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Home My WebLink AboutBLD2018-00210 RES - BLD Permit / Conditions - 5/7/2018 Qr� co'p4 MASON COUNTY COMMUNITY SERVICES'' Permit°• ,f�. ?�' PERMIT ASSISTANCE CENTER: I e><mit No: 3��'� z1O •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL l7 / , 615 W.Alder Street,Shelton,WA 98584 / ' Phone Shelton:(360)427-9670 ext. 352•Fax:(360)427-7798 Phone I859 a Belfair;(360)275-4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION ,�� PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: r, y � J�n>u� �✓ ue � NAME: ` /Lire 1*n e S MAII ING�DRESS: /2�/ C �"�/1 JA/1 o,i C,xak �4 MAILING DRESS: 1/2,66 4,buj .I V CITY: �Jq_(-t-avi STATE: "X ZII': 9 q CITY: ht i,c ' _ STATE: t tl ZIP: 18, 7.3 PHONE#1: (�5 ) 8 L Ft- -714,� PHONE: (` 76-2Z'/ CELL: PHONE#2: EMAIL : EMAIL: cc unc L&I REG# EXP. PRIMARY CONTACT: OWNER I2" CONTRACTOR OTHER❑ NAME EMAIL LCOc MAILING AD RESS CITY S S ATE U-1A ZIP�M 1 PHONE 3�v� i3lo�— 7Lu7 ' CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) ..t h cic g z� -U(iGt C% ZONING I /0 LEGAL DESCRIPTION(Abbreviated) NW SO W 1 - W 1 7 5 5 FIRE DISTRICT /0 SITE ADDRESS qlCd ' Ur , ''} In;� rr ,,:, CITY 'S/bUy 1.. DIRECTIONS TO SITE ADDRESS p�+�n �1 �,� w Its 1 i () �^ f 4 t IS THE PROJECT WITHIN 300 FT OIL SLOPE(S)GREA ER THAN 14° XES[s'� NO ❑ t'eo ��«s IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that app : SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND ❑ WETLANE J SEASONAL RUNOFF ❑ STREAM❑ TYPE OF WORK: NEW ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Conrnrer•cial Bldg,Etc) Fitt= IS USE: PRIMARY .r SEASONAL❑ NUMBER OF BEDROOMS J NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES (Whole Bldg) [r/]� YES (Part[s]of Bldg) ❑ NO DESCRIBE WORK SQUARE FOOTAGE: (propose+existing) IST FLOOR f??:� 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 f' kJI sq. ft. Attached[d Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 CO ES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL H ALTH: SEWAGE/SEWER SOURCE: SEPTIC❑� SEWER NEW[�� EXISTING ❑ PLUMBING IN STRUCTUR87 YES [' NO ❑ If yes, c i ach completed Water Adequacy Form PERIMETEWFOUNDATION DRAINS PROPOSED? YES ❑ NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate information may result in a stop wo 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 reive this permit and to do the work as proposed.I have obtained permission from all then cessary 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 permitiapplication 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 > m Si ature of OWNER Must be signed by the OWNER) Date APPROVED DATE DE +D DATE TAGS/NOTES/CONDITIONS DI;I ARTMI;NTAL REVIEW ...... BUILDING DEPARTMENT J7ZL t PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY RECEIVED i I COMMUNITY SERVICES MAR v R K 71 Building,Planning,Environmental Health,Community Health 201Q r V Physical and Mailing Address: 615 W Alder St., Bldg 8, Shelton, WA 98584 6�5 W.J%er S Shelton Phone (360)427 9670 ext 352 iO Fax (360)427 7798 PLUMBING & MECHANICAL PERMIT APPLICATION Permit#: '002,10 [OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: r _ f NAME: Ci Hams d MAILING AD RESS: 12,5 N4tict�wt� e Rat MAILING ADDR S: ii Sato 1oln 6t\v CITY: �;VtA' 'o STATE.W_ZIP:9858 CITY: P' STATE: ZIP: 98373 1st PHONE:/3rv�� BIP�s- 71 d`� PHONE: 3 22 CELL: 2nd PHONE: (%OU 36'?