HomeMy WebLinkAboutBLD2025-00538 - BLD CD Environmental Health Review - 5/6/2025 MASON COUNTY Permit � ,Te )t�; d i -C
COMMUNITY DEVELOPMENT
Permit Assistance Center, Building,Planning RECEIVED
BUILDING PERMIT APPLICATION MAY p i 2025
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Dons Prouty NAME: 615 W. Alder Street
MAILING ADDRESS:990 E Strong Rd MAILING ADDRESS:
CITY:Shelton STATE:WA ZIP:9884 CITY: STATE: ZIP:
PHONE#1:3608317244 PHONE: CELL:
PHONE#2: EMAIL:
EMAIL:donaldwprouty®gmail.com L&I REG# EXP. / /
PRIMARY CONTACT: OWNER El CONTRACTOR 0 OTHER❑
NAME ASASO'ie EMAIL '9�
MAILING ADDRESS CITY STATE ZIP �?‘
PHONE CELL 0 ep
PARCEL INFORMATION: .G 10
PARCEL NUMBER(12 Digit Number) 22128-77-000 ZONING RR5 ��
08
LEGAL DESCRIPTION(Abbreviated) TR 8 OF SURVEY 8/76(GI_5)S 51/33 FIRE DISTRICT
SITE ADDRESS 691 E Strong Rd CITY Shelton
DIRECTIONS TO SITE ADDRESS From Shelton N on HWY 3 to Pickering. Pickering to Strong Rd. Strong Rd to 691,driveway 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: (Check all Mai apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residency.Garage.Commercial Bldg,Erc•.)Residence
IS USE: PRIMARY❑+ SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg)ElYES(Pants)ofBldg)0 NO 0
DESCRIBE WORK
SOUARE FOOTAGE:(proposed)
(591Q 1_ ST FLOG 2 ' sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
L-•HEer sq.ft. COVERED DECK 240 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE 588 sq.fl. Attached❑ Detached 0 CARPORT sq.ft. Attached 0 Detached 0
MANUFA , ED HOME INF ON: *4 COPIES OF THE FLOOR PLAN REQUIR D*
MAK MODEL • YEAR LENG
W H BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC ElSEWER 0 I NEW❑ EXISTING 0
PLUMBING IN STRUCTURE? YES +❑ NO 0 Ifyes,attach completed Water Adequacy Form ,
PERIMETER/FOUNDATION DRAINS PROPOSED? .Y N( ❑.) EXISTING SQ.FT.
EXISTING BEDROOMS _CI __ PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
. 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 ell 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 S 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 C a • INUA ON OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS '
PF�RAIR�P•LICATIO OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
(, COUNTY CODE 14.08.42)
Signature o:I^ E- Mu-'•'-r(vned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL ,,� A' _
PUBLIC HEALTH 1 I 4 t ��a8 d f WM
rNIIIIIIIIIMIllrr
0 h
w
0 0
r.
t.
4 ! - �`a = r % N -� m
`41 6t a� a (z "K i\ Q
N
s�� ; ? r `9 E 0 J 41 re
Q o+c O 3Nc i
l/1 a.c 3 m m _ 2, r /1
E 0 U C d R -
U e_o a=1 7 I / \1\�J t
Q
Do ,° a �3 - • Cc
� d � al 9 a
N o' m w� / !)
�� — d c O to
2d
T
uJ c ia m ELY _ 7
tcy cA c 4
dmyaro l 41)
� ccu M
o u ,
v N O q 21
, CJ r S dr.A -c L r
"c•-1ovuo+wa�-75 I
o_rn z ,,,,z c.,, a°, J
Q mV dSCw ipU ,- /� _ / tt
t F
FA / /= �I
aE j F / \ Z
O / ,s Z
9 / 5 , Z
< u / `O
z L ! a y 4, iIn a cj
itj �t L� CV > 0 Lv o �T�
I 7� ( / � o � O co aZ�
/. - n 0�
a Ec) 3 3 LO QOO °
,Y
os (00 (�6 O N C o
(D a)
I E I co -CD mN- a �
0
/ "'
! a'
c
.. _ / .
/k. N cl - m o
I r jai m TBo
o � c ac) c
m as
?i' " in ai..c) 0 i \
c / 2 Q ca >, No
O (p N —>, Ft:7j CC C
m a iii
/4�O I.. U
m � � U >� 2ocoE / ^ /A° c .
(73 r-
�r G)ii
O 0)U) } O -p 0
C6 C "O a) u) 3 O
L. r r Oc Q) c O (0 lZ' U o d
2 -' O > to N ' oo c) Q
�Y C 0 C6 c 00
`c� c a !Z'
12
1_ aa)) u) .° •� flLLO) ccaOO
I— Q CZ