HomeMy WebLinkAboutBLD2023-00290 - BLD CD Environmental Health Review - 3/13/2023 m.
''. �td2b23 —Cri290
~ MASON COUNTY COMMUNITY SERVICES Permit No:
• �. PERMIT ASSISTANCE CENTER: RECEIVED
l=� . ',YZ •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
;1 1. •Q 615 W.Alder Street.Shelton,WA 98584
,r Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
om �,i Beltair:(360)275-4467•Phone Elma:(360)482-5269 MAR 13 2023
BUILDING PERMIT APPLICATION
615 W. Alder St et
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 5-
� � [[[��,��+000���111111
NAME:Kevin Rogers&Amy Asbury NAME:Dougherty Custom Homes C�
MAILING ADDRESS:16921 E State Route 106 MAILING ADDRESS:•P.O.Box 279 m "`CC]]]V�l�ll
CITY:Beltair STATE:WA ZIP:98528 CITY:Silverdale STATE:WA ZIP:98383 L
PHONE#1:425-765-4954 PHONE:380-479-5670 CELL: 360-633-6578 m
PHONE#2:425-765-8210 EMAIL:Boyce@DoughertyCustomHomes.corn (.....-)
EMAIL Huskycoug@gmail.com L&I REG#497,139-02 EXP. CurrerYt m
PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑ C
NAME Kevin Rogers EMAIL Huskycoug@gmail.com
MAILING ADDRESS 16921 E State Route 106 CITY Betair STATE Wa zip 98528 T .T
PHONE CELL a25 tssa9sa �J.. .JV
m 0.
....4-
INFORMATION: D Z
PARCEL NUMBER(12 Digit Number) 22211-50-00015 ZONING 5 r T'1
LEGAL DESCRIPTION(Abbreviated) Sunset Beach#1 TR 9&TL S 48/91 FIRE DISTRICT MCRFA � m
SITE ADDRESS 16921 E State Route 106 CITY Beltair •i Z
DIRECTIONS TO SITE ADDRESS 1,000 feet SW of Sunset Beach Grocery(yellow mailbox on water side) 'd
D
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD:25 psf r
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER El LAKE❑ RIVER/CREEK 0 POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW p ADDITION 0 ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)Residence
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 3
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part's)gfBldg)❑ NO❑
DESCRIBE WORK Replacing old cabin with new residence
SQUARE FOOTAGE:(proposed)
1ST FLOOR 1,099 sq.ft. 2ND FLOOR 469 sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK 154 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached 0 CARPORT sq.ft. Attached 0 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 0 SEWER❑ / NEW 0 EXISTING❑
PLUMBING IN STRUCTURE? YES 0 NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS 1 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-0 WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 1 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
/ COUNTY CODE 14.08.42)
`X 3/7/23
Si ature o R "be iq the OW ) Date
DEPARTMENTAL REVIEW ,.....:;)APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL � �`��' Z1 PUBLIC HEALTH ��„_ I �I\17\7,5 c-((I'�\\1 W,.� L
6,
o
Nx A
4~ N �� ..E _ Ht IN•mh'yCr! vo Cr7
.IP A➢
IR,. ` _ _ '4 ? i n C a vs cam♦
3 0 aS F 2 g A n
u G
_ C _ = ri g = � g � O � ��y
1 _ - i§ .o „ v N g• y Icy
`t H r n ONO a
i
/3 CQ
r�rYY < «z�» it
a_dao it ,¢gib °° 116 s N
3-Sgg C a Fg B WCP = m i0w�ma
,P} I }� Eg g - d = .z$o
w' l' ,x 6 n g '� p3 D nm o m
O b'�''�'B a 5 d E .;€ X S t0,s. n a m
r I pp tltla = � O d s , N a
pr E _ 4 , !• A. 1 aFOO2-3
xx m m m
Ai wa f. e sE .v ._.='°v_i
o0,°im`2z
v a." = E " O• w 2 3 p,m m
vm �y2 _
J • A u,C.
p N 8 lD N Y/
.ND N ..-2 C.
`. 7 Q w♦
m o 3 9- n
mA F-'o
(A a 8 3 N
a Ogg
TRUE n - N
N a�i I .Z.
cD c
i
a ) " °m m
z o 0
4 O' N
: n •
`,
D ♦ \
,,, _ -sa \-`'~-
i \
m m g* , , \ \\j` n
4 4/. •-- \'-' ) '' , p .i
.. —. 51 ".' g :.,),;,.."%fli,"?-- '' - i % §:A C:;'''.
\\
\\ \ _ \\
�o Vlias
\ \\ `ram �y1, \\\%
,e `\ a \ �� •
¢ 5 g ss
o V` / •
•
•
t O H
W 2 • --Zs,-
•
I \�
N
p 4
N ♦ (O
W
c.rt r•.x
ICEVIN ROGERS ..:a, ,.e..-...t.rtNe,
> I NEW S.F.R.
__, F. 16921E State Route 106
Belfair WA 98528 0; 1 �"^