HomeMy WebLinkAboutBLD2024-00858 Rebuild Deck - BLD Application - 7/17/2024 ..U MASON COUNTY COMMUNITY SERVICES Permit No: l ;40` ' ` D
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext 352•Fax(360)427-779B Phone JUL 7 I,
Belfafr.(360)275-M67•Phone Elma:(360)482-5269 1 1 202T
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR ORMATION:
NAME: hukQt It NAME: �U" L.�C'
G ADD SS: E� i -,n 1�c� MARANG ADD SS: O �v SUy
CITY: STATE: ZIP: 5 CITY: on STATE: L")A ZIP:Cq1
PHONE#1: PHONE: L: `1tJ
PHONE#2: 4a� 1= ej
EMAM: L&I REG r1 t7WAM.W/aj%
PRIMARY O ACT: OWNER❑ CONTRACTORS O�fiE
NAME 1d1F;Ca(- v,1 kap �C Of
MAILINGADDRESS C'L c ITY STATE ZIP " �J
PHONE 0 CELL
PARCEL INFORMATION: ('� /� 1
PARCELNUMBER(12DigitNumber)_3�1�7'S m Woo 4 ZONING
LEGAL DESCRIPTION(Abbreviate( FIRE DIST CT
SITEADDRESSI L— I 1 cI y-511L OCR '
DIRECTIONS TO SITE ADDRESS
J
IS THE PROJECT WTI ]N 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO❑ SNOW LOAD:--.psf I�
IS PROPERTY VMBIN 200 FT OF THE FOLLOWING: (Checkall tharapply):
SALTWATER❑ LAKE RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION.K REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,GaragS Commerdal Bldg,Etc
IS USE: PRIMARY❑ SEASONAL JX NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? -YEES(FAoleBld S(Part(s)ofBldg)❑ NO❑
DESCRIBE WORK R '1 1
S9UARE FOOTAGE:(prapw4
1ST FLOOR sq.1 2ND FLOOR sq.I 3RD FLOOR sq.R BASEMENT sq.&
DECK sq.R COVERED DECK sq.fL STORAGE sq.ft OTHER sq.8
GARAGE sq.fL Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED + INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE EL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES)( NO❑ IYyas,attach completed WaterAdeguacy Form
PERIMETERNOUNDATION 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 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 permitlapplication 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 A PLIC ION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) l
gnature of OWNER(Must be signed by the OWNER) Date
�EPART]VIENTAL_REVIl Rr j•'= 4PPROVEDE'= DATE``.s:=AENIED_.- DATE;`.�-TAGS/NOTES/CONDITIONS��
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH