HomeMy WebLinkAboutCOM2020-00025 Shelter, Toilets 2 parcels - COM Application - 2/18/2020 MASON COUNTY COMMUNITY SERVICES Permit No: C+M Z024--6602,S
PERMIT ASSISTANCE CENTER: SKiPP-01
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
Beltair:(360)275-4467•Phone Elma:(360)482-5269 BUILDING
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: •
NAME: �Cr1 bF b1�F1E'%IlfW-14141WW NAME:
MAILING ADDRESS: MAILING ADDRESS:
CITYx/,1RAMVII�W STATE: Z CITY: STATE: ZIP:
PHONE#1:_'1 "S�I,2 lrLl PHONE: CELL:
PHONE#2: EMAIL
EMAIL: L&I REG# EXP.
PRIM RY CONTACT: OWNER❑ CONTRACTOR . OT E
Ag
NAMEI� EMAIL4�r�1 ,rylY)
MAILING ADDRESS 69 'S' ' N'� AVP, CITY T STATE Wgb-, ZIP 4�-
PHONE CELL "01Y.0 Sti
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) J oQ(C)rj— ,j j ZONING 1�1�
LEGAL DESCRIPTION(Abbreviated)"5 IU7Ne(5 1�?`S}.��1.1�� FIRE DISTRICT
SITEADDRESS �j��72, (a� i�l F�� �PW '90,6.9 CITY G1P-��*1I OWN
DIRECTIONS TO SITE ADDRESS
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: (Check all that apply):
SALTWATER LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM.❑
TYPE OF WORK: NEW X ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
.HEATED STRUCTURE? YES(MoleBldg)K YES(Part1s)ofBldg) ❑ NO ❑
DESCRIBEWORIr
SOUARE FOOTA-rF• nro o dj
I.
1ST FLOOR sq.R. I ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER I W sq.ftis I -T�
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
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 SEWER❑ / NEW❑ EXISTING❑ FEB 19 2020
PLUMBING IN STRUCTURE? YES K NO❑ If yes, attach completed Water Adequ F Alder Street
PERMMTER/FOUNDATIONDRASPROPOSED? YES El EEXISTINGSQ FT.
IN
EXISTING BEDROOMS '� PROPOSED BEDROOMS , #. _ TOTAL BEDROOMS H/�'•
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 TINUATI N OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
R IT APP ATI F 180 DAY$ OF MORE WILL CAUSE THE APPLICATION TO E EXPIRED. (MASON
e'; COUNTY CODE 14.08.42)
X t� c_ , 0
nature of NER(Must be signed by the OWNER) D to
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE AGS/NOTES/CONDITIONS
BUILDING DEPARTMENT .
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
PLANNING i , z {i ryLl
fs
12��S1 - (�3�v S `� To I i_..2 f �,�'� i1��� � EXISTING
�� b ar °a 'V(� �l�
\;\ �\\\\CSCOPE
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SCOPE OF WO 2a a L SLRPICNIC�
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ONSTRUCT RESTROOM
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KOPE OF WORK T41-N0TE9 FOR PANN•-.ICWR '
_ - Or._ e•_p � I PICNIC AREA � e ARCHITECTS
1. NEW ASPHALTPAVING Z
1.1 BASE COURSE 6'OF 1-114•CRUSHED ROCK / / P L L C
CPACTED TO 75%
12 TOPCOOMURSE T OF W-(-)CRUSHED SURFACING PER
WDOT STANDARD SPECIFICATION 9-03.9(3) St- J
1.3 ASPHALT.'r LIFT OFHOT MIXED ASPHALT(HMA)PER - - CCESSMLE STALL - Z0 i,_1 =O b
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WSDOT STANDARD S,PECIFICATON 50{ a: - _ Taco1 ,Washington 98402
/ 60 Helens
1A IF THE EXISTING PAVEMENT IS TO BE USED h3 [g -_. _ 1
THE 3'LIFT PER NOTE 2.31S TO BE FLUSH WITH O Phonee::(253)922-d168
THE EXISTING PAVING
2. THE EXISTING PAVEMENT MAY REMAIN UPON EVALUATION
ANODETERMINATIONTHATIT ISSUITABLEASABASE FOR �I i - / / i Project Title
ANEWUFTONTOP OFITPIR NOTE 38ELOW. W. 's ++ _
2.1 CONiRACTORTOSUBMITTHEEVALUATIONFOR -. - -- '• - ^. - ++ -_ _ /SHORELINE STABILIZATION
REVIEW AND APPROVAL BY THE OWNER AND q� ) - -- -- _ r _� LAND MITIGATIONS / PORT OF
THEPRCHITECT / 6y •'�" b /REFERENCE#.NWS-2018-1611
3. EXISTINGPAVING °p �Q , 6 ' (SHADED AREA / w GRAPEVIEW
3.1 .PREPARE EXISTING PAVED SURFACES PER
WSDOTSTANDARDSPECIFICATK)N5.W.3(4) - b PICNIC AREA /
31 APPLYATACKCOATPER 'd' >: - N T - - / o PHASE 3 -SITE
WSDOT STANDARD SPECIFICATION 5.04.3(4) r'�
3.3 INSTALLAN ENGINEERED PAVING FABRIC - b EXISINfi O
(PETROMAT OR EQUAL)OVER THE ENTIRE ' a- CONCRETE DEVELOPMENT
EXISTING PAVING.EXTRA PAVING FABRIC MAY LAP - I - b \ / - BULKFEAD of
ONTO NEW ADJACENT R THE LIFT
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3.! INSTALL ATHMA LIFT OVER THE EXISTING AND - _ .. _ � � �1�Y1 U
NEW ASPHALT _— .• ��'�••\,�\�\ \
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SCOPE OF WORK 111
PARKING LOT AND SITE PRE Sheat Title
#. -- APPROXIMATE LOCATION OF
EXISTPUMP NG TANK rricAND TANK .. � SITE PLAN -
b PUMP TANK AND REMOVE
BACKFILL WITH COMPACTED FILL
I IN16-UFTS AT 95%COMPACTION
--` ► c CONSTRUCTION
EXISTING
STALLIH4GTH-TYP— a __r.-. HOUSE i
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- - =J Submit date: 2/19/2020 9:46:42 AM
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TRANSFORMER VAULT RECENTLY INSTALLED =
SANITARY SEWER VAULT ° -
SCOPE OF WORK [41 / - __ r �•' o
REPAVE GRISWOLD AVE =-;1 j{••
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U Tacoma,Washington 98402
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