HomeMy WebLinkAboutBLD2019-01052 Wing Walls Bulkhead, Replace Float, Piles - BLD Application - 7/31/2018 3Zc�i� -CioSZ
MASON COUNTY COMMUNITY SERVICES Permit No: r
PERMIT ASSISTANCE CENTER:
•BUILDING-PLANNING•PUBLIC HEALTH•FIRE MARSHAL 1
la'° 615 W.Alder Street,Shelton.WA 98584
'1 Phone Shelton(360)427-9670 ext.352•Fax:(360)427-7798 Phone
i --BelfaEr 60 7rddb7=lWo—ne ETrn6-36�aB7=5264— ___ J •._
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
ara yn Vaideman o o
NAME: Scott Merritt NAME:Integrated NW Construction I I C
MAILING ADDRESS:410 214th Ave SE MAILING ADDRESS: PO Box 1008
CITY:Sammamish STATE:WA ZIP:98074 CITY: Hoodsport STATE: WA ZIP:98548-1008
PHONE#1:(206)214-6042 PHONE:253-888-5314 ext 1 CELL: 206-310-4239
PHONE#2: EMAIL:caralyn(a)intep-ratedNWconstruction.com
EMAIL: merrittsco@yahoo.com yahoo.com LR.I REG#INTEGNC843J I EXP. 04 /21 /2020
PRIMARY CONTACT: OWNER❑ CONTRACTOR Q OTHER❑
NAME EMAIL
MAILING ADDRESS CITY STATE p
PHONE CELL f
PARCEL INFORMATION: l•
PARCEL NUMBER(12 Digit Number) 42205-52-00051 ZONING I8-Residential
LEGAL DESCRIPTION(Abbreviated) Lake Cushman#19 Lot 51 FIRE DISTRICT
SITE ADDRESS 61 N Gull Place CITY Hoodsport
DIRECTIONS TO SITE ADDRESS From Shelton,proceed Non 101 to Lake Cushman Rd;Tum L Proceed uphill a p pprox 4
m iles,Take slight L onto N Standstill Dr S,Turn L onto N Gull Place
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES® NO❑
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Clreckal/drnrnppl�);
SALTWATER❑ LAKE[N RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM I]
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION Z' REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residcnre.Garage.Commercial Bldg,Erc.) Shoreline Structure
IS USE: PRIMARY❑ SEASONAL® NUMBER OF BEDROOMS NUMBER OF BATI(ROOMS
HEATED STRUCTURE? YES(6Ylro/eBldg)❑ YES(Parr(sJofBldg)❑ NO❑
DESCRIBE WORK Construct wing walls off of existing bulkhead;Remove existing boat slip,breakwaters,gabions,etc.;Repair piles
-fe-in,,tall-licar,-repiace Lima piles
SQUARE FOOTAGE: (protxue iexrstnrgl
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❑ Delached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: '4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC® SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES❑ NO® If,es,attach completed Water Adequag7 Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO® 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 I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from ail 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 d 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 14.08.42)
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT ((
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC)HEALTH