HomeMy WebLinkAboutBLD2023-00074 - BLD CD Environmental Health Review - 12/28/2022 rtc�P,4ti4�� MASON COUNTY COMMUNITY SERVICES Permit No:TV" i ?� -lJGl1`�'-�
" PERMIT ASSISTANCE CENTER:
t1. •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
'i I• o 615 W.Alder Street,Shelton,WA 98584
1. f Phone Shelton:(360)427-9670 ext. 352•Fax:(360)427-7798 Phone 1 /
)'ti yv Belfair:(360)275-4467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION RECEIVED
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION.: 2 8 2022
NAME:Watermark Estate Management Services LLC NAME:Fairbank Construction Co.
MAILING ADDRESS: 10230 NE Points Dr,Ste 200 MAILING ADDRESS:220 Mad6D4beW. Alder Street
CITY:Kirkland STATE:WA ZIP:98033 CITY:Bainbridge Island STATE:WA ZIP:98110
PHONE#1:425.576.3393 PHONE:206.842.9217 CELL: 206.551.9679
PHONE#2: EMAIL :colin@tairbankconstruction.com
EMAIL: -)i rYIGALf- ),c1 Ct c"_h .Co rY' L&I REG#FAIRBCC183C2 EXP. 06/25/24
PRIMARY CONTACT: OWNER❑ CONTRACTOR ❑ OTHER 0
NAME MATTHEW MACH,OWNER REPRESENTATIVE EMAIL matthewm@watermark-Ilc.com
MAILING ADDRESS 10230 NE Points Dr,Suite 200 CITY Kirkland STATE WA ZIP 98033
PHONE 425.576.3393 CELL 847.848.6459
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32233-50-00902 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) SUNNY BEACH PCL 1 OF BLAa04-59 SURVEY 30/232-3 FIRE DISTRICT 6
SITE ADDRESS 6997 E STATE ROUTE 106 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%: YES0 NO ❑ SNOW LOAD:25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): on other side of highway
SALTWATER 0 LAKE 0 RIVER/CREEK ❑ POND 0 WETLAND ❑ SEASONAL RUNOFF 0 STREAM ❑
TYPE OF WORK: NEW❑ ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)Residence
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 4
HEATED STRUCTURE? YES (whole Bldg)0 YES(Part[s]of Bldg) ❑ NO 0
DESCRIBE WORK Additon of 917 Sf to an existing 2067 sf house.General renovation of all existing spaces.
SQUARE FOOTAGE: (proposed) .--&mcei r. ova, 3t 7 '20 lo'.l lOj
1ST FLOOR 200 sq. ft. 2ND FLOOR 717 sq. ft. 3RD FLOOR 0 sq. ft. BASEMENT 0 sq. ft.
DECK 0 sq.ft. COVERED DECK 0 sq. ft. STORAGE 0 sq. ft. OTHER sq. ft. court
cover
GARAGE 0 sq. ft. Attached❑ Detached❑ CARPORT 0 sq. ft. Attached 0 Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE NA MODEL YEAR LENGTH
WIDTH BEDROOMS BATI-IS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE:NA SEPTIC 0 SEWER 0 / NEW 0 EXISTING 0
PLUMBING IN STRUCTURE? YES 0 NO 0 If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ. FT. 1854
EXISTING BEDROOMS 2 PROPOSED BEDROOMS 0 TOTAL BEDROOMS 2
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)
x / 11/16/2022
Signature of OWNER (Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH OT3�I i' ( 4 c 4
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