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Home My WebLink AboutBLD2016-00347 shop - BLD Permit / Conditions - 5/19/2016i ` MASON COUNTY COMMUNITY SERVICES i., PERMITA55I5TANCECENTER: Permit No: • BUILDING• PLANNING a FIRE MARSHAL Recv d: 615 W. Alder St - Shelton, WA 98584 Phone Shelton:(360)427-9670 ext 352 Fax:(360)427-7798 t. 854 ` Phone Belfair.*(360)275-4467 Phone Elm:(360)482-5269 t B U I LD I N C BUILDING PERMIT APPLI ATION Al I PROPERTY OWNER IN ORMATION: CONTRACTOR INFORMATI „ :Aider Street NAME: 1AA ALI NAME: MAILING ADDRESS y MAILING ADDRESS: CITY:5h_STA, E:�ZIP: CITY: STATE: ZIP: PHONE# : PRONE: CELL: PHONE#2: �� d f�1 Zvi EMAIL : EMAIL: L&I REG # EXP. CONTACT PER�ON : OWNERK, CONTRACT R ❑ *OTHER/Sec Blow ❑ *NAME: MA4/L � MAILING A RESS: � l✓� CITY: (STATE: ZIP: PHON -CELL- EMAIL: PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) — , 00 ZONING LEGAL DESCRIPTION(Abbreviated) 2 FIRE DISTIR ICT SITE ADDRESS i ` ` CITY DIRECTIONS TO SITE ADDRESS `T— o ( r� 4 ' p- IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14% YES4 NO ❑ IS PROPERTY WITHIN 200 T: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK ❑ POND ❑ WETLAND SEASONAL RUNOFF STREAM❑ TYPE OF WORK: NEW ; ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) IS USE: PRIMARY R SEASONAL❑ NUMBER OF BED OOMS - NUMBER OF BATHROOMS HEATED STRUCTURE? YES Whole BW ❑ YES (Part[s]of Bldg) ❑ 0 K. DESCRIBE WORK (Valuation reject Bid Amount: $ SQUARE FOOTAGE: IST FLOOR sq.ft. 2ND FLOOR sq. ft. 3RD FLOOR sq.ft. BASEME T sq.ft. DECK sq. ft. COVERED DECK sq.ft. STORAGE sq. ft. OTHER sq.ft. LiEY sq.ft. Attached❑ Detached CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COP S OF THE FLOOR PL kN REQUIRED* MAKE ODEL 7,AR LFT WIDTI S BA luAL NUMBER OWNER acknowledges that submission of inaccurate information may res It in a stop work order or ermit revocation. Acknowledgement of such is by signature below. I declare that I am the owner or owner's legal representative. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained perrr ission from all the necessary parties, including any easement holder or parties of interest regarding this project. Theo ner or legal representative, represents tha the information provided is accurate and gr, nts employees of Mason ounty access to the above described property�nd structure(s)for review and inspection. is permit/application bec mes null &void if work or authorized constructioh is not commenced within 180 days or if c struction work is suspended for a period of. 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS F ERMIT APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUN Y CODE 14.08.42) Signature of OWNER ate DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOT+S/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT PERMIT SPECIALISTS Intake; �ZS-JI¢ Approved& eady for Pick-Up: Visit us on-line: littp://w\vw.co.i-nasoii.wa.us/comiTiuiiity_dev/ F ev. 112712016 by JBN fi. K Co . MASON COUNTY COMMUNITY SERVICES permit No: L C tCi" PERMITASSI TANCE CENTER: •BUI DING•PLANNING•FIRE MARSHAL 615 W. Alder St-Shelton, WA 98584 RIECEIVED Phone Shelton:(360)427-9670 ext. 352 Fax:(360)427-7798 - — Phone Belfair. 60)275-4467 Phone Elma:(360)482-5269 I8S4 ', i PLUM ING & MECHANICAL PERMIT�,APPLICATION ` ° i Alder treat OWNER INF RMATION: CONTRACTO INFORMATION: NAME: NAME: �1 MAILING ADDRESS 7 MAILING ADDRESS: CITY: STATE: _, Wk ZIP: CITY: STATE: 1't PHONE: PHONE: CELL. 2nd PHONE EMAIL : EMAIL: c T L&I REG# E . PARCEL INFORMATION: PARCEL NUMBER(12 Digit ber): — 00 1,- 1 Zoning: LEGAL DESCRIPTION(Abbrev' ted): t' y SITE ADDRESS: . CITY: DIRECTIONS TO SITE ADDRESS: �r TYPE OF JOB NEW_�_ADD ALT REPAIR OTHER USE OF B DING fZqe,�-i"-4 5 her LOCATION OF FIXTURES/UNITS—1ST FLOOR 2ND FLOOR BASE NT GARAGE THE PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANIC ITS Tyne of Fixture No. of Fixtures Fees Fuel Type:Electri LPG Natural Gas Ductless` Toilets Tyne of Unit No.of Units Fees Bathroom Sink �_ Furnace Bath Tubs Heat Pump Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer VOCO'Jen tlets Kitchen Sinks Woo ' Gas/Pellet Stove Dishwasher Exhaust Bood Hose bibs Dryer Vent Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING T AL MECHANICAL OWNER/BUILDER acknowledges submission of inaccurate information may result in a st work order or permit revocati n. Acknowledgement of such is by signature below. I declare that I am the owner, owners legial representative,or contractor. further declare that I am entitled to receive this permit'liand to do the work as proposed. I have obtained pe-mission from all the necessary arties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the inform tion provided is accurate and grants employees of Mason County access to the above described property I ind structure(s)for review and i spection.This permit/application becomes null&void if work or authorized construction is not commence within 180 days or if constructi n work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEA S OF INSPECTION.INACTIV OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. x Im"A" —2 Z01 Signature of Applicant Date x Mlkgf— Owner wners Re resentative/Contractor Print Name (Circle ne) DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL �Ticit 110 n.._lin ki+n•/A-11er rn rnnenn%At7 r I/r-I In itv r—II Dn.r 7 n7l')01 MKI