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HomeMy WebLinkAboutBLD2022-00874 Cancelled Retaining Wall - BLD Application - 7/5/2022 MASON COUNTY COMMUNITY SERVICES Permit No:6L(/2D p2 2_C005 PERMIT ASSISTANCE CENTER: 7y .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 985114 RECEIVED Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone Beffair.(360)275-4467-Phone Elma:(360)482-5269 - JUL - 5 ZOZt BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFO *bAdef Street NAME'__.. MAILING ADDRESS Nth MAII ING RESS: CITY: STATE:Rj&ZIP CITY: STATE: ZIP: PH0NE#1: — 2 PHONE: CELL: PHONE#2: EMAIL EMAIL:Us 1 �I REG# PRUIAILY CO T: OWNER g CONTRACTOR 01&❑ NAME L EMAIL t- MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: ` PARCEL NUMBER(12 Digit Number)/22 ? 4 ZONING &� LEGAL DESCRIPTION(Abbreviated) - - FIRE CT STTEADDRESS f 0 tL f !7 ' CITY �zT DIRECTIONS TO S ADDRESS 55 /� IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREAT YES❑ NO SNAr IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: ply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ PO ❑ SEASONAL RUNO ❑ TYPE OF WORK: NEW❑ ADDITION❑ ON❑ REPAIR❑ O USE OF STRUCTURE(Besidenc_GaragS Commercial Bldg,Eic IS USE: PRIMARY❑ SEASONAL❑ ROOMS OF B 7S�� HEATED STRUC YES(".It B]dg)❑ [s] p ❑ NO❑ DESCRIBE WO I �/t % SO UARE FOOTAGE:(prap.4TW S O P- 6h,L 1ST FLOOR sq.R 2ND FLO ft 3RD FLOOR q. sq.fL DECK sq.fL COVERED D STORAGE sq.ft. R sq.fL GARAGE sq.1 Attached❑AD ❑ CARPORT sq.fL ched❑ Detached❑ MANUFACTURED HO O — *4 S OF TIM FLOOR PLAN REQUIRED* MAKE MO LENGTH WID BEDRO BATHS ER Ir ENVIItONMEN ` T7 SEWAGE/SE CE: ElSEWER El / _ I:XXISTING❑ PLUMBINGINS LCMrUIRE? ___--Tfyet-atta comp7efed Wafer Adequacy Form PERIlvIETER/FO ,� OPOSED? YES❑ NO[] EXISTING SQ.FT. EXIST PROPOSED BEDROOMS TOTALBEDROOMS OWNER acknowledges th of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I decare tha a 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 C T NUATION OF WORK ON THI PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT P ATION OF 1�M WI CAUSE THE APPLICATION TO BE EXPIRED.(MASON OU ODE 14.08.42) X zz- ignature of OWNER(Must be signed by the OWNER) Date :DEPARTMENTAL REVIEW=-= E APPROVED':'- DATE` =DENIED DATE ::TAGS)NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No: "008 PERMITASSISTANCE CENTER: 7f BUILDING-PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext 352•Fax:(360)427-7798 Phone JUL Belfair.(360)275-4467•Phone Oma:(360)482-5269 — 540 UULL BUILDING PERMIT APPLICATION ` Alder S#fit PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: I 66 jl. '� NANO: /L�/��-� w ■ ■ ' ®I MAILING ADDRESS AJ MAILING ADDRESS: NG CITY:'--/,tG( STATE: 7� CITY: STATE: ZIP: PRONE#1: -' — 2 PHONE: CELL: PHONE#2: EMAIL: EMAIL:Of � • ' I REG# M. p Y CO T: OWNER X CONTRACTOR❑ OTHER[] p NAME L EMAIL LJ MAILINGADDRESS O CITY STATE ZIP PHONE CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) �0�2 © Z ZONING LEGAL DESCRIPTION(Abbreviated) — FIRE S RICT ` SITE ADDRESS /y© C t l7l�CJ/Q L �T CITYL DIRECTIONS TO S ADDRESS 55 IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NKSNOW LOAD_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (C% kaft ihat app7y): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION[j AL �IONN E] REP^AIR,❑9 OT USE OF STRUCTURE(Resident Garage Comme rW Bldg,Eta) C .A IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUC �YES�(fvh.kBldg)❑ artfrjigpldg)❑ ElNO DESCRIBE womF I_C/�ti>'�I����/�LL �. �"% 16 SOUARE FOOTAGE:(pn po:ea) /6z.S� d otr 6k,�- 1ST FLOOR sq.fL 2ND FLOOR sq.It 3RD FLOOR sq.fL BASEMENT sq.fL DECK sq.ft. COVERED DECK sq.& STORAGE sq.fL OTHER sq.IL GARAGE sq.fL Attached❑ Detached❑ CARPORT sq.fL Attached❑ Detached❑ MANUFACTURED HOME INFO *4--COPIES OF THE FLOOR PLAN REQUIRED' MAKE MODEL YEAR LENGTH WID BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: - SEWAGEISEWER SOURCE: SEPTIC❑ SEWER[] / �F,X[SIING❑" PLUMBINGIN STRUCTURE? YES❑ �}yrs atmch completed Water Adequacy Form PERUVIETERNOUNDA OPOSED? YES❑ NO[] EXISTING SQ.FT. EXIS OMS 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 _ 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 penmlappiication 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 C NUATION OF WORK ON THI PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT P ATION OF 1 AY M WI CAUSE THE APPLICATION TO BE EXPIRED.(MASON OU ODE 14.08.42) 71 X Z! _ ignature of OWNE (Must be signed by the OWN RI Date �EPAIiTMENTAL REVIEWAPPROVEDs:'= DATE DEIVIF,D_. DATE `. �AGSlNOTES/CONDITIONS BUII DING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH