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Home My WebLink AboutBLD2018-00135 SFR - BLD Application - 2/8/2018 seaN°�i%lA MASON COUNTY COMMUNITY SERVICES �y �I PERMIT ASSISTANCE CENTER: 1'crntit Nu: Y 62-d/8 - 0 O (35 •13UILDING•PLANNING•PUBLIC HEALTI I-FIRE MARSHAL 615 W.Alder Street,Shelton,WA 965" REC E,VED _ Phone Shelton:(360)427-9670 ext. 362•Fax:(360)427-7798 Phone 834 Beltalc(360)275-4467•Phone Elms:(360)482-5269 FEBl CD 8 2018 BUILDING PERMIT APPLICATION. 61SW Alder . PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: treet_._ NAME: Zf�ya- Auq� NAME:(f., Csv yc.1�0,J MAILING ADDRESS: MAILING ADD SS:CITY: STATE: ZIP: CITY: _ STATE: PHONE#1: -- '_�� 2 PHONE: CEI�tS-d-3/Z-20 6s' PHONE#2: EMAIL :.J' y ,� EMAIL: n1 a. L&I REG#Cw111V7,i f U 3 p EXP. PRIMARY CONTACT: WNER� CONTRACEMAffLi TOR OTHER❑ NAME_ /,tJl� t MAILING ADDRESS PHONE CELL CITY STATE- ZIP PARCEL INFORMATION• ---9 PARCEL NUMBER(12 Digit Number)—,-11Z0131 5- 00 Z 7 0 ZONING 0 6 D LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT SITE ADDRESS- �O 2 W 6 -T CITY - DIRECTIONS TO SITE ADDRESS - IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOA IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVEWCREEK❑ POND❑ WETLAND ❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commerrclal Bldg Etc) IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS_,'_ NUMBER OF BATHROOMS •2 I IEATED STRUCTURE? YES(Whole Bldg) D( YES(Part ft]of Bldg) ❑ NO❑ DESCRIBE WORK SQUARE FOOTAGE: (propose+exrstarg) I ST FLOOR / >; sq.ft. 2ND FLOOR sq.R. 3RD FLOOR sq.ft. BASEMENT sq ft DECK sq.ft. COVERED DECK sq.ft. STORAGE sq. ft. OTHER sq.ft. GARAGE-§Y5 sq.ft. Attached[IDetached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN RUi QUMi D* MAKE MODEL YEAR LENGTII WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTICA SEWER❑ / NEW❑ EXISTING❑ PLUMBING IN STRUCTURE? YES Kl NO ❑ If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NO`FA EXISTING SQ.FT. EXISTING BEDROOMS 0 PROPOSED BEDROOMS �j 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 OF CONT UATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT A PLI ATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY CODE 14.08.42) X 2- Sigrkdureof OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT JTI -L PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH o-F MASON COUNTY COMMUNITY SERVICES RECEIVED Building,Planning,Environmental Health,Community Health WILDI G FEB 08 2018 Physical and Mailing Address: 615 W Alder St., Bldg 8, Shelton, WA 98584 Shelton Phone: (360)427-9670 ext 352 •: Fax (360)427-7798 PLUMBING & MECHANICAL PERMIT APPLICATION Permit#: OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: NAME: G c-e-) AJ C MAILING ADDRESS: MAILING ADDRESS: L dL0 CITY: STATE: ZIP: CITY:,��6;7 46�STATE: ZIP: 1st PHONE: PHONE: -2a r 2"d PHONE: EMAIL : I. CO EMAIL: L&I REG#G c91 Ho4 oZ j A a 4 r3P EXP. /_t3 / PARCEL INFORMATION: PARCEL NUMBER (12 Digit Number): Zoning: LEGAL DESCRIPTION (Abbreviated: SITE ADDRESS: CITY.- DIRECTIONS TO SITE ADDRESS: TYPE OF JOB/WORK: NEW ADD ALT REPAIR OTHER USE OF BUILDING PLUMBING FIXTURES MECHANICAL UNITS [J Electric in-wall heaters (none) Type of Fixture No. of Fixtures Fuel Type Fees Type of Unit No. of Units 9G/LPGI el T e Fees Toilet(s) Furnace I G/LPG] Bathroom Sink(s) Heat Pump Bath Tub(s) o Ductless H.P. [E/G/LPG] Shower(s) Spot Vent Fan _ Water Heater(s) / [E/G/LPG] Propane Tank Clothes Washer(s) [E/G/LPG] Gas Outlet(s) Kitchen Sink(s) Heat Stove [E/G/LPG/W] Dishwasher(s) / Kitchen Exhaust Hood >' Hose bib(s) 2z Dryer Vent / Other Solar Panel Other Other Plumbing Subtotal Mechanical Subtotal Plumbing Base Fee Mechanical Base Fee Final Inspection Fee Final Inspection 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 tructure(s)for review and inspection.This permit/application becomes null&void if work or authorized construction is not commenced wit in 1 ys or if construction work is suspended for a period of 180 days.PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECT�N. ' TY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. SibAattiFe JApplicant Date x w�L-� �9/�iZt y� _Owner/Owners Representative/Contractor Print Name rrc a one ---- ---- - — - DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS O Building -4_1 O Fire Marshal O Permit Tech (OTC permit only) V V,i! 'a, on-Ln ill"t[_-.'/wWW.,-o masoi,.Wa.L;S!CUill;i-iu 11TV_,)EV/ Permit number BLD Mechanical Permit Checklist • Name of owner: Name of Installer: • Fuel Type? LPG Nat Gas Electric Other • If propane, what is the proposed size of tank(s)? • What type of mechanical unit will be installed?(i.e.freestanding stove,forced air furnace, etc.) • If the unit is a wood stove,provide: Make Model Year Label Number • What is the use of the structure? (Circle one) Residential Commercial (A permit application for a commercial mechanical permit will be issued upon satisfactory review by staff' Include a floor plan showing the location of unit(s)and layout of duct work with the permit application.) • Type of structure: (Circle one) Site Built Home Manufactured Home Other • What room will the mechanical unit be located? • Will the unit be located in a basement?(circle one) Yes No • How will combustion air be supplied to the mechanical unit? (Describe, L e. direct vent, air inlets, etc.) • How will the mechanical unit be exhausted to the outside? Applies to appliances using gas,oil or wood fuel. (Indicate B-vent, direct vent,L-vent,etc.) • What year was the structure constructed? Was this structure part of a PUD upgrade? • What type of controls will be installed? (i.e. thermostat, etc.) • Will the proposed mechanical unit be a heat source?(circle one) Yes No • Additional information: Signature of Applicant Date Typical mechanical fees: Forced air furnace $ 18.30 Heat pump 18.20 Propane tank 73..00 Gas Outlets 6.20 additional outlets over 1-5 ($1.20 each after 5) Mechanical base fee 28.50 or$ 9.00 if base fee was paid on an active building or mechanical permit Freestanding unit, fireplace,pellet stove or wood stove $73.00 Final Inspection fee 73.00 coRA- RiAu;yaaJ 2,53- 3t;,-�2,0(Z.6 _ F APPRO p MASON COUNTY u ,_ �; �,NG - SITE PLAN REQL;I'2ED TO . E ON SIT t � J -- PROVAL BY LA KING: ALL SE BACK ARE MEASURED ER M T E FURTHE5T 2��t$' �� 1�� PROJE "ION f+Th1E BUILDING ��l��: �p Biq cn� c kJ o I,Q63 ec� A000 ?' tL� t 3 r = 3� 76 m Q_ h or 451- �x P©v� Fotc. -S CAI 5 2()