HomeMy WebLinkAboutCOM2018-00009 - COM Application - 3/17/2018 i
MASON COUNTY COMMUNITY SERVICES �lf
a° PERMIT ASSISTANCE CENTER; Permit No:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
1 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
Be/fair.(360)275-4467•Phone Elma:(360)462-5269
BUILDING PERMIT APPLICA �ON
PROPERTY OWNER INFORMATION: CONTRACTO INFORMATION:
NAME: Mason County NAME: TBD
MAILING ADDRESS: 100 W.Public Works Drive MAILING ADD SS:
CITY: Shelton STATE: WA ZIP:gS5R4 CITY: STATE: ZIP:
PHONE#I: 360AD-9670 x652 PHONE: CELL-.—
PHONE#2: EMAIL:
EMAIL: bstepp@co.mason.wa.us L&I REG# EXP.
PRIMARY CONTACT: OWNER® CONTRACTOR❑ OTHER❑
NAME Bart Stepp Deputy Director EMAIL bstebp@)co.mason.wa.us
MAILINGADDRESS 100 W.Public Works Drive CITY Shelton STATE WA ZIP
PHONE 360-427-9670x652 CELL 360 490-0396
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 4 ZONING Rural Res-20 Acres
LEGAL DESCRIPTION(Abbreviated) T 20N.R 4 W n FIRE DISTRICT 16
SITE ADDRESS 501 W Eells Hill Road CITY Shelton
DIRECTIONS TO SITE ADDRESS Take US 101 to Hwy 102 and eo west. Turn north on Eells Hill Road and go
1 4 mile and site will be on your left.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: Y SQ NO❑
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❑ ADDITION❑ ALTERATION[R REP MR® OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) County transfer stat ion building and access roads.
IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Part[,]of Bldg)❑ NO
DESCRIBE WORK Install waste chute,re-pave tipping floor and roads,imt
ve drainage system,exterior stairs.
SQUARE FOOTAGE:(propose+existing)Transfer station building is not en osed,it is essentially a large carport.
Project does not increase building
ize.
I ST FLOOR 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❑ Detached❑ CARPORT 5,625 sq.ft. Attached❑ Detached[�
MANUFACTURED HOME INFORMATION: *4 COPIES F THE FLOOR PLAN REQLT14D*
MAKE MODEL YEAR —LENGTH—
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC® SEWER❑ / NEW EXISTING
PLUMBING IN STRUCTURE? YES❑ NO® Ifyes,attach co pleted Water Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NOR ] EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 0 TOTAL BEDROOMS 0
OWNER acknowledges that submission of inaccurate information may result in a stop work order orgermit revocation.Acknowledgement of su is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this ¢nmit and to do the work as proposed.I he
obtained permission from all the necessary parties,including any easement holder or parties of inte st regarding this project.The owner or le;
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'rf 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 O INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MAS41N
COUNTY CODE 14.08.42)
X _ S{ � 12/21/17
Signature of OWNER Must be signed by he NER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT =�
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH