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Home My WebLink AboutBLD2021-00453 Addition, Remodel - BLD Application - 3/29/2021 MASON COUNTY COMMUNITY SERVICES Permit No:"61d 20-n- PERMIT ASSISTANCE CENTER: Im •BUILDING•PLANNING.PUBLIC HEALTH•FIRE MARSHAL RECEIVED 615 W.Alder Street,Shelton,WA 98584 Phone Shelton: 60)427-9670 ext. 352•Fax:(360)427-7798 Phone Belt ' )275-4467•Phone Elma:(360)482-5269 MAR 2 9 2021 BUILDING PERMIT APPLICATION Alder Street ® 615 W. PROPERTY, INFORMATION: CONTRACTOR INFORMATION: *. NAME: M1Et- '1p X rr.- ly NAME: MAILING ADDRESS:3\ aF MAILING ADDRESS: CITY: P-LL-/P-N STATE: L jA ZIP: q CITY: STATE: ZIP: PHONE#1: 3k o - l- LA VS-1. PHONE: CELL: PHONE#2: 260 - a- _69 3 B EMAIL : EMAIL: rovL 4�*tea.-.,. P g!,An. ccon�i�- L&I REG# EXP. PRIMARY CONTACT: OWNER` CONTRACTOR❑ OTHER❑ NAME tt"t-iPtt"Z Corot- � EMAIL Wksa. ( o✓- MAILING ADDRESS R:N �t��-E PL- CITY Art"xJ STATE t A 1A- ZIP of -'�Q ll-i PHONE 36 2- 6LD I- LA 1Sfo CELL <AzME PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) ``aaaO-5�-OOO ZONING g-IV:' LEGAL DESCRIPTION(Abbreviated) IRE DISTRICT SITE ADDRESS31 :E LAY�ESr",LE -P'L- CITY A Ll,�-JlJ DIRECTIONS TO SITE ADDRESS E-wA,:S a-T e LOrel -oU po pa- i L 6-3 -e AU��rto12�+�2_ Cl-:') cis 1—F t~-S tn,1zs Pt-- t ZOO 00 LE P'r- - IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO SNOW LOAD:.3-(ZPsf 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 ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc. (L IS USE: PRIMARY]. SEASONAL ❑ NUMBER OF BEDROOMS Z NUMBER OF BATHROOMS 7— HEATED STRUCTURE? YES(Whole Bldg). YES (Part[,]ojBldp) ❑ NO ❑ DESCRIBE WORK Ago 03 L- Sl o OA SQUARE FOOTAGE: (proposed) 1ST FLOOR aM c) sq. ft. 2ND FLOOR sq. ft. 3RD FLOOR sq.ft. BASEMENT sq. ft. DECK sq.ft. COVERED DECK Li 2) sq.ft. STORAGE sq. ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq. ft. Attached❑ Detached❑ MANUFACTURED HOML INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MODEL AR LENGTH 7IDTH_ BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWERM / NEW ❑ EXISTING X PLUMBING IN STRUCTURE? YESX NO ❑ If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YESX NO[] EXISTING SQ.FT. EXISTING BEDROOMS Z- PROPOSED BEDROOMS�_ 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 41 MASON COUNTY COMMUNITY SERVICES Permit No:Jb1&;wZI'w ,59 PERMIT ASSISTANCE CENTER: • ING •PLANNING •FIRE MARSHAL Alder St-Shelton, WA 98584 RECEIVED xo.masonma.us �` Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 Phone Belfair. (360)275-4467• Phone Elma:(360)482-5269 MAR 2 9 2021 el PLUMBING & MECHANICAL PERMIT APPLICATIOW15 W. Alder Street OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: %fit_ t oa-TMAt-J NAME: MAILING ADDRESS: f- LA*CSM.ejO e'er MAILING ADDRESS: CITY: L.LY� STATE:Jd ZIP: CITY: STATE: ZIP: 1 S`PHONE:'ZL0 _ q-J 1 - Lt I SL PHONE: CELL: 2nd PHONE: EMAIL : EMAIL:Adam= Moll•�e�-^f an w�<_r�.cower L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): as P d - �JL(— 0008S Zoning: R-\? LEGAL DESCRIPTION(Abbreviated): V- k.,a•N 5 6-S SITE ADDRESS: 3X E- l WigSt%b4E ice'- CITY: A"UtJ DIRECTIONS TO SITE ADDRESS: E-WX 3 'Tb 1-- 13 LA 5 2-" 1L 0 IL�- it cG ttt-., S EC oN0 ".COw&¢ O1u L TYPE OF JOB: NEW ADD &�T;S/UNITS ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXT — 1sT FLOOR 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 1 Type of Unit No.of Units Fees Bathroom Sink 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 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 OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL IT ATE THE APPLIC TION. ZX 3—Z�'aZr Signature of divFner Date DEPARTMENTAL REVIEW APPROVED I DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT J n— V Lf-Z PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 1 B N +201' OYOMAPPLIGANT R E C E I V 4c) MIGHAEL 4 AMY FORTMAN PLA N I�N G +2- ' 51 E LAKESHORE FL. ALL SETBAC S ARE MEASURED MAR 2 9 2021 ALLYN, WA g8524 FROM .HE FURTHEST 560-2'i1-4156 615 W. Alder Street PRWECTI N OF THE BUILDING PARGEL NUMBER 12220-54-00055 PLANNING NEW ADDITION AREAS <I- �rY 01 +IqB QI 21.6 FROVEVI O na +TY %� PLANNING TQ B� ON SITE Mkt;. ApipRONAL THIS SITE PLAN IS DRAWN BASED ON �? ioT DATA SUPPLIED BY GL I ENT AND WITHOUT '�� BENEFIT OF SURVEY OR TOPOGRAPHY +201' 30.0' ON ER/APPLIGANT RE C E� 4 MICHAEL 4 AMY FORTMAN / MAR 29 2021 +20 51 a LAKESHORE PL. ALLYN, WA 18524 560-211-4156 615 W. Alder Street PARGEL NUMBER ENVtr--, -�NMENTAL 12220-54-00055 u L N�-WPPROVED/ ExtS•�-tn 8' n APR 21 2021 1 / MASON COUNTYEN""11ENTAI RET LTN NEW ADDITION AREAS SCR BAD $' ry <l- On THIS SITE PLAN IS DRAWN BASED ON �? ? DATA SUPPLIED BY OL I ENT AND WITHOUT I BENEFIT OF SURVEY OR TOPOGRAPHY Name 1"11 G-!0� ?WN Parcel# BLD#2VS I l Mason County RECEIVED Department of Community Development MAR J�q Small Parcel Stormwater Management Application/Worksheet (page 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 re velopment', with more than 2,000 square feet of impervious surface 2. 'Redevelopment means,on an alreaens d site,the creation or addition of impervious surfaces,structural development including construction, installati of a building or other structure, and/or replacement of impervious surface that is not part of a routine maintenanc ti ,and land disturbing activities associated with structural or impervious redevelopment. 2Common im ervio s include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt pa ,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 I s = �7 0 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 = X = Any paved, gravel or packed area per definition above table X = Patios/Walks > X = Li 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) es 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 prqperty for review and inspection as may be required. X wnej/Agent/Contractor(circle one)Date: -T-26-2/ -37 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 2