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Home My WebLink AboutBLD2020-00837 Remodel - BLD Application - 8/3/2020 MASON COUNTY COMMUNITY SERVICES Permit No. PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 AUG 0 3 2020 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone \ j Bel(air(360)275-4467•Phone Elma:(360)482-5269 �`— BUILDING PERMIT APPLICATION 615 W. Alder Street 1 PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: T4M.M.. NAME: $e✓t(,o tP o em i t (rt4 MAILINGADD S: QO 15;)X ZOZS MAILINGADDRESS: 15CA 31 = Lmap tvf owing CITY: Atl!j d STATE:04 ZIP: 9g'6'W CITY: 014me•A STATE:MJ- ZIP: "14W516 PHONE#I: :2.o4 53(a 18e)7e PHONE: CELL: 3(0o 9'7o %J1 PHONE#2: EMAIL: 13Wto�Co ncc s4 EMAIL: IAM45M41rU a C-y�a;1,Cohn L&I REG#(3Hlhoptq!Q,a b EXP. PRIMARY CONTACT: OWNER❑ CONTRACTOR L OTHEkt❑ NAME KertGo e-, N,r. EMAIL yLovl'90IHC @ am-y;E4. flCa` MAILING ADDRESS 9750S !' 't- /-OUP NtC CITY OTCIt STATE 4 ZIP`'/$�Iw PHONE 3(04 97,E `Ifni CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 11.L L( " Z( ' y O(Z o ZONING LEGAL DESCRIPTION(Abbreviated) '72 12 o-P (say4- ` 4- 1 1- FIRE DISTRICT SITE ADDRESS 1470 L .54A.4% 44.0 e 3 Q'L CITY Of DIRECTIONS TO SITE ADDRESS Nor-It, ea " 7 41,erM A014 We*0 04 MAA7 702 rruppri3 c,- (LIC Vida y.t 40ata1 IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NO[K SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkalldwrapp!v): SALTWATER[A LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION� REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) z e CI den C C _ IS USE: PRIMARY X SEASONAL❑ NUMBER OF BEDROOMS Z NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(WholeBldg)EQ YES(Par1[s)ofBldg)❑ NO❑ DESCRIBE WORK IM IL VJ,n w J 14Cvi Sibyl G11Cr eX('g-V 1 +yeti (A l*t4nt/J M044 9141+ SOUARE FOOTAGE:(p�) r��p IST FLOOR sq.ft. 2ND FLOOR O sq.ft. 3RD FLOOR O sq.ft. BASEMENT_0 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 REQ MODEL YEAR LENGTH IDTH BEDROOMS BATHS .7 ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWERIV / NEW❑ EXISTING 1A PLUMBING IN STRUCTURE? YES N NO❑ Ifyes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT. EXISTING BEDROOMS 'L— PROPOSED BEDROOMS 2- TOTAL BEDROOMS 2- 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 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 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 OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT n (� FIRE MARSHAL n PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit Noi302D 0-0083r� PERMIT ASSISTANCE CENTER: C C I` /C D •BUILDING •PLANNING •FIRE MARSHAL RECEIVED C • - 615 W.Alder St-Shelton, WA 98584 www.co.mason.wa.us AUG 0 3 2020 Phone Shelton:(360)427-9670 ext. 352• Fax:(360)427-7798 �_4'' •• Phone Belfair:(360)275-4467• Phone Elma:(360)482-5269 615 W. Alder Street PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: ,. NAME:-TkNe" Atki 2" -rrOw -14.1 NAME: R3Qv co Proper.kie r tvu. MAILING ADD SS: Po PsK, ZoZB MAILING ADDRESS: 9569 cj xi -.,p He CITY: A(l y rJ STATE: IN 4 ZIP: O1 S ZL/ CITY: n k x w r� STATE: .uJ� Z : q PS 16 I'PHONE: 20fca 57(p 99-7 8 PHONE: CELL: 2°1 PHONE: EMAIL : Benco in c ('Z f.omCAP EMAIL: 6) L&I REG# to P t iD C(. C 0 EXP. c-f / I / ZI PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): 22 2( - ZI 061 -C) Zoning: LEGAL DESCRIPTION(Abbreviated): 'T2 1'L t, SITE ADDRESS: ?I-f`70 L <4�'4—e ;4t a CITY: i3g-14P6,- DItRECTIONS TO SITE ADDRESS: ,N ss r 4.'' �`t-' 7 A1(W U.e to R tc l,.I Cia 4t y f CJ^40 30'L. q ro=.prk„ 01% (Lt'cf.4- yjf 0; 1kiar TYPE OF JOB: NEW ADD ALT b( REPAIR OTHER USE OF BUILDING s F 2 LOCATION OF FIXTURES/UNITS- 11T FLOORJ_2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No. of Fixtures Fees Fuel Type:Electric X LPG Natural GasDuctless Toilets 4= Type of Unit No.of Units Fees Bathroom Sink a Furnace Bath Tubs D Heat Pump Showers — Spot Vent Fan Water Heater Propane Tank Clothes Washer Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood t Hose bibs Dryer Vent 1 Other 1 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 INVALIDATE THE APPLICATION. x ). ! -2- as nature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev;11/27/2016 )BN