HomeMy WebLinkAboutBLD2024-01213 Foundation Reparis, Plumbing and Remodel - BLD Application - 10/14/2024 MASON COUNTY Permit No: E�LOZoZ-1- 0J213
COMMUNITY DEVELOPMENT
Permit Assistance Center, Building,Planning RECEIVED
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATIOT 14 2024
NAME:Tahoraa Canym Propenles NAME:Prkne Building and Devafopment LAC
MAILING ADDRESS:4801 ThO1°p501 L18 SE MAILING ADDRESS:4m Thampse
CITY:O1inipfe STATE:wA ZIP:W513 CITY:O"Vla STATE:wA ZIP:"7r t
PHONE#1:253WO-5950 PHONE:m42"m CELL:
PHONE#2: EMAIL:phn�°°n'
EMAIL:PdmabulW—tiftmaa.can L&I REG#PFUMEBDM03 EXP. 08402/2(O
PRIMARY CONTACT: OWNER p CONTRACTOR p OTHER❑
NAME" P""'°n EMAIL pdmab am w®gme Lopn
MAILING ADDRESS 4B02Thanipionu-sE CITY O1yrnpie STATE wA ZIPi
PHONE� CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) �' 90102 ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS szg E Harstine Heights LN CITY Shelt n
DIRECTIONS TO SITE ADDRESS E Herffine Bridge Rd.Left m E North Island Dr.Rt E Harstine Heights Ln.Right at T.Follow road around bend to end of road.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑+ NO❑ SNOW LOAD:_Psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Ckeck all that apply):
SALTWATER Q LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDTTION❑ ALTERATION❑ REPAIR El OTHER ❑
USE OF STRUCTURE(Rer den",G.,W,Coaranc ddBldg,Eta)
IS USE: PRIMARY❑ SEASONAL 0 NUMBER OF BEDROOMS 9 NUMBER OF BATHROOMS s
HEATED STRUCTURE? YES(whole Bldg)0 YES(Part[s)ojBldg)❑ NO❑
DESCRIBE WORK Install pin piles to foundation.Lave)house.Repair damage.Install kitchen.install bathroom sinks.Install finishes.
SQUARE FOOTAGE:(prepared)
1 ST FLOOR sq.R 2ND FLOOR sq.ft. 3RD FLOOR sq.R BASEMENT sq.ft.
DECK sq.fL COVERED DECK sq.ft. STORAGE sq.fL OTHER sq.ft.
GARAGE 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 0 SEWER❑ / NEW❑ EXISTING I]
PLUMBING IN STRUCTURE? YES❑ NO❑ I,f yes,attach completed Water Adequacy Form
PERIlvIETERNOUNDATION DRAINS PROPOSED? YES Q NO[] EXISTING SQ.FT.
EXISTING BEDROOMS 3 PROPOSED BEDROOMS TOTAL BEDROOMS 9
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
COUNTY CODE 14.08.42)
X 9-28-24
Signature of OWNER(Must be sinned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH