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HomeMy WebLinkAboutBLD2023-00036 - BLD CD Environmental Health Review - 1/12/2023 �J�,)0'''' \•,,p,c MASON COUNTY COMMUNITY SERVICES Permit No:T2 ld /0') 000340 PERMIT ASSISTANCE CENTER: F .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL �{.� RECEIVED ti I• ir 615 W.Alder Street,Shelton,WA 98584 C�� �l; ,. '� .A,,g' Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone ��(� I�A' �n�� �'I v Belfair:(360)275-4467•Phone Elma:(360)482-5269 J AN iL f'-b•Fi1:orp5 ` BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Michael Johnson NAME: MAILING ADDRESS:9735 NW SKYLINE BLVD. MAILING ADDRESS: rn CITY: PORTLAND STATE:OR ZIP:9723.1 CITY: - STATE: ZIP: PHONE#1:360-989-4862 PHONE: CELL: 4 PHONE#2:503-444-0270 EMAIL : EMAIL:mIke.johnson@mzienterprises.com,kim.johnson@mzjenlerprises.com L&I REG# EXP. / • n' . oar_..., PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER❑ NAME EMAIL ImalLa MAILING ADDRESS CITY STATE ZIP - PHONE CELL PARCEL INFORMATION: `--PARCEL NUMBER(12 Digit Number) 22009-12-90012 ZONING RR5 LEGAL DESCRIPTION(Abbreviated) LOT:3 OF SP#1400&TL TL PTN G.L.2 EX FIRE DISTRICT SITE ADDRESS 50 E. Old Winery Rd. CITY Shelton DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NO ❑ SNOW LOAD:25 psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE 0 RIVER/CREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF 0 STREAM 0 TYPE OF WORK: NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR❑ OTHER 0 USE OF STRUCTURE(Residence,Garage.Commercial Bldg,Etc.) Residence/Garage IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 1 NUMBER OF BATHROOMS 1 .-- HEATED STRUCTURE? YES(Whole Bldg) 0 YES(Part(s)of Bldg) 0 NO ❑ DESCRIBE WORK Construct new Shop/ Residence on vacant lot. SOUARE FOOTAGE: (proposed) 1ST FLOOR 948 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq. ft. BASEMENT sq.ft. DECK sq. ft. COVERED DECK 270 N.ft. STORAGE sq.ft. OTHER sq. ft. GARAGE 1888 sq. ft. Attached 0 Detached❑ .''s CARPORT sq.ft. Attached❑ Detached 0 MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: NEW SEPTIC TANKS, EXISTING DRAINFIELD SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW 0 EXISTING ❑ PLUMBING IN STRUCTURE? YES 0 NO ❑ If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES © NOD EXISTING SQ.FT. EXISTING BEDROOMS 0 PROPOSED BEDROOMS 1 TOTAL BEDROOMS 1 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 UN CODE 14.08.42) X yll Signature of A -eQ� • .. • Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT • PLANNING DEPARTMENT FIRE MARSHAL • PUBLIC HEALTH 01 3hv' o (one,*s qacce. i Q a A• NOIBNINI►M'ALNIIOoNOVIII RI •?. Igli0 s1( 'J 066ai r,s NOSNHOr 13VH01W. 1 h `1 1rp a .((=� ( kfg-� 3�ai ONIAIWONS MIN >P 3 E O A 8 i o hg ,13I yyj 1 } ii /J A i <11 1 o § ..._----- .OL i 0 1 it . Ii ! ! I ! 1 SI 1 i 1 I I ) I I ci e I i I 1 il JUI i Si kill! I D I; tVl II 11- 1 I I �t I I I t QQQ i1 , I1 I I 1 d 1 II cn $$ III I gg ! !I I € N A 4 0 I I ° b dIf g zi 3 II i 1$ 1 ill I i (n SI § � 2 I II 11 e � >! A 1 _ 1®ao d � . ;i i 1 ill�t q L_____�' •NO ALVA 31N3�S•3 . . I tat. 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