HomeMy WebLinkAboutCOM2022-00016-00028 Cancelled Holland Self Storage Phase 1 Bldgs - COM Application - 4/19/2022 M
HOLLAND SELF STORAGE
PHASE 1
12 STORA , E BLDGS
COM2022 -0001 &/"-j BLDG A (HEATED)
COM2022- OGPO17 ^' BLDG B
COM2022 -WO19 "` BLDG C (HEATED)
CO �~L -000 0 �! BLDG D
co 2-00022 "' LDG E
COM2022 -00023 "' BLDG F
COM202 -00024 ^' BLDG G
COM2022 -00018 ^' BLDG H (HEATED)
COM2022 -00025 � BLDG
COM2022 -00026 "' BLDG J
COM2022 -00027 ^' BLDG K
COM2022 -00028 � BLDG L
�d A
MASON COUNTY COMMUNITY SERVICES Permit No: I
PERMIT ASSISTANCE CENTER: LIP
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:360)2 5-4 670 ext.Phone
•Fax:(360)827-7798 Phone Beflair.,(360)275�467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: OL[ N N 97 -Alrs Lt,C- NAME: T'$D
MAILING ADDRESS: f rU MAILING ADDRESS:
crrY:5jA&•ToA1 STATE: ZIP:9f3yR¢ CITY: STATE: ZIP:
PHONE 41: 2 57- (oUG Cl PHONE: CELL:
PHONE#2: _ ZS - $84- C7i)3/ /- EMAIL:
EMAIL: tULyhell eSnf CdM L&I REG# EXP._/_/
PRIMARY CONTA OWNER CONTRACTOR❑ OTHER❑
NAME T: J L-L-A_D EMAIL
MAILING ADDRESS I O N / e R0
CITY G-L STATF 71P
PHONE �jAI - �L,�7 . SOf CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 2 fe.7DZ-5' _ZONING (NP(45iWAL
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
SITE ADDRESS Al S L CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO SNOW LOAD:2 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Ch.k.11 dat
SALTWATER❑ LAKL•❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residnnw.Garage.C...nrrrciul Bldg.El,.) 74 L F e7 I BRA 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(IVhale Bldg), YES IPartjj of Bldg)❑ NO❑
DESCRIBE WORK_
SOUARE FOOTAGE:(proposed)
1ST FLOO .ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.fl. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE rV A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: f\I A 0 10L'4m 0/,,JG
SF.WAGE/SFWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ifyec,attach campleled Water Adequacy Farnr
PERIMETERNOUNDATION 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 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 permlUapplication 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. INACTMTY 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 slaned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED 'DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
41Etm ,Id'
MASON COUNTY COMMUNITY SERVICES Permit No
PERMIT ASSISTANCE CENTER.
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i
I 615 W.Alder Street,Shelton,WA 98584 i
Phone Shelton:360)2 5446 0 P ne•Fax:360)42-52 98 Phone - �14A��
Beflalr.•(360)275-0467•Phone Elora:(360)482-5269
BUILDING PERMIT APPLICATION
i
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4DLLAmp 1N*%MedrS L L C- NAME:
'T$D
MAILING ADDRESS: f N MAILING ADDRESS:
CITY:514 EL A STATE: ZIP:122 CITY: STATE: ZIP: i
PHONE#1: Gi PHONE: _CELL:
PHONE#'_: 2 S 3 - !_S 03/ EMAU,:
EMAIL:-juaj h,91l aid Q M Sy4 41M L&I REG# EXP.
PRIMARY CONTA T: OWNER)K CONTRACTOR❑ OTHER❑
NAME �1-I-l;Alp EMAIL
MAILING ADDRESS q 1 O iv / IQD CITY LL STATE ZIP
PHONE ?�J _r:+-j9:? • SO,6 J CELL
PARCEL INFORMATION: 2 2 atiA
PARCEL NUMBER(12 Digit Number) 7 2Qo 4 4/ 9 DOZ,,5, —ZONING I NP M 57WAL j
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
i
SITE ADDRESS jowyS CITY
DIRECTIONS TO SITE ADDRESS !
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO)( SNOW LOAD:?55 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chrek al/rhm apph-):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERCGATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence.Gnrugq G,m—ial Bldg,Etc) J�LF- S ORA 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(whole Bldg), YES(PargsjofBldg)❑ NO❑
DESCRIBE WORK_ I �I
SOUARE FOOTAGE:(pmposed)
IST FLOOR :fL 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. !
DECK sq.ft. COVERED DECK sq.R STORAGE sq.fl. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU /^END HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE � �-t MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA o Lyouof,, ,
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ !jj•ec,attach completed WalerAdeyaacv Form
PERTMETERTOUNDATION 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 revocabon.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 i
and structure(s)for review and inspection.This permttJapplication 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. INACTMTY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X
I
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED. -DATE DENIED `DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT 5
FIRE MARSHAL
PUBLIC HEALTH
Fire Marshal's Office
615 W. Alder St
Shelton WA 98584
rcollins@masoncountywa.gov
MEMORANDUM
FROM: Randy Collins, Fire Marshal
TO: Holland Investments LLC PO Box 581 Wauna WA 98584
DATE: May 31 , 2022
TOPIC: Fire Plan Check Approval, Holland Self-Storage (COM 2022-00016)
The plans for the above-mentioned project have been approved subject to the
following conditions:
1. Gates: Electric gates shall be equipped with a means (key switch) for opening by the
fire department. Emergency opening devices shall be listed in accordance with UL 325,
designed constructed/installed with the requirements of ASTM F2200 and be submitted
for approval by the Fire Marshal (MCBC 14.17.125).
2. Fire Alarms: Buildings in excess of 2000 square feet or buildings separated into "Fire
Areas" in excess of 2000 square feet shall be equipped with a Fire Alarm that conforms
to NFPA 72. Plans for said system shall be submitted and approved by this office prior
to installation (MCBC Fire Flow Worksheet).
If you have any questions regarding the plan review or these conditions, please
contact me at: rcollins masoncountywa.gov
MASON COUNTY COMMUNITY SERVICES Permit No: COm 2621--W1
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING.PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(860)427-9670 ext. •Fax:(360)42 98 Phone �ffA I`✓— i
Bedair.•(360)275�467•Phone na Elms:(360)482-52-5269 ?G �
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4OLLAND 1N*5fj-MErJT's LL C- NAME: T$D
MAILING ADDRESS:-31610 J0140 MAILING ADDRESS:
CITY:$'j4&-T0�1 STATE: M ZIP:9 5-0+ CITY: STATE: ZIP:
PHONE##I: 2 7• Loor�4 PHONE: CELL:
PHONE#t2:_- 25 3 - $84_ 903/ EMAIL:
EMAIL: of 1 inha 11 a- idgnf 60M L&I REG i# EXP.
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME 1 LJ.•Aw1p EMAIL
MAILING ADDRESS Ib 13 0 014 N IAZJe JQ0 CITY 91 6V TPOU STATE ZIP
PHONE 7_CJ _911C,7 . 5_L CELL
PARCEL INFORMATION:PARCEL NUMBER(12 Digit Numbcr) 32bb4 43 q IOOZ. ZONING 11VPWVWAL
LEGAL DESCRIPTION(Abbrcviatcd)
^FIRE DISTRICT
SITE ADDRESS JOl-(A75 IM1,121 CITY
DIRECTIONS TO SITE ADDRESS tt
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES❑ NOX SNOW LOAD:2 77 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (ChnkaRrhrRapplvl:
SALTWATER❑ LAKE-❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW)( ADDITION❑ ALTERATION❑ GREPAIR❑ OTHER ❑
USE OF STRUCTURE(R sidenre.Garage.C--rml Bldg. .f Lr'- 'j I DRA 66
IS USE: PRIMARY❑ SEASONAL❑ NU R NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(IV/,aleRl'dn)W- - VFSrP-1,Iatl�d,
DESCRIBE WORK_ Uh r^ ' zd— e II
S UARE FOOTAGE:(proposed)
ISTFLOOR98Wsci.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.It
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq,ft. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE tV A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA x o L'4m ol-16
SF,WAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ /f)•er,attach completed Water Adeyuacv Form
PERTMETER/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 j
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
I 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 permitlapplication becomes null 6 void 9 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. INACTMTY 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
Fire Marshal's Office
615 W. Alder St
Shelton WA 98584
d7Xb rcollins@masoncountywa.gov
Mr
MEMORANDUM
FROM: Randy Collins, Fire Marshal
TO: Holland Investments LLC PO Box 581 Wauna WA 98584
DATE: May 31 , 2022
TOPIC: Fire Plan Check Approval, Holland Self-Storage Bldg. B (COM 2022-
00017)
The plans for the above-mentioned project have been approved subject to the
following conditions:
1. Fire Alarms: Buildings in excess of 2000 square feet or buildings separated into "Fire
Areas" in excess of 2000 square feet shall be equipped with a Fire Alarm that conforms
to NFPA 72. Plans for said system shall be submitted and approved by this office prior
to installation (MCBC Fire Flow Worksheet).
If you have any questions regarding the plan review or these conditions, please
contact me at: rcollins masoncountywa.c�ov
MASON COUNTY COMMUNITY SERVICES Permit No: W I�
PERMIT ASSISTANCE CENTER: �� �"of
•BUILDING•PLANNING.PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone ��� I j
Beffair(3W)275-4467•Phone Elma:(360)482-5269 C✓n
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 0U4%N NV&9T -A1rs l.Lc- NAME: T$D
MAILING ADDRESS:?Ifco 00405MAILING ADDRESS:
CITY:51AC-4-TDA1 STATE:_ZIP: ¢ CITY: STATE: ZIP: �
PHONE fl 1: 2 9 rj7- fobL, PHONE: CELL:
PHONE#2: ?,53 95154-5D3/ EMAIL:
EMAIL:) it 1l Q /N SnJ CAM L&I REG f( EXP.
PRIMARY CONTACT' OWNER CONTRACTOR❑ OTHER❑
NAME ItM I 9D EMAIL
MAILING ADDRESS I6 bS r&91gj.-- CITY 6V STATE L41A ZIP
PHONE_ 9�S7 CELL
PARCEL INFORMATION: ,
PARCEL NUMBER(12 Digit Numbcr) 32004 43 9ooZ5 _ZONING 10C157WAL
LEGAL DESCRIPTION(Abbrcviatcd) r FIRE DISTRICT
SITE ADDRESS JDL{A75 jjL4/9/1S CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S) II°•H0'f4••: YES❑ NO)( SNOW LOAD:Z 55 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (C'hsienl/A t ph' �
SALTWATER❑ LAKE❑LAKE RIVER/CREEK❑ POND❑ WE Dt�_^;SE NAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ IEPA ❑ OTHER El
USE OF STRUCTURE(Residenrr.Gor g,,Gmre—ml Bldg,Err.) 7L LF— 51 DRiq 6C
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES IfvholeBldg) YES(Pnrt(.r/*fBidg) NO F1
DESCRIBE WORK_ )
SOUARE FOOTAGE:(proposed)
I ST FLOORNC6 sq I. 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.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ^ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE � /"� MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA No LY,t &-if.
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ifyec,attach completed Water Adequacy Fnrnh
PERIMETERTOUNDATION 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 j
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. INACTMTY 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
MASON COUNTY COMMUNITY SERVICES Permit No: CAM�Z��D�ot
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)4 5-4 670 ePL Phone
•Fax:(360)42-52 98 Phone ^14A I V
Beflair.•(360)275-0467•Phone Elma:(360)482-5269 1I1/ G✓.
BUILDING PERMIT APPLICATION i
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 40 N*9T _A1 6 LLB NAME: T$D
MAILING ADDRESS:?(61) 004IJ5 AA7Jd MAILING ADDRESS:
CITY:5146LTDAJ STATE:_//ZIP:9RyA¢ CITY: STATE: ZIP:
PHONE Ill: 29j - $rjl- (onr—c' PHONE: CELL:
PHONE#2: 2 5 3 - '51aU�Le
EMAIL: `
EMAIL: j jMhe1j G# EXP.
PRIMARY CONTA T: OWNER; CONTRACTOR❑ OTHER❑
NAME EMAIL
MAILINGADDRESS 1 O N / PO CITY 9161,TVAJ STATE 71P i
PHONE_')Ci7i $C�7 . 4l1 f CELL — — -
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Numbcr) 320b 4 43 9 oozy ZONING (NDu 57WAL j
LEGAL DESCRIPTION(Abbrcviated) r FIRE DISTRICT
SITE ADDRESS JoC{A75 /rZ/L CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOX SNOW LOAD:2 55 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all dva appM):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(R,,mdeare,Garage,Commrrcial Bldg.6rr.J Jt= 10I 0FAQ 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(lvlmleBldg) YES Wart(ajoj&dg) NO fl
DESCRIBE WORK— )
SQUARE FOOTAGE:rproposev"
I ST FLOOKY:Mb sq:fL 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.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ j
MANUFACTU /nEND HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE q kY MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA No Lqm o1n16
SEWAGEISEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ij)•ec,attach completed WaterAderlrmcv Form
PERIMETERIFOUNDATION 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 l 1
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 permitlapplication becomes null 8 void if work or authorized construction is not commenced within 180
days or C construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTWITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) j
X i
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
MASON COUNTY COMMUNITY SERVICES Permit r�//
No 2(� (N
PERMIT ASSISTANCE CENTER: ,
•BUILDING•PLANNING•PUBLIC HEALTH.FIRE MARSHAL
I 615 W.Alder Street,Shelton,WA 98584
Phone Shelton:360)2 5-4 670 ext.Phone
•Fax:(360)427-7798 Phone
Betlair.•(360)275�467•Phone Elma:(360)482-5269
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4OLLAND /NV&9-JftF1J'r:6 LL-C- NAME: T$D
MAILING ADDRESS: 0040 MAILING ADDRESS:
CITY:�D46LTOA) STATE:_ZIP:_"r2f)+ CITY: STATE: ZIP:
PHONE#1: 2 r7 $ 7- Lar'C, PHONE: CELL:
PHONE#?� _ 25 �84- O3/ EMAIL:
EMAIL: tI I�I��1laand� 5r4 40M L&I REG# EXP.
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME ) LL4^1D EMAIL
MAILING ADDRESS ib D 0 0140 / CITY L� STATE ZIP
PHONE 'j�!?JL =�,4T 2J CELL
PARCEL INFORMATION: ,
PARCEL NUMBER(12 Digit Number) 32004 43 9 DOZ 5, _ _ ZONING INP14 57WAL
LEGAL DESCRIPTION(Abbreviated) t —FIRE DISTRICT
SITE ADDRESS A7 S S CITY
DIRECTIONS TO SITE ADDRESS
i'
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER 4•/ NO)( SNOW LOAD:2 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (chrnt o11 rbn, p I:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND SONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW)( ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Rr.sidrnrr.G rugr,Comerrrdal Bldg.Etc) 51:LF' ev I OR04 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? VPc,,..,._,_02,_,)Srf vcc ,•,.,,fl NO F1
DESCRIBE WORK 1� Lrfi ��J L)n-htL
SOUARE FOOTAGE:,p,p..di
IST FLOOR q!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.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ppED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE � /'t MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: NIA No Lt f M fb/nlG
SFWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ /j3•er•attach completed Water Adequacy Form
PERIMETERIFOUNDATION 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 I am entitled to receive this permit and to do the work as proposed.1 have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this projecL 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 permitlapplication becomes null&void 0 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
MASON COUNTY COMMUNITY SE Permit �`.SERVICES No. 2 "Zo
PERMIT ASSISTANCE CENTER. j
.BUILDING•PLANNING.PUBLIC HEALTH-FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584 i
Phone Shelton:(360)4270 •Fax(360)42 98 Phone
Belait(360)275-4467•Phone Elma:(360)482-5269 ^` L A✓s L
BUILDING PERMIT APPLICATION III
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: OUAN NVG-5rj -AJrs LAC- NAME: -TOP
MAILING ADDRESS:-3r60 J04)05 Y1Z4AZM MAILING ADDRESS:
CITY:5J46LTOIJ STATE: ZIP: ¢ CITY: STATE: ZIP:
PHONE#I: 2 7 57- ( Q&4 PHONE: CELL:
PHONE#2: 2 Sh84- EMAIL:
EMAIL: �) h e ll eSni. CAM L&I REG# EXP.
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME f 41A*JD EMAIL
MAILING ADDRESS 161) 00140S t'9,91jZ1,e90 CITY GLI STATE WA ZIP
PHONE - `d C,� • 4a.6 f CELL
PARCEL INFORMATION: 2 2 ,
PARCEL NUMBER(12 Digit Numbcr) 7 ZOb 4 4 1 q I oo rl', _ _r ZONING 1 ND M 57WAL
LEGAL DESCRIPTION(Abbreviatcd) r FIRE DISTRICT !
SITE ADDRESS j owy 5 CITY
DIRECTIONS TO SITE ADDRESS
I
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOX SNOW LOAD:2-psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (ch«•,tondrrtrpph-):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE OZ sid,n .Ga ge.Gmme—W Bldg.Err.) 71 L G
-F— 7T02,04 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS i
HEATED STRUCTURE? vFc el_,lzf vice _gnu r rl NO I1
DESCRIBE WORK
SQUARE FOOTAGE:(proposed) 5 j
IST FLOOR3a—YZsq:ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. i
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE IV A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA No L[1M 6/"jl6
SFWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ !jj•er•attach completed Water Adequacy Form
PERTMETER/FOUNDATiON DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
i
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 j
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 or Mason County access to the above described property
and structure(s)for review and inspection.This permit/application becomes null 8 void 6 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
i
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
i
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED ']DATE^ DENIED -DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT S
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit No: 2 Q . Cho 0 22
PERMIT ASSISTANCE CENTER: j
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL j
615 W.Alder Street,Shelton,WA 98584 i
Phone Shelton:360)2 5-4 670 ext.Phone
•Fax:(360)42-52 98 Phone - ^14A I G
Beflair.(360)275-0467.Phone Elms:(360)482-5269 !`I/ G✓?
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4OUAND L-LC- NAME:
MAILING ADDRESS:-3160 J041JSMAILING ADDRESS:
CITY:51-4C-.IDIt) STATE: W/4 ZIP: rj8¢ CITY: STATE: ZIP:
PHONE#1: 2rj 3 - 1r57- ( n4 51 - _ PHONE: CELL:
PHONE#2: 25?j =j84- cj03/ EMAIL: 1
EMAIL: J l M h a ll Q /A sn1 CDM L&I REG# EXP.
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME 141 5 EMAIL
MAILING ADDRESS 1 001405 / A0 CITY STATE ZIP
PHONE J�r.7 • !jj2ZI I CELL
PARCEL INFORMATION:
� 1
PARCEL NUMBER(12 Digit Numbcr).32004 �?j 1 c�oon,
LEGAL DESCRIPTION(Abbreviatcd) r FIRE DI C
SITE ADDRESS J 0"A;S /R/L CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOX SNOW LOAD:2-psf i
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (cne,x�ndmrnpph-):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE/Rrsiden .Garuge.C--iat Bldg,Err.J 5j=�F- 101 09A 6 �-
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURF? vcc rnr,r i fl Nn n I
DESCRIBE WORK_ 6Eie ,IZt c—i U
SQUARE FOOTAGE:(proposed)
1ST FLOOR 'Q56sq!ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.IL STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ I
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* j
MAKE A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: NIA ' No L (4m 0/,.JG
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING 1N STRUCTURE? YES❑ NO❑ /j)•ec,attach completed Water Adeyuacv Forni
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 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 permitlapplication becomes null 8 void it work or authorized construction is not commenced within 180
days or if construction wait 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
COUNTY CODE 14.08.42)
X
i
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
'b E
4- MASON COUNTY COMMUNITY SERVICES Permit No: 0(l)I) rLO . 00 22•-
PERMIT ASSISTANCE CENTER: j
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL j
615 W.Alder Street,Shelton,WA 98584
Phone Shelton:(360)4 5-4 670 P ne•Fax:(360)42-52 98 Phone off A5C x r Beflair.(360)275-4467•Phone Elma:(360)482-5269 III
-F
BUILDING PERMIT APPLICATION i
1
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4OUAND /1q*5rfMFA1-r6 LLG NAME:
MAILING ADDRESS:-3160 004fisMAILING ADDRESS:
CITY:$)jG-LtOIJ STATE: W1 ZIP:9�5R¢ CITY: STATE: ZIP:
PHONE#1: 29 3- M7- L. 0651 PHONE: CELL:
PHON / EMAIL:
EMAIL: t J IM h a ll L 1�5t4. CDM L&I REG# EXP.
-- I
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME o"-4J✓15 EMAIL I
MAILING ADDRESS 1D 0014110S / Rfl CITY 511 L'L TE WA ZIP
PHONE 7 Ct7k �4� • tip Get l CELL
PARCEL INFORMATION: 2 ,
PARCEL NUMBER(12 Digit Number) 3 20b 4 % e7 oon, _ c- I ZONING s L
1
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
SITE ADDRESS JOH IV S X I-19JL CITY 1
DIRECTIONS TO SITE ADDRESS
. �
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES❑ NOX SNOW LOAD:2 CC 77 psf I
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: /check aB rhw app{wl:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ GREPAIR❑ OTHER ❑
USE OF STRUCTURE lRr.<idener.Gar ear,Gym dr l Bldg.Dr.) JL%`^ ✓10)2A 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURF? yr C.Rn. .mom_ vtc.n r-r_rnu-r fl NO F1 I
DESCRIBE WORK_ SEIF 1"Ct Ltd (�n TEA
SQUARE FOOTAGE:rp.,p dl
I ST FLOOR.276q:fL 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.fi. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* j
MAKE xj A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: /VJ A q Q L14,w of,-jG
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NFW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ If)-er,attach completed Water Adequacy Form
PERTMETER/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 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 projecL The owner or legal i
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 I 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. INACTMTY OF THIS ,
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON j
COUNTY CODE 14.08.42)
i
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
Abu F
MASON COUNTY COMMUNITY SERVICES Permit No: 0,r'120Z - O W 0�-3
PERMIT ASSISTANCE CENTER: j
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i
615 W.Alder Street,Shelton,WA 985M
i
Phone Shelton:360)2 5-4 670 ePL Phone
•Fax:(360)42-52 98 Phone - ^14A�& _
BeBalr.(360)275�467•Pfrone Elma:(3ti0)482-5269 ill/
BUILDING PERMIT APPLICATION
I
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAMEJ40LLAN HV%5rjf -Airs L-LC-
NAME: Tg1D i
MAILING ADDRESS:-3161) c !J MAILING ADDRESS:
CiTY:S14E[-IDNI STATE:_/WZIP: �• CITY: STATE: ZIP:
PHONE#l: 25 3_ S57- CDQ6 G! PHONE: CELL: I
PHONE#2: 25 3 - 1584 - Cj Zia/ EMAII —
EMAIL: jjjhe11 e L&I REG# EXP.
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑ i
NAME fm 14o4AtCD EMAIL
MAILING ADDRESS q 1 a N / AO CITY $ 6V STATE zip
PHONE 7_�j�r - u riBf CELL
PARCEL INFORMATION: i
PARCEL NUMBER(12 Digit Numbcr) 32004 43 q f OOZ rJ, _ 1 ZONING NP M STEAL
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
SITE ADDRESS jot-IMS 11��—qlglg CITY I
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPES(GREATER THAN 14%: YES[] NOX SNOW LOAD:2 55 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: 1Chrek all d t opph): '
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL R ❑ STREAM❑
TYPE OF WORK: NEW)� ADDITION❑ ALTERATION❑ REPAIR❑ O
USE OF STRUCTURE(Recidence.Garwge.Cammerrial Bldg,Err.) 71!1-P— _✓I OR/Q 66 ;
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHR!00/AS
HEATED STRUCTURF? Vr:c nw...r- M vcc,awr.r rau r FI No n I
DESCRIBE WORK
SQUARE FOOTAGE:(pmpored) IIA163 j
IST FLOOR_3z�5b5q:ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.fL STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft.Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
I
MANUFACTU /END HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* i
MAKE
MODEL YEAR LENGTH i
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA No Lymop-jG
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE! YES❑ NO❑ Ifyec,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 I am enured 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 1
and structure(s)for review and inspection.This permit/application becomes null&void H 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 I Date
DEPARTMENTAL REVIEW APPROVED 'DATE DENIED `DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit No: 7 � 2
PERMIT ASSISTANCE CENTER.
.BUILDING-PLANNING-PUBLIC HEALTH-FIRE MARSHAL 1
615 W.Alder Street,Shelton,WA 98584
- Phone Shelton:360)2 5-4 670 ext.Phone
•Fax:(860)42-52 98 Phone f 14n I C .�• s
BeNair.•(360)275-4467•Phone Elma:(360)482-5269 !✓^ -ll-
-- mF
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:_4OLLAND /AIVL9-J-41E^!T_S_ LLC- NAME: T$D
MAILING ADDRESS:3lbpA75 KAA2/cs MAILING ADDRESS:
CITY:SI-C- TOIJ STATE: W14 ZiP:g ¢ CITY: STATE: ZIP:
PHONE#I: PHONE: CELL:
PHONE#2: 253 - $84- cj031 EMAIL:
EMAIL:-jiliYj h e ll Q M Sol. Cd n L&I REG# EXP.
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME LLAw1p EMAIL
MAILINGADDRESS l iy / CITY CL STATE ZIP
PHONE _I_tj?i ��? CiO�� CELL
PARCEL INFORMATION: i
PARCEL NUMBER(12 Digit Number) lob 4 43 9 ooZ`J, 1 ZONING JNP"SWAL
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT r.
SITE ADDRESS J01-(N5 U/FZ/L CITY
DIRECTIONS TO SITE ADDRESS
i
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOX SNOW LO 5 psf i
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (ChnkaA,ha,appk):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑
TYPE OF WORK: NEW ADDITION❑ ALTERAATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(R sidener,Garver.Comes,60 Bldg,E,c) 1Jl%1.F— ed I ORA 66 �U
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? ��
DESCRIBE WORK__ S:�ff5'o 1d U e
SOUARE FOOTAGE:rprapased) ._ ��
I ST FLOOR5;;7bq:ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.fL STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* i
MAKE � MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: MIA Q 10Ltfm 0/nJ(�
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ij)•ea,attach completed Water Adeyuacv Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
I
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 permiVappiicalion becomes null&void if work or authorized construction is not commenced within 180 i
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. INACTMTY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON i
COUNTY CODE 14.08.42) j
I
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW > APPROVED. -DATE DENIED `DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT i
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit No: i X0 I
PERMIT ASSISTANCE CENTER:
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i
I 615 W.Alder Street,Shelton,WA 98584
--' Phone Shelton:360)2 5-4 670 ext.Phone
•Fax:(360)42-52 98 Phone - ^14A,576
Bellair.(360)275-4467•Phone Elma:(360)482-5269 !1/
BUILDING PERMIT APPLICATION j
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 40U4WD MVL%McAIT`5 L -C- NAME: T'$D
MAILING ADDRESS:3160 J04tis 114)x� MAILING ADDRESS:
CITY:5146L O-0 STATE:/ ZTP:g"yg¢ CITY: STATE: ZIP:
PHONE#1: T 5-_- $4-1- C:,n4 5k PHONE: CELL:
PHONE#?: _ Zri3'Tj84- Gj03/ EMAIL:
EMAIL:Jjmhell L L&I REG# EXP.
PRIMARY CONTA T: OWNERX CONTRACTOR❑ OTHER❑
NAME I l-1-") EMAIL
MAILING ADDRESS I O N / PO CITY SI Ell STATE 7.1P
PHONE �j�il�_�C.7 . �(Lf CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Numbcr) 3 Zbb 4 43 e7 ooZ 5, _ y ZONING 11VD u 57WAL j
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
SITE ADDRESS JOHNS / /!Z/L CITY
DIRECTIONS TO SITE ADDRESS
i
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOX SN 25 psf I
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (('heck all thm apph): /t
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF j Aqtj
TYPE OF WORK: NEWk ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence.Garver,Commercial Bldg,Etc.) Je LF' e7 1 DRA 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES ttvlwleBldg)X_gS IPar[,I.fBldgl NO,F-�,
DESCRfBE WORK iJ
SQUARE FOOTAGE:(pcapased)
I ST FLOOk7!hC0sq.fL 2ND FLOOR sq. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.fL STORAGE sq.fl. OTHER sq.ft.
GARAGE sq.ft.Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA No Lymol-,iG
SFWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
i
PLUMBING IN STRUCTURE? YES❑ NO attach completed Witter Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
I
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 1
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 !
i
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
I
X
Signature of OWNER(Must be sinned by the OWNER) Date
DEPARTMENTAL REVIEW - APPROVED,: DATE DENIED `DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT 2
FIRE MARSHAL '
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit No 2 -;DDOZ J
PERMIT ASSISTANCE CENTER: j
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL i
615 W.Alder Street,Shelton,WA 98584
—' Phone SheltoBeffain:360)2 5-4 670 ezt.Phone
•Fax:(360)427-7798 Phone —
Bedair.(360)275-4467•Phone Elma:(360)482-5269 11..1E L
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4DU4%ND jNV&9TfijEA1T"'- LLC- NAME: T$D
MAILING ADDRESS:( N MAILING ADDRESS:
CITY:514rq-TDAI STATE: W/4 ZIP: ejj!f CITY: STATE: ZIP:
PHONE#1: 2 - G„t — PHONE: CELL: l
PHONE#2: 25 $84- Gj03/ EMAIL:
EMAIL: j11n h e ll A /M 5W. 40M L&i REG# EXP. / /
PRIMARY CONTA T: OWNER; CONTRACTOR❑ OTHER❑
NAME LI A*J EMAIL j
MAILING ADDRESS 1 00140 1jZle AOF CITY SH GL STATE ZIP
PHONE S_ 13 - 9!1C1 - CELL
PARCEL INFORMATION: ,
PARCEL NUMBER(12 Digit Number)_?Zbb 4 3 loon,oon ZONING ND u:VWAL
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
SITE ADDRESS j0"A7S ! /rZJL CITY
DIRECTIONS TO SITE ADDRESS CC
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOX SNOW LOAD:27 psf i
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that applr):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Rnsidrnrr.Gnr,;,.Grmnmrml Bldg.Err.) Jta LF- 51 0FA b�
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YFS rlv/mleBldp)X YES(Pnrr(J]oJBldg)❑ NO n n
DESCRIBE WORK r
SQUARE FOOTAGE:(propnsed)
1 ST FLOG sq.fi. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENL16,11ift
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
I
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
I
MANUFACTU ED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE LA MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: N A No Liim6/-,jG
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ Ij)•ac,attach cmnpleled NaleiAdeyuacv Fnrnr
PERTMETERNOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT,
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER acknowledges that submission of inaccurate information may result in a slop 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 i
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 structures)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 j
days or if construction work is suspended for a period of 180 days. 3
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTMTY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
I
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
lid
MASON COUNTY COMMUNITY SERVICES PermitNo:- bnqZZ OOOZ�
PERMIT ASSISTANCE CENTER: j
•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
I
615 W.Alder Street,SheHon,WA 98584 I
_ Phone Shelton:360)2 S4460 P ne•Fax:(360)427-7798 Phone
Beltair,(360)275-4467•Phone Etma:(360)482-5269
i
BUILDING PERMIT APPLICATION j
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: OLlAN HVL`fi -ors LLC- NAME: T$D
MAILING ADDRESS:-31610 004jisMAILING ADDRESS:
CITY:$1-}C-L.TD,\) STATE:_ZIP: 9�ff CITY: STATE: ZIP:
PHONE#l: Z $ CELL:
PHONE#?:
5 �4=Gj 03/ EMAIL:
2� 8
EMAIL: jrjfth e II Q M Sn1. CDM I L&I REG# EXP.
