelton, WA 98584 www.co.mason.wa.us FEB 0 2 2023 Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 Phone Belfair.• (360)275-4467• Phone Elma:(360)482-5269 615 W. Alder Street PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: at ✓ii2f In ;5aC(e NAME: iikri e/ Wa.,O(- MAILING A DD RESS:26g6 M G ,C 1114 We&7 MAILING ADDRESS: Jr CITY 4n(&W STATE: 6R ZIP:9'1//0 CITY:1 STATE: 7IP:9,S' IStPHONE: 3/. WE 2137 PHONE: / ,y2 3J-r CELL: I/G.42J"'SW8 2"1 PHONE: /'I ,d EMAIL : n'!C(r/J%{I«l'1/yiZtC77GY1 (Figmai/• 649" EMAIL: ODQO •COM L&I REG#CC Yn n P- � 3/22 EXP.12 /2249 PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): Zoning: LEGAL DESCRIPTION(Abbreviated): SITE ADDRESS: CITY: DIRECTIONS TO SITE ADDRESS: TYPE OF JOB: NEW=ADD=AL'ICtD REPAI OTHER USE OF BUILDING gi/0/6n CV LOCATION OF FIXTURES/UNITS—IST FLOOR 2ND FLOOR=BASEMENT=GARAGE=OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNJXS Type of Fixture No.of Fixtures Fees Fuel Type:Electric PC=Natural Gas=Ductless= Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kitchen Sinks 1 Wood/Gas/Pellet Stove Dishwasher / Kitchen Exhaust Hood I Hose bibs Dryer Vent Other 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 �3 Signature of Owner Date DEPARTMENTAL REVIEW APPROVED I DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT JrL PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN