HomeMy WebLinkAboutBLD2023-01430 - BLD CD Environmental Health Review - 11/30/2023 G.Pi** MASON COUNTY COMMUNITY SERVICES Permit No: Al Ar AO e� 0 O
Sri, ' Q. PERMIT ASSISTANCE CENTER:
r !' `4 •BUILDING•-PLANNING •PUBLIC HEALTH•FIRE MARSHAL RECEIVED N��,
p 615 W.Alder Street,Shelton,WA 98584
�." A Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone NOV — 1 2023 RFC' ?0?J�
2•Y� �dy Belfair:(360)275-4467•Phone Efma:(360)482-5269 F�VF,
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BUILDING PERMIT APPLICATION
HEALTH PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Watermark Estate Management Services LLC NAME:Fairbank Construction Co.
MAILING ADDRESS: 10230 NE Points Dr,Ste 200 MAILING ADDRESS:220 Madison Ave S
CITY:Kirkland STATE:WA ZIP:98033 CITY:Bainbridge Island STATE:WA ZIP:98110
PHONE#1:425.576.3303 PHONE:206.842.9217 CELL: 206.551.9679
PHONE#2: EMAIL :colin@fairbankconstruction.com
EMAIL: L&I REG#FAIRBCC183C2 EXP. 06/25/24
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER1A
NAME MATTHEW MACH,OWNER REPRESENTATIVE EMAIL matthewm@watermark-Ilc.com
MAILING ADDRESS 10230 NE Points Dr,Ste 200 CITY Kirkland STATE WA ZIP 98033
PHONE 425.576.3393 CELL 847-848.6459
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32233-50-00012 ZONING RC2
LEGAL DESCRIPTION(Abbreviated) SUNNY BEACH PCL 1 OF BLA#04-57&T.L. FIRE DISTRICT 8
SITE ADDRESS 6999 E STATE ROUTE 106,SITE M CITY Union
DIRECTIONS TO SITE ADDRESS Travel East from Union on Highway 106,property on left just before Alderbrook Resort
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO 0 SNOW LOAD:25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM ❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION j REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Conrmerrial Bldg,Etc.)Residential Accessory,"Playhouse"Clubhouse
IS USE: PRIMARY ❑ SEASONAL I] NUMBER OF BEDROOMS 1 NUMBER OF BATHROOMS 1.75
HEATED STRUCTURE? YES(337note Bldg) ❑ YES(Peril's]of Bldg)0 NO❑
DESCRIBE WORK Interior remodel of existing building,including new non-loadbearing walls and a 3/4 bathroom
SQUARE FOOTAGE: (proposed)
1ST FLOOR 893 sq.ft. 2ND FLOOR N/A sq.ft. 3RD FLOOR N/A sq. ft. BASEMENT 750 sq. ft.
DECK 0 sq. ft. COVERED DECK 80 sq.ft. STORAGE 0 sq.ft. OTHER 0 sq. ft.
GARAGE 0 sq. ft. Attached 0 Detached❑ CARPORT 0 sq. ft. Attached 0 Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW❑ EXISTING 0
PLUMBING IN STRUCTURE? YES 0 NO ❑ If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0EXISTING NO❑ EXISTING SQ.FT. 893(no change)
EXISTING BEDROOMS 1 PROPOSED BEDROOMS 1 TOTAL BEDROOMS 1
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
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&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)
j X 'i 09/07/2023
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
i PLANNING DEPARTMENT
FIRE MARSHAL /��
PUBLIC HEALTH I (1,66(0 C-'" >7` 0 • t 61 ' '
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