--
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME 4t• D EMAIL
MAILING ADDRESS I 014AJ S 1iZ9/AZ/,eXF CITY SI 1—EV STATE WA ZIP
PHONE'_CJ7k��C.�. r1lL CELL
PARCEL INFORMATION: ,
PARCEL NUMBER(12 Digit Number) 3 4o 4 43 9 oon, I ZONING 1ND(457WAL j
LEGAL DESCRIPTION(Abbreviated) ( FIRE DISTRICT i
SITE ADDRESS JOI-(A)S CITY
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO)( SNOW LOAD:25 psf i
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chrrk all rbm applr):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERAATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residener.Garu,e,Commrrrial Bldg,Etr.) 7L Lr— e2 10"66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROWHIL
HEATED STRUCTURE? YEStIN-1-8rf•rbif VPgiProoraldetn NO❑
DESCRIBE WORK_ • j
SOUARE FOOTAGE:rprapasrdl j
I ST FLOOR32!�Osq:fL 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.fL STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
i
MANUFACTU /EN�D HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE ft MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: NIA No Li4mo/n1E,
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO❑ lj}•ec,attach completed Water Adequacy Form
PERD.4ETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT,
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
I
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 1 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 permlUapplication becomes null&void B 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. INACTMTY OF THIS j
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) i
I
X
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW" > APPROVED":,'DAT,i7 DENIED `DATE" TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
i
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
MASON COUNTY COMMUNITY SERVICES Permit No: COM 2-2';'I' 00 2-7'
PERMIT ASSISTANCE CENTER;
.BUILDING•PLANNING°PUBLIC HEALTH•FIRE MARSHAL
I 615 W.Alder Street,Shelton,WA 98584
Phone SheBon:360)2 5-4 670 P ne•Fax:(360)427-7798 Phone
Bellair.(360)275-0467•Phone Elma:(360)482-5269JI-
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 4OLLAND jNV&9'j-AjEA1Z LLG NAME: TOP
MAILING ADDRESS ' N MAILING ADDRESS:
CITY:$1-f E[.TDAJ STATE:/ ZIP:9R5R¢ CITY: STATE: ZIP:
PHONE#I: LnG 52 PHONE: CELL:
PHONE#2: EMAIL:
EMAIL: tjj heU a i-Agnf. 46M L&I REG# EXP._/_/
PRIMARY CONTA T: OWNER)< CONTRACTOR❑ OTHER❑
NAME , OLLi✓D EMAIL
MAILING ADDRESS 161) 00440S 6941AZWPO CITY 51 I-ti STATE ZIP i
PHONE 'I�j - �C�y�Gi(1 f CELL
PARCEL INFORMATION: ,
PARCEL NUMBER(12 Digit Number) 3 ZO0 4 43 9 oon, _ 7 ZONING (ND 0 57WA,L j
LEGAL DESCRIPTION(Abbreviated) r FIRE DISTRICT
SITE ADDRESS JOiIA75 /RJL CITY
DIRECTIONS TO SITE ADDRESS
CC �t
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14°!°: YES[] NOV SNOW LOAD: psf
27
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chnkall dmtnpplv):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ '
USE OF STRUCTURE(Rrsidenrr.Garage.0-.—ia1 Bldg.Etc.) ��-'LF' S i DRA 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTIIRF7 VFc nw,,,r.Rle°t YES wartjs)ojBldg)❑ NO❑
DESCRIBE WORK__ _ • II
r - -
SQUARE FOOTAGE:(p-mp d)
I ST FLOOR I► q:ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq,tl.
GARAGE sq.ft. Atlaehed❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTU ppED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE
/-t MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA No LymolnI(,
SFWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ ! NEW❑ EXISTTNG❑
PLUMBING IN STRUCTURE? YES❑ NO❑ /j)•ec,attach completed Water Adegaacv Form
PERTMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
I
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 1 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 permittapplicatiion becomes null 3 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. INACTMTY OF THIS
i
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON i
COUNTY CODE 14.08.42)
X j
Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED.:"DATE DENIED `DATE TAGS/NOTES/CONDITIONS j
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
-6 id L—
MASON COUNTY COMMUNITY SERVICES Permit Nora lrlrl 2Q Z Z-C28
PERMIT ASSISTANCE CENTER:
•BUILDING.PLANNING•PUBLIC HEALTH.FIRE MARSHAL t
615 W.Alder Street,Shelton,WA 98584 {I
Phone Shelton:(360)427-9670 ext.352
Phone
•Fax:(360)427-7798 Phone
Bellair.•(360)275-4467•Phone Elma:(360)482-5269 j`I/ G✓•
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: ROLLAND INV&97MEAIT's LLC- NAME: TOP
MAILING ADDRESS: 160 J0404MAILING ADDRESS:
CITY:$14C4-TD-0 STATE:_ ZIP:925A¢ CITY: STATE: ZIP:
PHONE#l: 25 - $47- 1z;,Qr,4 PHONE: CELL: I
PHONE#2: 25 84- c103/ EMAIL:
EMAIL: ej ImhelL Q INan/. 66M L&I REG# EXP. ! /_
PRIMARY CONTA T: OWNER CONTRACTOR❑ OTHER❑
NAME 1.1-/�I9D EMAIL
MAILING ADDRESS 16 IQ, 0014A)s / 4i CITY GLI STATE ZlP
PHONE 2S7Jt _8c�7 • Ci.— i� CELL
PARCEL INFORMATION: q
PARCEL NUMBER(12 Digit Numbcr) 32 4 4 3 1 ocin I ZONING ND u 57W qL
LEGAL DESCRIPTION(Abbrcviatcd) r FIRE DISTRICT
SITE ADDRESS J0I-{A),5 fzo CITY
DIRECTIONS TO SITE ADDRESS t
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOX SNOW LOAD:25 psf I
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (L'hrrk oll rhnr opph4:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM
_ /- �
TYPE OF WORK: NEW El ALTERAATION❑ REPAIR❑ OTHER ❑ J /
USE OF STRUCTURE IRraidrrorr.Gnrr eat.Cnn,x,rrciul Bldg,Ere.) J{i LF' '�P�_OR/Q 66
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS I
HEATED STRUCTURE? YEA rrvk,-',Rldnl W YES(PartLrl o/Bidg)(1 NO❑
DESCRIBE WORK 11
SQUARE FOOTAGE:rp-pored) _
IST FLOORS` (;Isq:ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.fl. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.it. Attached❑ Detached❑
MANUFACTU ED HOME INFORMATION: "4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE Irt,) A MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: IV IA Q L'4mo/nJG
SEWAGE/SEWER SOURCE: SEPTIC❑ SEWER❑ / NEW❑ EXISTING❑ f
PLUMBING IN STRUCTURE? YES❑ NO❑ lfye-T,attach completed(later Adequacy Fnrni
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 ft 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 it 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. INACTMTY 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 Z2
FIRE MARSHAL
PUBLIC HEALTH
Mason County WA GIS Web Map
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Tax Parcels (Zoom in to 1:30,000) Source: Esri, Maxar, GeoEye, Earthstar Geographics, CNES/Airbus DS,
USDA,USGS,AeroGRID, IGN,and the GIS User Community, Esri, HERE,
Garmin,(c)OpenStreetMap contributors,and the GIS user community
Mason County WA GIS Web Map Application
Maxar I Esri,HERE,Garmin,GeoTechnologies,Inc.
HOLLAND SELF-STORAGE FACILITY VICINITY MAP
PHASE 1 SEC 04, TWP 20N, RGE SW, W.M. o g
MASON COUNTY, WASHINGTON SITE
PHASE 2
pR4 o
RD �
It
b
G -- -- __ MIN.10'LANDSCAPE z ORE
y BAYSH
C BUFFER i COURSE
OHNS
_ 5 88Ji'41'E E J PRAT IE RD
f I2'IXh YE
?p
1NIPY.10"tANBSCAPE—
5 88'2657 E f35.53 PROPERTY LINE BUFFER -
\
F_I �� F -- ---- -- - --------- - �� \,\
DRAINFlELD >G— r- —i6b4-- y3, CL
L O ❑ N e6'20 OB E 5 8759 T9 ' ot0---/- ORAINFlELD / 1 _ �— 120 �� E
- BUILDING "A" —_=21, i/ ``�
EXISTING SEPTIC �I '0 _ � ' 3•B0b SF 1 I r� —` BUILDING '�A" 1` PROJECT INFORMATION
SYSTEM ro BE FF��1D.D I I \ \�/ s,BOE �' I --� O
RE-DESIGNED I I - _ Im 2oZ2= L_� I 2 1 T12 p � R25' v, OWNER/APPLICANT: HOLLAND INVESTMENTS, LLC F
d --c - .. y��'" I a I ( I \f - 12 / I f\ ATTN: JIM HOLLAND co>
�3 I PO BOX 581 LL H
' =FIRE ANE �W,EN�9• -_- Ras' \\ I L_-�, '`� I I �-- `I I,I r �• FIRE LANE w g10 I \I I WAUNA, WA 98395 J_
2B I J I I I / PARCEL N0: 320044390027, 320044300030 H LL f j
i 3 '(J•� J. PE, rc R25' \ I �2." .
PARKING 320044390027, 320044300030 O W
TRUCK I I ,
sEnc I dEN1 �# 4' SITE ADDRESS: 3160/3290 E. JOHNS PRAIRIE RD. Z p V
(PARKING n^r,A,AAA(�S eP� I e' s' 24• 25' 24' 30' o t SHELTON, WA 98584 Q
•BU DIN I •B ILDI MIN.5' J O
I PERIMETER V)
\ _ I LANDSCAPE ZONING: INDUSTRIAL. SHELTON UGA O Q
i 24. 25 24' S' 24' � I \� l W (TW.) _ �
5' �. - 3 3p• 24 PARCEL AREAS: PHASE 1: t4.083 ACRES((t177,836 SF
LARD- I U O • oNI I I I m U • I III PHASE 2: f4.950 ACRES(3215,635 SF;
LAND-
SCAPE e ° o �I o U' i 8'HIGH PERIMETER 0 e
gOrLDiNG I I FENCE TIP ! • e LOOGG/
V• '^ i = 211.44 I I G I ( ) I �'v1 1%o m 4 I I PHASE 1
o I�\ �
ri I ` •� 5'
n w
Iunun'EGRESS.
z' 3 �LL -�� - - = it ---- I I� „i• ri Y PROPOSED 30*
BUILDING AREA: 46,800 SF(INCL. 400 SF OFFICE)
0 7 m 4 I - - _.L I m DRIVE AISLES ARKING: 94,202 SF uj
I ai DO Do m II ;a m m m LIy I,I o n TOTAL HARD SURFACE AREA: 141.002 SF(79.3X COVERAGE)
210 —— �I I / P,'E• b I Sul ING 2 /Z o - - PHASE 2 W
j GR L 1 I o,R / F.F.217.ao Q 444 z Z CC
/�.,• 13 I II o �..-- '1�_ f A E 8 I w BUILDING AREA: 25,200 SF Q W
MZQ22 I w P I n ry I U zi DRIVE AISLES/PARKING 4-4,904 SF a C
M I UI - U.
