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HomeMy WebLinkAboutBLD2024-01467 Remodel, Addition - BLD Application - 12/12/2024 MASON COUNTY COMMUNITY SERVICER hVmitNo:ry�F PERMIT ASSISTANCE CENTER: BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98594 DEC 12 2024 Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone Belfair.(360)275-4467•Phone Elms:(360)482-5269 BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: 5' 2 �C NAME:Jce�11 Wo koiaAtQ- C ' MAILING ADDRESS:2 MAMMO ADDRESS: a L^ CITY' STA ZIP: am-3hithe STA ZIP:WX& --� PHONE#1: -7 PHONE: - "1177EI - O PHONE#2: EMAIL: Z WOK M EMAI .: L&I REG#C C C.4g+ "$I IN 4 EXP.k)!J/2 tv PRpI6,U CO ACT: OWNER❑ CONTRACTOR❑ OTHERI? G"1 NAME IvIbr)TE FWc-kg EMAIL �}— MAILIN ADD S QTY+ n STATE ZIP l: PHONE CELL — (� PARCEL INFORMATION: e� PARCELNUMBER(12 Digit Number) .0 0 ZONING LEGAL DESCRIPTION(Abbreviated) C40E8L4U92l-15-F7'TT7 FIRED( Cry 1 ' SITE ADDRESS L.,j ACITY DIRE TIONS TO SITE ADD S Ink _y IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 9 SNOW LOAD:_psf 1 IS PROPERTY WTD1[v 200 FT OF THE FOLLOWING: (Chw*.II zha:apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION K REPAIR❑ OTHER ❑ r USE OF STRUCTURE(R.W.,!,GaregS Commerakl BId&El.) r Q S j j IF A C C �J IS USE: PRIMARY g SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whok YES(P f.I ofBW❑ NO❑ e j J� DESCRIBE WORK P'C `1 - J��f ►�-- SOUARE FOOTAGE:(propwe4 - /VV0 Ch a in E 1ST FLOOR sq.R 2ND FLOOR sq.It FLOOR sq.ft. BASEMENT sq.& 1 DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.fL Q� GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.fL Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUMED* Q,, MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER FSjEWAGGE/SEWER, RONMENTAL HEALTH: SOURCE: SEPTIC'< SEWER❑ / NEW❑ EXISTING`Y ING IN STRUCTURE? YESXr NO❑ ayes,attach completed Water Adequacy Form TER/FOUNDATION DRAINS PROPOSED? YES❑ NOW 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.Admowledgement 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,represerls 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 permidappGcation becomes null&void If work or authorized construction is not commenced within 180 days or if constructon 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 DEpARTMEIVTAL REVIEW=u' APPROVED`:_ DATE4 ` DEFIED DATE =TAGSINOTES/CONDITIONS__ BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No �G�20�`1 -6ILI ' . PERMIT ASSISTANCE CENTER: •BUILDING •PLANNING -FIRE MARSHAL • 615 W.Alder St-Shelton,WA 98584 www.co.mason.wa.us Phone Shelton:(360)427-9670 ext 352• Fax:(360)427-7798 Phone Belfair. (360)275-4467• Phone Elma:(360)482-5269 PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: � tic NAME: MAILING ADDRESS: 20 MAILING?DDRESS: CITY: S 'P '�b STATE: ZIP:9S CITY: STATE: ZIP: 1s`PHONE: ( _710 2 O4'O PHONE: CELL: 2nd PHONE: EMAIL' EMAIL: L&I REG# PARCEL INFORMATION: PARCEL NUMBER(12 DigitNumber): 3 2 © 2 2 2 1 Cl ©oS o Zoning. R R LEGAL DESCRIPTION(Abbreviated): O -V R SITE ADDRESS: , C r Q 4 CITY: DIRECTIONS TO S E ADDRESS: cialev <e �h C aes11De h TYPE OF JOB• / NEW ADD ALT \/ REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS—1 sT FLOORS 2�FLOOR BASEMENT GARAGE OTHER P fUMBING FIXTURES(SHOW NUMBER OF EACH). MECHANICAL UNITS ' T,Me of Fixture No.of Fixtures Fees Fuel Type:Electric_\L/LPG Natural Gas Ductless_ Toilets ape of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs rx.l�v Heat Pump Showers Spot Vent Fan Water Heater _�_ Propane Tank Clothes Washer _ Gas Outlets. Kitchen Sinks J77 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 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 OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. X Signature of Owner Date DEPARTYMNTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev.1/272016 JBN MASON COUNTY COMMUNITY SERVICES Permit No: 427r�l.�4 U �(19 PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98564 DEC 12 2024 Phone Shelton:(360)427-9670 ext.352•Far(360)427-7798 Phone Beflalr.(360)2754467•Phone Elmer(360)482-5269 BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: U' e '1` c NAME: k e.1 it' info k 61 o la i z MAMING ADDRESS:Z r 1 C- L A MAILING ADDRESS: ryc S ! CTI Ir C�'�C h STATE: ZIP: S� S CTTY:.3 h o-f l-h STATE:V ZIP: jt PxoNE#1:3 .