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HomeMy WebLinkAboutBLD2023-01443 Remodel - BLD Application - 11/29/2023 MASON COUNTY COMMUNITY SERVICFS Permil�!L�T�7-,�_44J PERNT ASSISTANCE CENTER 'r . N 1 S.BUILDING.PLANNING.PUBLIC HEALTH.FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 � 1 7t Phone Shelton:(360)427--9670 ext 352•Fax.(360)427-7798 Plane Belfair.(360)275-4467•Phone E/ma:(360)482-5269 + BUILDING PERMIT APPLICATION 5 w Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Todd C.and Holly Fague NAME:Same MAILING ADDRESS:780 E Island Lake Or MAILING ADDRESS: Z CITY:Shelton STATRWA ZP:98584 CITY: STATE: M: PHONE#1:919-624-2473 PHONE: CELL: PHONE#2: EMAIL: EMAIL:thfagtle@gmail.com L&I REG# EXP. PRIMARY CONTACT: OWNER E) CONTRACTOR I] OTHER❑ NAME Todd C Fague EMAIL ttlfaoue@gmail.com MAILING ADDRESS 780 E Island Lake Dr CITY Shelton STATE WA ZIp98584 PHONE CELL 919-624 2473 M PARCEL INFORMATION: �! PARCEL NUMBER(12 Digit Number)32006-50-03001 ZONINGResldentlal LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT11 SITE ADDRESS780 E Island Lake Dr CTTySheHon DIRECTIONS TO SITE ADDRESS Off Island Lake Or IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO I] SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check all that apply): SALTWATER❑ I - RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW IZ ADDITION❑ ALTERATION© REPAIR❑ OTHER ❑ USE OF STRUCTURE OUsidence,Garage,Convnercial Bldg Etc.)Game Room IS USE: PRIMARY I] SEASONAL❑ NUMBER OF BEDROOMS3 NUMBER OF BATHROOMS3 3/4 HEATED STRUCTURE? YES(Whole Bldg)❑� YES(Part[s]ofBldg)❑ NO❑ DESCRIBE WORK,d,..m�,..�.....ronm•meR mw�....•c.�•�...�w...�+a.o.+....e�.m�ro�..,.ma.....a•.....,.�.on.��w�.,M,,.. SOUARE FOOTAGE: (proposed) 1ST FLOOR sq.ft. 2ND FLOOR sq.8. 3RD FLOOR sq.8. BASEMENT sq.ft DECK sq.ft. COVERED DECK sq.R. STORAGE sq.ft. OTHER sq.R 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 SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGEISEWER SOURCE: SEPTIC[/ SEWER❑ / NOW:%- EXISTING I] PLUMBING IN STRUCTURE? YES Q NO❑ If yes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NO© EXISTING SQ.FT. EXISTING BEDROOMS 3 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3 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 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 permit/application becomes null&void if 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 9F 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X /c ' C. Signature of 6WNER ust be si ne Date DEPARTMENTA.LREVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDTfIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH