HomeMy WebLinkAboutBLD2022-00850 Decks - BLD Application - 7/5/2022 0 MASON COUNTY COMMUNITY SERVICES Permit No:1-9u �M"--00850
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL I D
615 W.Alder Street,Shelton,WA 98584 RECE
Phone Shelton:(360)427-9670 exL 352•Fatc(360)427-7798 Phone ,U L — 5 �f`02�
Be1Fair(360)2754467•Phone Elmer(360)482-5269
BUILDING PERMIT APPLICATION I +
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
o l
NAME (( l /i G 1 R / 3�IAME:
MAIL G,ADDRFSS;Z ®' A
CITY: 1Y� �7rC1', STATE: IA. � CITY: STATE: ZIP: 'tl
PHONE#I: 7 n � PHONE: CELL:
PHONE#2: _2 n EMAIL:
EMAIL: L&I REG# EXP. / /
PRIMARY,CONTACT: OWNER CONTRACTOR[] OTHER❑
NAME EMAIL
MAILING, , S ) �'' c', G'. C i.ISX !STATE �`�7 ZIP i;
PHONE �C- ' ! St v CELL
PARCEL INFORMATION: 56 'fj 6 1`f 7
V
e PARCEL NUMBER(12 Digit Number) ZONING
LEGAL DESCRIPTION(Abb 'ated)h C (, <J/ ]� j( FIREDIS Cr
SITE ADDRESS , r- n c P )
ONS TO SITE DRESS r / T r't k {I
^ l
IS THE PROJECT WITMN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cl-kauthw pply):
SALTWATER❑ LASE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ AL TION[] REPAIR❑ O ❑
USE OF STRUCTURE(R=dem Garags Commerdnl Bldg,Etc)
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(wkokBldg)Q YES(wdr Bldg)❑ NO❑
DESCRIBE WORK W LL L- be— C'
1� SOUARE FOOTAGE:(props 4
1ST FLOOOR� sq fL 2ND FLOOR sq,fL 3RD FLOOR sq.fL BASEMENT sq.fL
N aGYEL
tJ sq.ft. COVERED DECK sq.fL STORAGE sq.ft. OTHER sq.ft.
sq.fL Attached❑ Detached❑ CARPORT sq.ft.Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIIIED*
MODEL YEAR LENGTH
TH BEDROOMS BATHS
ENVIRONMENTAL HEALTH•
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ifyes,attach completed Water Adequacy Form
PERIIvIETER/FOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
`- 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 .
c> obtained permission from all the necessary parties,Including any easement holder or parties of interest regarding this project The owner or legal
vim_] representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and struclure(s)for review and inspection.This permitlappfication 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. INACTIVRY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.011.42)
Signature of OWNER Must a svthe OWNER) Date
?�EPARTMEIVTAL_RENTER'_;=-R APPROVED::- I)AT _'=1)l�HIED_.%DATE77 r=TAGS/NOTES/CONDITIONS�:
BUILDING DEPARTMENT j �- -
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
I Lo
Jaw
77n7 9 - I n f
RECEIVED
SCALE: 1"s30 FEET / v l [z
0 15 so 60 J� ,� ' Ss 615 Alder
BASIS O4 BEARING / Q
Volume 8 of Plats, Page 84, /
Records of Mason County
Washington
C"'�
, 87
44
REBAR
/Ci 1j 5'BUILDING
SETBACK
810'WOE DRIVE 1
/ \� \� CURVE
bI' R
DELTA RADI
/ \\ \ ; ;, 2�$ 1'19'57' 1000.
_ _ \ i� 54'4 ' 43.CR=30' 74'23'01' 457 1'- 15.0 5T05'4t' IS.(
8126'30' 45.0
p
\
\ 40
�9
LEGEND \
FOUND 3 1 4 BRASS CAP \
SURFACE MONUMENT \