HomeMy WebLinkAboutCOM2024-00047 Storage Tent, Concrete Slab - COM Application - 7/16/2024 :L''�'1ASO, Permit No: L�iYJ Zo
`1..°�`.�J�:l 1 1
COMMUNITY DEVELOPMENT
p,eri-itAssistancecenter,Buildin.&Rlanritng JUL 6 ZOZ4
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPLrADDRESS:
NER,NF�O1RMATION: CONTRACTOR INFORMATION:
NAME:
MAIL �).v tt �`S '�( MAILING ADDRESS: CM
CITY: STATE:W ZIP: CITY: STATE: ZIP:
PHONE#I: ,' 0 S �' PHONE: CELL:
PHONE#2: I EMAIL:
EMAIL: �R r lCY17 C,I✓1 L&I REG# ERE / /_
PRIMARY CONTA T: OWNER❑ CONTRACTOR❑ O HER'19.
NAME S�Aa w?. EMAIL r2 jl a e�effat 07 C��M�J� eL(7✓J'J
MAILING ADDRESS n 1 CITY �� t( STATE f ZIP
PHONE 1 CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) i �1 o q 3`a-9a ZONING
LEGAL DESCRIPTION(Abbreviated)_ c h� �.� i tdAS�ilr '� S FIRE DIST�R.ICT
SITE ADDRESS ( -CITY f3e[ i f
DIRECTIONS TO SITE ADDRESS t Id lik
41 cl,, C'k N btu— W 16
i
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO[o SNOW LOAD:11�psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check.uthotappty):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW V ADDITION❑ ALTER ON❑ _ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Gaingq Commercial Bldg,Etc) sv*^�"�,►i'
IS USE: .PRIMARY❑ SEASONAL$ NUMBER OF BEDROOMS NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(N.1,gBldg)❑ YES(Pax[s]of Bldg`)❑ (�NO W
DESCRIBE WORK 5: tAEin / 1 c'rt�C'tY_'1c P A2
SOUARE FOOTAGE:(pmpaseo
1ST FLOOR; t1V sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.& STORAGE sq.ft. OTHER sq_fL
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.R Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKg MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO I$ Ifyes,attach completed Water Adequacy 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 1 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 permitlapplicatlon becomes nun&void If work or authorized constructlon 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 (CATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
-.. '7_ 5'.o2ua9
x
Si ure of OWNER(Must be signed by the OWNER) Date
DEP TMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH