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Home My WebLink AboutBLD20223-01285 Addition - BLD Application - 2/17/1998 Permit No: 111 �F2--j •Q I a b- MASON COUNTY RECEIVED COMMUNITY DEVELOPMENT we Permit Assistance Center,Building,Planning O C T 2 3 2023 BUILDING PERMIT APPLICATION Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Paul Jensen NAME: MAILING ADDRESS:51 skylark Ct E MAILING ADDRESS: CITY:Allyn STATE:WA ZIP: 98524 CITY: STATE: ZIP: PHONE#1:971-600-1302 PHONE: CELL: PHONE#2:971-600-1007 EMAIL: EMAIL: seryumdominiQgmail.som L&1 REG# EXP. PRIMARY CONTACT: OWNER I] CONTRACTOR❑ OTHER❑ NAME Paw ion— EMAIL same as owner �r MAILING ADDRESS same as above owner CITY STATE ZIP PHONE CELL 971NO.13M tamer PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 122085102015 ZONING Rural Res 20 v LEGAL DESCRIPTION(Abbreviated) Lakewood Plat,1 blk 2 lots lot 5 Belwood FIRE DISTRICT rya SITE ADDRESS 51 Skylark Ct.E CITYAIIyn DIRECTIONS TO SITE ADDRESS Rt 3 to SR 302 intersection,East to Belwood Estates IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO E] SNOW LOAD:25 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 0 ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence.Garage.Commercial Bldg.Ft,.) Residence IS USE: PRIMARY I] SEASONAL❑ NUMBER OF BEDROOMS 3 _ NUMBER OF BATHROOMS2 HEATED STRUCTURE? YES(Whole Bldg)E] YES(partls/q/Bldg)❑ NO❑ DESCRIBE WORK Addition of a living space(den/office)in rear of existing home,slab on grade Ness than 240 sq ft SQUARE FOOTAGE:(proposed) I ST FLOG sq.ft. 2ND FLOORO sq.ft. 3RD FLOORO sq.ft. BASEMENTO sq.ft. DECKO q.ft. COVERED DECKO sq.ft. STORAGEO sq.ft. OTHERO sq.ft. GARAGEO sq.ft. Attached❑ Detached❑ CARPORTO sq.ft. Attached❑ Detached❑ MANUFAC *4 COPIES OF THE FLOOR PLAN REQUIRED* 7DTH MODEL R LENGTH BEDROOMS BATHS SERIAL NU ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC Q SEWER❑ / NEW❑ EXISTING El PLUMBING IN STRUCTURE? YES El NO❑ lf)vs,attach completed WaterAdeguacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES El NO[] EXISTING SQ.FT. EXISTING BEDROOMS 3 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3 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 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 F N ATI N OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PER IT A C TIO OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) all Signature of W R(Must be signed by the OWNER) Date DEPARTMENTA EVIEW APPROVED ATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Permit No: vo'DA;� MASON COUNTY COMMUNITY DEVELOPMENT Permit Assistance Center, Building,Planning PLUMBING & MECHANICAL PERMIT APPLICATION OWNER JNFOR2dATION: CONTRACTOR INFORMATION: NAME: pool j e---,<-c n NAME: MAILING ADDRESS: MAILING ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: 1" PHONE: PHONE: CELL: 2nd PHONE: EMAIL : EMAIL:111 QA I - tj 1 t- L2 Ott - 1�b 2 L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Numher):122085102015 Zoning: LEGAL DESCRIPTION (Abbreviated): SITE ADDRESS: 51 skylark ct E.aiyn WA 98524 CITY: DIRECTIONS TO SITE ADDRESS: TYPE OF JOB: NEW F--]ADD=ALT=REPAIR=OTHER=USE OF BUILDING LOCATION OF FIXTURES/UNITS— I ST FLOOR=2ND FLOOR=BASEMENT=GARAGE=OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric0LPG0Natural GasODuctless[�K 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 4 1.b0 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 I DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev: 1/2 j/2016 16N