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Home My WebLink AboutBLD2021-01017 SFR - BLD Application - 6/30/2021 •` MASON COUNTY COMMUNITY SERVICES Permit No: LID oana1 1 [A 0t7 PERMIT ASSISTANCE CENTER: ( Y .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED i 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone J U N 3 0 2021 Belfair. (360)2754467•Phone Elma:(360)482-5269 Street BUILDING PERMIT APPLICATF6�1 W. Alder PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATIO : NAME: J htj NAME: A*"(A AM.f LJ'& MAILING ADDRESS: 3 MAILING ADDRESS:3'j2 IM 1u6V VA) CITY: A•II y'N STATE:W4 ZIP: Z CITY: ftMh ,e_STATEIMd• _Z4P:qAa.4, • PHONE#1:31:0 P12/-9%V PHONE:3 - 2 CELL: — PHONE#2: EMAIL : 4-H EMAIL: $j(fit �AAtE /UGVZ ( . L&I REG#/�I(�',�rd.L.%Z. fZ L EXP. S l�l�� PRIMARY CONTACT: OWNER ❑ CONTRACTORX OTHER NAME Mfiltr EMAIL MAILING ADDRESS CITY OLE fiWff2lA!ff STATE144 ' ZIP PHONE 360 CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 12'z-Zo ^5b — co L ZONING �—Z LEGAL DESCRIPTION(Abbreviated) aI M )?LjL�3 7— FIRE DISTRICT SITE ADDRESS ,x * S. o L*V S T CITY MLfyj DIRECTIONS TO SITE ADDRESS fni Ir ? 7V kA46ST'—fO j 7 CA) ! VFt4 L w :—Jv2� D)J 110P IS TIM PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN.14%:. YES❑ NOY1 SNOW LOAD:_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 ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ LT USE OF STRUCTURE(Residence,Garage,Commercial Bldg;Etc) J MIL IS USE: PRIMARY-f SEASONAL ❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 7—'12. HEA`I-ED ST-RU,CTUR ? YES(WholeBldg)V YES(Rrirttsj.fBldg)❑ -NO DESCRIBE WORK JV�GlaJ SAW, fro/ A7-rA *A'F' 66C!A ,- SQUARE FOOTAGE: (proposed) 1ST FLOOR ( 5 sq.ft. 2ND FLOORFZS sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGUA-0 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"k / NEW)4 EXISTING❑ PLUMBING IN STRUCTURE? YES' NO ❑ Ifyes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES U NO❑ EXISTING SQ.FT. EXISTING BEDROOMS 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. 1 have obtained permission from aitthe necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal ranracantativa rpnrpcpntc�t,at the infnrma n nrnvirlpri is arri irate anri nrantc pmnlnvppc of Macnn rani into arracc to the ahnvp rip.crrihprl nrnnprtv MASON COUNTY COMMUNITY SERVICES Permit No: -Q/d 1� PERMIT ASSISTANCE CENTER: u •BUILDING •PLANNING •FIRE MARSHAL RECEIVED i 615 W. Alder St- Shelton, WA 98584 www.co.mason.wams JUN 3 0 2021 Phone Shelton:(360)427-9670 ext. 352+ Fax:(360)427-7798 �+ Phone Belfair. (360)275-4467. Phone Elma:(360)482-5269 615 W. Alder Street PLUMBING & MECHANICAL PERMIT APPLJCATIOtt U I LD I N G OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: -XgbW t(&tAW NAME: M i MAILING ADDRESS: 11kM MAILING ADDRESS: &'A W CITY: J'a1)Viy STATEAW ZIP: Z CITY: STATE:W4, ZIP. V PHONE: 31PO $61--gy(o j PHONE: 'P / '7 CF,LL: —� 2ne PHONE: EMAIL : AM1 /00 2.67W OuD. LDhA EMAIL: fRpGLJ N& )Vi4) 2 l-Ior L�f�rM L&I REG# NKLer%LQG2 &C. EXP..S' /L PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): d 6A Zoning: �-Z LEGAL DESCRIPTION (Abbreviated):A It SITE ADDRESS: -* CITY: JQVW DIRECTIONS TO SITE ADDRESS: / Y 3 To In_.410 A_-Cr w sy f(i LIM TwN Td t 10 Liff- 0 N LA*q TYPE OF JOB: NEW�_ADD ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS-I ST FLOOR�C_2ND 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 3 Type of Unit No. of Units Fees Bathroom Sink Furnace Bath TubVS&,O,,, Z• Heat Pump Showers Spot Vent Fan Water Heater 1 Proper Tar* 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. l 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 QEIk11 PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALID THE AP LICATION. x (l/�/1ZO20 Signature Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev: 1/27/2016 1 B N Name i Parcel# 122ZD—5b-�340g1 BLD# U2D CA BUILDING T Mason County Department of Community Development SUN 3 202� Small Parcel Stormwater Management Application/WorkshRq� pg, l et 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'. 