HomeMy WebLinkAboutBld2024-01455 - BLD CD Environmental Health Review - 3/4/2025 MASON COUN'I`Y�ivVIRONMENTAL Permit No:8LSaha� j
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COMMUNITY DEVELOPMENT CEIVED
Permit Assistance Center, Building,Planning ULL I 2024
BUILDING PERMIT APPLICATION ;; ':N. Alder St,
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PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: F�
NAME:Travis& Dawn Twiddy NAME:JACOB FLETCHER(NORTHSTAR RENOVATIONS L
MAILING ADDRESS:121 N. Enatai Cf. MAILING ADDRESS:3845 STEAMBOAT LOOP N
CITY:SKOKOMISH STATE:WA ZIP:98584 CITY:OLYMPIA STATE:WA ZIP:98502
PHONE#1:360-490-1978 PHONE:360-970-0219 CELL:
PHONE#2:360-490-5431 EMAIL :
EMAIL:dawnill 980@gmail.com L&I REG#NORTHRL788C3 Exp, 02/23/26
PRIMARY CONTACT: OWNER❑ CONTRACTOR E] OTHER❑
NAME NICK SANDOVAL EMAIL NICKOWILLIAMS-ARCHITECTURE.COM
MAILINGADDRESS PO BOX 102 CITY SHELTON STATE WA ZIP98584
PHONE 360-426-0511 CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32006-50-02073 ZONING SHELTON UGA
LEGAL DESCRIPTION(Abbreviated) ISLAND LAKE SHORELAND BILK 2 FIRE DISTRICT
SITE ADDRESS 1910 E. ISLAND LAKE DR. CITY SHELTON
DIRECTIONS TO SITE ADDRESS FROM DT SHELTON,TAKE N. 1ST ST. N. RIGHT ON N. 1TH ST. CONTINUE ON
E. BROCKDALE R.D. LEFT ON E. ISLAND LAKE DR. RIGHT ON E. ISLAND LAKE DR. LOOP.SITE IS ON LEFT.
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: (Checkoff that apply):
SALTWATER❑ LAKE E] IU VER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION I] ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence.Garage.CmmsncialBldg,Etc.)RESIDENCE
IS USE: PRIMARY E] SEASONAL❑ NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Panel MBldgl❑ NO❑
DESCRIBE WORK CONSTRUCT NEW TWO STORY ADDITION FOR RESIDENCE.WORK WILL INCLUDE INTERIOR RENOVATITIONS
SOUARE FOOTAGE: (v oyame)
1ST FLOOR 359 SF NEW 2ND FLOOR 876 sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq. ft. COVERED DECK 128 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
ME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC +❑ SEWER❑ / NEW❑ EXISTING❑+
PLUMBING IN STRUCTURE? YES ❑+ NO❑ Ijyes, attach completed Water Adequacy Form
PERIMETERIFOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. 1104
EXISTING BEDROOMS 2 PROPOSED BEDROOMS 2 TOTALBEDROOMS 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 call that I am the owner and 1 further declare that I am entitled to receive this peal and to do the work as proposed.I have
obtained wariesion fro on all the necessary parties,including any easement holder or parties of interest regarding this project The owner or legal
representative,represents that the infoanation provided Is accurate and grants employees of Mason County access to the above described property
and structureud for review and inspection. This permlVapplicalion becomes null 8 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
/ TY CODE 14.08.42)
12-2-24
Signature of AGENT Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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