HomeMy WebLinkAboutBLD2022-01435 - BLD CD Environmental Health Review - 11/8/2022 e�s�'`'.1.7- �^ MASON COUNTY COMMUNITY SERVICES Permit No: _ i.41-�.�_-.1 V ` �j`�
PERMIT ASSISTANCE CENTER: I O C.LI Ir,) U
• / l •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
a •I I• 0 615 W.Alder Street,Shelton,WA 98584
\ ic
1. ' 7� Phone Shelton /(360)427-9670 ext 352•Fax (360)427-7798 Phone \\
25, yy Belfair(360)275-4467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION 615 W, Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Crystal&Stephen Mannila NAME:COVAL HOMES LLC
MAILING ADDRESS:Po BOX 1221 MAILING ADDRESS:2023 125th st E
CTTY:AIMn STATE:WA ZIP:98524 CITY:Tacoma STATE:WA ZIP:95
PHONE#1:380-620-1865 PHONE:800'6930352 CELL: 360-662-1520
PHONE#2:206-375.1386 EMAIL:construction@coval iomes.com m
EMAIL:etzwan@9mail.com L&I REG#COVALHL8940D EXP.11 /04/23 Z
PRIMARY CONTACT: OWNER El CONTRACTOR❑ OTHER❑ C
NAME c 'U.". EMAIL clzwan@gmail.com =
MAILING ADDRESS PO BOX 1221 CITY AIY" STATE WA ZIP98524 T 0
PHONE 3G0 le"65 CELL 360 a1w 25
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number)22114-14-50040 ZONING _ m
LEGAL DESCRIPTION(Abbreviated)Lot 4 of LLS#07-08 S 38/108 FIRE DISTRICT3 z
• SITE ADDRESS 120 E Wild Grape Way CI'IyGrapeview
DIRECTIONS TO SITE ADDRESS E Wild Grape Way crosses E Grapeview Loop Road just after the 1 mile marker D
r
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO❑+ SNOW LOAD:14 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM D
TYPE OF WORK: NEW❑+ ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,EN)Residence
IS USE: PRIMARY❑i SEASONAL 0 NUMBER OF BEDROOMS .3 NUMBER OF BATHROOMS 2 `S
HEATED STRUCTURE? YES(Whole Bldg) i❑ YES(Parr/s)ofBldg)0 NO 0
DESCRIBE WORK New Build of a Single Family Home
SQUARE FOOTAGE:(proposed)
1ST FLOOR2737 sq.ft. .2I4,D FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED n C!7(1'}, sq.ft. STORAGE sq.ft. OTHERS sq.ft.
GARAGE789 sq.ft. Attached 0 Detached 0 CARPORT sq.ft. Attached 0 Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKES MODEL YEAR LENGTH
Y}31. BEDROOMS BATHS --NUMBER------------
/ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER D / NEW D EXISTING❑
PLUMBING IN STRUCTURE? YES❑+ NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES NOD EXISTING SQ.FT.°
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
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
PE PUCATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
v COUNTY CODE 14.08.42)
X
Sig ature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
i FIRE MARSHAL
PUBLIC HEALTH Q/ -1-/ti `""Fl I;\0A,S k J-J.124
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