Loading...
HomeMy WebLinkAboutBLD2022-01538 - BLD CD Environmental Health Review - 12/13/2022 ��.9t�'"''t-44. MASON COUNTY COMMUNITY SERVICES Permit No: S)? Z 22-0I.53 8 0. PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL •1 I. - 615 W.Alder Street,Shelton,WA 98584C. !! y Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone NC) („ r^ �iyt, �yy, Belfair:(360)275-4467•Phone Elma:(360)482-5269 1 X! I t J;y,_ — lQ).IrI:IY)t� /// l/ F.",: BUILDING PERMIT APPLICATION !- PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 615 �r(/ NAME:1-►cut, l�-:u l S.'�-ytn NAME: .' /e r c.. MAILING ADDRESS: Sf'L('Z 4-t3 S4-,C-+-,W MAILING ADDRESS: L:( 0et CITY:WI v.Plow STATE:t.tr'4 z>P:404C-7 CITY: STATE: ZIP: PHONE#1: 2,5 3 °Le Ei•-S(o� PHONE: CELL: PHONE#2: EMAIL: EMAIL:+i M r o i 5 km(, tal'Lo O.Cc re L&I REG# EXP. / /_ PRIMARY CONTACT: OWNERg CONTRACTOR 0 OTHER❑ NAME Sty s•`b over EMAIL MAILING ADDRESS CITY STATE Z 'j PHONE CELL fe l an I;,R� ' TAL I r- PARCEL INFORMATION: j PARCEL NUMBER(12 Digit Number) Z 0 ( 5 0 0 0 2 I ZONING 1 I 1 Z LEGAL DESCRIPTION(Abbreviated)I j0(bei-I0.kZ iv( Lei e 28 I FIRE DISTRICT SITE ADDRESS5I E Raccro^-on C:i- ci 5"Flei+oil DIRECTIONS TO SITE ADDRESS G4r1:{'41r ' .: t• eti,xl e,L� S L l ej k F c,A--v �C:�'sknrxe Or t �I,Q.,. -Fr- _ 2 l 4,_-4t et A � <•c is_ L..1— J IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14•/0: YES❑ NO f2c, SNOW LOAD: psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER 0 LAKE❑ RIVER/CREEK 0 POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg.Etc) Pte-S y 4-tE.0C:e. IS USE: PRIMARY SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 'L HEM CD STRUCTURE? YES(Who 1e Bidg)' AYES(Part[s]of Bldg)0 NO❑ DESCRIBE WORK NeA,./ ± e�-f r.�4-,.red 'ItbWC+e. SOUARE FOOTAGE:(propesed) 1ST FLOOR I'l.i b sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.R COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.fL Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED�A HOME INFORMATIION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE ) 7Jt e C '7 /MODEL "1 2-7 YEAR 'Lv ZZ LENGTH 4 WIDTH 27 BEDROOMS 3 BATHS 2. SERIAL NUMBERft E PO 3 3101 O RA13 ENVIRONMENTAL HEALTH: S LO 2-2. —tx)9(5 SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW' EXISTING 0 PLUMBING IN STRUCTURE? YES g NO❑ If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOD EXISTING SQ.FT. 12-5I(� EXISTING BEDROOMS 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 casement 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 APPLIC ON OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON 4 COUNTY CODE 14.08.42) X /i/(,k, t 'ww. /2-c= 7-2- 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 5b I t�l u,s U r 'fir =r m T C-1 33 01 IC)1) �0,r Cto—1DD v 158.85' 1—73 m �'�_ _ — _ Zc-KZ _. _._._._._._._. 1 , z A I I O 3- . • . I; T T.: ��J 8-g O ■ © m� O �a c' . / . 2.a [ill ® 1 7 �L s �- r © oo N....1- ( • S[ppE A 0 O p• C ,, M 1M+ S +:' s Am ,1m _ zm • Ca m II T 0x i c El(1) O r- d> a m c m d z D °z, � _ � (O � NZ Dv 3D � ov, Z A� § 33 I o 0 WTI 0 X N 0 m < (/) O Z m m Q C7 m XI co 0 o N —1 O r w vF, p co ; 0 E0 T OZ N () z m /m2 ceO © 00 DH. Fl W Q !1 G g ppr▪ �O�mm ,.im _'p,'I Im- ll ZZZ_ TY r A 5 y • y 'N p� > 0,r >'z z z 0 � Do-m� 8 n- ozo 1 !ii l zo Zir,< A m q� A Pm� Z Dm Z Iv > O« o« v >T ZCzm 27 & > Z� o At, ag2 �' 0 0 0 0 u s <AS^ zZoc w n i� G� 2i o1 of 1 ; m °, ��o mH:, mNs :mz Og A (� � 3 0 ° ;gym nn -ti3 ° ,- ,,33 C Dg-m Uy u• o I ° cp Z � o hI M S 7 A A U m Z P A m D - �G"m \! 0000ma sa z >S9 ao m p 0m O=; 1� � '. `�Y z o 6o7 P g 1 d -i° ° <nzz0 o ` m $m. > p m OO C7 mho" � �) p $ 3 iCl2 F 0 ~j m O O �m 0 0�Wyy07 CA�•• o 0 ; x = agm03-g ti 0 5aZ f1 g W 'om - AU2 061M4 .71 71 0 ‘,1),.... oa°,30`° m Z 0 �r a m N rm ZZ z�@ ��p N 55y,R�� g `•` ,1 N m NC + < rn. x Z W WAO I�CY C Z 2 2,:. ,, _`�'...\ I;; !P; 9 ,' e, 9� O ., ll A 0 /t 0 A ?.3 fA z cm> gl i P_ 4 N i g. . Wo N • . E .v.g.? W a.m w a.