HomeMy WebLinkAboutBLD2017-00368 Garage - BLD Application - 5/1/2017 �9oN c;v�A MASON COUNTY COMMUNITY SERVICES '7n D
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PERMIT ASSISTANCE CENTER: Per No: ���zo� 7_� 06
•BUILDING •PLANNING ,FIRE MARSHAL �95C- RECEIVED
615 W. Alder St - Shelton, WA 98584 -a VE�
6(v
, Phone Shelton:(360)427-9670 ext.352 • Fax:(360)427-7798 Phone
lti.f,t Belfair:(360)275-4467• Phone Elma:(360)482-5269 MAY 0 12017
BUILDING BUILDING PERMIT APPLICATION 615 W.Ald w g
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: V f l ,`�, /� "C NAME: b yoor Hano
MAILIT4/ AD RItSS: ,57/Z ��t 1 r /l �c ei ��. MAILING ADDRE S: 2-13 LCr?<
CITY: rCZl�I dy1 ' STATE: 'C ZIP:6U CITY: 'r fi"a lli STATE: ly/f ZIP: '
PHONE#1:_v%ft PHONE: ,�) -A1, -l�`lc CELL:, ( '�I-G' r
PHONE#2:�'C!r- J&3-/.5le- J'fk EMAIL : ll( f, h' S ('all
EMAIL:�i //OZ'l�f 7��2C'/, G/IJ L&I REG# �=X-'I�C'hOE,FAGS" EXP, 1;7 l 77
CONTACT PERSON : OWNER ❑ CONTRACTOR 01' OTHER❑
NAME: MAILING ADDRESS:
CITY: STATE: ZIP: PHONE: CELL:
EMAIL:
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) ���I-5�i y ZONING ���
LEGAL DESCRIPTION(Ab Ieviated) lt'f ►; /L` Z01 4/ FIRE DISTRICT
SITE ADDRESS kC CITY
DIRE/�'"CTII�O/NS TO SITEA,tDDR/ESS / e'1 /`/C�'c L3 " C� � �e.,1�/�i1�' ef-1- 'I'!
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO ❑
IS PROPERTY WITHIN 200 FT: (Check all that apply):
SALTWATER 0' LAKE❑ RIVER/CREEK❑ POND❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑
TYPE OF WORK: NEW ADDITION ❑ AJRAITONE]
REPAlt❑ OTHER ❑USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) �� J
IS USE: PRIMARY 0'SEASONAL❑ NUMBER OF BEDROOMS ? ER OF BATHROOMS
HEATED STRUCTURE? YES(Whole Bldg) [ YES(Part[s]of BIdK) NO ❑
DESCRIBE WORK G J ' tr I M
(Valuation/ roject Bid Amount:$ P y
SOUARE FOOTAGE:
1ST FLOOR sq. ft. 2ND FLOOR sq.ft. 3RD FLOOR sq. ft. BASEMENT sq. ft.
-uuwDECK sq. ft. COVERED DECK q. ft. STORAGE sq. ft. OTHER sq. ft.
GARAGE �.) > sq. Attache CARPORT sq. ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL - YEAR LENGTH
WIDTH BEDROOMS THS ER
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)
�rignpfufj OWNER(Must be signed by the OWNER) Date
DEPARTME AL REVIEW APPROVED DATE DENIED DATE I TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT / -L 7-t
PLANNING DEPARTMENT
FIRE MARSHAL
PERMIT SPECIALISTS Int lApproved&Ready for Pick UP:
5M See 17W2017-003 6
Visit us on-line: http://www.co.mason.wa.us/community_dev/ Rev. 112 712016 by JBN
0r*9;tjQ1 pins 4&04: L D 2,017- 003(o 7
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RECEIVED Tot PLANNING k� 6LP _
MAY 0
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615 W.Alder Street J ' zo Qc
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APPROV D AL x `�
MASON C0U JTY v U PLANNING
J�Q eeL 5-t$-2017 SITE PLAN REQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL 7 ~
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Nt"CIN C at o�o�L By gidta A4i&r — Date. 3�5-� > p� 7, 1
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RECEIVED, 1 REC IVED S (� (ah �OR2t7�7-00�`�'2
MAY 15 2017 DATE
'1
615 W. Alder street = PLANNING: 3
ALL SETBACKS ARE MEASURED
FROM THE FURTHEST
PROJECTION OF THE BUILDING