HomeMy WebLinkAboutCOM2021-00066 Sign - COM Application - 8/26/2024 Permit Nvzrogg sfkB
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MASON COUNTY
COMMUNITY DEVELOPMENT AUG 2 6 2024
Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAIN E: f W NAME: 1, ,/�1I�
MAILING ADD S: c 4 2IAILIN9 ADD SS:Zrj1- AN.? u Ids t1. CJl��rt/r
CTrY STAT :)pJq ZM%M�3 CITY STATE-ZIP: 1
PHO #1: 3 16��'f 9 `// PHONE:.3(ob'/ CELL:
PHONE#2: EMAIL: /QAttO z ti ai/ if Id tJe a COYIJ
EMAIL: L&I RE # f -D EXP.-Y-lL12
PRIMARY CONTACT:. OWNER[I CONTRACTORIM OTHER
NAME r EMAIL t f-14/1/t-C� -
MAILING ADDRESS Z41b fvw CITY� ' STATE,4,14 ZIP
PHON CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) ZONING
LEGAL DESCRIPTION(Abbreviated) 1 FIRE DISTRICT
SITE ADDRESS 2356 4 Ale&U a 2 CITY&Ilk I'p'
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WMaN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO a SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkall thatapply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION[IREPAIR[I OTHER t fa
USE OF STRUCTURE(Residence.Gamge,Commercial Bldg•Etc.) &d1 d1dA ►f l4`/
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS V NUMBER OF BATHROOMS
HEATED STRUCTURE? 7S(Whole BWg)❑ YES(Partlt of Bldg)❑ NO[I ,
DESCRIBE WORK Q 1 / _ z�
SQUARE FOOTAGE:(proposed) UL U C/Y) a2' olvt V
1ST FLOOR sq.ft 2ND FLOOR sq.ft. 3RD FLOOR sq.ft BASEMENT sq.ft.
DECK sq.ft COVERED DECK sq.ft STORAGE sq.ft OTHER sq.ft.
GARAGE sq.R Attached❑ Detached❑ CARPORT sq.ft Attached❑ Detached❑
NLANUFACTIMED HOME INYORMATION: *4 COPIES OF THE FLOO QUHiED*
MAKE YEAR
BEDROMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWERR / NEW❑ EXISTINMT
PLUMBING IN STRUCTURE? YES❑ NOZ Ifyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NQJT 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 permit/application 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 APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
YA' COUNTY CODE 14.08.42)
"71 i I 14
rgnature of OWNER(Must be signed by the OWNER I Date
DEPARTMENTALREVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT t"-All
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
rY� Com 2621-4 • ObouLP
stote
`72`e' A
(ate 3 Water Line
!, Existing Drivewat� $, APA Parking
K Sign
Set Back Line �y ,�' o.' .� �' Ramp
Property Line
50' Parking Required: ` I
�.. 3 per 1000 sq.feet
Power Line
Parking Provided:
1 Handicap-Front
5'i ""~�: ''j _.__.Existing blouse
f"' 3 Mditionai-Rear (No change to Footp
i Ramps udth a rise greater than 6"
1 Shall have handrails on each side,K "1 i
handrails are not required at a I I ► m
minimum edge Protection Is Ref
ANSI 117.1 2009,405.8.405A and j
t (�� section 505 For handrails when t /7
t i "• required, + - i
_ -Sewer Line
1 Shrubs
t i y A�,,. Tree _ -Existing DralnHel<
i I
a I
40 Ground Cover
I
li
t I Landscaping For Protect:
t t 1 rees
9 Shrubs:
50
f 90 Shrubs:at least 16"tell at I tr
10'>,' 1
i planting at least J-A'maturity I.---.- I
I
� j• Planting will meet the Foiloudng
j Requirements:
-drought resistance �
mix of evergreen and deciduous
50, shrubs I III
� -native to Puget Sound t3asln I
125Plan
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ie 4dre40' Parcel „1 2332 D p� 5Gafe: 1 is -' 20'
5ELBY DE51C7N LTD DESIGN FOR: !9 Address: 9 P,�
1027 Killeen PI 5w Pon Orchard,YVa 98367 Ted & Kathy Becker 23361 N E 5T RT 3
1� uuw.selbydcsignitdcom 9b0-bg9.1B26 March 31, 2Q22
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