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Home My WebLink AboutBLD2024-00638 Storage - BLD Application - 5/21/2024 MASON COUNTY COMMUNITY SERVICES PERMIT ASSISTANCE CENTER: •BUILDING.PLANNING•PUBLIC HEALTH•RRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 • Phone Shelton:(360)427-9670 ext 352•Far(360)427-7796 Phone MAY 2 12024 Beffair(360)2754467•Phone Elms:(360)482-5269 BUILDING PERMIT APPL[6160. Alder Street UILC X . PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:J P-Ina e,S 1�c-- IY%eL,K NAME: MAILINGADDRESS:Y�-2— 6 dI-Af MAILINGADDRESS: CITY: Ske.1-10 r STATE: UVA ZIP- : jt4 4 CTTY: STATE: ZIP: PHONE#1: 6 60 LI PHONE: CELL: PHONE#2: i G 609 l l EMAIL: EMAIL: CL ik 1-ZI'2 t 0? Nc L C %✓1 L&I REG# EXP. PRIMARY CONTACT: OWNERIg CONTRACTOR❑ IOTHERq NAME �G✓wt P �� I�l/�L V!�iC�1� EMAIL At Z I - GL�o- .c,o r� MAILING ADDRESS SLZ 7 O'n D Ir• E CITY l-1 e I—Fa,- STA L' WA ZIP , '1 PHONE ��i 6 y I'L cl t CELL (�C? i 10, PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) j Z l f 5 3 U 0 J/ u ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTR1IICT ei--S a r— SITEADDRESS e-/Z 2 E Pi i A - 11- CITY DIREC ONS T SITE ADORES ' f7OAlt?_ d t P O o Y4 Imo, IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NOR SNOW LOAD:-----psf IS PROPERTY 200 FT OF THE FOLLOWING: (Checka7l that app7y): SALTWATER LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION ALTERATION X REP ADZ❑ OTHER ❑ USE OF STRUCTURE(Besidv=e,Garage,Con &ri lBldo;FJe)_ IS USE: PRIMARY❑ SEASONAL® NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(WhokBldg)❑ YES(PartW ofBidg)❑ NO J5 DESCRIBE WORK � ��' Q SOIIARE FOOTAGE:(prapo:� 1ST FLOOR sq 1i 2ND FLOOR sq.fL 3RD FLOOR sq.& BASEMENT sq.fL DECIC sq.fL COVERED DECK L-1 0 sq.fL STORAGE sq.8. OTHER sq.8. GARAGE sq.&Attached❑ Detached❑ CARPORT sq.$Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUnIED* MAKE MODEL YEAR LINGTH WIDTH BEDROOMS BATHS SERIALNUMBER ENVIRONMENTAL HEALTH- SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING R PLUMBING IN STRUCTURE? YES❑ NO X Ifyes,attach completed Water Adequacy Form PER]M[ETER/FOUNDATION DRAINS PROPOSED? YES❑ NOR EXISTING SQ.FT. EXISTING BEDROOMS 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 1 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 pemildappfication becomes null&void ff work or authorized construction is not commenced within 180 days or if construction work Is suspended for a period d 1 BO days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON "fit COUNTY CODE 14.08.42) Signature of OWNER(Must be signed by the OWN ERI Date ARTMF.IVTAI_REVIF VFr LAPPRO DATE= _DEIQIED = .DATL.'=TAGSII�OTES/CONDITIONS=�= BUILDINGDEPARTI%= J rL— PLANNING DEPARTMENT FIRE MAR CFf AT. PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit No DD(P 58 PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARS 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext 352-Fax:(360)427- hone MAY 21 2024 Beffalr.(360)275-4467•Phone Elora:(360)482-5269 BUILDING PERMIT APPLICATION 15 W• Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAtv1E: MAILING ADDRESS: 6 K01-A ,1,S MAHJNG ADDRESS: CITY: SIk e-I-fC r STATE: W A ZIP: S 14 CITY: STATE: ZIP: 9 PHONE#1: C 6 6 Z q ( PHONE: CELL: y PHONE#2: :3 1C 6 609 j L EMA]L: EMAIL: a ik -5�2 i C* V,-- Wk L&I REG# EXP. / PRIMARY CONTACT: OWNER CONTRACTOR❑ pTHERq NAME D=1M S c EMAIL_ 11T cam..I � o-,� -G 0&-^- MAILING ADDRESS �j 2 C. 1q,,nor s" D r- E CITY (1 L', STATE ZIP t PHONE �i 4 t' 6 6 11 I'L 11 1 CELL a 600 ( 4� PARCEL INFORMATION: PARCELNUMBER(12 Digit Ntrmbcr) Z l f q 5 U l/O I u ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT �s C r— SITE ADDRESS 9Z 2 E Pi ;A s r CITY S k_A, Ira r� DIREC IONS TO SITE ADD!] ' a 1 d f P qL�t3o-e4 k IS THE PROJECT WIT=300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOR SNOW LOAD:_psf IS PROPERTY 200 FT OF THE FOLLOWING: (Cl,-k.21 thar apply): SALTWATER LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION ALTEERATION W REPAIR❑ OTHER ❑ USE OF STRUCTURE(Beddeec4 GaragS CammazWB&d Etc) e—e,4 r G[C_' , D " IS USE: PRIMARY❑ SEASONAL® NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YFtS(Whore Bldg)❑ YES(Partr.7ora1dg)❑ NO DESCRIBE WORK Q e ' Ca,/' k C) SOUARE FOOTAGE:6;rapwe4 1ST FLOOR sq fL 2ND FLOOR sq.It 3RD FLOOR sq.1 BASEMENT sq.fL DECK sq.It COVERED DECK D sq.ft. STORAGE sq.fL OTHER sq.ft. GARAGE sq.ft.Attached❑ Detached❑ CARPORT sq.ft.Attached❑ Detached❑ - MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIALNUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING L9 PLUMBING IN STRUCTURE? YES❑ NOJ& Ijyes attach completed Water Adequacy Form PEPDI ETEPJFOUNDATION DRAINS PROPOSED? YES❑ NOg E=ING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS OWNEP.acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I dedare 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 arty easerient 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 parmIIfapplication becomes null&void W work or authorized construction is not commenced within 180 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 PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.09.42) X - �1 Signature of OWNER(Must be signed by the OWNER) Date ARTMEI�TAI_REVIEW_2;'-? APPROVED`==DATE`:'=DENM) DATE.=�TAGS/NOTES/CONDITIONS= : BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE 1AA R SE AL PUBLIC HEALTH h1 i \y ay 1 � y S ► � REC ED � �►..` MAY 21 2024 � I I 615 W. Alder Street ,` Printed From Mason County:DMS _��------' __- - -' Printed from Njason County DMS