-7 - 2�Y PHONE:_ - '2AlR' I:3 ()-L PHONE#2: EMAIL: ( 4 2 S') �F-0a n a}L t ", EM AIL: L&I REG#C Ca C ,j&+AS$)INQ PPJMAP,Y CONTACT' OWNER❑ CONTRACTOR❑ OTHER NAME JVH�ATE- 1 CE EMAIL MAILIN ADD S 410 k'c `c. Lh CITY D n STATE UZA ZIPIAV PHONE — CELL q V PARCEL INFORMATION: r� �y PARCEL NUMBER(12 Digit Number) 32 0 :?1 Q bn�0 ZONING LEGAL DESCRIPTION(Abbreviated) RCLI 0 F 13 14 C7 " FIRE DISTR ICI SITE ADDRESS 4q ! C F d n-f- C n d a n CITY ;)4 t o DIRECTIONS TO SITEADDUSS �^F1 iG f Pf�s97 Q � '�D � t✓� l'r F,r- v I i�°r1'-t' f IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOV SNOW LOAD:_psf IS PROPERTY WTTHIN 200 FT OF THE FOLLOWING: (CheckaRrharapply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION X AAREPAIR❑ OTHER ❑ USE OF STRUCTURE(Rcsida+rr GmagS Cammerdal Bldg,Etc) S 1 fl C C. IS USE PRIMARY. SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS 4- HEATED STRUCTURE? YES(whole Bldg)j' YES(P [.j ojBldg)❑ NO❑ k -DESCRIBE WORKI-� r t i-xr t r r� - .L 22 W i Adv > G �t,,-r `�L_ SQUARE FOOTAGE:(proposed) -Alp eh ao a p- 1ST FLOOR sq.ft 2ND FLOOR sq.R 3RD FLOOR sq.ft. BASEMENT sq.ft_ k DECK sq.ft. COVERED DECK sq.& STORAGE sq.ft. OTHER sq.8. GARAGE sq.fL Attached❑ Detached❑ CARPORT sq.fL Attached❑ Detached❑ N ANfTFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIALNUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTICW SEWER❑ / NEW❑ EXISTINGY �-4PLUMBINGIN STRUCTURE? YESX NO❑ I,'yes,attach completed Water Adequacy Form v PERRAETER/FOUNDATION DRAINS PROPOSED? YES❑ NC►g EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS a OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit avocation.Acknowledgement of such is by signature below.I declare that I am the owner and 1 further declare that I am entitled to receive this permit and to do the work as proposed 1 have obtained permission from al the necessary parfies,including any easerient holder or parties of interest regarding this project The owner or legal j. 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 au_Ihorimd 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. INACTIVriY OF THIS PE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON _ 94.08.42) ER Date �EPARTh7ENTAL---_ m-_: -. --------• AMA E _DENIED_i..:.DATE: r:TAGS/1gOTES/CONDITIONS. BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: [41 PERMIT ASSISTANCE CENTER: .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton.WA 9a584 D' 1 Z 212 Phone Shelton:(360)427--9670 eA 352•F=(360)427--7798 Phone Beltatr.(360)27&4467•Phone Eirnw(360)482-5269 BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: , Q T NAME: K e F 1! Wp k o)a w EE92M!�� nMAILING ADDRESS: ,min S: I'14L STATP_:V ZIP: &a PHONE: 0- '2 -!) �ZR.L'3 L PHONE#2: EMAM-7A It 14 Cir09rr-� _2to at}h t I W EMAII: L&I REG#C C Ctn n, PPJMAKY CO ACT: OWNER❑ CONTRACTOR❑ OTHERR NAME Jet T t c K c EMAIL MAIIdN ADDRESS 1 r C'�+S �_ h CITY * R STATE ZIP � ' PHONE PARCEL INFORMATION: 'P PARCELNUMBER(12 Digit Number) 3:? 07" -_>P uSO ZONING K LEGAL DESCRIPTION(Abbreviated) PC_L1 OP L t C7fL-: P7*TR FIRE DI4TRICr S �Q SITEADDRESS �1 r) ~` C —t,Y�i. :? CITY A:;. ,d.t A DIRECTIONS TO SITE ADDRESS i°3 G F =D s D t✓1% �:r f,fl- +1 C. w IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO;< SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: ((I astern that appty): SALTWATER❑ LAKE❑ RIVERICREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK NEW❑ ADDITION❑ ALTERATION X REPAIR❑ OTHER ❑ 1 V u USE OF STRUCTURE ae id.=4 Garage Commercial Bld&Etc) r P u 1 t C 0t AA IS USE: PRIMARY$ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS �d. HEATED STRUCTURE? YES(whale Bldg)K YES(P. [s)ofBW❑ NO❑ t DESCRIDEwoRK r� n� 2 '' r= '� V n I e�.'_t fW-C - SOUARE FOOTAGE:(prapasrd) - IVO c k a( j a+ 1ST FLOOR sq A 2ND FLOOR sq.It 3RD FLOOR sq.fL BASEMENT sq.R DECK sq.fL COVERED DECK sq.R STORAGE sq.fL OTHER sq.fL GARAGE sq.$Attached❑ Detached❑ CARPORT sq.ft.Attached❑ Detached❑ _ MANIIFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER F24MONMENTAL HEALTH• SEWAGE/SEWER SOURCE: SEPTIC K SEWER❑ NEw❑ EXISTING')? UMBING IN STRUCTURE? YESX NO❑ fjyes,attach completed WaierAdequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ C M STING SQ.FP. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER acla o adges that submission of inaccurate information may result in a stop work order or pemdt revocation.ArImowiedgement or such is by signabi a below.I declare that i am the owner and I further declare that I am entitled to receive this pem,@ and to do the work as proposed.I have obtained permission frorn aM 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 employers of Mason County access to the above described property and struchue(s)for review and inspection.This pemnit/application becomes null&void E work or authoraed construction is not commenced within I SO 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 OWNERI Date REPARThDTTAI_REVI1zW_ -APPROVED=`- DATA _DENIED rI DATE TAGS/NOTES/CONDITION'S" : BUILDING DEPARTMENT Z. PLANNING DEPARTMENT A FIRE MfAR RAAT PUBLIC HEALTH I