HomeMy WebLinkAboutBLD2023-00858 - BLD CD Environmental Health Review - 7/25/2023 4
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e,,s" '4:t MASON COUNTY COMMUNITY SERVICES Permit No:
,i PERMIT ASSISTANCE CENTER: C C C I\ /
t BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARS C G V
•1�' 0 615 W.Alder Street,Shelton,WA 98584
y`f I Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phony L 2 5 2023 ENVIRONMENTAL
v Belfair(360)275 4467•Phone Elma:(360)482-5269
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BUILDING PERMIT AP,P� CffIder Street HEALTH
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:AB Fine Homes NAME:AB Fine Homes rit
MAILING ADDRESS:871 E Beach Dr MAILING ADDRESS:871 E Beach Dr
CITY:Union STATE:WA ZIP:98592 CITY:Union STATE:WA ZIP:98592 2 ? .143
PHONE#1:360-898-0055 ext 3 PHONE:360-898-0055 ext 3 CELL: J U
PHONE#2: EMAIL:amanda@alderbrookproperties.com c
EMAIL:amanda@aIderbrookproperties.com L&I REG#ABFINFH809OB EXP. 1 1/1 •• 4 CEIVED
PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER❑
NAME Amanda Montgomery EMAIL amandagalderbrookproperties corn
MAILING ADDRESS 871 E Beach Dr CITY Union STATE WA Zip 98592
PHONE 360-898-0055 CELL 215-450-5184
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32104-52-00121 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) raocaeao°K06Y/2LOT l2 020'20 00020000UJ@.00000 URVEYteewoo FIRE DISTRICT 6
SITE ADDRESS 30 E Vine Maple Ct CITY Union
DIRECTIONS TO SITE ADDRESS Right on to Manzanita,right at Jack Pine Ln,left on Vine Maple Ln
and left onto Vine Maple Ct.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NO 0
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
7r, USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Fic.)
Residential
It).. IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 3
HEATED STRUCTURE? YES(Whole Bldg)Q YES(Pan/s]of Bldg)❑ NO❑
DESCRIBE WORK New single family residence
SOUARE FOOTAGE: (propose+existing)
1ST FLOOR 1,$$$ sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK 338 sq.ft. COVERED DECKS" sq.ft STORAGE sq.ft. OTHER sq.ft.
GARAGE 576 sq.ft. Attached in 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[ SEWER❑ / NEW N EXISTING❑
PLUMBING IN STRUCTURE? YES® NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
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 APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x k,0At v7__,, 71 -,-::5 I q
Signature of OWNER(Must-be. i 0 by the OWNER) Date `
DEPARTMENTAL REVIEW 'PPRF VED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH K7 9t 7,,, CO?ny&,S 6 JS-4
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