'Redevelo ment 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. 'Common 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 13uiidings. S X 22 s ' � � $6 X = Measurements for buildings are taken at the perimeter of the farthest projections (example: X = eaves/gutters) X = Driveways �( X 13 = 52.0 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 3 = 6 X = Any paved, gravel or packed area per definition above table X Others B 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) If the Total Impervious Surface Area is LESS THAN 200 8twarry 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 act e that the information provided is accurate and employees of Mason County are granted access to the above- des ed 70 spection as may be required. X Owner/Age /Contractor( rcle one)Tate: U ZS 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. Pagel of 2 RECEIVED � 1 jUN 3 0 2021 ' 615 W- Alder Street � I -ro fq�S '/Z Pier G.prpp� PLANNING e PLANNING ALL SETBACKS ARE MEASURED FROM THE FURTHES PROJECTION OF THE BUI DING ' 1 APPROVE 'f'ax MASON COUNTY DCD P ANNING i SITE PLAN REQUIRED TO B ON SITE I I Z2- S� l CH GES S JECT TO AP ROVAL BY Date Now I Z i i I aaaD � 0 - 3 boo a, ON CotjV�' Publ Health Always working for a safer healthier Mason County 415 N.6th Street,Bldg 8,Shelton WA 98584 360-427-9670 or 360-275-4467,extension 400 Application for Determination of Sewer Adequacy Instructions: 1.Complete Part 1 of application. Permit number may be added at later date. 2.Take application, Site plan,and any other associated information with the proposed development to the Sewer System Manager or Designated Employee for approval. 3. Submit completed application and information to Permit Center or Mason County Public Health for review. NOTE:You must supply the System Manager with a site plan for the project,showing all existing or proposed sewer components and lines in relation to proposed development and property. Part 1: Applicant/ Parcel I formation UD Applicant: Date: l �10i �U Mailing Address: _ City, State,Zip: "�� Wk E W, Site Address: %)JJtVr(ALI :S . �� -phone: Parcel Number: A� �/el!®�� q�Ly) , Permit Number: Part 2: Sewer System Information Name of Sewer System: 1 �z�,` ❑ Site Plan attached? Official use only: Sewer System Manager or Designated Employee Is to complete. New Connection: I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding son County Permit. ❑ Existing Connection: I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. ❑ I have reviewed the applicants information and have determined sewer connection is currently NOT available to this property. ❑ Please add the following condition(s)on the corresponding Mason County Permit(optional) GOuq.gm J�r Is nl� qx --)� Prinled Name of System Manager/Employee n re of System Manager/Employee Date Part 3: Mason County Public Health Review/Approval ❑ Satisfactory ❑ Unsatisfactory Signature of Environmental Health Specialist Date This form may be scanned and available for public view on the Mason County Web Site. REVISEo 10/28/2015 C k1/I l L ,io, VED JUN 3 0 202, 615 W. Alder Street -ro t4ty Gpr,4p� ENV/R� � scn�ter. N wev JU EARTH L � 0 f 4 e 1 ?vll� Ap p R -rA x�zz� SEP 3 202� H 1H AgON COONS EN�RONMENZ A� , � ,�. RFC i � z S I a'o�-� v 50 3�002