HomeMy WebLinkAboutBLD2025-00003 Pole Bldg - BLD Application - 1/2/2024 MASON COUNTY Permit No: R1_n)_pZC, —p0063
_ COMMUNITY DEVELOPMENT RECEIVED/{Permit Assistance Center,Building,Planning A L
N O^ 2024
BUILDING PERMIT APPLICATION J
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMA •AkW Stmet
NAME:CHERYL MCBRIDE NAME:KIFER CONSTRUCTION LLC
MAILING ADDRESS:200 EAST COTTON WOOD DRIVE MAILING ADDRESS:1515 KRESKY AVENUE
CrfY:GRAPEVIEw STATE:WA ZIP:98W CITY:contrails STATE:we ZIP:98531
PHONE#1:zoo 714-0457 PHONE:360 807-4140 CELL: 360 888-7548
PHONE#Z: EMAIL:CHUCKHKIFERCONSTRUCTION.ORG
EMAIL:MCSIRDYl iOGMAIL.COM L&I REG#KIFERCL823DM Ex?. 3 2rl 2026
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑� OTHER❑
NAME CHARLES KIFER EMAIL CHUCK@KIFERCONSTRUCTION.ORG
MAILING ADDRESS 1515 KRESKY AVENUE CITY CENTRALIA STATE"a ZIP 98531
PHONE W0 e074M CELL 360 Sas 7548
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 221 281 45001 0 ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS 200 EAST COTTON WOOD DRIVE CITY GRAPEVIEW,WA 98546
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO Q SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkatt that apply):
SALTWATER❑ LAKE❑ RIVERICREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Gomge,Comraetriat Bid&Etc.)GARAGE
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(R'hoteBldg)❑ YES(PaH[s]ofB1dg)❑ NO❑
DESCRIBE WORK WX40%16'POST FRAME STRUCTURE Wt 17X40'LEANTO
SQUARE FOOTAGE:(proposed)
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 1680 sq.ft.Attached❑ Detached❑ 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❑ SEWER❑ / NEW❑ EXISTING E]
PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form
PERIIvMTER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. 1728
EXISTING BEDROOMS NONE 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 APP OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X 12/30/2024
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