HomeMy WebLinkAboutBLD2023-00788 - BLD CD Environmental Health Review - 7/7/2023 t MASON COUNTY COMMUNITYSF.R.yICES� PilmitNwa2l+OOR? -00766
PERMIT ASSISTANCE CENTER: r Jam—
.BUIBp .PUMING.PUBICHEN.TH.FIREMMSHN.
615W.NEer Sheet Sneron,WA9959e
F,w,reS , 36� 27-9S,�et3U-Fa.,13B0).z,.np63A 11 2023 ENVIRONMENTAL
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BUILDING 1DERMITk&iIIr Street HEALTH
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION•
NAME: R. A�C II ry NAME:
MAIL RESS:.J/an .I.� MAILING ADDRESS:
CRY: I STATE: ZIP: CITY: STATE: ZIP:
PHONE qI: b PHONE: CELL;
PHONE#2: LRI EMAIL:
EMAIL: L&I REG# EXP.
PRIMARY CONTACT: OWNER Zj"�ONTRACTUR❑ OMER Q /� J
NAME suaMia.. Y- di ...w.en [a_lln — HMAIL IJ Ldllne.^ LLMt naF.
On jai STATHi ZIP.Ocw
PHONE 2r /nOI 7Ltll CELL
PARCEL INFORMATION:
PARCELNUMBER(121igit Number)�=370 - SO -004/1 ZGNDJG
LEGAL DESCRIPTION(Abbrsai FIRE DISTRICT
SITEADDRESS aIZZO A7.E Idi JNe(_I CRY `T k.v VOL
DIRECTIONS TO SITE ADDRESS �—
E MBPROIF.LTWITMIN300FI'OFSLOPE(S)GREATERTRAN14%: YES❑ NO8-5NOWLOAD:--_,af
ISPROPERTYVITTHIN"OFTOFTHEFOLLOWING: Clandrmrnievo :
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF W Or NEW GSA DITION❑ ALTERATION❑ REPAIR❑ OTHER n
USE OF STRUCTURE(Emtese,Bmi Cmmress g,Fs)—fl.Qe ap��(J�t'_
ISUSE'. PRIMARY9-SEASONAL❑ NUMBEROFBEDROOMS 0. NUMBEROFBATHROOi
HEATED STRUCTURE? YES""'w�'ES yeMy[I NO
A 0
DESCRIBE WORK /e,�Q `�C'AF�•
SOUARE FOOTAGE:tampart/
R j� R
pL STFLOO�sq.ft. 2NDFLOOR SNA sq.ft 3RDFLOOR_]q. BASEMENT N.GARAGE IS ftCl)VEhed�ECK ft�STORAGE R a OTHER
CARPORT W.ft ANaehei De6mhe"i
MANUFACTURED HOME INFORMATION: `d COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDi BEDROOMS BATHS SERIAL,NUMBER
ENVIRONMENTAL HEALTH:
SEWAGVSEWER SOURCE: SEPTIC P-- SEWER[I / NEWB— EXISTING❑
PLUMBING IN STRUCTURE? YES Er NO[I UTMr,amch completed Wan Adequee,Form
PERIMETERTOUNDATION DRAINS PROPOSED? YES R- NO[] EUSTINGSQ.FT.
EXISTING BEDROOMS—i PROPOSED BEDR00i TOTAL BEDROOMS__-� _
OPINE0.a kvMMaea Mel aubnheion ol'mmrele inlortnMM mry reauX in a sIW xoik oNerry permt rerceNm,pLFnv.IMaeirreMN wN le bI
slOreWrebYaw,IEedu MtlIam MecomereMINMerdWam MalIamentitledtome wthispemtitaMtodonemm espt Wp e6.l eM
odamedperm¢tlon humallthe necessarypeNe;mtludln0BM eeeemenl holder or parties ofinterest mparding this prosid Thenvmerorlepel
rderruerepreseM'etlws' sS nse^a ne information goaded is$=rate and grants¢mployees---.Cwnrya¢e.to do—raw deecnbed properly
apesson. TN]onWuppliuoon Semmesnulldwdity waNMniedmns ambnWmnmerced nIW
drys orttwn9ruc9an vmM b w]pended Iwe period M I W dys.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
APPL ATIO F ISP DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.E1
X Dm//(O�A.1
reaOWN u6t el ned the OWN pets
DEPARTMENTAL REVIEW APPROVED I DATE I DENIED I DATE I TAGRMOTESrCONDMONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT 1 -4 11
FIRE MARSHAL
PUBLIC HEALTH ( \lMd
PLANNING: t ��
ALL SETBACKS ARE MEASURED FROM
THE FURTHEST PROJECTION OF THE
BUILDING
t,
0
to ta`� S\o t
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(jl 31x4S rc,^iut� 'tP S\c�a j� tpa' q a3
DF �q eM tkeS� � e,
APPROVE 4e r \°
MASON COUNTY DC LANNING
SITE PLAN REQUIRED TO ON SITE y�
CHANGES SUBJECT TO A PROVAL
By: Date: 0 /26/2023 t
EH Setbac
A.) Dralnfleld/Reserve requires 10'setback fro footing/foundations y
B.)Septic fank(s)requires 5'setback from all f ting/founof bons /\
C.)No foundation/Perimeter Drains within 30ft, owngradient of
Drainfield/Reserve area
D.1 No Cut Bank(s)(greater than 5ft and over 45 egr, within
SOIL down gradient of Drainfiekl/Reserve area 110 f
EH APPROVED —_
Rhonda Thompson 10/06/2024_ V E i.,� G I� e.IJ
I ' 1
SEP 2 5 2023 PLANNING SETBACKS
Front: O���
Alder Street Rear andnd Side: b�0a0a3
'Subject to EH Setbacks