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HomeMy WebLinkAboutBLD2019-00436 Pole Bldg - BLD Application - 4/30/2019 MASON COUNTY COMMUNITY SERVICES Permit No: 1 I PERMIT AS ST U(iLCNC�•PI' NN G / •FIRE MARSHA �f 615W.Mder Street,Shelton,WA98584 rnl 4" REC 'EIVED 015W • Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone Belfair.(360)275.4467•Phone Elma:(360)482-5269 APR 3 0 BUILDING PERMIT APPLICATION 20�9 PROPERTY OWNER INFORMATION: CONTRACTOR INFO ION: der Sb'86t NAME: e coW NAmF,.T6q,4 4 C fr MAILING AD RESS: , 13 ON 11 MAILING ADDRESS: M21 lttld(4 Iq -tr— _ CITY: r,L STATE:_ IP:A=1 CITY: L Oo" STATE: ZIP:� " PHONE#I: <3 6 0 2 ")S —0(� PHON }?N_5-i55S' ELL: PHONE#2: EMAIL: f'er�ltaa54I d-Oe.CY1Ll�CJt�') EMAIL: L&I RE( #'1"D(J1U�Pt��r1c(LTPXP. / PRIMARY CONTACT: OWNER❑ CONTRACTOR Rf OTHER❑ NAME C --! EMAIL MAILING ADDR S 16-5- tJ �1-G CITY ��� STATE �LIP��� `7 PHONE ( c{2 S l 44 3 —f 5-"Li CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number)A T 1 r) Sr — 0 0 ZONING LEGAL DESCRIPTION(Abbreviated) ,-C cy 01 1 l 6 3 FIRE DISTRICT SITE ADDRESS Q 2 CITY 03¢1'F l r DIRECTIONS TO SITE ADDRESS " �eecdfac4ed "t o Si IS THE PROJECT WITHIIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO Y/ 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❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage.Commercial Bldg,Etc.) P— IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Parr(s)ofBldg)❑ NO DESCRIBEWORK 2 dIs `� y' p rrQ/"Q firk 2 A f n1o. l rt�r' SOUARE FOOTAGE:(propose+existing) IST 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.fL GARAGE 6 sq.ft. Attached❑ Detached g/ 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 j SEWER❑ / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES❑ NO 11d Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ . NOV EXISTING SQ.FP. EXISTING BEDROOMS PROPOSED BEDROOMS_ia_ 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 obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal r' 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 (t`i 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 C PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON t4a COUNTY CODE 14.08.42) X 12,E 1 « � Signature of OWNER(Must be sinned by the OWNER) Date t'� DEPARTMENTAL REVIEW PPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS 4 BUILDING DEPARTMENT PLANNING DEPARTMENT _ L.8 FIRE MARSHAL 1a --r PUBLIC HEALTH ;.1. 4) Town & Country, A Dlvlslon Of 16521 Highway 99.Suite C-Lynnwood,WA 98037-3161 R E R MAa I LTDesign Draw North Arrow in Circle Puyallup:(253)Headquarters: ■ ■FAX:(42 )742-4378-800-0(425)743-1555B u Id� n FAX:(425)'s Lic. : -WNCP 099LT 552 Contractors Lic.N:TOWNCPF099LT Building Proud' pe nabltt.com-facebook.com/permabilt P SE CHECK Roll-up doors fit in Bays Wind MPH U' Roll-up doors will not hit Truss Wind Exposure 4"12. Roof Pitch 10' Eave Height Snow Load _a� Minimum Clearance ® YES (0 (please circle) FLOOR PLAN SERIES 1�-DOWNS otlT so La 46 11- eZ RSV LA-71OtJ 14 Rri0f C*iLy �2 Z d - -tat c��trn Z-reti` Aaor i u,;Ais N `� IO RNLI VENT WlrRov+ "Hakf'T& SI.Ad, S► O' Fo4i5N wl'trt {1� F tatR N t-, 4 =4p S' tp 3' 3xG8 1t o 'P 2 �!o (vow 0SPout j Corr (� PLANNING PLANNING: [ALL SETBACKS ARE MEASURED FROM THE FURTHEST PF'(' `EC E ION OF THE BUILDING I I U. i BUILDING ELEVATION Customer has verified and approved the orientation of the building to the-North and verifies that all items specified in Paragraph B of the contract are shown on this drawing and IIIIII IIIII I�kl((f I Customer Name: f G poloro-M E(Z u W PI __ Lead#: R 1 q(P L Customer Signature: / 0 a II II� ! White-Customer Copy Canary-Office Copy ®2012 Penna-&It®Industn 5 0/17 Town & Country, A Division Of ♦7,)[1111.1,0''r14311 f R E R MAa I LT 16521 Highway 99,Suite 0•Lynnwood,WA 98037-3161 Please Check After Doing Site Plan: [2 Septic and drainfield O,Lot size Draw North Arrow in Circle NI-Property(253)840-9552 Property dimensions ❑f'Sewer lines 2 Elevation of property Administrative Headquarters:(425)743-1555 %Existing buildings O#Setbacks of proposed&existing buildings E)Bodies of water } • FAX:(425)742-4378 •800-824-9552 Contractor's Lie.#:TOWNCPF099LT Proposed building Cain road with name ❑Floorplan r`a permabilt.com •facebook.corr/permabilt Easements- L�1 Access to proposed building Slopes&Contours(5'increments) Building Proud" Job Name: ``�1"�� � �k� +}`� �'-�� �' Job Site Address: r 3 Legal Description: `' 4 A � Tax Account#: it `� �• �e�� � �.r•\ ••O~' ,» yr• �4:4� `:�v �++""�".. t ' • / AC t� t ` RECEIVED APR 3 0 2019 pm 7 615 W. Alder Street pP�o`If�©�AN�ING �k,'1��. `�C:r:¢ ►�'lt'D',�'L}ti;V�: - i'`t:> OONTY 00 BE oN skIE t W' MiASON 0 REQOF(So10 o p,P�`� {` sk PNG�S SUS3EC BHA pate ` , N �`o s{'ac ��eg�( �r � Posh ��'a� �a � r�s�,��(C�Y-D� P l . ."tAle A P � C leaC (fL� I �,5 FALL A NN,j ARC r 7 TF' FORTHEST RED - RUILI�INr, 0 I+,:ti .r t=V 0 0 DO NOT SIGN INCOMPLETE SITE PLANI W Customer has verified and approved the I9pation of the building,orientation of the building to the North,and verifies that all Grid White-Customer Copy Plain White-Office Copy utilities are shown on this drawirjg in t,a orrect location. CUSTOMER SIGNATURE �' ( '"�- LEAD# / ©2012 Perma-Bilt®Industries FR-34 10/17 I IIIIII lllll I'll IIII.. 1 0