HomeMy WebLinkAboutBLD2023-00771 - BLD CD Environmental Health Review - 6/6/2023 `e,�c•rtttti MASON COUNTYCOMMUNTTYSERVICES ,.- Permit No:
,CI:
ms= .�, ��a3 06771
0.4 \c\ PERMIT ASSISTANCE CENTER:
if 1 -BUILDING-PLANNING.PUBUJC HEALTH.FIRE MARSHAL
;I; 615 W.Alder Street,Shelton,WA98584
Phone Shellon 360 427-9670 ext 352•Far 60 427-7798 Phone 6 2023
�\.} BBelfair.(360)275-4467-PhoneElma:(360)482-5269
;�1er Street
BUILDING PERMIT APPLICATION cc `, t MENTAL
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATIONL
, N VIR
O
NAME:James Goldstein NAME:Coval Homes LLC HEALTH
MAILING ADDRESS'840 RETSIL RD E MAILING ADDRESS:2023125th St E •
CffY Port Orchard STATE:WA ZIP:98366 CTPY:Tacoma STATE:WA ZIP:98445
PHONE#1:720.621.1181 PHONE:251693.4446 CELL:
PHONE#2: EMAIL:Brett@covalhomes.com
i( EMAIL:jamesgoldsteinT7@yaahoo.com T•,4rT REG#COVALHL894QD EXp.11/D4/23
PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER 0
NAME Tia3 EMAIL ua@fasttrackc.com
MAILING ADDRESS PO Box 1563 CITY H __ STATE WA ZIP98335
PHONE 390,93°2717 CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number)5190850-00033 ZONING lnholding Lands
LEGAL DESCRIPTION(Abbreviated)STAR LAKE#1 LOT:33 S 51/9 FIRE DISTRICT13
SITE ADDRESS421 W Satsop Dr. CTTYEIma
DIRECTIONS TO SITE ADDRESS Turn Left to enter the Stadake Community at the first entrance.Turn left onto Satsop Dr.Continue
on Satsop Dr unlit the road comes to a dead end.
IS TEE PROJECT WITHIN 300 FT OF SLOPE(S)-GREATER THAN 14%: YES NO❑ SNOW LOAD:25 psf
IS PROPERTY WITHIN 200 BT OF THE FOLLOWING: (Cheek all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR❑ OTHER El
USE OF STRUCTURE(Residence.Garage,Commercial Bldg.Erc)Residence
IS USE: PRIMARY 0 SEASONAL]] NUMBEROF BEDROOMS3 NUMBER OF BATHROOMS 25
HEAl EL)STRUCTURE? YES(Whet eBldg)0 YES(Perils]of Bldg)9 NO❑
DESCRIBE WORKProposing to build a 1,202 SF Single Family Residence
SQUARE FOOTAGE:(proposed)
1ST FLOOR 4°�5 sq.ft 2ND FLOOR /OS sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft
DECK 250,sq.R COVERED DECK sq.ft. STORAGE sq.ft OTHER sq.R
GARAGE 25 6 sq.ft.Attached 0 Detached❑ CARPORT sq.ft Attached❑ 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❑ I NEW 0 EXISTI 1_El 7
PLUMBING IN STRUCTURE? YES 0 NO❑ IJ attaompleted WaterAd�equacyForm
PERIMETER/FOUNDATION DRAINS PROPOSED? YES(}',, / N9'�-�/ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 3 � TOTAL BEDROOMS 3
OWNER acknowledges that submission of inaccurate information may result in a stop wo order or permit revocation.Acknowledgement of such is by
signature below.1 declare that I am the owner and 1 further declare that Yam entitled t ceve this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,Including any easement hotderer 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 commeiced 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 OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x 'a.>rzj Joldjeein. 02 / 01 /2023
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL RE VIEW APPROVED DATE L DENIED_I DATFi •TAGS/NOTES/CONDTTIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL OP �i j ,��
PUBLIC•HEALTH • •I�111073 VNIS a
Doc ID:7940dd8bbe01b98e2f4863d30143cb23a0745066
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Y a Y I I n ' a PROJECT ADDRESS STRUCTURAL ENGINEER a i =n
O T. m ' GOLDSTEINELMARESIDENCE ff O 71 g�ii oo
421 W Satsop Dr.
g A EIma,Wa98541 BEYLER CONSULTING l e sgx' n�
R '' (D ' Mason County 5920 100T1 SI SW•25 H S 6 a �, n
4 b o y 1 51908 50 00033 L 964-22900 99 4 g 3 "r
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m Elma.Wa 98541 BEYLER CONSULTING i 8 i i i s I n'y
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ENVIRONMENTAL
HEALTH DaiR Z.
MASON COUNTY
4�e°n r "TA COMMUNITY SERVICES DEPARTMENT SUN - 6 2023
'' BUILDING•PLANNING• FIRE MARSHAL
615 W. Alder Street
Mason County Bldg.8,615 W.Alder St
c, Shelton,WA 98584 www.co.mason.wa.us 360-427-9670 ext 352
Permit#: PA,./0 G d
0771
Property Owner's Authorization Letter
I (we): James Goldstein
(Print Property Owners Name/Firm/Organization)
Hereby Authorize: Tia Schwarz
(Applicant-Name of Person to Sign Permit)
Representative of: Fast Track Permit Services
(Applicant Company Name/Organization)
To apply for, sign, and pick-up building permits for the following proposed work:
1,202sf Single Family Residence and Retaining Wall
(Brief Description of Work to be Done)
Job Location: 421 Satsop Dr.Elma,Wa 98541 -Parcels: 51908-50-00033, 51908-50-00034, 51908-50-00050
(Property Site Address)
As property owner(s),I(we)hereby grant permission to the applicant referenced above to apply for,sign,and pick-
up the building permit for the work as indicated above.All work performed must meet all provisions of the
Building Codes and the Laws of Mason County and the State of Washington,as applicable,whether specified or
not.Residential Contractors are required to have a current State of Washington Contractors License (RCW 18.27).
'a�Zt.3 5U01066-1ic 01 / 13 /2023
(Property Owner Signature) ("Date)
Rev.03/10/2016 jlbn
Doc ID:70da4e901 b42687bf7d3154f0120dae530f2025c