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Home My WebLink AboutBLD2025-00041 Foundation - BLD Application - 1/28/2025 4PMASON COUNTY Perinit No.-I Id 2.6215-QM14 COMMUNITY DEVELOPMENT Permit Assistance Center, Building,Planning BUILDING PERMIT APPLICATION PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:Cheri Raff NAME:Korey Yada/Ram Jack West MAILING ADDRESS:196 E Vineyard Or MAILING ADDRESS:PO Box 11701 CITY:Shelton STATE:WA ZIP:98584 CITY:Eugene STATE:OR ZIP:97440 PHONE#I:360-789-3361 PHONE:541-852-1976 CELL: PHONE#2: EMAIL:Korey@ramjackwest.com EMAIL:Craffl@msn.com L&I REG#RAMJAW852PW EXp, O5./16. ?5 PRIMARY CONTACT: OWNER❑ CONTRACTOR I] OTHER❑ NAME Korey Yada EMAIL Korey@ramjackwest.com MAILING ADDRESS 862 Bethel Drive CITY Eugene STATE OR ZIP 97402 PHONE 541-852-1976 CELL PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 221273300010 ZONING LEGAL DESCRIPTION(Abbreviated) TR 1 OF GOVT LOT 4&TAX 63-A-1 FIRE DISTRICT SITE ADDRESS 196 E.Vineyard Or CITY Shelton DIRECTIONS TO SITE ADDRESS 302 NW,left on E North Bay Dr,Left on WAJ,Left on E Pickering,Straight on E Vineyard Dr. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO E] SNOW LOAD:_psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that appty): SALTWATER[] LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF(WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR I] OTHER ❑ USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Etc.)Single Family Residence IS USE: PRIMARY E] SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 1 HEATED STRUCTURE? YES(".t,8tdg)❑ YES(Part/s1 afB1dg)❑� NO❑ DESCRIBE WORK Voluntary foundation stabilization at portion of existing foundation.No footprint mod. SQUARE FOOTAGE:(proposed) 1 ST FLOOR 0 sq.ft. 2ND FLOOR 0 sq.ft. 3RD FLOOR 0 sq.ft. BASEMENT 0 sq.ft. DECK 0 sq.ft. COVERED DECK 0 sq.ft. STORAGE 0 sq.ft. OTHER O sq.ft. GARAGE O sq.ft. Attached❑ Detached❑ CARPORT O 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: 27—S I,el rnoo l.—�' SEWAGE/SEWER SOURCE: SEPTIC 13 SEWER❑ 1 NEW❑ EXISTING I] 2 J Q� 0 r PLUMBING IN STRUCTURE? YES❑ NO❑ If yes,attach completed Water Adequacy Form PERIMETERIFOUNDATION DRAINS PROPOSED? YES❑ NOE) EXISTING SQ.FT. EXISTING BEDROOMS 2 PROPOSED BEDROOMS O TOTAL BEDROOMS 2 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 �� 01/06/2025 Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED I DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH 01/28/2025 APPROVED SITE PLAN - VOLUNTARY FOUNDATION REPAIRS MASON COUNTY DCD PLANNING Digitally SCOTf RUEDy,AICP Scott Reedy signed by Scott ` The approval of this project is subject to the recommendations Ruedy _ _ .._. _� Rf�''�, �• ..:and specifications outlined in the attached geotechn_ical report.All applicable recommendations and specifications shall be applied E to the development on this site. Any deviation requires stamped " t FINE 1AR1 written approval from the registered design professional responsible for the report and may require special inspection by - same. Structures and/or land modifications(grading,cuts,fills.. etc.)required in the geotechnical report,may require a separate -.� permit.The geotechnical report shall remain attached to the 194 E VINEYARD DR approved building plans. '✓ , FOUNDATION REPAI R ONLY. Work to footprint ONLY.No expansion of concrete slab or �� single family home 7212 ft >t' ' r6FJE.'i •a , vc 2212780UM 2212722 22 ;1W .d t '1b N.t r LN 111148000M 2213 222 33 ~ .me.L4I I E ,itiFRE v LN}boo p004 I 16 �c _ iJ4�EDD0 1:767 PARCEL DETAILS o ss 70 140 e PARCEL NUMBER: 221273300010 r—+ , `—� y� 0 10 20 4 0 m LEGAL DESCRIPTION:TR 1 OF GOVT LOT 4&TAX 63-A-1 9--F-.Mat.1,tminar Geegrap slh-.mid the GIS User C—ty SIZE IN ACRES: 1.55 Disclaimer: Mason County does not require a ADDRESS: 196 E.VINEYARD DR survey to obtain a building permit. As a result, site Mason C—ty VVA GAS Wab Map ApOraaon ieuness od WEb51lo iNo,ndl Lade fa WWI hwn rNience Ur 1 h1lW.irWww.maso—dyw 9.0dlselime",php OWNER: RAFF,CHERYLA plans may not reflect accurate data. It is the applicant's responsibility to comply with setback requirements.