HomeMy WebLinkAboutBLD2022-00755 - BLD Application - 6/13/2022 ,L r N �k MASON COUNTY COMMUNITY SERVICES Permit No:e21 Do20 Ra- 7 5 �J
PERMIT ASSISTANCE CENTER:
FJ"^ Q! BUILDING•PLANNING.PUBLIC HEALTH•FIRE MARSHAL
I 615 W.Alder Street,Shelton,WA 98584-� RECEIVED
-y�-.�.•^ " � Phone Shelton:(360)427-9670 ext.352 Fax (360)427-7798 Phone
. ?e 3- Belfair:(360)275-4467•Phone Elma:(360)482-5269 t
t �R BUILDING PERMIT APPLICATI(�NN 1 3 2022 ENVIRONMENTAL
PROPERTY OWNER INFORMATION: CONTRACwNwmieet H EA LT H
NAME: MARC!&RYAN SIBONGA NAME:CLOUDY BAY CONSTRUCTION,LLC
MAILING ADDRESS: 1840 CENTRAL PLACE SOUTH,APT 5 MAILING ADDRESS: PO BOX 5697
CITY:KENT STATE:WA ZIP:98030 CITY:LACEY STATE:WA ZIP:98509
PHONE#1:253 250-3143 PHONE:360-559-5129 CELL: 360-556-4478
PHONE#2:253-426-9153 EMAIL:EPETERS@CLOUDYBAYCONSTRUCTION.COM
EMAIL:MGOOSEMAN22@YAHOO.COM L8t1 REG#CLOUDBC814C7 EXP.2 /27/23
PRIMARY CONTACT: OWNER❑ CONTRACTOR 0 OTHER❑
NAME ERIKA PETERS EMAIL EPETERS@CLOUDYBAYCONSTRUCTION.COM
, MAILING ADDRESS PO BOX 5697 CITY LACEY STATE WA ZIP 98509
PHONE 360-559-5129 CELL 360-556-4478
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number)42216-51-00013 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) LAKE CUSHMAN#10 TR 13 FIRE DISTRICT 18
SITE ADDRESS 121 CONIFER CREST CITY HOODSPORT
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD:q Opsf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF 0 STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)SFR
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part[s]ofBldg)0 NO 0
DESCRIBE WORK INSTALLING A NEW MANUFACTURED HOME.
SQUARE FOOTAGE:(proposed)
1ST FLOOR 710 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK 16 sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE FLEETWOOD MODEL TRINIDAD YEAR 2022 LENGTH 52'+8'PORCH
WIDTH 13'8" BEDROOMS 2 BATHS 1 SERIAL NUMBER TBD
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 NOD EXISTING SQ.FT.
• EXISTING BEDROOMS PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
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
o COUNTY CODE 14.08.42)
X t- q...Q.7 .51—NC 1 (3 I
Signature of OWNER(Must be Maned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
—
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH \ 0 Ibill C('it( a 1ade-j
/ 49/7,7(t.„ gre/ , . c?7LP.ad23.- M-755
, / 7/ /v/ .e, 1
. .
LN
-- {3 f� , r-e� ALL SETBAP SAR NING MEASURED FROM
/7 f CG / t !/ THE FURTHEST PROJECTION OF THE
1aa J t '5 1e-?i :5/.. '7 ///3
BUILDING
f " .-Potter' . A ,
ZiU- w c ' i
1 .M
.'".'°
,>/'-4g(41, - --- :
PLANNING SETBACKS •
Front:10' •.
•
Rear: 20' y lip,
Side:North 20'
Side: South 5' (ADV2022-00081) k
*Subject to EH Setbacks `
or APPROVED
MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE - .
CHANGESSUBJECT TO APPROVAL t
"'gip`'. *m- " :4...- —r'1",-..,.
By: ,w -Date:07/06/2022 r'4, .
4 t ( re:5r'rwr. 1,g
sss
EH APPROVED
Rhonda Thompson 07108/2022
EH Setbacks
1 A.) Drainfield/Reserve requires 10'setback from footing/foundations
7 w it•*co B.)Septic tank(s)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of
+[ 0_ I si (..,"„ Drainfield/Reserve area
L I f S" D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
M 50ft,down gradient of Drainfield/Reserve area
-7-441 — !to( i.
14«. "QC) 4-OAS .
. ti