HomeMy WebLinkAboutBLD2022-01560 - BLD CD Environmental Health Review - 10/26/2022 !Ciffililir43'
s�ti6 k. MASON COUNTY COMMUNITY SERVICES Permit No:)Id�(,') _G 1 S U C-!
PERMIT ASSISTANCE CENTER:..44 •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL '.—�• s. 615 W.Alder Street,Shelton,WA 98564 \'
Z. .,—.------ q Phone Shelton:(360)427-9670 exf.352•Fax:(360)427-7798 Phone
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Bellair.(360)275-4467•Phone Elmo:(360)482.5269
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BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Housing Kitsap NAME: S I? 1 E
MAILING ADDRESS:2244 NW Bucklin Hill Rd MAILING ADDRESS:
CITY:silverdale STATE:WA ZIP:98383 CITY: STATE: ZIP:
J PHONE#1:360-535-6134 PHONE: CELL: r
-_ PHONE#2:360-535-6138 EMAIL,: _
EMAIL:NailD@housingkitsap.org L&I REG# EXP. / / �/
(''' , PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER Q `•
\ t NAME JOe1Kievrp EMAIL klempj@housingkitsap.org = X
\� MAILING ADDRESS 2244 NW Bucklin Hill Rd CITY s'iv."00 STATE WA ZIP98383 rn O
PHONE 36os35bt38 CELL 3e0-509-92,8 D Z
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PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) /9 2 O •52 ^ £i G 004 ZONING R-1P = rn
LEGAL DESCRIPTION(Abbreviated) Lakeland Village 10 LOT:21&VAC PTN Blackwell SI adj. FIRE DISTRICT S Z
\j ,) SITE ADDRESS q C �.. I 1 Lfitl a<1 CITY Allyn
-3 DIRECTIONS TO SITE ADDRESS
y 4,"
�orc isr FEt0 f e 4 rop LF cr,V4 D
jv' � rp g e I✓ke.cf[.... I. ST' A . it?/Ai.1.S IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO 0 SNOW LOAD: 3o psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND❑ WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEW C] ADDITION 0 ALTERATION 0 REPAIR 0 OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Erc)Single Family Residence
IS USE: PRIMARY al/SEASONAL 0 NUMBER OF BEDROOMS 3 , NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(Whole Bldg)IV"-YES(Part(s]ofBldg)0 NO 0
DESCRIBE WORK A/td �awn,:IL, ntliort Kct
SQUARE FOOTAGE:(proposed)
1ST FLOOR 633 sq.ft. 2ND FLOOR , sq.ft. 3RD FLOOR ' sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK 1 S sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE L(5'7 sq.ft. Attached[I-Derached 0 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:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER 12r..... / NEW❑ EXISTING 0
PLUMBING IN STRUCTURE? YES Q NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES I NOD EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 3 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 1 am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
I 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 8 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) /1
cyAlc
Siyii i OWNER(Must be signe by the OWNER) a e
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL {�
PUBLIC HEALTH ((b(23 C(�"—(i GL 4
H-2 Zoning
Front yard-15 feet.
Side yard-5 feet,or less with review and approval of an
administrative building variance,see Section 17.10.460.
Street side yard-8 feet
Rear yard-10 feet. In cases when the rear yard abuts a
right-of-way,the primary structure setback shall be 20 feet. 46 E WI .� I I
d► ' .cm 1'1 e
Garage doors-20 feet with roll-up door,or 5 feet from an alley or �!
private drive.
•R ici 222. - 0 15L )
Susan Cottey I222 -50- 6006
12/30/2022 `Ne."--
APPROVED Allyn Group 1 LOT 4 1333 PLAN EH APPROVED
MASON COUNTY DCD PLANNING Rhonda Thompson 01/0612023
SCOTT RUEDY,AICP
E 104 Public water and sewer
itn_ 83' Stormwater
• 1 run-o
Ru 1 — 1
1
I
I 10'
I ——
1 E 102
I • 22.75'
1
5' II `—�,
I /
I 52' /
II FIN.FLR. /
102.5 / 5'
•97' II /
/
46' /
/ /333 G 21' / 75'
/ iii
I I
2 Bath 2 caadDRM AEG •r // 7' 1=20
I 2' WATER
I 14' ' / POWER
25' ORCH / 0 SEWER
5' /
8' /
/
DRitTK'AY l
/ `` DB /_
14' /
E 102 15 45' / Road E.semool 5'
1 r
D' 47.36'
WICKERSHAM LN
Easement lines are REQUIRED to be marke• , the footing — D
inspection
115' 96
All required setbacks shall be measured from the nearest i
property line,except that front yard setbacks shall be measured
from the property line or the edge of an access easement.
20'
1