HomeMy WebLinkAboutBLD2023-00426 - BLD CD Environmental Health Review - 4/20/2023 , ,1-‘:—'G.,9011.4A;;t MASON COUNTY COMMUNITY SERVICES Permit No: b 01.apa 3_ 0d a(Q PERMIT ASSISTANCE CENTER: V L-•�~t. •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i v -•- `. ,
•1 I•. 'o I 615 W.Alder Street Shelton,WA 98584 }�f C,a
Phone Shelton:360)2 5-4(360)427-9670 ext. 52•Far:360)4(360)427-7798 98 Phone
�,PR 2 G `t•
t.r �yv 8elfair.(360)275-4467•Phone Elma:(360)482-5269
ro•FulY3a 1 Alder S!reot
BUILDING PERMIT APPLICATION6.5
W
\: 20NNIENTAL
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION.
NAME:Jennifer and Douglas Hanson NAME:HiLine Homes H EA LT H
MAILING ADDRESS:w 140 Little Nahwatzel Dr MAILING ADDRESS:11306 62nd Ave E
CITY:Shelton STATE:WA ZIP:98584 CITY:Puyafup STATE:WA ZIP:98373
PHONE#1:206-406-6966 PHONE:253-8401849 CELL:
PHONE#2: EMAIL:Pre-construction@hilinehomes.com
EMAIL:Owute@msn.com L&I REG#HILINH•983BD EXP.11082023:
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER 0 JP'
i""sw8r."9" EMAIL jlnute@msn.com "0
MAILING ADDRESS W 140 Little Nahw 5 atzei Dr CITY '"" STATE WA ZIP981� rn �7 n
PHONE CELL 206-406-6966C') tv 11UU
PARCEL INFORMATION: < N
m
PARCEL NUMBER(12 Digit Number)220257900100 ZONING k. v w
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT '--k.
SITE ADDRESS 161E Merlot Ln CITY Shelton
DIRECTIONS TO SITE ADDRESS`"• "'^`•""'"""""`"^"'" .""""•""`."_"`-ww""`"•.r"r-."
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD:t' 'opsf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION 0 REPAIR 0 OTHER f
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Eu)Residence
IS USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS3 NUMBER OF BATHROOMS2
HEATED STRUCTURE? YES(Whole Bldg)El YES(Part/s]of Bldg)0 NO❑
DESCRIBE WORKne w build
SQUARE FOOTAGE:(proposed)
1ST FLOOR1793 sq.R 2ND FLOOR sq.ft. 3RD FLOOR sq.ft BASEMENT sq.ft.
DECK sq.ft. COVERED DECK138"i= sq.ft. STORAGE sq.ft OTHER S`( sq.ft.
GARAGE890 sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached 0 Detached 0
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 0
PLUMBING IN STRUCTURE? YES❑ NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT. =P-
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
OWNER acknowledges that submission of inaccurate information may result in a stop work circler or permit revocation.Acknowledgement of such Is by
signature below.I declare that l 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 180 DAYS OF MORE WILL CAUSE THE APPLICATION T BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X ao (FQa3
i lure o ER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT ,
PLANNING DEPARTMENT
FIRE MARSHAL
,•r ,, jJ ,,
PUBLIC HEALTH ' p 7 '. "
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