Loading...
HomeMy WebLinkAboutBLD2022-01366 - BLD CD Environmental Health Review - 10/25/2022 "---''4l. MASON COUNTY COMMUNITY SERVICES Pratt I LQ10 "'vvv /`r . PERMIT ASSISTANCE CENTER: "^61.14111r.c.' ` 0 v.. •BUILDING•PLANNING NINGe•PUBLI Sh HEALTH•FIRE,WA 84 MARSHAL 61 r 's l— : Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone O t.l ���� �� Bellaic(360)275�467•Phone Elma:(360)482-5269 ,?'\?'y BUILDING PERMIT APPLICATION 15 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: E A 1\/I R J^I M E N T A L NAME..�I/(t V11 fb RT 1—Le NAME: ) V V rHEALTH � E(AVL'VTt H'�J /-� MAILING AD RESS: t t. ILING ADDRESS: CITY �C(.f ST TE: ZIP: D�j CITY: STATE: ZIP: PHONE#1:'L4'p. Wk. (q'1 PHONE: CELL: PHONE#2: EMAIL: EMAIL: (/e e 1M V9 YEMWR /u1,C14) REG# EXP._/_/_ PRIM R ONT T: �n o NE CONTRACTOR❑ p t: fki NAME ,, skl� L EMAIL IC�/1Q(p •�'OM MAILIN R S I CITY ST E ZIP PHONE, CELL PARCEL INFORMATION: I_ PARCEL NUMBER(12 Digit Number) kin'IAA 1 L�ry�k E10 ONNIING LEGAL DESCRIPTION(Abbreviated 112-• I(P Or /14-.0,6 0 3/q/ SITE ADDRESS 2 34" 4 101 CITY{"L101:6Vb ( DeaTIOATO SItAi D SS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO I/ SNOW LOAD: 6 psf IS PROPERTY (THIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0 TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION4 R9,„ EPPAIR OTHER ❑ USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) T'�.�,IS USE: PRIMARY❑ SEASONAL/ NUMBER OF BEDROO NUMBER OF BATHROOMS HEATED STRUCTURE?c', YES(Whole Bldg) n YES Pa s o Bid NO DESCRIBE WORK li N411 I RI-- ^L SQUARE FOOTAGE:(proposed) /� p 1ST FLOOR I sq.ft. 2ND FLOORVIZd sq.ft. 3RD FLOOR sq.ft. BASEMENTt'7124 sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached 0 CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIX SEWER 0 / NEW 0 EXISTING4 PLUMBING IN STRUCTURE? YES/rif NO 0 If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 Stvl NO EXISTING SQ.FT. EXISTING BEDROOMS 3 PROPOSED BEDROOMS TOTAL BEDROOMS Z 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 CO I ATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS P T AP CAT N OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.08.42) X tiff Sw vv 10 . 71r- 2A . Si r N (Must be igned by the OWNER) Date DEPARTMENTA REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL ,Q PUBLIC HEALTH 10(Z17 C GA-i iN/tc ,h I e 101 cnnx toEe>z n3a a�i . :n3a Id S -• _$ Iapom :n3a F PH odS oo Wd 91:bb:L1 :3Yna ccoc/t/01 •31va - ' EEA mil/ , , • .... „. ... ., / I it / � . . ei. •. .. 1 ` 1.‘ ;� 4• i l ...-- I .1 • i 74:: 117CP ) 4,:t6 -- " /II ' ..i. r I ,:.. i / t ya c V IIID I, i 7 � I O 1 tlr 1 5.,,\ --! . -.44.11 'gm '1: t 1 2 ��II m0 1 Ts. R H o y-.ot/ .o m / 1 ` ! o '\ y 11 I I r \ \ ad4 ' I I I I1 c 'P'\ F 1 .. N C \ \ I I m c o l gym= § \ \ 1 o-o m co \ \\ i1 a9 /iC 1 c o \ R ; a N E g V N \ ' u)•^ E3 I .. o c v m ?\ \ - CO - ems Ue t 1 N U g VI m ( I 0 (I) N R 1 V W O a) N N D N N ., ) W cmdrna > o I, +I \'1 Q. m �a1° � ( �, N 2 m- CC a 1 ---- mYamcv a s r I �N _-0 0 m a, Q r r 1 l a~ 1 RI4 ' m3 =f, m U fla`Z2 W I�ov) CZ - I / I I . cx.vacaa.- 01362(t) .-.1 \ \\N\\,—A.),./ HOOD CANAL 1 ACCESS ROAD WATER TANKS 1 6 \ •• SHED j ,� ' i •ilia — EXISTING BUILDING ' II DRIVE/PARKING — BULK HEAD i r DOCK MN ! /IIIihIiqiig; INiViNt I ' 44,te _ EXISTING GREASE TRAP& t I 1200-1500 GAL.SEPTIC TANK~y' 0 I iii, — I + EXISTING DRAINFIELD AREA I (300-500 fr) r � ' �— -- — CABINS r! i r 6 ® - APPROX.TOP OF BANK(DASHED) rri i EH APPROVED `J`'�' Rhonda Thompson OY06�7073 EH Setbacks WASTEWATER SYSTEM'AS-BUILT: A.) Drainfield,'Reserve requires 10'setback from footing/foundations FOR: GORSE JOB#; B.)Septic tank(s)requires 5'setback from all footing/foundations PARCELDATE:03 NOVEMBER 2004 C.)No foundation/Perimeter Drains within 30ft,downgradient of Drainfield!Reserve area 13Y:TJS DESIGN PAGE' OF D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within 50ft,down gradient of DrainfieldiReserve area NORTH ARROVV: A SC%LtI,E: 1"= 30' ©TAHJA-SYRETT DESIGNS o' 60' 3(90 g.3a. 4 gaol .