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BLD2023-00719 - BLD CD Environmental Health Review - 6/27/2023
rr No: �' 1G��7���1D��� MASON COUNTY �,�, • CEIVED lioCOMMUNITY DEVELOPME ► �ti?� Permit Assistance Center, Building,Planning RFCF� 1��� 2 6 2023 LF BUILDING PERMIT APPLICATION 61 . Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMA 'S N: rri NAME:Bob&Ellen Collins NAME:Bradley Louderback Construction,LLC MAILING ADDRESS:1231 NE Mcwilliams Rd,Apt E103 MAILING ADDRESS:PO BOX 608 . 584<- CITY:Bremerton STATE:WA ZIP:98311 CITY:Shelton STATE:WA ZIP:98 80 PHONE#1:425-457-1792 PHONE:360-426-1412 CELL: 360-7g9-2352 1:1 Z PHONE#2:425-273-5116 EMAIL :bradleylouderback@gmail.com rj EMAIL:bobellenc©gmail.com L&I REd#BRADLLC949M7 EXP. 7/ PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER 0 -Y NAME Bob&Ellen Collins EMAIL bobellencpgmail.com MAILING ADDRESS 1231 NE Mcwilliams Rd,Apt E103 CITY Bremerton STATE WA ZIP 98311 r PHONE 425-457-1792 CELL 425-273-5116 PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 22105-52-00037 ZONING RR5 LEGAL DESCRIPTION(Abbreviated) MASON LAKE ESTATES#3 TR 37 FIRE DISTRICT 5 SITE ADDRESS 2730 E MASON LAKE DR W CITY GRAPEVIEW DIRECTIONS TO SITE ADDRESS From Shelton,head NE on Hwy 3 through Bayshore.Approximately 1/2 mile past Bayshore,turn left on E Mason Lake Rd.Continue for six miles,then turn left on E Mason Lake Dr W.Continue for 2.5 miles and the site will be on the right(along the lake shore). IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO ❑ SNOW LOAD:25 psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND 0 WETLAND ❑ SEASONAL RUNOFF❑ STREAM ❑ TYPE OF WORK: NEW ❑ ADDITION 0 ALTERATION 0 REPAIR❑ OTHER 0 USE OF STRUCTURE (Residence,Garage,Commercial Bldg,Etc.)Residence IS USE: PRIMARY ❑ SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 3 HEATED STRUCTURE? YES(Whole Bldg) 0 YES(Parris)of Bldg) ❑ NO 0 DESCRIBE WORK New 2-story single-family residence with attached garage to replace existing cabin SQUARE FOOTAGE: (proposed) 12.1 • 1ST FLOOR 1,779 sq.ft. 2ND FLOOR 6' sq. ft. 3RD FLOOR N/A sq.ft. BASEMENT N/A sq.ft. DECK 411 sq. ft. COVERED DECK sq. ft. STORAGE`' sq.ft. OTHER sq. ft. GARAGE 869 sq.ft. Attached 0 Detached❑ CARPORT sq. ft. Attached❑ Detached 0 MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE YEAR LENGTH TH BEDROOMS BATHS ENVIRONMENTAL HEALTH: iwa & I5• SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWER❑ / NEW* W EXISTING' PLUMBING IN STRUCTURE? YES/Ec NO ❑ I yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES NO EXISTING SQ.FT. 576 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 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 AP LICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) x / /(1'/ Ki/A4 * 6 - a G —,2_02.3 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 Iiy g/.7IA Wl G0k.. .i „41.