HomeMy WebLinkAboutBLD2023-00983 - BLD CD Environmental Health Review - 8/16/2023 `;: MASON COUNTY Permit No: 1:5Ln2-1 —00/03
COMMUNITY DEVELOPMENT
nn
h�/ C:%''� Permit Assistance Center, Building,Planning
BUILDING PERMIT APPLICATION 1 _Icier Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Henley 13 LLC NAME:Dave Young
MAILING ADDRESS:1537 NW Woodbine Way MAILING ADDRESS:
CITY:seethe STATE:WA ZIP:98177 CITY: STATE: ZIP: rn
PHONE#1: PHONE: CELL: 2
PHONE#2: EMAIL:
EMAIL: L&I REG#YOUNGD'854CF EXP,03/81/24
PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER 0 : O
NAME LmotteAriuiiw/E""9reanPertf°nngaConsulting EMAIL evergreonpermit@gmail.com Z
MAILING ADDRESS 1673 S.Market Blvd.#132 CITY cne^ai STATE WA ZIP98532
PHONE Aso sza+zs+ CELL r 2.
PARCEL INFORMATION: = m�r
PARCEL NUMBER(12 Digit Number) 32021-56-03021 ZONING 2
LEGAL DESCRIPTION(Abbreviated) Shorecrest Terrace 3rd Add Blk:3,Lot 21 FIRE DISTRICT D
SITE ADDRESS389 E Wood Ln CITY Shelton r
DIRECTIONS TO SITE ADDRESS WA-3 N,right on E Agate Rd,right on E Crestview Dr,left on E Cross Rd,right on E Wood Ln
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check on that apply):
SALTWATER❑ LAKE 0 RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence.Garage.Commercial Bldg,Etc.)Residence
IS USE: PRIMARY f SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(whole Bldg)0 YES(Part(s)of Bldg)❑ NO 0
DESCRIBE WORKNew 3 Bedroom Mfg Home
SQUARE FOOTAGE:(proposed)
1ST FLOOR1280 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached 0 Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE Imperial Homes MODELTempo YEAR2023 LENGTH48
WIDTH27 BEDROOMS3 BATHS2 SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW 0 EXISTING 0
PLUMBING IN STRUCTURE? YES D NO 0 If yes.attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO9 EXISTING SQ.FT.
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 CONTIN 3N OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT A PL ON 0 0 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x
—� 8/15/2023
Sign re of NER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL n n
PUBLIC HEALTH 6K I et K°I l/� f
§
i�
�
.___ -
)
$ k
\ ;\
§ CA/§
) \(
2
O£60
t §
•
&1\N & ?
\ / o
[ }
x / \} \ /\ \§\� a
\2293a 0 :
no,o2- \ \ \�
72t/t\ G '�
J ,
ƒƒ\/72 7 ' \ •
f!7 ® _
01Tasai,.Pc-.-52:o,ala\k i
_ 1a31Z30&
(\\ 2 - /CO(!
§ «aJI@m
¥\( c co = oca
§2 $)( q f R %
°/ \/( g # \ \ \ q- %
;}[ 0 0 E 0 \ _
~ \(/ 0 ° [ o \ \ /
} \_ ( m \ /# 9ft % ° $ O aTI_•
\ -I \}/ \-0 E \ @ H
m
° \ > .0c) % / \ \
m eCD Rgw 'I = e _ a
co O 3 I
\ O / 0 < ® ? c
B m ] » \ r n
\ - CD \ 0
\
\ § j 7 ! p /
!• ( { m ® x •
| , _ + }
! ! § § .. )-0 \) 0 Z
� \ § § ) -0l §7
\ 2 \ �� ƒ§\ (r En
z \\ )k\ )\ i C)
rn \\\ z1 13 . 2
0
} `k c91 zz> D
! 7 § /±
z Z
0 'M( )� 0
/ \k
0 / .
• 1
y
w 8
a
N
A A
1D'". il•YA_
f r"111-1-
L:-------Timi--- l'Im"..7,, , I
ii
'
r
=I ' k3
Le
e 9 m
eti l' «q
i I� C. ^ Pr`
m 1
"... i -q
\ Lg.j .. ... r--— W§
p
• 1 1
' .;:� ../' -to W
O I
i
:
1 S i i C 1f �F I
Ur•
F
LL & JIJi
t
11 P x. t
f
IT: T
F
g C f
z
E
s
t
4