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HomeMy WebLinkAboutBLD2018-01208 - BLD CD Environmental Health Review - 11/5/2018 MASON COUNTY COMMUNITY SERVI CES Permit No-t02b t 8 -61'DU r PERMIT ASSISTANCE CENTER: •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 ENV I RO N M E Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone Belfair.•(360)275-4467•Phone Elma:(360)482-5269 HEALTH BUILDING PERMIT APPLICATION RE ED PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NOV 0 2018 NAME: JAN OOSTERVELD NAME: REI CONTRACTORS MAILING ADDRESS: PO BOX 1709 MAILING ADDRESS: Po BOX 1936 ef SI"t3ti CITY. PORT ORCHARD STATE: wn ZIP: CITY: BELFAIR STATE:wA ZIP: 98528 PHONE#1: 360-990-3919 PHONE: 360-990-3919 CELL: 3W-552-5117 PHONE 92: 360-552-5117 EMAIL: SONNY@REI.CONTRACTORS EMAIL: SONNY@REI.CONTRACTORS L&I REG# REICOCLu903 EXP. 09/ 23 2019 PRIMARY CONTACT: OWNER❑ CONTRACTOR® OTHER❑ 360 NAME soNNYRoGERs EMAIL sONNVQRE NTRAcrog MAILINGADDRESS POBOX1938, CITY BELFAIR STATE wA ZIP 98528 PHONE 360-9903919 CELL aaR-sso.s„� PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 2233151-00061 ZONING COLLINS LAKE#2 LEGAL DESCRIPTION(Abbreviated) LOT 61 PLAT OF COLLINS LAKE NO 2 FIRE DISTRICTN MASON REGIONAL FIRE SITE ADDRESS 171 NE HILLTOP PL CITY TAHUYA, AUTHORITY DIRECTIONS TO SITE ADDRESS TAiRN RIGHT ONTO NE COLuNs LAKE OR ao 1 RILE TURN RIGHT ONTO NE HILLTOP PL,Go 0_1 MILE 1'M NE HILL TOP PL,WILL BE ON YOUR LEFT IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):NIA SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Connnercial Bldg,Etc.) uEw raeNl IEeemoen Hnm1E IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS--2— HEATED STRUCTURE? YES M ole Bldg)® YES(Part(s)of Bldg)❑ NO❑ DESCRIBE WORK W&J Ma SOUARE FOOTAGE:(propose+existing) 1ST FLOOR 1.e8o sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK _ _ sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR 2b t g LENGTH sw WIDTH 28' BEDROOMS 3 BATHS 2 SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC x❑ SEWER❑ / NEW© EXISTING❑ PLUMBING IN STRUCTURE? YES 0 NO❑ Ifyes,attach completed Water Adequacy Form PERIMETERNOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS a 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 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 permitlapplication 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 COUNTY CODE 14.08.42) Ig ER(Must be slaved by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH I b-m C C 0.-4.'t 3CJ A= - 5 0, REC IVED NOV 0 5 2018 �P+ /►mo?V�;. 111,11,1111114er>. het el-ille C zQ� "� �: � ►,°yea-�fl (� - - r D rYI Ickes C)a- _ O ° o VIRONMENTAL N � � HEALTH D � �qoo ld 2o.18 .61 9\0 S /ayckf, � 1`71 ne �I�,cQ. ?LP 14 00 a ROVE DEC 0 3 2018 MASON COUNTY ENVIRONMENTAL HEALTH 10, °WLJ Kew s c-a-LI: ,=3a G Audio-Visual Alarm o �5 3o DES• 60 O Cleanout ?�X'h O3 500 Gallon Pre-Trash tank ONuWater BNR-500 ATU Tank i'i,re Q 1 22331-5-1- 00057 5 1,000 Gallon Pump Chamber OValve Control Box I f ac ' l'' 1 0 0 �•y=! � 3 �� 1 Z 1. i 1 F- 1 SR < I C71L1 AX9M O 1 O LiJ 1' II 11 11 ti W AIWVA V _ j 114 W mx Q N O ® e1 EE ��< T t 1n Ocn W O� -r. �• I tu a� ZAL" - L.L N f �•- 1 p '�J Ncr Q 1 5w z ---- 3.0 ,� E O O --- �s3a lao � i Co 1cr- N L 00 m 3 N 1 Q a- • �` oN � w wN � J w L �p t O ' n Q 0 m c N