HomeMy WebLinkAboutBLD2024-00271 - BLD CD Environmental Health Review - 3/5/2024 ENVIRONMENTRETIDIt No: 0LQgDR�
MASON COUNTY HEALTH rCEI 7
COMMUNITY DEVELOPMENT o
PermitAssistance Center, Building,Planning FEB 29 2024
BUILDING PERMIT APPLICATIONN Alder Street Olso wed
d6.
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Jed Curtis NAME:Cameron Damskov
MAILING ADDRESS:50 E. Bucking am Ln. MAILING ADDRESS: 1940 124th Ave. NE, te. A10
CITY:Grapeview STATE:WA ZIP:98546 CITY:Bellevue STATE:WA Zip:98005
PHONE#1:425-753-1300 PHONE:425-454-8059 CELL:
PHONE#2:425-557-2680 EMAIL :cameron@damskovconstruction.com
EMAIL:jedcurtis@gmail.com L&I REG#DAMSKCL877DN EXP. 04/06/25
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER❑
NAME Len Williams. Architecture EMAIL IenCrd
_ illiams-arChiteClure.COm
Williamsam
MAILING ADDRESS PO BOX 102 CITY SHELTON STATE WA ZIP 98584
PHONE 360-426-0511 CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 1 21 0 8-1 1-9001 2 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) LOT2 OF SP#3150 AF#218565 FIRE DISTRICT
SITE ADDRESS 50 E. BUCKINGHAM LN. CITY GRAPEVI EW
DIRECTIONS TO SITE ADDRESS TAKE WA-3 N. RIGHT ON E. GRAPEVIEW LOOP RD.
STREIGHT ON E. ECKERT RD. CONTINUE ON BUCKINGHAM LN. SITE IS ON RIGHT.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN]i YES❑ NO E] SNOW LOAD..2�sf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkallthatopply):
SALTWATER[a LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM ❑
TYPE OF WORK: NEW❑+ ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER ❑REPLACEMENT
USE OF STRUCTURE(. eeldmce,Garage.GmamemisiBldg.EA,.)Garage
IS USE: PRIMARY ❑+ SEASONAL❑ NUMBER OF BEDROOMS 0 NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YES(WholeStdg) ❑ YES(Port(e)ofemg)❑+ NO❑
DESCRIBE WORK CONSTRUCT NEW GARAGE AND HOBBY ROOM TO REPLACE EXISTING
SOUARE FOOTAGE: (prepared)
I v'
1ST FLOG sq. ft. 2ND FLOOR sq.R 3RD FLOOR sq.ft. BASEMENT 834 sq.ft.
i DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
1
n` qkliAGE sq. ft. Attached Q Detached❑ CARPORT sq.ft. Attached❑ Detached❑
U
ME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL AR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGF/SEWER SOURCE: SEPTIC E❑ SEWER❑ / NEW El EXISTING❑
PLUMBING IN STRUCTURE? YES ❑' NO❑ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES +❑ NOD EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 0 TOTAL BEDROOMS 0
OWNER acknowledges that submission of Inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such ie by
signature below.I decors that I am the owner and I Posher declare Brat 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 etruclure(s)for review and inspection. This permNapplicatlon becomes null a void if work or authorized constructon 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 OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
j�cO�U/y.TY CODE 14.08.42)
X G / 2-29-24
Signature of agent 11-- Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH G C f
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