HomeMy WebLinkAboutbld2023-01320 - BLD CD Environmental Health Review - 11/28/2023 MASON COUNTY COMMUNITY SERVICES Permit{N��; / ign o;2 AI� i�2
' I �PERMIT ASSISTANCE CENTER: R E C E I V C DTI^v
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL A
615 W.Alder Street,Shelton,WA 98584 `
Phone Station (360)427-9670 ext.352"Fax:(360)427-7798 Phone NOV - 1 2023 L I �
Bei(3601 Phone Elma:(360)482-5269
615 W. Alder Street -J� 1 B1p13
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 2 2
NAME_Christopher M.Cadet,Trustee NAME:Falrleak Construction Co.
MAILING ADDRESS:102M NE Pains Dr,Set 200 MAILING ADDRESS:220 Medison Ave s r
CITY:Kirkland STATE:AAA ZIP:98033 CITY:Bainbridge Island STATE:WA ZIP:M110
PHONE#1:".370.8314 PHONE:209.842.9217 CELL: tat6551.9679
PHONE#2: EMAIL :colluglielrbankmne volan. n
EMAIL: L&I REG#FAIRBCC183C2 Egp, 06/ 6/24
PRIMARY CONTACT: OWNER❑ CONTRACTOR[] OTHER❑+
NAME BILL HUGHES,OWNER REPRESENTAME EMAIL v-ulln�,alerman-nc<,m
MAILING ADDRESS 10230 NE Polak Dr,Ste 200 CITY Kirdi STATE WA ZIP OW33
PHONE CELL -1.s21 torn
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32233-5MG009 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) sUNW ePACH Patp SAar-sa W iiurar 761a12a.suavEvss " FIREDISTRICT6
SITE ADDRESS 12 E Beech Dr CITY union
DIRECTIONS TO SITE ADDRESS Travel East from Union on Highway 106,property on left lust before Alderbmok Resod
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES❑+ NO❑ SNOW LOAD:25 pst'
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: H7hsokoll thot a*yI:
SALTWATER❑ LAKE❑ RIVER/CREEK❑+ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑+ Dedriou Interiorremodel
USE OF STRUCTURE rR.idw,,,,Garage,Carnnie,Hal Bldg,Etc)"Bern"GamW(Residential Accessory)
IS USE: PRIMARY❑ SEASONAL❑+ NUMBER OF BEDROOMS_ NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YES(If7b rs BidA)Q YES(Pour[,/ojBidg)❑ NO❑
DESCRIBE WORK Finish Interior dexisting building,including relocation of electrical wiring and con iersbn of unconditioned to conditioned apace
SOUARE FOOTAGE:
1ST FLOOR 1832 sq.ft. 2ND FLOOR fi14 sq.ft 3RD FLOOR WA sq.ft. BASEMENT NIA sq.ft
DECK sq.ft. COVEREDDECKO sq.ft. STORAGEO sq.ft. OTHERO sq.ft.
GARAGE 0 sq.ft. Attached❑ Detached❑ CARPORT 0 sq.& Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAG&SEWER SOURCE: SEPTIC❑+ SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES Q NO❑ Ifyes, attach completed Water Adequacy Fomt
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO❑+ EXISTING SQ.Fr.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS O TOTAL BEDROOMS 0
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowfedgement of such is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive thus permit and to do the work as proposed.I have
obteined 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 grams employees of Mason County access to the above described property
and shucture(s)for mview and inspection. This perm thapplioation becomes null 8 van f work or authoraed 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 150 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
COUNTY CODE 14.08.42)
William T. Hughes Digitally signed bywlreenT.Hughes 10-26-2023
X g Date,2023.10.261201-N-00'
Signature of OWNER(Must be stand by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL ^ �
PUBLIC HEALTH 7 ((SI23
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ARCHITECTS