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Home My WebLink AboutBLD2021-01012 Foundation - BLD Application - 6/30/2021 MASON COUNTY COMMUNITY SERVICES Permit No� PERNITASSISTANCE CENTER: •BU:LOt/YG.p(AA!NLVG,FrlBLIC NEALTN•FIRE MARSHAL R �D 615 W.Alder Semi,Shelton,WA 98564 Phone Sh&*On(360)427.9670 o°t 352•Fax(360J427A798 Pfmne Betfar(350)275-0487.phone Etehs.(360)482-5269 J U N,i V 421 BUILDING PERMIT APPLICATION 2021 PROPERTY OWNER INFORIIIATION: CONTRACTOR INFORMATION � ) pp,lder Street NAtiIL" Brad°Q Lace),Muyskcns W. Alder Street MAILING ADllR1abS:18931 E.Ste Rle 106 NAME:RGR Foundation Specialist CITY:Bclfair MAILING ADDRESS:3d09 McDou nil Ave STE q 204 S—TAT ZIP:98528 CITY:Everett STA'I'C:WA ZIP: �f PHO\Ed1:36 — - 6 PHONE: CEI-L: a PHONE k2: ali EMAIL:amber(nlrrspecialisLnet EMAIL:lacey.11017ter(mhotmail.com LRI REG ly RRFOUFS829DA EXP.03 /1/21 PRIMARY CONTACT: OWNER❑ CONTRACTOR® OTIIER❑ NAME Amber Miller EMAILamber@rrspC istnet MAILING ADDRESS 3409 McDougall Ave,STE 8204 CITY Everett STATE WA ZIP 8201 PHONE 425-249-2878 CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 12206-31-00060 ZONING RR5 LEGAL DESCRIPTION(Abbreviated)"- Iweu.w.t.FIRE DISTRICT SITE ADDRESS 18931 E.Ste Rte 106 CITY Belfair DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NO© SNOW LOAD:_psf IS PROPERTY WITIIIN 200 FT OF THE FOLLOWING: (CherkntUhat oppty)• SALTWATER❑ LAKE❑ . R1VER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR® OTHER ❑ USE OF STRUCTURE(Re,hknoe.Gwoge.ColnnJ.1 x)dg.E,,)Residence 1S USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2 HEATED STRUCTURE? YES(N—aidpo DESCRIBE WORK SOUARE FOOTAGE:& p-wo IST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.IL BASEMENT sq.IL DECK sq.R COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.R GARAGE sq.R Attached❑ 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❑ EXISTING❑ PLUMBING IN STRUCTURE? YES© NO❑ /jyes,attach completed Water Adequacy Form PERIMETERIFOUNDATION DRAINS PROPOSED? YES❑ NO© EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNER admowledges that submission of Inaccurate Information may result In a slop 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 pernission from all the necessary parties,including any easement holder or parties of Interest regarding this project.The owner at legal representative,represents that the Information provided Is accurate and grams employees of Meson County access to the above described property and structure(s)for review and Inspection.This permNapplication becomes null 3 void if work or authorized construction is not commenced within 180 days or 8 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 PPL CATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) Si9fifluk of OWNER CAD be si ned by the OWNER Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH