HomeMy WebLinkAboutBLD2015-00241 SFR - BLD Application - 4/4/2013 MASON COUNTY PERMIT NO.&a 7-616 -X2-1 1
DEPARTMENT OF COMMUNITY DEVELOPMENT
BUILDING• PLANNING. FIRE MARSHAL
WWW.CO.MASON.WA.US (360)427-9670 Shelton ext.352
Mason County Bldg. III, 426 West Cedar Street (360)275-4467 Belfair ext. 352
1854 PO Box 279, Shelton, WA 98584 (360)482-5269 Elma ext. 352
BUILDING PERMIT APPLICATION
OWNER INFORMATION: / CONTRACTOR INFORMATION:
NAME: nl ST CAQ c�Tr�(Q/+J����j''lGt� NAME:
MAILING ADDRESS: aO f 3oa MAILING A DRESS:
CITY: , W STATE:_ZIP: 9N;�ZR CITY:7- STATE:_ZIP: 15yV�!
PHONE360;277 ye CELL: PHONE-aZ�3�5,. 691v/ CELL:
EMAIL: EMAIL
L&I REG#L�9iUBS"�'Sp79�1// EXP.,�//�//'
PARCEL INFORMATION:
PARCEL NUMBER(12 DIGIT NUMBER) FIRE DISTRICT
LEGAL DESCRIPTION(ABBREVIATE ):
SITE ADDRESS D JW. oZ CITY
DIRECTIONS TO SITE ADDRESS /,'
f / 3
IS PROPERTY WITHIN 200 FT:
SALTWATER ❑ LAKE ❑ RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM ❑
DOES PROPERTY HAVE SLOPE(S)WITHIN 300 FT OF THE PROJECT-GREATER THAN 14% YES❑ NO ❑
TYPE OF JOB: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ OTHER
USE OF STRUCTURE(RESIDENCE,GARAGE ETC.)
IS USE: PRIMARYQ SEASONAL ❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
DESCRIBE WORK )5pjWkp Q,&O 175-40gll"
SQUARE FOOTAGE: /
I ST 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 sq. ft. ATTACHED ❑ DETACHED ❑ CARPORT sq.ft. ATTACHED ❑ DETACHED ❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
OWNER/BUILDER acknowledges 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, owners legal representative, or contractor. 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 ease holder or parties of interest regarding this project.The owner or authorized agent represents that the
informati rovided is ac r to and grants employees of Mason County access to the above described property and structure(s)for
review d nspe ion.T s ermit/application becomes null&void if work or authorized construction is not commenced within 180
days o if c nstru tion s suspended-for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF
INSP CT IN IV OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION.
x ! �/3
gnat e f Applica t Date
X OWNER/ REPRESENTATIV /CONTRACTOR
Print Na (CIRCLE TO INDICATE
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
SITE LOCATION MAP
_ Milbrad Residence
4920 E. State Route 302
Belfair, WA 98528
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house
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51 675-gal. _ _
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driveway 10 01 garage
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[not to scale] East State Route 302
Seth
April 3, 2015 -
To: Mason County Department of Community Development
From: Langseth Environmental Services, Inc.
Subject: Residential Underground Storage Tank Removal Project
Site: 4920 E. State Route 302, Belfair, WA 98528
We will be removing one 675-gallon underground heating oil storage tank from the
above-referenced site. The tank will be pumped of all residual petroleum product and
then removed from the ground. The tank will be transported to Langseth Environmental
Services, Inc. where it will be cut in half, scraped and cleaned, and then disposed of at
Schnitzer Steel facility in Tacoma.
7517 Portland Avenue, Suite A, Tacoma, WA 98404 • Phone: (253) 536-6961 • Fax: (253) 548-0201
LangsethEnviro @gmail.com