HomeMy WebLinkAboutBLD2024-01443 - BLD CD Environmental Health Review - 3/4/2025 �� MASON COUNTY Permit No:?)iC-11 _ ;` tiI V
'� "� COMMUNITY DEVELOPMENT DEC 09 2024
Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION 615 W. Ald- tre t
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
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NAME:Cesar Zepeda NAME:Counter-Fit Construction,Inc. s.
MAILING ADDRESS:80 E.EI Fuego Dr MAILING ADDRESS:819 Countryside Beach Dr NW 'Q<<% I
CITY:shelton STATE:Wa ZIP:9 CITY:OIyr'Pia STATE:WA ZIP:98502 0 �'2
PHONE#1:3604519876 PHONE: 2915666 CELL: �2-
PHONE#2: EMAIL:�nterfrtconsmtction@gmel.com
x EMAIL: I�.I REG#CouNrc1934 IF EXP.1/21/2026 b
lj PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER❑
NAME O ' EMAIL counterftconsbuction@gmal.com
MAILING ADDRESS 58/9 Countryside Beach Dr NW CITY°Nc+7s STATE WA ZIPS` 2 `
PHONE 36°7915566 CELL � 4
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p. PARCEL INFORMATION: O Ll.l
PARCEL NUMBER(12 Digit Number)32007-14-90041 ZONING R Cr
LEGAL DESCRIPTION(Abbreviated)Lot 1 of SP#1674 AF#467873 PTN of SE NE FIRE DISTRICT 5
SITE ADDRESS To Be Addressed/E.Hiawatha Blvd CITY ShalShelton
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DIRECTIONS TO SITE ADDRESS From Bldg Dept:north on Olympic Hwy North;right onto N.13th streak right onto Johns Prairie Rd; eZ
• J right onto Hiawatha;site on left LI J
C IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
• SALTWATER 0 LAKE 0 RIVER/CREEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
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TYPE OF WORK: NEW p ADDITION 0 ALTERATION 0 REPAIR 0 OTHER ❑
USE OF STRUCTURE(Residence.Garage.Commercial Bldg,Etc.)duplex
IS USE: PRIMARY Q SEASONAL❑ NUMBER OF BEDROOMS 2/BEDROOMS 2Iside NUMBER OF BATHROOMS2/Side
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part[s]of Bldg)❑ NO❑
DESCRIBE WORK Budd new residential duplex on vacant property
SQUARE FOOTAGE:(proposed)
• 1ST FLOOR 14991'de sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft-
DECK sq.ft COVERED DECK238h4e sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE35 hide sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached 0 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 0 EXISTING 0
PLUMBING IN STRUCTURE? YES 0 NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 Lf NO9 EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS 4
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 fora period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPUCATIO r r DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
-' COUNTY CODE 14.08A2) / l
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- ,n. re of 0 R(Must be signed by the OWNER) Date
DEPARTMEN -' I W APPROVED DATE DENIED DATE TAGS/NOTES/CONDTTIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH K 3/k c �'2 2-- f-LA.0
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