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Home My WebLink AboutBLD2018-01312 Addition - BLD Application - 12/10/2018 MASON COUNTY COMMUNITY SERVICES Permit Nob- 6a L� PERMIT ASSISTANCE CENTER: inn •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 RECEIVED Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-77 IA DIN G Belfair.(360)275-4467•Phone Dina:(360)482-52 DEC 10 2018 BUILDING PERMIT APPLICATION 615 W. Alder S1 reet PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: &red �Ct& I NAME: Ri r4i and Sh t,(er MAILING ADDRESS: PO 'L3 0 2 MAILING ADDRESS: f0 CITY:j52,A k I r STATE: WA ZIP: CIC6 1j CITY: r e VIC uJ STATE:VA- ZIP: PHONE#1: PHONE. Vl CELL:Z400(pW Wq-((Q PHONE#2: EMAIL: I,( r ns+ruc-h c 4 q&o to a r EMAIL: L&I REG EXP. / / PRIMARY CONTACT: OWNER❑ CONTRACTORK OTHER❑ NAME EMAIL MAILING ADDRESS G' 00X 5i CITY Q-QW rle-PJ STATE ZIP PHONE CELL Cn 2 ;'— PARCEL INFORMATION: �} PARCEL NUMBER(12 Digit Number) ,Z"1V - 7S qO 1 ,51 ZONING 1�5' A) LEGAL DESCRIPTION(Abbreviated) LcT' 3 or Se :1`2 L Ip4 T-k' I FIRE DISTRICT SITE ADDRESS E ( 011 -A I d P►-wood lid CITY 6e],✓a rr DIRECTIONS TO SITE ADDRESS 6 OUO QOf-e led JV f}'jWe ,006f W IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO[ IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check aA thw apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND J�r WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION IX ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc) Ra6i d err_p_ IS USE: PRIMARY K SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS-1- HEATED STRUCTURE? YES(Whole Bldg) 11 YES(Part[V ofB1dg) ❑ NO❑ DESCRIBE WORK I (o X-2 y e' Ate.•{-t" o -) SQUARE FOOTAGE: (propose+ed tfng)W otc3C 1ST FLOOR D,� q.fL 2ND FLOOR sq.ft. 3RD FLOOR sq.& BASEMENT sq.& DECK sq.fL COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.R GARAGI -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❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES Pr NO❑ If yes,attach completed Water Adequacy Form PERIIAETER/FOUNDATION DRAINS PROPOSED? YESV NO[] EXISTING SQ.FT. EXISTING BEDROOMS_ PROPOSED BEDROOMS 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 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 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 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) MASON COUNTY COMMUNITY SERVICES Permit No: PERMIT ASSISTANCE CENTER: BUILDING •PLANNING •FIRE MARSHAL 615 W.Alder St-Shelton,WA 98584 www.co.mason.wa.us Phone Shelton:(360)427-9670 ext.352• Fax:(360)427-7798 • Phone Belfair. (360)275-4467• Phone Elma:(360)482-5269 PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: ld Cyr MAILING ADDRESS: �'11 MAILING ADDRESS: D RPX CITY:f eI FA.j 1- STATE: WA: ZIP: ffM'Z$ CITY: ('q eViCW STATE:_ TJ4 ZIP: V PHONE: PHONE:'* CELL: Cop QQ 2'PHONE: EMAIL :cShujet"6C0115"( on�GlMU11, v EMAIL: L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): Zoning- LEGAL DESCRIPTION(Abbreviated): SITE ADDRESS: F / D'7I AJgJ2/--W00d Pd CITY: biT �r DIRECTIONS TO SITE ADDRESS: Gbu _hers Rd -to XJd Pn4)oo-d ied TYPE OF JOB: NEW ADD ALT REPAIR OTHER USE OF BUILDING Ke-51d649G2- LOCATION OF FIXTURES/UNITS—I ST FLOOR 2No FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric_LPGNatural 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 Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood 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 Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 1BN Name Parcel# { `�.� S d 1�j 3 BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 1 of 2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 'Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved,gravel or packed area per definition above table X = Patios/Walks X = X = Any paved,gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. Owner/Builder/Agent 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,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- des review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: t'D If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 Property Owner Authorization Form I hereby affirm that I am the owner of the property located at: City: Belfair State: WA Zip Code: 98528 Tax Map Parcel Number: 1220=- -g015� By signing below,I authorize the indentified in this following section to act as my authorized agent with regard to any and all application(s)made to the Mason DCD for the activities described.The individual shall remain in this capacity with regard to any applications and subsequently issued permits related to these activities until all permits have been finalized unless an express written request to terminate this authorization,signed by me,is submitted to the Mason DCD. Project/Activity for which Application is being made: W x 20'Bedroom Addition to Existing Single Family Residence Signature of Owner: Date: 1-;2 Printed Owner Name: 1= Printed Name of Permit Applicant/ Owner's Authorized Agent: Richard Shuler(DBA)Shulers Construction Address: PO Box 54 City: Grapeview State:WA Zip Code: o8546 Telephone Number: 6o-62o-6 i6 Signature of Applicant/Agent: Date: PLANNING PLANNING: ALL SETBACKS ARE MEASURED FROM THE FURTHEST g PROJECTION OF THE BUILDING pEc 1 2p1 �o Ndec St�eet�oo� 6 W 15 12207-75-90153 ti 1071 E Alderwood Road Belfair, WA 98528 Paryd ;p0 260, 265 � yti 1h�O �e +l s 9 i / �6Q �QQ 1 30'Driveivay i.a APPROVED MASON COUNTY DCD PLANNING SITE PLAN REQUIRED TO BE ON SITE N ' SUBJECT TO APPR VAL BY Date �5