TOTAL HARD SURFACE AREA: 70,104 SF(32.5X COVERAGE) O
3- Vf v: W C�
I2 ! 30' MIN.20 FlRE J I I [�- 20'FlRE PROPOSED 40' g PARKING REQUIRED: 1/300 SF OFFICE= 2 STALLS F
PHASE I LANE(TYP.) W I 2��i I ) !_i{ LANE(TYPJ 20 INGRESS,EGRESS,& a �D= PARKING PROVIDED: 10 STALLS (PHASE 1) y
' ;W MLMff(TYP)E a I BUILDING O / in _ UTILITIES EASEMENT LL
m S I II 2 F.�.2f0.56 I ,p
LL I Y •g ILpI G• SURVEY INFORMATION o
II �' _
?$; 39.0I ! •BU DIN I I ( z THE TOPOGRAPHIC, BOUNDARY, AND UTILITY INFORMATION a
I ! I I \ t I 1, _ PROFESSIONAOCIATES
L HEREON
LAND SURVEYORWAS ES.. THIS INFORMATIONSWAS NOT
zo -- --- I m VERIFIED BY OLYMPIC ENGINEERING AND OLYMPIC ENGINEERING
Z ASSUMES NO LIABILITY IN THE ACCURACY OF THIS
I ! 07 INFORMATION. o
J_ �� m o
3 9"T� -- m� -_ --. ;D -- -_' w a+ MIN. IMTYP , �� mn TW J~w aI f E N
m-- m- m ( kaP4� I / I m m I LANDSCAPING "
LANDSCAPE
z I' I eunan LANDSCAPING WILL MEET SECTION 17.07.860 OF THE MASON M1
2022 = /I / 4ar Q I COUNTY CODE.
I � ,' m W
L
LEGEND €
I '
--- so'M1ri I 2fe
rr��yy� i
2s' W••L- .__- / E.i wELL WELL
1 I I PARK NG _SD
— STORM PIPE
vi
_--^wR g 13 BUI DN
{/W ttin o
o a
y BUIUNNG I ---__'1 a FIRE LANE F.F.2to.3a i I— 1 FIRE LANE 'a j I _ ■ CATCH BASIN
r�F
-- -�� J
_c6m Oov2"I I I -- —�._,ANDSGAPE(,YP. -= I
3 HR FIRE BARRIERS I I � I MRr s"�1jMeTe � � o POWER POLE
FOR MAX. 2,500 SF I 105' __ ./ w WATER SERVICE
FIRE AREA(GS)) P RKI G _ SPOT ELEVATION
ALL BUILDINGS)) I - RV 0 \ I I DiRr ReAD -T/
1 /4N/F1LTRATION TREN
\� 2 iTT BA tit \B\AVER
0 _ __ 'eYR c 16�i 5T6RMWATtR
PROPERTY Lk1E S 87'37'23"W 358.04 MIN 5'PERIMETER / j�� J\ ✓ /('�)_ _ E
/ 7RE,4,TMENTY NO DELTA RADIUS LENGTH
UWDSCAPE(TYP.) 2Dd \ �'�\ ��P�S�IBLE FUTURE PRIVATE! �' 1 1 C7 30'34'OJ' 670.0000 357.4474 �o '
// �� ROADWAY EXTENSION TO c2 B'3s'S+' s7o.0000 f00.7413 o a ^a i
/ ` PROJECT BENCHMARK \ I�( \ , \ THF�SOU4FI ( , C3 7'40'43' 640.0000 B5.7721 N 3 n 1
6'HIGH PERIMETER
/ \ FENCE(TYPJ \/ SET a tt10N BAR W RED 100'PROTECTIVE\� x m o c
4/ CAP'TRAV 15653'21 / WELL RADIUS \ I\ , ` I ( III I E n
SOUTHEAST OF BUILDING /
I� W 11 CORNER ELEVATION- \ \ / / /I� � _._ 2 E 3 _
:�oa —— I '\_100't>rlotECT'VE ---I 209.07 1 I III _ °o ''D^i
! WELL RADIUS c'Jh. HGJSE _� l l
1 / —��- I I / �11 —� e,
4YELL -
o
\I / —
BUILOING/FlRE CODE(SUMMARY �
2018 IBC tWu
• TYPE II-B NON-COMBUSTIBLE CONSTRUCTION H _
• 5-1 OCCUPANCY I
• ALLOWABLE AREA PER TABLE 5011 17,500 SF. NON-SPRINKLERED VERTICAL DATUM Q W
• THE STORAGE BUILDINGS BE"GROUPED" ONE "BUILDING", AS ALLOWED IN SITE PLAN AS PREVIOUSLY APPROVED ASSUMED
SECTION 705.3 OF THE IBC.C.FOR EXAMPLE, BUILDINGS
LDINGS C-G IN PHASE ONE ARE JOB NUMBER:
GROUPED AS ONE "BUILDING" AND TOTAL LESS THAN 17,500 SF
• WITHIN EACH BUILDING THE FIRE AREAS WILL BE LIMITED TO 2,500 SF OR LESS TO 19076
ALLOW STORAGE OF MATTRESSES OR UPHOLSTERED FURNITURE PER 903.2.9(5) UNDER S E PA and GRADING PERMIT SCALE 1'=80 FEET DRAINING NAME
• 3 HOUR FIRE BARRIERS WILL BE UTIUZED TO SEPARATE FIRE AREAS PER TABLE 19076 SITE
707.3.10 #GRD2020-00008
• PER TABLE 602, FOR S-1 OCCUPANCY, OPENINGS SHALL BE UNLIMITED AND
UNPROTECTED, DUE TO TYPE II-B CONSTRUCTION, AND AT LEAST 10-FEET FROM AN 0 40 80 160
ADJACENT PROPERTY LINE, OR AN IMAGINARY PROPERTY LINE BETWEEN BUILDINGS SHEET: 1 OF 1