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Home My WebLink AboutBLD2019-00561 Deck - BLD Application - 5/28/2019 MASON COUNTY COMMUWI-IY SbRVICES permit No:�(r �� PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBVC HEALTH•FIRE MARSHAL (6t4 R E C E I V F n 615 W.rider Street,Shelton,WA 98584 }- Phone Shelton:(360)427-9670 ext-352-Fax:(360)427-7798 Phone Betfair(360)275-4467-Phone Elma:(360)482-5269 MAY 2 8 2019 BUILDING PERMIT APPLICATION - 615 W.-A1der Street PROPERTY RMATION: CONTRACTOR INFORMATION' �• (/rl.Zlf Ct/'fli NAME:�jlCl'fil(�c/% M RESS: D' ' t°f MAILING ADDRESS: 5 4•,,�;St Lir1t�F/ JAI STATE: ZIP: f CITY: p.4�l�I�i'�ST�E: V ZIP:_ — PHONE:A1(c0 Z3/'Q/y,SCELL:;2�r; 3AC1 PHONE#2: EMAIL: EMAIL: &A 17 00L. ol d/4 L&I REG# EXP.09'Ii/ PRIMARY CONTACT: OWNER), CONTRACTOR❑ OTHER❑ NAME -s" EMAIL ' MAILINGADDRESS �' CITYA�I V _ STATE y1A ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Numbs e() � ff/ U G`000 7 7 ZONIN U LEGAL DESCRIPTION(Abbreviated) QZk 1 LO[_yZ &g/Z�A,& 1�1A_CE FIRE DISTRICT L:S��C r j SITE ADDRESS 2,01 Z )QOt/Z�d L'nt12f CITY / A/ DIRECTIONS TO SITE ADDRESS " O �J o O to C .9 c L IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 147.: YES[] NON IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: /Check all than apply): SALTWATER❑ LAKE❑ RIVERiCREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW[I ADDITION[] ALTERATION❑ REPAIR N OTHER U USE OF STRUCTURf:(Residewe.Garage Ca memat Bldg.Etc) Oecg IS USE: PRIMARY❑ SEASONAL X NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(whole stag)❑ YES(Part/:)oJBtdg)❑ NO)9 DESCRIBE WORKA!54'2"(! D C)< NEW SOUARE FOOTAGE:(propme+er ems) 1ST FLOOR sq.ft. 2ND FLOOR sq.R 3RD FLOOR sq.ft. BASEMENT sq,ft. DICK 4/ sq.ft. COVERED DECK sq,ft. STORAGE sq.ft. OTHER sq,ft. GARAGE 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❑ SEWERX 1 NEW❑ EXISTINGO PLUMBING IN STRUCTURE? YES U NO x Ijyes,attach completed Water 9degttat v Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOR EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER ackwMedges that submission of inaccurate Information may result In a stop work order or permit revocation.Acknowledgement of such is by signature below,t declare @tat t 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 hem all the necessary parties.including any easement holder or parties of interest regarding this prgeet The owner or"I representative,represents that the information provided is awe and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permdlapplication becomes null 6 void ti work or authorized construction is not commenced within 180 days or K construction work is suspended for a period of 180 days. PROOF OF CONTINUATION_ ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPUClkTI6 _ AYS OF MORE WILL CAUSE THE APPUC�jA�TIONNTTO BE EXPIRED.(MASON E 14.08.��r�. _S;g ature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED D -E DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT /� 2 PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH oar ,_ MASON COUNTY COMMUNITY SERVICES permitNo�lGIoOita 00350 PERMITASSISTANCE CENTER; ' d' • •BUILDING•PLANNING•FIRE MARSHAL 615 W. Alder St-Shelton, WA 98584 _- 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 US.S NAME: MAILIN ADDRESS: 4 01,E. yj�I /�'F2 SO T- MAILING ADDRESS: CITY: STATE: ig ZIP:95 ?y CITY: STATE: ZIP: 1 s'PHONE: 7J 9- 5�8/` 151 t6 - PHONE: CELL: 2nd PHONE- I I EMAIL : EMAIL: h50' AdA';7ySS Q O,4, G'D'y L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): J Al X C I- $D- PP04 7 Zoning: LEGAL DESCRIPTION(Ab ted). CITY: SITE ADDRESS: O DIRECTIONS TO SITE ADD SS: TYPE OF JOB NEW ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS-I ST FLOOR 21''D FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump Showers Spot Vent Fan Water Heater + - �"Z Propane Tank Clothes Washer Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood Hose bibs Dryer Vent Other ,°C' _ Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER/BUILDER acknowledges 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 truction is not commenced within 180 days or if construction work is suspended for a period of 180 d I" N F WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATI ILL IN P ICATION. x R 5"ff�%/z o14�G Signatu p ica�r Date x WaSSZZL 4/Oy7W Owne Owners Representative/Contractor Print Name cle one) DEPARTMENTAL REVIEW APPROVED DATE DENTED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL tT;c;t nc nn-l;. kttn•//%AnAne/rn mxnn%An i inity riaw/ D r!-;'MI c MKI