HomeMy WebLinkAboutBLD2023-00032 Interior Improvements - BLD Application - 5/8/2023 MASON COUNTY COMMUNITY SERVICES Permit No: ll
PERMIT ASSISTANCE CENTER: 0—b
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL REU
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext.352•Fax (360)427-7798 Phone MAR 2 7 2023
Beifair:(360)2754467•Phan Elma:(360)462-5269
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Chris Noble NAME:T80
MAILING ADDRESS:9849 Concord Ct MAILING ADDRESS:
CITY:Highlands Ranh STATE:CO ZIP:80130 CITY: STATE: ZIP:
PHONE#1:7M 36140793 PHONE: CELL:
PHONE#2: EMAIL: — C
• � EMAIL,:olrcis.rolkQveNdine.com L&I REG# EXP.
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'O W PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER p r
NAME 0wWQos1.y-AmhoLmdAes r EMAIL darra—itlinppros—
MAILING ADDRESS 660 4th Street#124 CITY Son Frsnrlsco STATE CA ZIP 94107
PHONE CELL
� PARCEL INFORMATION:
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PARCEL NUMBER(12 Digit Number) 12329-41-eo240 ZONING GC
LEGAL DESCRIPTION(Abbreviated) LOT:A OF SP N1059 AF#395693 PTN OF NE SE FIRE DISTRICT North Mason
SITE ADDRESS 23970 Stars Routs 3 CITY Besa.,WA 98528
DIRECTIONS TO SITE ADDRESS APprox.1/4 mile NE of intersection of WA-300 and WA-3,East side of WA.3
IS THE PROJECT WPPHIN 300 FT OF SLOPE(S)GREATER THAN 14e/6: YES[] NO❑+ SNOW I OAD:NIA psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkd/draraWy):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK NEW❑ ADDITION❑ ALTERATION O REPAIR❑ OTHER Q
USE OF STRUCTURE(Residence,Garage,Conmrsrcld Bldg,Esc.)S-1 Commercial Building(Valvoline Of Change)
IS USE: PRIMARY O SEASONAL❑ NUMBER OF BEDROOMS 0 NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YES(Wha Bldg)❑ YES(Psrt(s]of Bldg)❑� NO❑
DESCRIBE WORK Interlor-only structural improvements to existing building. No change in use,occupancy,or tenant No associated MEP work.
SQUARE FOOTAGE:(P-P—)
1ST FLOOR 1732 sq.ft. 2ND FLOOR 0 sq.ft 3RD FLOOR 0 sq.ft BASEMENT 800 sq.ft
DECK 0 sq.ft COVERED DECK 0 sq.ft. STORAGE 0 sq.ft OTHER 0 sq.ft
GARAGE 0 sq.ft Attached❑ Detached❑ CARPORT 0 sq.ft Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: s4 COPIES OF THE FLOOR PLAN REQUIRED"
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form
PERIMETFRIFOUNDATION DRAINS PROPOSED? YES❑ NO[] 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 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 N 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 OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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Letter of Authorization
To:
Development Services Department
February 22, 2023
To whom it may concern:
the owner/owner's agent of Valvoline Instant Oil Change,
hereby authorize agents Dan Crowley and David Wood of Permitting Pros LLC to submit permit
documentation, sign forms/applications, and complete any other action related to the
submission of permit applications, on my behalf.
Sincerely,
2jZZ12
Signature Date
Gh ii s�ap�i� /✓oGTF_'
Printed Name
I
ppr_ LPlansPrinting &. site Requirements
MASON COUNTY
COMMUNTIY SERVICES .. __ .... .
The Mason County Community Services Department has completed.the plan review for
your project. You are now being issued a permit and can move forward with
construction. The attached flash drive contains the approved plans and supporting
documents.
Please follow these directions carefully and ask questions if you require additional
information.
1. Print ALL plan sets a minimum of 24x36 in COLOR. Have the sets available for
the County Inspection Staff as needed at the ALL inspections. Do not use the
plans for any reason except for inspection purposes.
2. Print one set of supporting documents in COLOR. Have the supporting
documents available for the County Inspection Staff as at ALL inspections.
3. Do not modify any documents by writing on them or changing them. Only the
"Approved" Stamped County Documents will be recognized for inspection
purposes.
4. If you do not have the approved documents available for the inspection staff,
your inspection may be canceled or delayed.
If you require additional information, please contact our County Permit Center at (360)
427-9670 extension 352.
1 acknowledge receipt of the approved documents and understand the requirements for
inspection documents being available on site.
Project Representative �� Date:
1