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Home My WebLink AboutBLD2024-00367 Remodel - BLD Application - 3/18/2024 MASON COUNTY COMMUNITY SERVICES Permit No:_FAZ2: -()U, Q I PERMIT ASSISTANCE CENTER: !' •BUILDING•PLANNING-PUBLIC HEALTH.RRE MARSHAL R E C E 1 V'L 615 W.Alder Street,Shelton,WA 98584 Phone Sheffon:(360)427-9670 ext.352•Far(360)427-7798 Phone MAR p Q �1�� Beffalr.(360)275-4467•Phone Elmer(360)482-5269 HIS V U BUILDING PERMIT APPLICATION 615 W. Alder S eet C PROPERTY OWNER INFORMATION: CONTRACTOR IN`FORM. ATION: NAME: CV)o� e.: NAME: Sv 2r\o1 ` YLQl1G? S r MAILING AD RESS: - w MAIL NG ADDRESS:&b/4 F r3eAn,) n S CrrY:S he k STATE: K-L P: 118 Wq CITY: O • STATE:L->ter- ZIP: PHONE#1: b O `I I PHONE: ,- r/bnow PHONE#2: {�c o Yc✓i EMAII L&I REG#Sc�V C. lj /I E� PRIMARY CONTACT: OWNER❑ CONTRACTORV' OTHER❑ NAME EMAIL MAII ING ADDRESS CITY 4.I I4 \p STATE! ZIP PHONE Z CELL PARCEL INFORMATION• r l l PARCEL NUMBER(12 Digit Number) 1 J S—1 ZONING I gL LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT LIP SITE ADDRESS `2\ Snow ov,12N (DQ _ _ CITY S►y_\X� DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOXPT'SNOW LOAD:,21 psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: pi-k n L6m apply): SALTWATER❑ LAKE❑ RIVER/CREETC❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK NEW❑ ADDITION❑ ALTERATION REPAIR❑ OTHER ❑ USE OF STRUCTURE Garag4 Canmer<i I xd&E.) IS USE: PRIMARY K SEASONAL❑ NUMBER OF BEDROOMS_ 3 _NUMBER OF BATHROOMS_ HEATED STRUCTURE? YES(WholeBUZ) YES(Pan[,)o1BhW❑ NO❑ DESGRIDE WORK SOUARE FOOTAGE: 1ST FLOOR 87a R.8. 2ND FLOOR _ l sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.1 DECK sq.ft. COVERED DECK sq.R STORAGE sq.ft. OTHER sq.ft. GARAGE sq.& Attached❑ Detached❑ CARPORT sq.ft.Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIIM- MAgE MODEL LENGTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING) PLUMBING IN STRUCTURE? YES.E NO[I Ifyes,attach completed Water Adequacy Form PF.RI&M-f;RNOUNDATION DRAINS PROPOSED? YES❑ N� EXISTING SQ.FP. EXISTING BEDROOMS—\.3— PROPOSED BEDROOMS__Q_ 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 1 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 easertient holder or parties of interest regarding this projecL 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 permitlappOration becomes null 3 void If work or authorized construction is not commenced within 180 days or if construction work Is suspended for a period d 1110 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 Signature of OWNER(Must be signed by the OWNER) Date -v a '�EPARTMEIVTAL_REVIE APPROVE_D'-'D_ATR*L: =DENIk = ::DATE'=TAGS/NOTLS/CONDITIONS-t: BUILDING DEPARTMENT PLA141-UNG DEPART1v1EN'T FIRE NiAR HAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING-PUBLIC HEALTH•FIRE MARSHAL RECEIVED 615 W.Alder Street,Shelton,WA98584 Phone Shelton:(360)427-9670 ext 352-Far(360)427-7796 Phone ��1R 1 8 2uL-t Belfalr.(360)275-4467-Phone Flma(360)482-5269 BUILDING PERMIT APPLICATION m 615 W. Alder S eet z PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: C NAME: NAME: Sal lYo 12pncu � S MAILING AD RESS (Sw MAILING ADDRESS:&P4 ,/1 S- - m O CITY:S hel/ STATE:�^-'A-ziP�-- q SZ$c� CITY: OI STATE:L->VN ZIP: Z PHONE#1: (cv O 1 10 PHONE: 3 „Cl ")V 16 CELL: r PHONE#2: gLon AB 0'ijEMAIL: Scxrc v t22�ov �� EMAIL:- L&I REG#SdV' C.1'�F� /I 1�✓I= Z PRIMARY CONTACT: OWNER El CONTRACTORS OTHER❑ NAME " EMAIL D MAILING ADDRESS CITY e.jtL4m p iVN STATE L-3 A 21" r PHONE Z Z CELL PARCEL INFORMATION: f7 PARCELNUMBER(12DigitNumb') -1 1 Z-� S-1 ZONING Ig-I�Z ERECEIVE]D LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT_ IlesITEADDRESS 1-2 Snc7t�u ok�\ nt CITY gh<-`�DIRECTIONS TO SITE ADDRESS �CIS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES❑ NO�'SNOW LOAD:�J pdf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chw1 an char app7y): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATIONS REPAIR❑ OTHER n USE OF STRUCTURE(B denm Garagq r mm=alB7dr Et.) Ek -.d Q,hC+�� IS USE: PRIMARY If SEASONAL❑ NUMBER OF BEDROOMS_ J _NUMBER OF BATHROOMS_ HEATED STRUCTURE? YES(Whale Bldg) YES(PartAl afB7dg)❑ NO❑ DESCRIBE WORK SQUARE FOOTAGE:(proposed C(1Gx-Xsqft D lU S E 1ST FLOOR 872 sq.fL 2ND FLOOR . 