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HomeMy WebLinkAboutBLD2022-00213 Pole Bldg - BLD Application - 2/24/2022 MASON COUNTY COMMUNITY SERVICES Permit No: - PERMIT ASSISTANCE CENTER: _ •BUILDING.PLANNING-PUBLIC H H EALT -ARE MARSHAL 615 W.Alder Street,Shelton,WA 93584 1 I R f� Phone Shelton:(360)427-9670 ext.352•Pax.(360)427.7798 Phone VV Belfair.(360)275.4467-Phone Elmar(360)482-5269 i4. BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION-CONTRACTOR INFORt1IATION: NAME: I'll ll .8 rerh e-r.S NAME: 50und' Build'" S 6 to 8t n MAILING ADDRESS: 6'1"m 5 rci e it stre e r MAILING ADDRESS: a S.44 it d It s CITY: Ter; o»,a STATE: WA ZTP:9b'yoP CITY:Porgy"Lrtiloal STATE_ iP: e3 PHONEi4I: I PHONE:3bc-Y37-+a+i CELL. PHONE42: EMAIL: sound6ul)rltna5Us1~eMst�hofir+r+r/-corm EMAIL: L&I REG#SDIA AI0 g 5 t7 2 7111 M EXP. &//c)/-1: PRIMARY CONTACT: OWNER❑ CONTRACTOR 0 OTHER Q NAME sun u.! r S 4 lea EMAIL$$lln��...1d+e�Sy57errs�.1?a/+nQ.�'G+e.r. MAILINGADDRESS 3Stlip CITY pnrf 1, tlo:.4 S7'ATEI.ZA ZIP PHONE 3&D-137-!.Z 19 CELL - tsiu o L D I N G PARCEL INFORMATTON: PARCEL NUMBER(12 Digit Number) .32-7iF-75-00.2.2G ZONING Rectelen�tilJ�ai,,/r LEGAL DESCRIPTION(Abbrcviatett') e: of eatrmy 'Jai 11.19,5 FRt E DISTRICT SITE ADDRESS 930 Nk 14a Lt r la �JP/t sr A-4 CITY_Ta h u J g " DiRELTIOIdSITO SITE ADDRES 5 o>i /Vdfib ShrrB 11c:,Pt o.t 111E ArAah rrleG fitc�. 5'1a lc the /x t of tw r�c..c. .�'.r'fG t 5 a.+ riak7 atnte�✓cu /1as5Ors Ia. Crrr! c IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%; YSSO NO g SNOW LOAD: j W IS PROPERTY WPTHIIY 200 FT OF THE FOLLOWING: (check an(hat apphy: SALTYvATER❑ LAKE❑ RTVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW® ADDITION❑ ALTERATION❑ REPAIR© OTHER n ^� I i S E OF STRUCTURE(Rasidenea Garage.Coa,nerriot Bkfz€a:.) Po(C 61u IId r aES4 e-f/S tDr4 q e IS USE: PRIMARY Q SEASONAL(f IvL?vIBER OF BEDROOMS t� 2vLT�4BER OF BATHROOMS U HEATED STRUCTURE? YES twholeBidg)❑ YES(Parr(sj ofoldg,❑ - NO DESCRIBEIWORK '-AyA38Aff 1201t b.c,Gdr+y caara�G SOUARE FOOTAGE: I ST FLOOR sq.fL 2ND FLOOR sq.k 3RD FLOOR sq.ft. EASEMENT sq.& 3 DECK sq.& COVERED DECK sq.ft. STORAGE sq.8. OTHER sq.ft. GARAGE ?b4 sq.ft.Attached❑ Detached® CARPORT sq.ft. Attached Q Detached❑ i MAN-UFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MARE MODEL PEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER EI�'VIRONIVIENTAL HEALTH: SEWAGEISENVER SOURCE: SEPTIC N SEWER 0 ( :FEW❑ EXISTING Q PLUMBING IN STRUCTURE? YES Q NO® lfpes,attach completed Water AdeglutcyForm PERIMETERTOUNTDATION DRAINS PROPOSED? 'ITS❑ NOQ 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 oelow.1 declare that 1 am tie owner and I furtner dedare that 1 am entitled to reeerve this permit and to do the work as proposed.I have obtained permission from all the necessary parties.including any easement holder or parties at 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 pe.-mittapplication becomes null&void it work or authori'ed construction is not commenced within 180 days or it construction work is suspended for a penod of 180 days. PROOF OF CONTINUA77ON OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT PLICAT N OF 80 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON AM �� COUNTY CODE 14.08.42) to.wy vX Sig atuA of OWNER(Must be sianed by the OWNER) Date pEPARTlvf ALRE''rEW - APPROVED DATE DENTED DATE TAGS/NOTES/COVD1"ri0n 13LRLDD40 DEPARTMENT IZZ-, PLANINING DEPARTMENT FIRE WARSHAL j 1 PUBLIC HEALTR Name r E r Parcel# 3.7.7 iY 7S- 0 y Z a D BLD# aL P ao,2a~b b A J Mason County e' ®� FES Z � '°�1`� Department of Community Development `J NG Small Parce�i >rmwater Management Application/Worksheet (page 1 of 2) Per Mason County Code, Title 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residential development,or redevelopment',with more than 2,000 square feet of impervious surface 2. '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 X 3 Lo = K X = Measurements for buildings are taken at the X _ perimeter of the farthest projections(example: eaves/gutters) X = Driveways 1190 X i D = a t) 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) 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 IS NOT required for this development activity. OwnerBuilder/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 r e for rev' wand' spection as may be required. l X Owner/Agen Contractor 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 ,. MASON COUNTY aA COMMUNITY SERVICES DEPARTMENT 6 4 ef111 NG•PZANIVING•tZRE 25N�tL �C� Lu��' < l` Mason county Mg.a,sU w.Airier St 615 W. Alder Street Shelton,WA 98584 www.co.masonma.us 360-427-9670 eA 352 i Permit#:&W2&RR Property Owner's Authorization Letter 1 (we): t r i r� t e � ;Print Proveriy Dwners.Name/Firm 1Organization) Hereby Authorize: ffi�hgrj k+e_t-te,r (Applicont-Na,ne of Person to Sign,Permit) Representative of: 5121, Kd 184,;ld to J-e h, S Li e- (Appiic Co pan} Name/Organ,:ation} To apply for, sign, and pick-up building permits for the following proposed work: dr'r,5 f¢kc-�a of 'Xd3 -� - (BnefDacription of Tork to be Done) Job Location' r1} _ �V E yq j 2 j ! / 1 +r i J�i� c _ �l��elGL.. > /G7Q ei JTGL4�(/,, 1 L';X?if'✓ Cn --- � PropertySite.Address) As property ou,ner(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 Contractors are required to have a current State of Washington Contractors License(RCW 1&27), -Z- (Prop�v Awnar Signature) Rer.p3�D.2CIb7F.n a IA?902��- Lnal APPROVED PLANNING: MASON COUNTY DCD PLANNING ALL SETBACKS ARE MEASURED FROM SITE PLAN REQUIRED TO BE ON SITE CHANGES SUBJECT TO APPROVAL THE FURTHEST PROJECTION OF THE BUILDING By. r — -_Date:03/04/2022 PLANNING SETBACKS Front: 25' Side and Rear: 20' i*Subject to EH Setbacks � o i m a� ,y ,' .� N 8ri.t f�1� Bro ther5 ".Bo 93o AIEA,w,la Rsd9a Roa.l G{ dt t \ - i � 5 3 F�SEM 0 ��2 �� BUILDING FEB 1 L W.boa Alder Street � m E B I T Il Uro 1 her$ . a / C �"= S'a' 130 A/E/ ps/a Rrds& Ro4c-1 IAV 7a h u a WA 9ss�P g 1 \ � Q \ \ i r ,toot