HomeMy WebLinkAboutBLD2022-01526 - BLD CD Environmental Health Review - 12/8/2022 • �I1(1-b i. 2 b1(72 Le
e`w`" "' ��� MASON COUNTY COMMUNITY SERVICES Permit No: ��- w
PERMIT ASSISTANCE CENTER: I` , D
BUILDING••PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED
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r. `,o 615 W.Alder Street,Shelton,WA 98584 ' \
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-+ Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone v
y�. .. .y Beltair.(360)275 4467•Phone Elma:(360)482-5269 DEC 0 8 2022 \`h
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATIO§�5 W. Alder Street \
NAME:Gordon Lewis NAME:Town&Country Post Frame Buildings
MAILING ADDRESS:Po Box 3252 MAILING ADDRESS:'652'Highway 99.Suite C M
CITY:Shelton STATE:WA ZIP:98584 CITY:Lynnwood STATE:WA ZIP:B3037 z
PHONE#I:(360)463.1476 PHONE:425'13-'555 CELL: "M
PHONE#2: EMAIL:Pef"ndePutPer neD'a•C011
EMAIL:NIA L841 REG 4TOWNCPFO99LT EXP. 06302023 = 31
PRIMARY CONTACT: OWNER 0 CONTRACTOR Q OTHER❑ > Z
Country Town&Cotry loom Frame&�. ngs EMAIL oef"enleP "rn nec
MAILING ADDRESS 16521 Highway' a 99.Suite C CITY Lynnwood STATE wA ZIP 98037 ILI
PHONE '25443-'555 CELL NIA =
PARCEL INFORMATION: Z
PARCEL NUMBER(12 Digit Number)22031500004'J ZONING RR5
LEGAL DESCRIPTION(Abbreviated) TOTTEN SI4ORES TR 43&T.L.&INT IN TRS 57.58 FIRE DISTRICT —
SITE ADDRESS 401 SE Totten Shores Dr. CITY Shelton
DIRECTIONS TO SITE ADDRESS See attatched
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NO 0 SNOW LOAD:25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkout/to/Nip/0:
SALTWATER Q LAKE❑ RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence.Garage.Commercial Bldg.Etc.)Garage
IS USE: PRIMARY E SEASONAL 0 NUMBER OF BEDROOMS 0 NUMBER OF BATHROOMS°
HEATED STRUCTURE? YES(Whole Bldg)0 YES(I'arrls)ofBldg)❑ NO Q
DESCRIBE WORK 24.x 40'Pole Building,no heat or plumbing
SQUARE FOOTAGE: (proposed)
1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGES sq.ft. Attached 0 Detached Q CARPORT sq.ft. Attached 0 Detached 0
MANU E INFORMATION: *4 COPIES OF THE FLO
MAKE MODEL YEAR LENGTH
WIDTH BATHS SERIAL NUMB
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC Q SEWER❑ / NEW❑ EXISTING❑'
PLUMBING IN STRUCTURE? YES 0 NO Q If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOQ EXISTING SQ.FT.
EXISTING BEDROOMS 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 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 pernit/apprcation 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 WOR ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT PPLICATION OF 180 D S F MORE
WILL 4S 8.42)E APPLICATION TO BE EXPIRED.(MASON
COUNTYLODE
__12/1/4/.2.2....
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DEPARTMENTAL IEW • APPROVED DATE • DENIED , DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT Q�(;,,�
FIRE MARSHAL {, ���� �
PUBLIC HEALTH ff .7r L�
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TOTTEN SHORES TR 43&T.L.&INT IN TRS 57-58 Pamel#22031-50.00043
ABBREVIATED DF.SC:RIPTICNdS. &
TOTTEN SHORES TR 44&T.L.&INT IN TRS 57-58 Parcel#22031-50-00044
r' �at7L Gordon J.Lewis s A`."'-
M.Halverson Design LLC PO Box 3252 401 SE TOTTEN SHORES DR 7
•
PO Box 1519 Shelton Wa 98584 St ;ucxn.Wa 985e.: SHELTON,WA 98584 ,,,,E
Halversondesianllcaoutlook.com