3RD FLOOR sq.fL BASEMENT sq.IL DECK sq.ft COVERED DECK sq R STORAGE sq.ft. OTHER sq.ft. GARAGE sq.1h Attached F1 Detached❑ CARPORT sq.f- Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL LENGTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: 1 SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES NO❑ Ifyes,attach completed Wafer Adequacy Form PEREVIETERIFOUNDATION DRAINS PROPOSED? YES❑ No EXISTING SQ.FT. EXISTING BEDROOMS _ 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 1 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 pwrilthapprication 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 Signature of OWNER(Must be signed by the OWNER) Date �EPARTMENTAL_REVII�W=u :AP PROVED::-I -- ,:'_DEIZIED_ DATA-' TAGS/NOTES/CONDTIIONS= : BUILDING DEPARTMENT PI-ANtSUNG DEPARTMENT FIRE MARSHAL All PUBLIC HEALTH k MASON COUNTY COMMUNITY SERVICES Permit No: -003V7. PERMIT ASSISTANCE CENTER: BUILDING •PLANNING •FIRE MARSHAL 615 W.Alder St-Shelton,WA 98584 RE C L IV`D wwwxo.masonma.us Phone Shelton:(360)427-9670 ext 352• Fax:(360)427-7798 MAR 18 2024 Phone Belfair.(360)275-4467• Phone Elma:(360)482-5269 PLUMBING & MECHANICAL PERMIT APPLICATION 615 W. Alder Street OWNER INFORMATION: CONTRACTOR INFO TION: NAME: I�L )P ry()ck Fr--7a S k-.' � NAME: MAILING ADDRESS:1 t SnC�ti-'U Ow MAILING ADDRESS: 86q�- P R<<M��&N N-:p Sz CITY: Sly\ cam STATE:w*�- ZIP: S?73 CITY: 0jq OW A- STATE:u A ID: 01 gy Srz, 1 n PHONE: O O PHONE: 3GO It,I S CELL: 2nd PHONE: 9L,-,n -7A9 309-1 EMAIL: SOvV\1A 'Y,v,\k- nc uA+h EMAIL:"-e wF�e •Lc L&I REG#Scrc1�rL��-7C✓h EXP.0 PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): q Z- 2 - S - 6 O S Zoning- LEGAL DESCRIPTION(Abbreviated): SITE ADDRESS: IZ\ Snr'D�A b U'\ VX CITY: hC � DIRECTIONS TO SUE ADDRESS: TYPE OF JOB: 'NEW ADD ALIT V REPAIR OTHER USE OF BUELDING 5 K LOCATION OF FIXTURES S—�1sT FLOOR 2NDFLOOR BASEMENT GARAGE OTHER PLUMBING FIR I'URES(SHOW NUMBER OF EACH). MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump �— Showers Spot Vent Fan Water Heater Propane Tank Clothes Washer � Gas Outlets Kitchen Sinks Wood/Gas/Pellet Stove Dishwasher Kitchen Exhaust Hood 1 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 INV E THE APPLICATION. J S' ature of Owner Date DEPARTMENTAL REVIEW APPROVED I DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT J^R- -7-Z b- PLANNING DEPARTMENT FIRE MARSHAL Re;!127/2016 JBN MASON COUNTY �a� t ;E I Vi�_. ' COMMUNITY SERVICES DEPARTMENT 4 Mason County Bldg.a,st 5 W,Rider St 615 W. Alder Street "� .e : StFa ton VtiR 58< www Co R1��On.�ra.St 36"27.9670 ext 352 Fernut 0: L Property Owner's Authorization Letter I(we): t ( +3 � (5#-ec�rk) J C;Y'1 t1� �� Y 1 C (Print Property owners Name/Farm/Organization) Hereby Authorize: QSt i n!1 f (.dppficant-Name of Person to Sig,Permit) Representative of: -� C�_ , l — (4ppticant Company Name/Organization) To apply for,sign,and pick-up building permits for the following proposed work: (Brief Description of Work to be Done) Job Location: _ � C.-)\ 0 r perry Site Address) As property owner(s),I(we)hereby grant permission to the applicant referenced above to apply for,sign,and pick- up the building permit for the work as indicated above.All work performed must meet all provisions of the Building Codes and the Laws of Mason County and the State of Washington,as applicable,whether specified or not.Residential Contractors are required to have a current State of Washington Contractors License(RCW 18.2 7). (Prop ty fawner gnAtureJ �7n7") t Rev +