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HomeMy WebLinkAboutBLD2023-00065 BLD2023-00067 SFR Garage - BLD Application - 1/19/2023 MASON COUNTY COMMUNITY SERVICES Permit No: I/zdZ✓ PERMIT ASSISTANCE CENTER: BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 10 615 W.Alder Street,Shelton,WA 98584 Phone Shelton.(360)427-9670 ext.352•Fax:(360)427-7798 Phone Belfair.(360)275-4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Lawr rin U nclei('w cc NAME: MAILING ADDRESS:3'Sti1$A MAILING ADDRESS: CITY:HZI ii U ti,. STATE: ii I ZIP:Ci G 7 i 7 CITY: STATE: ZIP: PHONE#1: S'GS 252, 93Y6 PHONE: CELL: PHONE#2: Sc W 'J.3 Cy qr"., Z EMAIL: EMAIL,: L&I REG# EXP. PRIMARY CONTACT_ : OWNER 14 CONTRACTOR❑ OTHER❑ NAME Lc h _ rv.)C EMAIL MAILING ADDRESS " — :r; fA "!Q CITY jjCA {it t C, STATE ZIP PHONE trSi �,i;'"2 i-; CELL F^ �t PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) ZONING LEGAL DESCRIPTION(Abbreviated)P_� Me'/A-I C f 3 e `.1 tj V-4to FIRE DISTRICT 19? SITE ADDRESS 3(o j t^ Vr{612 12c CITY L)VjL tsn O�J DIRECTIONS TO SITE ADDRESS —T �aers fre IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO Dt SNOW LOAD: psf et IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all thaiapply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW4 ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Erc.) IS USE: PRIMARYV SEASONAL❑ NUMBER OF BEDROOMS 'iu NUMBER OF BATHROOMS 7 .5 HEATED STRUCTURE? YES(Whole Bldg),4 YES(Part(s)o(Bldg)❑ NO❑ DESCRIBE WORK �b v�5`V uC� yl c-AC S i SOUARE FOOTAGE:(proposed) 1ST FLOOR_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 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 IR SEWER❑ / NEW® EXISTING❑ PLUMBING IN STRUCTURE? YES.4 NO❑ If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES NOD 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 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 8 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 O ONTINUATION OF W ON/THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PE A ATION OF 1 AYS MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) a 4nature of OW (Mus sea ed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: b 1023 -006 PERMIT ASSISTANCE CENTER: •BUILDING •PLANNING •FIRE MARSHAL RECEIVED 615 W. Alder St- Shelton, WA 98584 www.co.mason.wa.us Phone Shelton: (360)427-9670 ext. 352• Fax: (360)427-7798 JAN 19 2023 ,OF Phone Belfair.-(360)275-4467• Phone Elma: (360)482-5269 15 W. Alder Street PLUMBING & MECHANICAL PERMIT APPLICATIO4 OWNER INFORMATION: CONTRACTOR INFORMATIQR U 1LDiN.G NAME: a: rvP lac.-,Ae oA NAME: 11111mv 7 MAILING ADDRESS: GS-Olb A Ia"r, r2cA MAILING ADDRESS: CITY: JAA00 STATE: ZIP: qb?!-7 CITY: STATE: ZIP: I"PHONE: �,o ' s q8¢v PHONE: CELL: 2°d PHONE: Go4l 430 CID42. EMAIL : EMAIL: Ia.�rveanuytdPvu:csrYf (-'))q1AAE�,l tcvcvA L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): 421 3 - -15 ' `10 100 Zoning: LEGAL DESCRIPTION(Abbreviated): Prll`l V,�€ 114. S 13 r`T 21 tJ 0 AF SITE ADDRESS: ',Ito 1 �` a A CITY: L) r� DIRECTIONS TO SITE ADDRESS: TYPE OF JOB: NEW IIlIII�IIllIADDD ALTD REPAIR OTHER=USE OF BUILDING <,,1 LOCATION OF FIXTURES/UNITS-1 ST FLOOR=2ND FLOOR=BASEMENT D GARAGED OTHERO PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:ElectricJWPG[O atural Gas=Ductless0 Toilets A Type of Unit No.of Units Fees Bathroom Sink Furnace 1 Bath Tubs Heat Pump Showers L Spot Vent Fan Water Heater i Propane Tank i Clothes Washer utlets Z Kitchen Sinks r oo as/Pellet Stove 1 Dishwasher 1 r c en Exhaust Hood 1 Hose bibs 2 Dryer Vent 1 Other I 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 menced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CO NUATION OFTHIS P IT I BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WI IN TE THE APP TI x Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT J-1i- PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 1 BN Name LA Ind e r w GQ A Parcel# Ll ZJ l 3—75--9 6 10 G) BLD# 10 Z�'�000(05 Mason County Department of Community Development wMAMILM.NG 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 surface 2. '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. 2Common 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 L X f = 1 3 X = Measurements for buildings are taken at the perimeter of the farthest projections(example: X = eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X LO = U L 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) 2133 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 ackno ge th e�iformation provided is accurate and employees of Mason County are granted access to the above- describe rope r revind inspection as may be required. X Owner/Agent/Contractor(circle one)Date: 0 7 — 2 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 RECEIVE-✓- 615 W. Alder Street Name en V J (IQ C Parcel# "l2 13"-7 S�V(�V BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to"Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE ) The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed i ntirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. B) &n alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the syst will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at: Phone: (360)-427-9670 EXT.450 Mail:P 0 Box 1850, Shelton WA 98584 Physical:415 N 6th St, Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to consult with the septic design professional involved with the project. Mason County Division of Environmental Health can be reached at: Phone: (360)-427-9670 EXT.352 Mail: P 0 Box 1666,Shelton WA 98584 Physical:426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowled ent such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I furthe nowledg that ation provided is accurate and employees of Mason County are granted access to the above- ndebedope o ie d inspection as may be required. Owner/Agent/Contractor(circle one)Date: (}'t ' d Z — Name (kJg,[ Q1Tt.l_)G Qck Parcel# L' Z 11 ? — 75j - 76 100 BLD# U Z3'd 000 P n 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 surface 2. '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. 2Common 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 H = 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) 3 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. RECEIVED Page 1 of 2 JAN 19 2023 615 W. Alder Street k -ti► Name L la Vh (NA MW Parcel#q21 13-75--90 ip 6 BLD# Mason County Department of Community Development Small Parcel Stormwater Management Application/Worksheet (page 2 of 2) Based Upon the information you have provided a Stormwater Site Plan IS Required for this development activity. Title 14,Chapter 14.48 of the Mason County Code(MCC)regulates compliance requirements for Stormwater Management in this jurisdiction.A complete copy of the ordinance can be found on the Mason County website: http//www.co.mason.wa—us/code/commissioners/index.htm Please follow the links to "Title 14,Chapter 14.48 Stormwater Management". Regulated activities shall be conducted only after Mason County Public Works approves a stormwater site plan (Mason County Code Title 14 Chapter 14.48 section 14.48.70).You will receive a copy of the Public Works document entitled"Managing Storm Drainage on Small Lots,The Small Parcel Stormwater Site Plan".This document will assist you in preparing the necessary information and plans for Public Works to review and approve. Per Department of Public Works this document will constitute an approved plan if all of the relevant details* are to be installed in their entirety AND no part of the stormwater system adversely affects any septic system (see Environmental Health information below). If an alternative system is to be used a plan will need to be submitted to Public Works for approval. A design by a registered professional may be required for more complex sites. *These details are found in the document Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan on the pages that begin with"Handout" PLEASE INITIAL BELOW TO INDICATE THE STORMWATER MANAGEMENT PLAN FOR THIS SITE A The relevant details from Managing Storm Drainage on Small Lots, The Small Parcel Stormwater Site Plan will be installed in it entirety AND the system will be located as not to adversely affect any septic systems on this,or any other,parcel. BA An alternative plan and/or professional design will be submitted to the Department of Public Works for approval AND the syk6m will be located as not to adversely affect any septic systems on this,or any other,parcel. If you have further questions pertaining to parcel drainage and stormwater management Mason County's Public Works Department can provide additional instructions,guidance and examples.(Section 14.48.130)contact Public works at: Phone:(360)-427-9670 EXT.450 Mail: P 0 Box 1850,Shelton WA 98584 Physical:415 N 6th St, Shelton WA 98584 If this development has,or will have,a septic/drainfield system you may need to contact Mason County Division of Environmental Health to ensure that the stormwater system will not adversely affect the septic system of this,or any other,parcel.You may also wish to consult with the septic design professional involved with the project.Mason County Division of Environmental Health can be reached at: Phone:(360)-427-9670 EXT.352 Mail: P 0 Box 1666,Shelton WA 98584 Physical:426 W Cedar St, Shelton WA 98584 A condition will be added to the building permit that states,in part,that all conditions the stormwater site plan will be met prior to a request for final inspection of the building permit. Owner/Builder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of s is by signature low.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowle tha he infbrrrli'ofrovided is accurate and employees of Mason County are granted access to the above- describ pr rty fo -review section as may be required. X Owner/Agent/Contractor(circle one)Date: C 7 - Z Pa of 2 Date R c i C� MASON COUNTY COMMUNITY SERVICES DEPARTMENT JAA1 � © BUILDING•PLANNING•FIRE MARSHAL _ 616 1,9?��3 x— I~ Mason County Bldg.8,615 W.Alder St Shelton,WA 98584 www.co.mason.wa.us 360-427-9670 ext 352 �'bler �tr�e Permit#: t Property Owner's Authorization Letter BUILDING I (we): CL y.YY? Vl U in cA e VW 0g6 (Print Property Owners Name/Firm/Organization) Hereby Authorize: T� 1 cxq e l Epc1 L('n+--- pplicant--Name of Person to Sign Permit) Representative of: (Applicant Company Name/Organization) To apply for, sign, and pick-up building permits for the following proposed work: (Brief Description of FTbrk to be Done) Job Location: (o E S u n s e -� 'R I Q e 12 L U m c'aj��.� (Property Site Ad ess) As property owner(s),I(we)hereby grant permission to the applicant referenced above to apply for,sign, and pick- up the building permit for the work as indicated above.All work performed must meet all provisions of the Building Codes and the Laws of ounty and the State of Washington,as applicable,whether specified or no dential Contractors ar equire to have a current State of Washington Contractors License(RCW 18.27). 0 1 - 0 o - 2 � ,perry caner Signatur (Date) Rev.03./1012016 jlbn 12 MASON COUNTY COMMUNITY SERVICES Permit No: I 0 0 PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone 00 Belfair.(360)275-4467•Phone Elma:(360)4B2-5269 BUILDING PERMIT APPLICATION �� PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: JA NAME: L-i-v vrve" t7��cle✓w��c.� NAME:_ p i tz r. _ 192023 MAILING ADDRESS: G3-C1P. A Ma kat> �' MAILING ADDRESS: CITY: 4�a 0 V i A STATE: 4-1 ZIP:q 1pJ i"l CITY: STATE: ZIP: '��d�r S PHONE#I: 808 �j 2 4fo PHONE: CELL: tree t PHONE#2:_ vs^i 4-3Q 'J0 42 EMAIL: EMAIL: f mAeyiA:4N5cJ *&I REG# EXP. PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAME (j�ulevw�e,C EMAIL1AL, '{�1U1de-1- nnr(��4✓ �� Lt,L MAILING ADDRESS 3-0 16 A t� � �� CITY is STATE N4i ZIPr�1 PHONE E-O 9" 25 CELL PARCEL INFORMATION: L n ,n,� PARCEL NUMBER(12 Digit Number)1'2((� — 15 �D 1`W ZONING LEGAL DESCRIPTION(Abbreviated)ff 1U A-C (3 I?'Z-1 IJ P—'f-GJ FIRE DISTRICT SITEADDRESS 6(c(��W's-ei R=zz—'2 o-( CITY V✓L`Oy,l__ DIRECTIONS TO SITE ADDRESS 7-- IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO]K SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all ihar 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.) Gd IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF EDRO S NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part[s]ojBldg)❑ NO DESCRIBE WORK SQUARE FOOTAGE: (proposed) 1 ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OST'HER 33119sq.ft. GARAGE_715 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: SEWAGEISEWER SOURCE: SEPTIC SEWER❑ / NEW JJL EXISTING❑ PLUMBING IN STRUCTURE? YES( NO❑ IJ'yes,attach completed Water Adequacy Form PERIMETERNOUNDATION 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 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 C INIIATION OF WO ON HIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS P IT LIGATION OF 180 D S MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X o / -o7 — z3 S ture of OWNER(Wit be iqperd e IDWNER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: ! 2a3— = r PERMIT ASSISTANCE CENTER: .BUILDING.PLANNING•PUBLIC HEALTH-FIRE MARSHAL 014�11/ 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone Belfair.(360)275-4467•Phone Elma:(360)482-5269 /�► / BUILDING PERMIT APPLICATION ! �/ U PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: Jq Af NAME: L-a aj rvevx 0VICkP/W CdA NAME: fj'1 ,. - 192023 MAILING ADDRESS: S3-OIS A Ma ka C'o _ct MAILING ADDRESS: CITY: 4.,O v 1 a STATE: 44�1 ZIP: bl is 1 CITY: STATE: • Adder S PHONE#1: 808 2_e'� 934(c PHONE: CELL: Street PHONE#2: `j 4-30 %4-7 EMAIL: EMAIL: VXAk6c &I REG# EXP. PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAME EMAIL 1Auv-re" Uktig- ,Goeln'(�)�:tit��(• tt,L MAILING ADDRESS -0 1 F ,' CITY o v La STATE Nei ZIPS r j PHONE so 1b 2S5- -Is j--CP CELL PARCEL INFORMATION: ,�,r� Ar PARCEL NUMBER(12 Digit Number) g2 j — 1S 50 1W ZONING LEGAL DESCRIPTION(Abbreviated)P-7_�J t/¢ S 1 2-f-IJ FIRE DISTRICT SITE ADDRESS 201 '�qm t �, c /�( CITY V'rl dh� DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO H SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all Mai apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW gJ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Ex) IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF EDRO S NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Parr/sJofBldg)❑ NO❑ DESCRIBE WORK SQUARE FOOTAGE: (proposed) 1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BAS. EN-4ENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. 05T„HEERR 330sq.ft. GARAGE_70 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 g EXISTING❑ PLUMBING IN STRUCTURE? YES q NO❑ Ijyes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS__CL�__ TOTAL BEDROOMS OWNER acknowledges that submission of inaccurate information may result in a slop 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 C�ATION OF WO ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS P IT P LICATION OF 180 D S MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) 1 /��''7 X 0 l �V / — Z J 5 ture of OWNER st be iqped e bWNER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT 3 FIRE MARSHAL PUBLIC HEALTH 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 RECEIVED Phone Shelton: (360)427-9670 ext. 352• Fax: (360)427-7798 Phone Be/fair.-(360)275-4467• Phone Elma:(360)482-5269 PLUMBING & MECHANICAL PERMIT APPLICATION6 JAN 9 ?023 OWNER INFORMATION: CONTRACTOR INFORMATION: r t eet NAME: L-Ayeye VI lAhAe yu)oo ct NAME: MAILING ADDRESS: 53--G l g W MCt ko0 JL a MAILING ADDRESS: CITY:14 A uU t a STATE: }-I I ZIP: �l l CITY: STATE: ZIP: I S`PHONE: �(j$ Z S��ll 6 PHONE: CELL: 2°d PHONE: Cq L/3p -90y2 EMAIL : EMAIL: 1QU rU."u lxlerw xd,,Qgrha(I . C G Vvi L&I REG # EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): q Z 113 _7 S—g G I 0 G Zoning: LEGAL DESCRIPTION(Abbreviated):PIN kid 1/g si3. 2/9 C y w SITE ADDRESS: CITY: LAn j on DIRECTIONS TO SITE ADDRESS: BUILDIN TYPE OF JOB: NEW ADD=ALT=REPAIR=OTHER=USE OF BUILDING LOCAT N OF FIXTURES/UNITS— 1sT FLOOR=2ND FLOOR=BASEMENT=GARAG OTHERO PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric=PG=Natural Gas=Ductless= Toilets t Type of Unit No.of Units Fees Bathroom Sink I Furnace Bath Tubs Heat Pump Showers 1 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 ag resents that the information provided is accurate and grants employees of Mason County access to the above described propert d st cture(s)for review and inspection.This permit/application becomes null&void if work or auth a ction is not commence ithi 80 days or if construction work is suspended for a period of 180 days. PROOF OF CONT ATI OFT IS PERMIT IS BY M 6F INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL I ALI rTHE APPLICATION. X tigftatfi—re of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN PLN Approved 06/06/2023 Mason County Community Development EH Setbacks Gavin Scouten EH APPROVED All Changes Subject to Approval A.) Drainfield/Reserve requires 10'setback from tooting/foundations Rhonda Thompson 06/07/2023 B.)Septic tank(s)requires 5'setback from all tooting/foundations Planning Setbacks C.)No foundation/Perimeter Drains within 3011,downgradient of Front:25' Drainfield/Reserve area D.)No Cut Bank(s)(greater than 5fl and over 45 degrees)within Sides:20' 50ft,down gradient of Drainfield/Reserve area Rear:20' all setbacks measured from the farthest projection of the building i 'subject to EH setbacks rc N --------------- i ------ i r Z I 46 ; 1 3'' 4AMG! 9[PTIL ANDOUINPI[LO __ ! 1 L___------ POWlR -- 3ir7s.e'----------------- GRADING NOTES: L CONTRACTOR TO VERIFY LOCATION OF ALL EXISTING UTILITIES. 2.PROVIDE POSITIVE DRAINAGE AWAY FROM BUILDING. RECEIVEC I S,ie- PtCrn.(i 3.FINAL GRADE TO CONVEY SURFACE DRAINAGE TOWARD ROCK m DetaCktd Gnu CHANNELS AND DISPERSION TRENCHES. `' Bld 2c23 ott4l- 4.AREAS TO BE FILLED SHALL BE CLEARED,GRUBBED TO REMOVE z. gtdu2;-00065:NW Ef2., TREES,VEGETATION,ROOTS AND OTHER OBJECTIONABLE MATERIAL AND STRIPPED OF TOPSOIL. s 5.PLACE FILL SLOPES WITH A GRADIENT STEEPER THAT 3:1 IN LIFTS NOT TO EXCEED 8 INCHES,AND MAKE SURE EACH LIFT IS PROPERLY COMPACTED. DATE 1/12/23 Plot Plan sc._e r-4z SCALE: SHEET: L z � PLN Approved 06/06/2023 Mason County Community Development Gavin Scouten All Changes Subject to Approval Planning Setbacks EH APPROVED EH Setbacks Front:25' Rhonda Thompson 06/07/2023 Sides:20' a A.) Drainfield/Reserve requires 10'setback from footing/foundations - i Rear:20' B.)Septic lank(s)requires 5'setback from all footing/foundations ! i all setbacks measured from the farthest C.)No foundation/Perimeter Drains within 30ft,downgradient of projection of the building Drainfield/Reserve area 'subject to EH setbacks D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within 50ft,down gradient of Drainfield/Reserve area ------------------------------- v�� u51rE ———————' I/ / r t 7 GAMGE 52VTIL AND DRAINFIELD � ����--- t L__________ •OWeR _ 5czoe s.�s+ GRADING NOTES: CONTRACTOR TO VERIFY LOCATION OF ALL EXISTING UTILITIES. 2.PROVIDE POSITIVE DRAINAGE AWAY FROM BUILDING. RECEIVED i SUM- flan 2 Pt of l- 3.FINAL GRADE TO CONVEY SURFACE DRAINAGE TOWARD ROCK AN 19 n;; De t4Cna a 6a-fu CHANNELS AND DISPERSION TRENCHES. - $Id 2C23 4.AREAS TO BE FILLED SHALL BE CLEARED,GRUBBED TO REMOVE b15YJ Aiie."'-- BIa2,Zg-poob5:NW SPQ., TREES,VEGETATION,ROOTS AND OTHER OBJECTIONABLE MATERIAL AND STRIPPED OF TOPSOIL. 5.PLACE FILL SLOPES WITH A GRADIENT STEEPER THAT 3:1 IN LIFTS ; A NOT TO EXCEED 8 INCHES,AND MAKE SURE EACH LIFT IS PROPERLY COMPACTED. DP.TE: irz/zs Plot Plan SL��E1'"e0' SCALE: SHEET; 2