-'7335, EMAIL EMAIL: Cb ` h�' ^ L&I REG# ek PARCEL INFORMATION: PARCEL NUMBER (12 Digit Number): Zi7G ��2 Dc� — Zoning: ` f� LEGAL DESCRIPTION (Abbreviated: 4X IV Z 64J Z .S'' 3Lf 3g SITE ADDRESS: CG w o dC CITY: skt.L�,p_ti DIRECTIONS TO SITE ADDRESS: w lU J+tirn Lon OL I' ' ✓I. k cohc�rid TYPE OF JOB/WORK: NEW J ADD ALT REPAIR THEIR USE OF BUILDING _) e_ PLUMBING FIXTURES MECHANICAL UNITS [] Electric in-wall heaters (no Fee) Type of Fixture No. of Fixtures Fuel Type Fees ape of Unit No. of Units Fuel T Ge Fees Furnace [ ] Toilet(s) Heat Pump [E/G/LPG] Bathroom Sink(s) 3 Bath Tub(s) 3 o Ductless H.P. d [E/G/LPG] Shower(s) Spot Vent Fan a[.] Water Heater(s) ; [E/G/LPG] Propane Tank Clothes Washer(s) [E/G/LPG] Gas Outlet(s) I Heat Stove [E/G/LPG/W] Kitchen Sink(s) Dishwasher(s) I Kitchen Exhaust Hood I Hose bib(s) Dryer Vent f Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee Final Inspe *on Fee Final Inspection Fee TOTAL PLUMBING TOTAL MECHANICAL y result in a stop work order or permit revocation.Acknowledgement of such is OWNER/BUILDER acknowledges submission of inaccurate information ma 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 OF WORK IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Sig at a of Applicant Date', x Owner/Owners Representative/Contractor Print Name (Circle one) FrDEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS O Building �� O Fire Marshal O Permit Tech (OTC permit only) .fi1uSOt'..wa.L!S�Cc)il ',l-LunitV_(=',ev/ Rcv:3/08/20 7 RECEIVE® _ MAY 0 4 2018 .. _ _ —$'15 W.Alder Street i L NN G® ALL SETBACKS AR MEASURED FROM THE HEST D PRO>lE�'IC�N OF T E I�IJIIL ING_ _ 4-17 Alt i44 29.Q-7 � S r �r�s1,'•��'. '4'i �...f!;�'�g 3 �lacuy* ha��c.. NCi44r.. � 1 /bOf } wt�ti-7A n MASON COUN T DCL )LANNING �! s 1 i r ILI SITE PLAN REQU! �;' i'<- = 'ON SITE ,� CHANGES U. � T �-- � i �IROVAL ��o t 5 Zv+e.Cl. Eef0 cPt5 w 510WOa WAM THOM MAWERM LICUD EO UEuKWA L �1+� Name het �t/ Parcel y2o00 -7Z-00� BLD# 2-Old 'do2/ Mason County V Department of Community Development �'Qi�49S C Small Parcel Stormwater Management Application/Worksheet (page Per Mason County Code,Title 14, Chapter 14.48 a stormwater site plan is required whenever a building application isers't made for residential development, or redevelopment',with more than 2,000 square feet of impervious surface 2. l` '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 7 sm. . Buildin s X Measurements for buildings are taken at the X — perimeter of the farthest projections(example: X = eaves/gutters) X = Drivewa s X X = Length of drive begins at the right of way X = Parkin Areas X Any paved, gravel or packed area per definition X = above table X = Patios/Walks X Any paved, gravel or packed area per definition X = above table X = Others X X = If the total impervious area of the proposed site development is greater than 2000 square feet a X = 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- described property for review and inspection as may be required. X Owner/Agent/Contractor(circle one)Date: 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