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HomeMy WebLinkAboutBLD2018-01030 Pole Bldg - BLD Application - 8/30/2018 I MASON COUNTY COMMUNITY SERVICES Permit No: —c I C.1 3 O PERMITASSISTANCE CENTER. Recv'd.- ll •BUILDING•PLANNING•FIRE MARSHAL 615 W.Alder St-Shelton, WA 98584 Phone:360-427-9670 ext. 352 Fax:360-427-7798 *. t,e5r http://www.co.mason.wa.us/community dev/ IF/I �. BUILDING PERMIT APPLICATION ��' «itT PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: .glder S NAME: Kathleen Bakergumprecht-Davies _ NAME: Town & Country Permabilt eL°t MAILING ADDRESS: 255 S Thompson Ave MAILING ADDRESS: 16521 Hwy 99 Suite C CITY: Sanger STATE: CA ZIP: 93657 CITY: Lynnwood STATE: WA ZIP: 98037 PHONE#1: o .'z 7 —� PHONE: 425-743-1555 CELL: PHONE#2: 2E0 5'%+7 EMAIL : permit_assist@permabilt.com EMAIL: kbgdlaw@hotmail.com L&I REG# TOWNCPF099LT EXP. 06 /30/19 CONTACT PERSON : OWNER ❑ CONTRACTOR ® OTHER/BELOW ❑ NAME: Keni i @ Town & Country Permabilt MAILING ADDRESS: 16521 Hwy 99 Suite C CITY: Lynnwood STATE: WA ZIP: 98037 PHONE: 425-743-1555 EMAIL: permit_assist@permabilt.com PARCEL INFORMATION: PARCEL NUMBER(12 DIGIT NUMBER) 12-2o_ q 3'00 t 3 O ZONING R Q.(0 LEGAL DESCRIPTION(ABBREVIATED) FIRE DISTRICT Z. SITE ADDRESS 480 E Quail Hill Road CITY Belfair DIRECTIONS TO SITE ADDRESS see Directions to Site IS PROPERTY WITHIN 200 FT: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF ❑ STREAM❑ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14% YES[] NO TYPE OF WORK: NEW x❑ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) Garage IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS 0 NUMBER OF BATHROOMS 0 HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Part[s]of Bldg) ❑ NO Pq DESCRIBE WORK New, detached, no heat or plumbing, 30' x 42' pole building garage SQUARE FOOTAGE: 1ST 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 1260 sq.ft. ATTACHED ❑ DETACHED© CARPORT sq.ft. ATTACHED ❑ DETACHED❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REOUIRED MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER 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 or owner's legal representative. 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 f�l 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON COUNTY(:ODF 1a.08A2) X LlXY �� 4d;fA) Signature of OWNER Date r , N , DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS r- 0 BUILDING DEPARTMENT PLANNING DEPARTMENT O FIRE MARSHAL PERMIT SPECIALISTS Intake By: Approved&Ready for Pick-Up: W Z Name Bakergumprecht-Davies Parcel# 122094300130 BLD# UJ 6`0(0�G Mason County .e6 Department of Community Development �CCI/C Small Parcel Stormwater Management Application/Worksheet (page J18!2) Per Mason County Code,Title 14,Chapter 14.48 a stormwater site plan is required whenever a bt6Q6gW p ication is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surraa t:: , 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction,installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area * All dimensions in feet Buildings 42 X 30 = 1260 X = Measurements for buildings are taken at the perimeter of the farthest projections(example: X = eaves/gutters) X = Driveways X = X = Length of drive begins at the right of way X = Parking Areas X = X _ Any paved, gravel or packed area per definition above table X = Patios/Walks X = X _ Any paved, gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area(sum of all areas) 1260 If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read,acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan/S NOT required for this development activity. Owner/Builder/Agent 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,owner's legal representative,or the contractor.I further acknowledge that the information provided is accurate and employees of Mason County are granted access to the above- described property for review and inspection as may be required. X Owner/ ent ontractor(circle one)Date: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please read,acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 Dal ceived: �� MASON COUNTY d - ' COMMUNITY SERVICES DEPARTMENT C BUILDING•PLANNING•FIRE MARSHAL AUG 3 - Mason County Bldg.8,615 W.Alder St 20�� �+ Shelton,WA 98584 www.co.mason.wa.us 360-427-9670 ext 352 "'S t AlcfB! Permi Property owner's Authorization Letter I (we): j� �nt K�RGvN�R�cNT (Print Pr•op(Qerriv Otii-ners(dame/Firm%Organization) Hereby Authorize: MATT 6 P_(TTOf-4 (Applicant-Name of Person to Sign Permit) Representative of: Towiq &ur4-m-/ poste Fy n A P. 6f_l l Ml N GS (,Applicant Companv Name/Organization) To apply for, sign, and pick-up building permits for the following proposed work: A TEZAcI pa? �o�l�`'12 �t 1D `t j_I= f3U VD(tg6 3 4(3 f AN 9 STdAGEL WaHoom ?..c)rASIMC., (Brief Description o-f Work to be Done) Job Location: 4J 80 QSIAI L, HA �Z�r�D EL��}I R rA)�1 9kS28 (Propert);Site Addr As property owner(s),I(we)hereby grant permission to the applicant referenced above to apply for, sign, and pick- up the building permit for the work as indicated above. All work performed must meet all provisions of the Building Codes and the Laws of Mason County and the State of Washington,as applicable,whether specified or not.Residential Con ors are required to have a current State of Washington Contractors License(RCW 18.27). (Prot,eri))Owner Si ature) (De) r( r L Lt Rev.43.70..r2016 j1bn y =Z j._ vrvi�iuri vi V •LG 1 IQI I f R E R MAC I LT 16521 Highway 99,Suite C•Lynnwood,WA 98037.3161 P Ease Check After Doing Site Plan: Septic and drainfield 91,Lot size property Daw North Arrow in Circle Puyallup:(253)840.9552 roperty dimensions ❑Sewer lines Elevation of Administrative Headquarters:(425)743-1555 rEAsting buildings [Setbacks of proposed&existing buildings Bodies of water FAX:(425)742.4378 • 800-824-9552 [�• roposed building fMain road with name ❑Floor Ian Contractor's Lic.#:TOWNCPF099LT ©. p rrot permabilt.com facebook.com/permabilt O Easements Access to prop d b it Ing [,Slopes&Contours(5'increments) Building Proud "PPIL _�'j k(K 4�uth 'ReCe rr— �t � `"1'"+ �,) td r��n.-u. g Job Name: ob tte Address s� Legal Description: ,F A.:17.,. Tax Account#: fi�i7lf ii+1. t �_ 6 M .r•' i �y � v Gr W 7L°r LLI M a 1 r w Q lf9 CID '7 1 } r � h / JA A. t W Z r Cr. Cl 4 Ln � 1 a UA S e e Z g � � ; Uj Z = 0 1 o a An IL a GO r � y�y S� •yt. -q �r t 5 G�pN AN J t, y. F �e i 1 NO f c aLk V0 I)e _ 2 p o' t j s f S � � r C>\11^40, C Cy✓l ,' J`�.te i e„v1 )O NOT SIGN INCOMPLETE SITE PLANI t ` G 5 ;ustomer has verified and app�orawing ed the location of the building;,orientation of the building to the North,and verifies that all Iti sto are shown on this drawing•irt the dPcr do location. :USTOMER SIGNATURE r Grid White-Customer Copy Plain White-Office Copy LEAD# 0 2012 Perma-Bilt@ Industries FR-34 10/17 I I"I'I II'll"II I" * 0