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Home My WebLink AboutBLD2025-00052 ADA Addition - BLD Application - 1/15/2025 MASON COUNTY COMMUNITY SERVICES Permit No: BLDa oas-DC�S� PERMIT ASSISTANCE CENTER: RECEIVED C E I` 'E D BUILDING.PLANNING-PUBLIC HEALTH•FIRE MARSHAL K V 40 615 W.Alder Street,Shelton,WA 9a584 Phone Shelfon:(360)427-9670 ext 352•Fax:(360)427-7798 Phone A N 1 5 2025 Belfair.(360)275-4467•Phone Elma:(360)482-5269 BUILDING PERMIT APPLICATION 615 W. Alder St at PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION- NAME: &+h q CI.r r(5 i n NAME: ,Z'I - MAILING ADDRESS: P 0. 13v 6 ' I (F MAILING ADDRESS: CITY: S h c I-�O n STATE: r ZiP:djj;jL-j( CITY: STATE: ZIP: PHONE WI: 3 to Q-•H 2JO •0 5 31t1 PHONE: PHONE#2: "S6;1 l �2 2 y- &3/0 EMAIL: r EMAIL: a' �t 'rGL Yl; L&I REG# M. / / PRIMARY CONTACT: OWNER p CONTRACTOR❑ OTHER❑ rrrr� NAME ' cx EMAIL C M MAILING ADDRESS I . S CITY ( G rx STATE 1,4 ZIP Sr PHONE101--12il-Cr 34 CELL IL.U-i2'?-62 3 7 V PARCEL INFORMATION: PARCELNUMBER(12 Digit Number) 2 i 3 2'3 3' 760 c� ZONING C 25 tdc"1 '•cii t LEGAL DESCRIPTION(Abbreviated) Y GC:u�' Zir f0 7(j 5�� 1.2].7 FIRE DISTRICT j SITE ADDRESS % 5 • , CITY SAe I te-tl DIRECTIONS TO SITE ADD SL. =+ '—�� .t c fay C n F'P t' LS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NO❑ SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: p;=kau rl a apply): SALTWATER❑ LAKE'® RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION a REPAIR❑ OTHER n USE OF STRUCTURE(Rrs dears Gmagq Comm rid. &Erc) RC'S id e A C IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS Z NUMBER OF BATHROOMS I HEATED STRUCTURE? YES OM kBldg)M YES(P.1f4ofBW❑ NO❑ DESCRIBEwoRKAjd ADA be-thr000r, C,.T-h Shccz)(i C +LL A doc r -fo SQUARE FOOTAGE:{propare� 1ST FLOOR? sq IL 2ND FLOOR sq.& 3RD FLOOR sq.fL BASEMENT sq.& DECK sq.& COVERED DECK sq fL STORAGE sq.fL OTHER sq.fL GARAGE sq.fL Attached❑ Detached❑ CARPORT sq.&Attached[ Detached❑ MANUFACTURED HOME TNFORMATTON: *4 COPIES OF THE FLOOR PLAN REQUIIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIALNUMBER ENVICRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC[ SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES J� NO❑ Iyyes,attach completed Water Adequacy Form PERIMETEWFOUNDATION DRAINS PROPOSED? YES❑ NON EXISTING SQ.FT. EXISTING BEDROOMS -L 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 represerrh6ve,represents that the information provided is accurate and grants employees of Mason County access to the above described property and sh uctur e(s)for review and inspection.This permidappGcation becomes null&void If work or authorized consW dion is not commenced within 180 days or if construction work is suspended for a period of ISO 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 1 COUNTY CODE 14.08.42) Signature of OWNER(Must be signed by the OWNER) Pate �-DLPARTME�ITAI._REVIERr===-.: :�PPIROVED`��DATE°-•;<:_DENIED:%:DATE,==TAGS/NOTES/COI+IDITIONS_�: BUI DING DEPARTTONl I i PLANNING DEPARTMENT FIRE MARSHAL. PUBLIC HEALTH 4 MASON COUNTY COMMUNITY SERVICES Permit No: ]3=DR5—DWSc�- PERMIT -PLAN U4G- CENTER: RECEIVED .BUILDING•PLANNING•PUBLIC HEALTH•F1RE IiMRSHAL 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext 362-Fax:(360)427-7798 Phone• A N 1 5 2025 Belfair.(360)275-4467.Phone Qna:(360)4B2-5269 BUILDING PERMIT APPLICATION 615 W. Alder Sir PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 01 Z NAME:�Ii I- CI,V"f( .5 i i r) NAME: J C' MAILING ADDRESS: P 0. 5y 6 ' i U' MAILING ADDRESS: �1U CITY: S r,1±4 n STATE: U,1A ZIP: :� CITY: STATE: ZIP: PHONE#1: 3&0 12.4' •0 5 3 q PHONE: CELL- PHONE#2: -3 wG?•--2 2 y- W 3 1•0 EMAIL.: �O EMAIL: t ci5 is Y1 zLLLciy L&I REG# EXP. PRIMARY CONTACT: OWNER a CONTRACTOR❑ OTHER❑ r1 NAME ' _ti 11 EMAIL t ) MAILING ADDRESS !G 1 C r—. S fin.' r �,k {�ci CITYS h�l L rx STATE w ZIP 5,r Z PHONE 3 4 CELL'Sl✓0- a A=j 1 S 7 42 D PARCEL INFORMATION: 3 „ C'`I' r PARCEL NUMBER(12 Digit Nurd-) 2�- "3' 1 U TONING LEGALDESCRIPTION(Abbreviatcd)Td It Lif 6 -"R-2 Sin�J217 FIREDISTRICT SITE ADDRESS i -SIpjSk) CITY 5 Ae!?z fl DIRECITONSTOSITEADD ,S i4t,L4,; j-�• �To tt 11aCnFic.hcf lluyn tun IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO❑ SNOW LOAD:_pd IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chrzk att char zWy): SALTWATER❑ LAKE'® RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION g REPAIR❑ OTHER ❑ USE OF STRUCTURE(Reddmc_Garage,Co mauc arBra&Ete) Re 5 1 j e n C IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS --2- NUMBER OF BATHROOMS / BEATER STRUCTURE? YES(Fn-kBW® YES(Farr[s)ofBZ4j[] NO❑ DESCRIBEWORgA-W hDA C J—h �nr�L:��• -it:,�B il�•e •Fc dl-, -av b,:,j4x SQUARE FOOTAGE:(pro we4 1ST FT.UOR—sq& 2ND FLOOR sq.fL 3RD FLOOR sq.ft. BASEMENT sq.fL DECK sq.fL COVERED DECK sq fL STORAGE sq R OTHER sq.& GARAGE sq.&Attached❑ Detached❑ CARPORT sq.$Attached[ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* IVL E MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIALNUMBER ENVIRONMENTAL HEALTH: SEWAGVSEWER SOURCE: SEPTIC[ SEWER❑ J NEW❑ EXISTING PLUMBING IN STRUCTURE? YES J4 NO❑ Ifyes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NOIN EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS ti + OWNER adaum4edges that submission aFinakzwate information may result In a stop work order orpermlt revocation.Admawledgement atsuch is by signature below.I dadare 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 arty easerrient holder or parties of interest regarding this project The owner or legal repressent dive,represents that the information provided s accurate and grants employees of Mason County access to the above described properly and struchrre(s)for review and inspection.This pennittappGcation becornes null&void If work or autharind construction is not commenced within 180 days or if construction work is suspended fora 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) 61,X �L/-Z/ iV -awo _ J a nU 0. C =i Signature 0(OWNER N(_Iust be signed bythe OWNE Date :�EPARTMEIVTAI_REVIEW_=-' 9PPROVED'==DATES=<•= DENIED_ DATE='=TAGSINOTES/CONDITIONS tP' BUII DING DEPARTM[ENT PLANING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH F MASON COUNTY COMMUNITY SERVICES Permit No: L —QQ05L-;.- PERMIT ASSISTANCE CENTER: BUILDING •PLANNING -FIRE MARSHAL RECEIVED - 615 W.Alder St-Shelton,WA 98584 www.co.mason.wa.us JAN 15 2025 Phone Shelton:(360)427-9670 ext 352- Fax.(360)427-7798 Phone Belfair.