HomeMy WebLinkAboutBLD2023-00556 - BLD CD Environmental Health Review - 5/17/2023Mi
o•P`NC. It MASON COUNTY COMMUNITY SERVICES Permit No: ri Ir1 c.E,I[-' ,
PERMIT ASSISTANCE CENTER:
. II �p •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL MAY 17 2023
p 615 W.Alder Street,Shelton,WA 98584
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Phone Shelton:(3 0)427-9670 ex 252•Fax:(350)427-7798 Phone
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h?tckJ'tit pa,��3y Be#eir.(360)275-4467•Phone Elms:(360)482-5269
615 W. Alder S t re of
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:WAYNE MANN NAME:COVAL HOMES
MAILING ADDRESS:7605 19TH LANE SE#101 MAILING ADDRESS:2023 125TH ST E. '411' M
CITY:LACEY STATE:WA ZIP:98503 CITY:TACOMA STATE:WA ZIP:98844 ' <--I!• Z
PHONE#1:3607636830 PHONE:360-662-1520 CELL: ( %.1
PHONE#2: EMAIL:CONSTRUCTION@COVALHOLMES.COM `/� Ore .
EMAIL:WDMANNnCOMCAST.NET L&I REG# EXP._/_/_ FQ
0
PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER 0 )> Z
NAME WAYNEMANN EMAIL WDMANN@COMCAST.NET
MAILING ADDRESS 7605 19TH LANE SE#101 CITY LACEY STATE WA ZIP98603 ..,,,�
PHONE '63- CELL 36oa63e83o T m
PARCEL INFORMATION: :i Z
PARCEL NUMBER(12 Digit Number) 12019-77-00050 ZONING Rural Residential RR5 D
LEGAL DESCRIPTION(Abbreviated)WWMNE1/4-1/4 or SE1/4Sos19 Township 20N Range 1W FIRE DISTRICTS r"-
SITE ADDRESS784 E POINT WILSON RD,SHELTON WA.98585 CITY SHELTON
DIRECTIONS TO SITE ADDRESS On the right hand side of Point Wilson Road SE then drive down joint easrnenL
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO 0 SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM[]
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)RESIDENTIAL SINGLE FAMILY HOME
IS USE: PRIMARY D SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(8730le Bldg)❑ YES(Parifs/oj8ldg)0 NO 0
DESCRIBE WORKNEW CONSTRUCTION 1626SF SINGLE LEVEL RESIDENTIAL HOME. GARAGE NOT HEATED
SQUARE FOOTAGE:(proposed)
1ST FLOOR 1662 sq.ft. 2ND FLOOR° sq.ft. 3RD FLOOR° sq.ft. BASEMENT° sq.ft,
DECK° sq.ft. COVERED DECK* Ilift sq.ft. STORAGE° sq.ft. OTHER sq.ft.
GARAGE506 sq.ft. Attached 0 Detached 0 CARPORT° sq.ft. Attached 0 Detached 0
MANUFAC RMATION: *4 COPIES OF THE FLOOR PLAN REQ D*
M MODEL YEAR LE
IDTH BEDROOMS BATHS SERIAL NUMBER
1 ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER 0 / NEW 0 EXISTING❑
PLUMBING IN STRUCTURE? YES 0 NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT.
0EXISTING BEDROOMS PROPOSED BEDROOMS THREE TOTAL BEDROOMS '5
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 pemrission 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.
j PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APP.L'ICA ION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
%�� COUNTY CODE 14.08.42)
X / 7 :'-'r°� /.c< c
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 (0 j 13 C�M'A.?;fi' .S ` U rce
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