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HomeMy WebLinkAboutBLD2023-01001 - BLD CD Environmental Health Review - 8/23/2023 DocuSign Envelope ID:44ADSABO-DE91-46F0-AE23-32A4B9AF372C .�7� / 1 MASON COUNTY Permit No:� ";"QIOO! COMMUNITY DEVELOPMENTRE Permit Assistance Center, Building,Planning AUG 2 3 2023 BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:DAVID&KARYLIN SHOEMAKER NAME:SOUTH SHORE CONSTRUCTION INC MAILING ADDRESS: 8393 E STATE ROUTE 3 MAILING ADDRESS:PO BOX 983 rn CITY:SHELTON STATE:WA ZIP:98564 CITY:BEL FAIR STATE:WA ZIP:98528 Z PHONE#1:1-541-844-4067 PHONE:380-801- 32 CELL: PHONE#2:1.541-499-4325 EMAIL:southshore©q.com T... EMAIL:karylin3©gmail.com L&I REG#SOUTHSC018NL EXP.02/10/24 = N PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER❑ ni Z NAME SOUTH SHORE CONSTRUCTION INC EMAIL soothshoreui q.com MAILING ADDRESS PO BOX 983 CI Y BELFAIR STATE WA ZIP 98528 PHONE 360-8014432 CELL _ rn PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 22129-24-50010 ZONING SEE NOTES-RR5 LEGAL DESCRIPTION(Abbreviated) LOT 1 OF LLS#06-06 S 15/56 S 32/232 FIRE DISTRICT 5 SITE ADDRESS 8393 E STATE ROUTE 3 CITY SHELTON DIRECTIONS TO SITE ADDRESS Head east on W Alder St toward N 6th St,at traffk:circle,take the 1st exit onto N 1st St.Turn left onto E • I /�1 U1(` Pine St.,continue onto WA-3 N,destination will be on the left in 6.6 miles rl U z 5 2023 IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD:25 psf RECEIVED IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER 0 LAKE❑ RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM❑ , TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR 0 OTHER ❑ USE OF STRUCTURE(Residence.Garage.Commercial Bldg.Etc.)RESIDENTIAL IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(Whole Bldg/0 YES(Part[s]of Bldg)0 NO 0 DESCRIBE WORK INSTALL MANUFACTURED HOME FOR RESIDENTIAL USE SOUARE FOOTAGE: (proposed) 1ST FLOOR 2006 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 KIT HOME BUILDERS MODEL PINEHURST 2506 YEAR 2023 LENGTH 68' WIDTH 29'6" BEDROOMS 3 BATHS 2 SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER 0 / NEW 0 EXISTING 0 PLUMBING IN STRUCTURE? YES 0 NO 0 If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT. EXISTING BEDROOMS 0 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 APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON . ..—Doc us/ian.d by: I COUNTY CODE 14.08.42) X PBM.IL S eC/15iue aYtt(iti. S(at_Atdt,r 8/17/2023 OraPur�wF�f. anature oOWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL � PUBLIC HEALTH 2- yI ClijA4t.3 C4i- I)' Ili' r\.) * STATE ROUTE 3 356.35' n.) 0 -0 0 73 :. •. ..--- - ------ • ..7-737-7-7. . ,-. . -. 7- a . . (A) > (0 > r- .-. .....„ .........___.--. . _ ....._ „--: wri 10 r\.) mc) ,,,, -I -,,,) 0, ,/•-• ,„,•,..,.." N . 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