HomeMy WebLinkAboutBLD2024-00741 - BLD CD Environmental Health Review - 6/21/2024 MASON COUNTY COMMUNITY SERVICES Permit No:&0g60,7y'/)h7t,�
PERMIT ASSISTANCE CENTER:
BUILDING a PLANNING•PUBLIC HEALTH a FIRE MARSHAL RECEIVED
615 W.Alder Street,Shelton,WA 98584
Phone Belfaic(360)275-4467 Phone Elmo:(90)482- Phone
5269 JUN 17
2024
BUILDING PERMIT APPLICATION15 V11. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORM.CNDIfiJONMENTA
NAME:Bob 4 Agnes LaTumw NAME: HFIlI TH
MAILING ADDRESS:22212351h Ct.NE MAILING ADDRESS:
CITY:Sammamish STATE:WA ZIP:W74 CITY: STATE: ZIP:-
PHONE#1:425-7356892 PHONE: CELL:
PHONE#2:42543"893 EMAIL:
EMAIL:datumer®wmeasl.nel L&I REG# EXP. /
PRIMARY CONTACT: OWNER Ei CONTRACTOR❑ OTHER[] T
NAME EMAIL .+
MAILINGADDRESS CITY STATE_ ZIP r'
PHONE CELL p r
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 52004-50-00026 ZONING M5
LEGAL DESCRIPTION(Abbreviated) 14M.zel Bccch TR 26 FIRE DISTRICT 16
SITE ADDRESS 3D1 W Nahwatzel Beach Drive CITY Shallow,
DIRECTIONS TO SITE ADDRESS Take Shelton Matlock Rd.west toward Dayton.Stay on the road not lust getting to lake Nam1dml.Take an RIGHT
on W.Nahwa2el Beach Dr.301 will be an the left.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO Q+ SNOW LOAD:Su` nsf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checka111hatapply):
SALTWATER❑ LAKE 2 RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM
TYPE OF WORK: NEW EI ADDITION❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Beadesm.Garage,Commercial Bldg,Etc.)Garage
IS USE: PRIMARY E+ SEASONAL❑ NUMBER OF BEDROOMS 0 NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YES(while Bldg)❑ YES/ParQrl ofS1dg) ❑ NO Q+
DESCRIBE WORK New Garage w1a,malstorage space in uppergoor
SQUARE FOOTAGE: ovopored)
1ST FLOOR672 sq.ft. 2ND FLOOR338 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❑ Detached 0 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 El SEWER❑ / NEW EXISTING Q
PLUMBING IN STRUCTURE? YES [I NO❑ Iri attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOE] 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.AGnowledgemsnt of such is by
signature below.I declare that 1 am the owner and I further declare that I am smiled 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 stmcture(s)for review and inspection. This permitlappllcation becomes null 6 void 9work or adhor zad construction is not commenced within 180
days or R 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)
Pignaturl of OWNER Must be sinned D to
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
! �
. /,
\
\ `
| | (T7|
§ � ) §
- a | .
k � / r k )
` \ \ ` t a¥ A
=---
\ i w� \ ~ d
|
$ /
i f � `
750 \
9 � w
�
y; 7 `
.N
■ Ji ( () !! �..
= G !
w {�/