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Home My WebLink AboutBLD2018-00108 Finish Basement - BLD Application - 1/30/2018 MASON COUNTY COMMUNITY SERVICES PERMIT ASSISTANCE CENTER: Permit No:-.4AA •BUILDING•PLANNING*PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 R I� Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone C6/ 1854 Belfair.(360)275-4467•Phone Elmo:(360)482-5269 J4 ^f'it BUILDING PERMIT APPLICATION e�5 3p PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATIO tderstree/ NAME: ��LS 'S �p� ,�. -� NAME: MAILING ADDRESS:^PD'fesc Z.4A MAILING ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: PHONE#I:"3tro� Sib cxt�co PHONE: CELL: PHONE#2: EMAIL : EMAIL: L&I REG# EXP. PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER[� NAME L S IxZ EMAIL gJJt'_ MAILING ADDRESS ng L &aY S LA&L-F— tom_ CITY , STATE�_ ZIP t{. PHONE -STB`t3 CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) l Z220 54— 2700 N ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT SITE ADDRESS_�OQ C g)Gt,4 it L)en `Se CITY__ it ti�. DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO 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❑ ALTERATION W REPAIR❑ OTHER ❑ USE OF STRUCTURE(R idence,Garage,Commercial Bldg,Etc.) IS USE: PRIMARY V'SEASONAL❑ NUMBER OF BEDROOMS�I` NUMBER OF BATHR90MS HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Part[s]of Bldg) (j� NO ❑ ��e�f� `�"�' DESCRIBE WORK SQUARE FOOTAGE: (propose+existing) IST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT-5 1 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❑ SEWER / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES VV NO ❑ If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NOK EXISTING SQ.FT. EXISTING BEDROOMS Z_ PROPOSED BEDROOMS I 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 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) Signature of u the OWNER) Delle DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES PERMIT ASSISTANCE CENTER: Ycrntil No: jJ •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 as4 Belfair.(380)275 4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION JAN 3� ��.. 6� lct' PROPERTY OWNER INFORMATION: CONTRACTOR INFO1tMATIO P'erslr ^-�- NAME: JhJ T iw- 'hr NAME: MAILING ADDRESS:-POyk;�,c Z-44 MAILING ADDRESS: CITY: A44-N►J STATE:\ad ZIP: 9B&Z4 CITY: STATE: ZIP: PHONE#1:(g4wp�� S 3tO-- b44, PHONE: CELL: PHONE#2: EMAIL : EMAIL: L&I REG# EXP. PRIMARY CONTACT: OWNER e CONTRACTOR❑ OTHER[[� NAME S. alp_ EMAIL MAILING ADDRESS n - S 1�� M CITY STt'1TE' _ ZIP_qI2,� PHONE,1 WE'R^ryyim CELL PARCEL INFORMATION: It PARCEL NUMBER(12 Digit Number)-_ I Z2ZO -50— 270 d cl ZONING LEGAL DESCRIPTION(Abbreviated) "e FIRE DISTRICT SITE ADDRESS_-440 F B)Q,GICI✓['X.0 � CITY DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO x 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❑ ALTERATION V REPAIR❑ OTHER ❑ USE OF STRUCTURE(R tdence,Garage,Commercial Bldg,Etc) IS USE: PRIMARY[SEASONAL❑ NUMBER OF BEDROOMS %4r NUMBER OF BATHR90MS HEATED STRUCTURE? YES(Whole Bldg) ❑ YES Mart[sj of Bldg) LR NO❑ � ^ DESCRIBE WORK R ' f SOUARE FOOTAUL: (propose+existing/ L 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 ❑ SEWER / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES V NO ❑ If yes, attach completed Water Adequacy Form PERIMETER(FOUNDATION DRAINS PROPOSED? YES ❑ NO f EXISTING SQ.FT. _- EXISTING BEDROOMS 7i 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 permitlapplication 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 l \3 l� Signature of the OWNER) D e DEPARTMENTAL REVIEW APPROVED D TE DENIED DATE TAGS/NOTES/COND IONS BUILDING DEPARTMENT 00r, OP 3 PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Planner: Grace 7AII:a ) Rebecca MASON COUNTY PLANNING INTAKE CHECKLIST Owners Name: Q—" Date: (L4 - Project: 4 Commercial ?: yes Site Plan: North Arrow Property Dimensions: qo x i do Irregular Shape ? yes no t Streets and Driveways shown r '5< Road Frontage Name: BIG — �jh All Existing Structures Shown with setbacks and use. V Well Location, Septic and Drain-field show with setbacks shown. 06 Identified Surface water(streams, ponds, shoreline, wetlands, natural/historic drainage, defined drainage) A Topography (slopes) .eWinimum Structure Setbacks (direction/setback): F: W / R: [E� / q 2- S 1 / 5 S2 / J l� Utility and Drainage Easements: 7 ye no (if yes enter condition #5022) Other Easements N Accessory Appurtenances: propane tank Heat pump of Does site plan show landings at all exits ? d-Variance-applied for: yes �Jn Parking spaces allotted: yes no VCounty Access Permit Needed (add condition #0010) ❑ State Access Permit needed (add condition #0020) b� Standard Planning conditions: #5019 and #700 )�Are there any impediments (dogs/gates) that may restrict access to your site? yes n If yes, do we need appointment? yes r , ❑ Is site clearly marked? Address Name Other UGA'S ALLYN LFAIR/SHELTON Rural LAND DESIGNATIONS ❑ GC ❑PF ❑R-1 ❑R-IP ❑RC 1 ❑RR 2.5 ❑ AGRICULTURAL ❑POS ❑FR R-2 ❑R-1R ❑RC 2 ❑RR 5 ❑ LTCFL ❑BI ❑GC-CI ❑R-3 ❑RI ❑RC 3 ❑RR 10 ❑ IN-HOLDING ❑HC ❑LTA ❑R-5 ❑RT ❑RMF ❑RR 20 ❑ TRIBAL ❑T ❑ MU ❑R-10 ❑RT/RTC ❑RNR ❑MHP ❑BP ❑VC ❑RAC Critical Areas: (streams, ponds, shoreline, wetlands& steep slopes) Shoreline Designation: A N/A ❑ Urban ❑ Rural ❑ Conservancy ❑ Natural Water Body: SEPA: ye unknown Flood Plain: yes��A7) unknown Map # Aquifer Recharge: yes �to�unknown Map# TaLys/Cases: RLC/SPI: 6 year Reforestation: yes n Eagle Nest Tag: yes Other/North Bay Sewer: yes S+sT ►: jTe" ; r" 1221 i436001G ., � - f ► � 1221i4390020 ,y� !�' N ik rl• f� 1 � � �D' r � f��- � 3�� •" 1221 4 cGO 0 t 122205028006 T r .� '.+,Z ! f' OWL —4w;�p' cy 122205030001 12L205J23005 �of�• .�` � f r r N 12-220'02700 4*9 122205029001 122205028004 « 122205028003� p fit• �1�.'?0'>021�00� � ' �'' `T r �': ,"A '��.' ++5,.�rt �7s' "�� 1 .q"`�5 *'.•� �-� •.''�� -�....1222050280 � 1 j2"2�20 5025006 1222oY, �oG1 22050 - . 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J 5 0> 001 3►f 122205025002 ems + 122205035010 ice, •` A& ' �. `r , �+!" : •__ r 122205034006 1 2 2 2 0 50 35008 � � � •µ��. - ? 20. ,�• t, _ F22NR1 . �r :r Ss . 121 jG50250C 12220503600g `� F� '*"il `�� i�y�,,�y► 1 �f, t • {'`Jl;� 12220503 7009 �`.12220`0 tiS��; .122205035006 ,, • 1 �� .� , ' �, / s""r•'.'�� -- ,'�.� - �� y,� , 'V :� :.rib �•Mp.�r� �' 220,0 3 4001. - 122201)035004 - 122205036004 �• `'• * s� 0,''010 12.2205037006 f "�12220503�� 03 � " T� 1222050380C 1 r hAf- �� ' ` 120508 01�' �.{"=r '� :k }f/l Y Ia+ :'r � — r � `:C'• ,"• � ,f rt 1�22205037003 . 122�20500338005 `y _ . y _ - :. t s F Wq 122205036001 j� � , � /,�122T050390 6 Dcs 22205038004 F "�+ '_�}• „ Y# u5037JJ1 !ram' 22205038003 ! 7if, #r� 122205039004 � i 1 222 0 5048009" — , 2200060010 , -: " ,, 16 0 " �. ?OJr D'J 122205039003 122205047010 ' 22205038002 �r 122205039002 122205048001 '5�122205047002J 122205004601`0 i! , 122205039001 1 inch = 100 feet w � 1 inch = 0.02 miles