HomeMy WebLinkAboutCOM2023-00040 - COM CD Environmental Health Review - 5/25/2023 M
*.,r c., MASON COUNTY COMMUNITY SERVICES 2 ^ • it E D
+/ '1 PERMIT ASSISTANCE CENTER:
3� Permit No: C,/ (� -
.BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street.Shelton,WA 98584
"' . , Phone Shelton:(360)427-9670 ext.352•Fax'(360)427-7798 Phone • MAY 17
2023
Belfair(360)2754467•Phone Elms:(360)482-5269
RV
BUILDING PERMIT APPLICATION 615 W. AId-r Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Bruce Brenner JJ Brenner OYSTER CO. NAME: Unknown at this time
MAILING ADDRESS: 402 SW 333 RD ST 106 MAILING ADDRESS:
CITY: Federal way STATE: Wa. ZIP: 'RMA CITY: STATE: ZIP: V
PHONE#I: 360-230-4943 PHONE: CELL: 13
PHONE#2 EMAIL: (1 m
EMAIL; Jjclam@AOLCom L&I REG# EXP._/ NI' rf
—PRIMARY CONTACT OWNER Contractor OTHER-X '
NAME Christopjr Guzek EMAIL Cengzek@mac.com 119
MAILING ADDRESS 125011 122nd ct ct F CITY Pmrallup STATE Wa ZIP 99272
PHONE (253)376-217B CELL (2)
> Z
PARCEL INFORMATION: m
PARCEL NUMBER(12 Digit Number) 31909-13-00010 ZONING Rural 5
LEGAL DESCRIPTION(Abbreviated) TR 1 of Govt.Lots 1-2+NW NE FIRE DISTRICT Fire district 4 2
SITE ADDRESS 130 SE Brenner Oyster RD CITY Shelton Z
DIRECTIONS TO SITE ADDRESS North Hvsye.101 to Lynch Rd. -Turn Right.Go East to SE Brenner Oyster Rd.Gate
locked, Please call 360 239-4943, go down long drive way,Shop on right 01,0
IS THE PROJECT WITHIN 300 F1'OF SLOPE(S)GREATER THAN 14%: YES® NO❑ r
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all thatoppl)9•
SALTWATER® LAKE 0 RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION 0 ALTERATION❑ REPAIR❑ OTHER ®Replace existing bldg.
USE OF STRUCTURE(Residency.Garage.C n onerrial Bldg.Ex) Buisness Machine Repair Shop
IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS__ NUMBER OF BATHROOMS 0
HEATED STRUCTURE? YES(Whole Brig)❑ YES(Part/s/o/Bldg)❑ NO
DESCRIBE WORK Storage and Tool and Repair Shoo
SQUARE FOOTAGE:(pro/row•ensting)
1ST FLOOR 4380 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
1 DECK sq.ft. COVERED DECK+432 sq.0. STORAGE 1980 sq.ft. OTHER -[6001 sq.ft.
GARAGE +1oBO sq.ft. Attached❑ Detached® CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE N/a MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: I
SEWAGE/SEWER SOURCE: SEPTIC® SEWER❑ / NEW❑ EXISTING ig
PLUMBING IN STRUCTURE? YES❑ NO lj If yes,altac),completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOM EXISTING SQ.FT. 600 so ft.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 0 TOTAL BEDROOMS 0
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Ad,nowledgement of such is by
signature below.I dedare 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 at 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 nut&void if work or authorized construction is not commenced within 180
days or 8 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
4 COUNTY CODE 14.08.42)
-1R
X Signat Iol`OWVil441'-
ust be s gned by the OWNER) Date July 10,2022
DEPARTMENTAL REVIEW' APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL t_ p� �,p
PUBLIC HEALTH IZ�--I I(z3 cAv O1�-
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