(360)275-4467- Phone Elma:(360)482-5269 615 W. Alder Sheet PLUMBING & MECHANICAL PERMIT APPLICATION OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:RA 11 i4c,r 1'IS&n NAME: 5 C,I f MAILING ADDRESS: P G.l3cx i W MAILING ADDRESS: CITY:5 h (fc n STATE:_ZIP:9 CITY: STATE: ZIP: Is'PHONE: 3(oo- li 6 c 3 3 4 PHONE: CELL: 2°d PHONE: 3&O--2�2 q-&37 O EMAIL: EMAIL:0(CxUe'4 nth►A4%sia dn Hama, 1.Lorn L&I REG# EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): aZ j3 a--3 3 - q00 of 0 Zoning- LEGAL DESCRIPTION(Abbreviated):`f I, q 6{ G G VT T Rom, c 5 Qz-7 SITE ADDRESS: /&10 S 1P16/NC C r k,,&e (Rd 'CITY: fo DIRECTIONS TO SITE ADD S: —T.,r-n le-4-o W AQ&& Rl vt Ptorwer Sr hc,,, ( � Mite , 5 fe ,s n +(e v,c k fac.cru TYPE OF JOB: NEW ADD ALT ✓ REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNTTS—1sr FLOORS 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FVCFURES(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 f Furnace Bath Tubs Heat Pump Showers f 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 INVALIDATE THE APPLICATION. x i1/_ /'7j f�lt�l.�ati� JGr AL.<-et Signature of Owner Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSINOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL Rev.1/27/2016 JBN Sa. r ► i■ ■�■■ ®H0 ONE ■■■r�■■■Kf■■■■ ■■i■■r `�f 1 ■ ■ j■■n WONso 0 MR s1EOO ONE i■■■■ MEN NO NONE XWEESE off NONE ■■■ Woos■i/■■■■/f■■ONE E NOWUNESSE HE NONE ■■ No AN rR%ii■■■FMOORE WOMEN IS N ■■■ ■i■® � �■ ";I Cat . ��!�'�3��■■■■ No ■�ii■t� %■ �■■■�■ rim■■■■■■■ ■ ■■rcr®�cirE S■■r■r/��e■�■■■ rat � r Buil • . . • h -11 1 I�� O I, c Owner/Applicant F- Number _ ! r MASON COUNTY COMMUNITY SERVICES Puildng,Planniig Envionmmtd Hiahh.Commniry HealM I I Name�2� Permit#: a Lz7goo,3_6 DQC�;02 FEE CALCULATION OR - Determination Occupancy Type Square Footage Valuation Amount Total Valuation (vB) (sq. ft. x valuation) Residence/Addition /Basement $167.37 $ Garage/Storage $66.48 $ Unfinished Basement $31.50 $ Deck $17.00 $ Carport/Covered Deck $pp2,,4.00 $ Other m I SS O g� U3 �Ocj $ aO TOTAL VALUATION $ 5,010 Estimated Plan Review Fee: $ .QO Planning Dept. Review Fee [$275, $450, $100]: $ Environmental Health Review Fee: $ 0-p0 Fire Access & Grade Review Fee [$97.00]: $ ADD - Address Application Fee [$185.00]: $ GEO - Geo-technical Review Fee [$300.00]: $ ADV - Review Fee[$130.00] $ WAT - WAT Fee: Other: TOTAL DUE WHEN PERMIT IS SUBMITTED: $ 00 The estimated plan review fee is based upon information provided at the time of application and is subject to change. Planning Department fee is a flat fee which is due when permit is submitted. Building permit fee, mechanical fees, and plumbing permit fees will be calculated during plan review. The balance of all other fees will be collected when permit is issued. ESTIMATED BUILDING PERMIT FEES Building Permit Fee (ICC, Table 1 — Building Valuation Data) $ pp Estimated Mechanical Fees (U.M.C., Table 1-A). $ 0 1 Estimated Plumbing Fees (U.P.C. ,Table 1-1) $ J. State Fee: $25 $6.50 $ (Y.5c) Technology Surcharge: 0V Other: $ Estimated Building Permit Fees WHEN PERMIT IS READY for pickup: 50 ('all fees subject to change w/o notice) GRAND TOTAtL $ V S ' t Y t i Total Ra ce Due: 0 Pest#: B► P2o25- 00052 Checked Con ractar's-Registraffolt +o i�aS caufiscfed?�: Dail'Coiifacted:. STsa Yh¢ae n xia7�? _Coii#aeted bY_' RUT" 03 •11- 202.5 pit PVN N PR . • Eta pt-►1. O er'. Ass��ia ed Cages fee AA3ttOi D.t gLc�2025-oov5-L �_ g5� • b0 45"I . Io0