HomeMy WebLinkAboutBLD2021-00890 - BLD Application - 2/25/2021 ~ MASON COUNTY COMMUNITY SERVICES' Permit No: Id 2Zi QC—FQI O
\1 PERMIT ASS/STANCE CENTER:
•BUILDING.PLANNINQ•PUBLIC HEALTH•FIP,E M.4RSHAL
l 6115 W-Alder Street.Shelton,WA 985S4 D
Phone Shelton.1360427-9670 ext 3.52•Fax�;360J4T7-7798 Pane
Behar.(36M275-+46'-Pt<:.e I-,Ima:(364)4W-5289 .1 J t 1,?f, „
BUILDING PERMIT APPLICATION 61,5
1 PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: :r
ar %~n a eman 0 0 t
NAME:. Rohert Thompson NAME:jplyglllt+ y1V C.utyJ
MAILING ADDRESS: '_50 N Ayock Beach Ur MAILING ADDRESS:1'O Box 1008 _
C(TY: Lilliwrgp , STATE:WA ZIP: 9R535 _ CITY: Hoodsnart STATE: V�',�ZIP:98S48-t008
PHONE#1: G .x¢9_ PNONE:253-MS-5314 ext (CELL: 20(t-310-1239
_3( 7 -�__--_
PHONE#2: _ EMAIL:-caral%'nj4intel;retedNWconstruction.cam
EMAIL M rdthgMm i.rmatl.cor� L&I REG#1' I-�t• 8d3J I EXP. 04 121 /2020
PRIMARY CONTACT: OWNER 7 CONTRACTOR OTHER
NAME Cara yn Va d EMAIL carat m a inreeratedNWconstructimt cunt '
MAILING ADDRESS POO Bo Box 1008 CITY Hoodsport STATE
PHONE 253.888.5314 ext 1 WA 71P c —
r � CELL 2tl6-31tl-4239
PARCEL INFORMATION:
1
PARCEL NUMBER(12 Digit Nutnhu) 32303-50--0101-1 _ ZONING_
t-FGAI_DESCRIPl70N(Abbreviated) AYC)CK BEACH BLK: I LOT' 1^_-I IA _—FIRE DIS-I-RIG r —� -
SITE ADDRESS 250 N Arnck Beach th
D1REC110NS 1'O SITI?ADDRESS I'rtice}ray 101 N from Shcltnn apt 22 nsiles m N Pcbhle Beach Dr 'rake a tight and get to'('
in the road I'ake a nhht onto N A)ock Beuch dr_Residence% ill he on the
IS THE PROJF.Cr WITHIN 300 F r OF SI.OPEts)C;REATER THAN 14%: YES3 NU 3
IS PROPERTY WITHIN 200 Fir OF THE FOLLOWING: d Awkuff rhn,eppA/
5ALTW':1TI R tk 1.A1:F( R1V[R('RFi_l: POND O WE 1 LAND[] SFASONAL RUNOFF C3 STRr•. kI Lt-- ------------
TYPE OF WORK: \rw[J ADarrI0N[ AI.rhRATION n REPAIR Ll OFIIER L"
USE t)F S'rRllC'rURF;(g,�;j,.,ur.finrngr.(�mnerr•;ral')trig,!ire 1. Bulkhead
1S 11SI;': PRIMARY j SF-.ASONAL!_) NUNIBLR OF BEDROOMS--'UMBER 01 BATHROOMS
HEATEDSTRUCTUIRF? 1'LSr)t9rarc811(:I J YESfP.,,!,/gfiw_RtC NO❑ -!^-
s DI?SCRIBE WORK.- Repair existink bulkh=l
SQUARE FOOTAGE:tjrryxar.rtrsrirrPJ
1ST FLOOR__.__ -__,,y-fl. 2ND FLOOR _____cy.11. MI)FI OOK _ sy.1't. BASf:MEN1__----sy.ft.
DECK sy,f1. COVERED DUCK^ sy,ft. S"I-ORAGL - sq.fl. 01111-R sq.ft.
GARAGE sy.A. Attached jam, Detached CARPORT sq.It. .4uached•,^• Detached
MANUFACTURED HOME INFORMATION: *4 COPIES OF WE FLOOR PLAN REQUIRED*
MAKE MODEI
WIDI'II . BLDRO0N1S_.____ BATHS__^ �__�SERIAL\UAiRI:R
ENVIRONMEN'rAL HEALTH:
SF.W AGUSI:WFR SOURCE: SEPTk:3 SEWER❑ ! NEW❑ EXISTING lx1
PLUMBING OJ s'rRtJ(-RIRF-? YES❑ NO❑ 11 yes.arlftc•h completed 1I'vIttr.4degtuu;)-For n
PERIMIiFEW['-0
UNDATION DRAINS PROPOSt.D:' YGS`{V1 NO["' EXISTING SQ,Fr.
F.XlSTING BFDR()OMS.. PROPOSED BEDROOxJS __.-.. . IO'FAL BEDRC OM.S
OWNER aratnomedges trial subniisstors of inaccurate information may result in a stop work order or permit revocabon.Acknowledgement of such is by 1
signature below-I declare that I am the owner and I fumt ier declare that I am entitled to receive this permit and to do the work as proposed.I have t
obtained permission from all the necessary parties,including any easement holder or panics of interest regarding this project. The owner or legal
i 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 pemidlappl+cation becomes null 6 void if work or cohort;-ed construction Is not commenced within 180 -
days or If construction work is suspended for a period of 180 days. I
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERW APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) I
Signature of OWNER(Must be sinned blithe OWNER) ' late
DEPARTM1-ATAI_RF%'IE%% APPROVED DATE: Df\IED DAFF: 'I'AGSI\oIT.S:(<t�UlllO\ti
BUILDING DEPARI'FvENT t +
PLANNING DFPARTMFNT
FIRE MARSHAL
PUBLIC HEALT)r �—