HomeMy WebLinkAboutBLD2022-00791 - BLD CD Environmental Health Review - 6/21/2022 esti'6'`''4Lt;t�t MASON COUNTY COMMUNITY SER Permit No: LO2O 22' OD 77/
PERMITASSISTANCE CENTER:fT\
F� •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARS L_ 615 W.Alder Street,Shelton,WA 98584
y f I Phone Shelton:(360)427-9670 exf.352•Fax:(360)427-7798 Pho `e 2022 ENV
R N E NTA�
�q),. ttl `,^dy Bellafn(360)275 4467•Phone Elma:(360)482-5269
BUILDING PERMIT AP�16jK�er Street HEA
W• LTH
PROPERTY OWNER.. j INFORMATION: CONTRACTOR INFORMATION:
NAME: C " ) NAME: SCIAle Q5 Pm iy ( or
MAILING DDRESS: 7 MAILING ADDRESS: Cme
CITY: . STATE: ZIP. CITY: STATE: ZIP:
PHONE#1: O" PHONE: CELL:
PHONE#2: EMAIL:
EMAIL: ()I L&I REG# EXP. / /
PRIMA Y CO TACT.NAME - S NER1( CONTRACTOR 's❑ THER❑� �000 9 40.1 1
MAILING A RESS CIT STATE WA ZIP y
PHONE CELL'
PARCEL INFORMATION: %,4_
PARCEL NUMBER(I2 Digit Number) p `..., SA.1y 0 ZONING
LEGAL DESCRIPTION(Abbreviated) , ��. - r IRE DISTRICT ��=►�1
SITE ADDRESS. ,t,l�b el_
iM/e1Sal•! tt I • CITY E Aid��/,��i m I
IRE TIONS TO SIT ADD t ESS t47� /f, _ -�'k'i..••0 '—jj.� ' �p.1 'A +s(7Tiltl1LCTI 71�) I le
• ^ • ll 1 I • _ as . i1I1f�+IS � "Lf��i7asCt �f i �i t, . -tcp tab
IS THE PROJE WIT IN 300 FT OF SLOPE(S)GREATER THAN 14%: YES I NOVI SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEKU POND❑ WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEVI ADDITION 0 AI,TERATION 0 REPAIR 0 OTHER [l
USE OF STRUCTURE(Residence.Garage.Commercial Bldg,Etc) -S ioxen(1
IS USE: PRIMARYe� SEASONAL 0 NUMBER OF BEDROOMS r NUMBER OF BATHROOMS_a_
HEATED STRUCTURE? YES(Whole Bldg) YES
(jPart(s)ojbid NO❑
DESCRIBE WORK NQu,) 470.SL OC.T/PS S . /// je
SQUARE FOOTAGE: (proposed) 1�
1ST FLOOR&1 Jyssq.ft. 2ND FLOOR l�sq.`Ij.S I�FIA�OR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECI3 q77 Iq. . FORAGE sq.ft. OTHER sq.ft.
GARAGEW)9 sq.ft. Attached Dif Detached 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 SEWER❑ / NEW EXISTING❑
PLUMBING IN STRUCTURE? YESX NO❑ If yes.attach completed Water Adequacy Form
"4,1E PERIMETER/FOUNDATION DRAINS PROPOSED? YES NOD EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS` 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 permit/application bocomes null&void if work or authorized construction is not commenced within 180
days or if constructon 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)
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Signat r of OWNER(Must be Silld by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL r
PUBLIC HEALTH L 1 rit ...` AVA'OLOA
A LQZO —o079I
RECEIVED
JUN 212622
SITE FLAN FOR BOB ESSENPREIS PREPARER: 615W.AIde, :t
LOT AREA: 11.1 ACRES RUEPPEL, INC. ��
ADDRESS: 6451 W. SATSOP CLOQUALLUM ROAD, (253) 291-8040
ELMA, IBA. 98541 v
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PARCEL NUMBER: 619284400030 O
PLAN: 2145 r'=6O'
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EH APPROVED
_y-,Cre__ 07/11/2022
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EH SETBACKS
A)Drainfield/Rese e requires 10' setback from footing/foundations
B)Septic tank(s)r quires 5'setback from all footing/foundations
C) No foundation perimeter drains within 30'down-gradient of drainfield/
*NTS- Septic system location to be reserve area 1
i installed per SWG2022-00262 D) No cut(s),banks)(greater than 5'&over 45 degrees)within 50'
down-gradient of drainfield/reserve area
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Us\ -0' 0 PLANNING
O I eL ALL SETBACKS ARE MEASURED
ETE Q FROM THE FURTHEST
' I61mm PROJECTION OF THE BUILDING
CL low u- I `
' � =±' Streams
-fish stream has 16,5 ft structural setback
w/150 ft vegetative buffer requirevneht.
Np stream amino parallel south of the'Fish
stream and runs adjacent to Eastern parcel
lihe 'nas 115 ft structural setback with 100 ft
vegetative buffer.
} Setbacks
Troht= 25 feet
— Side= 20 feet
II *'Parcel is split by fish avid Np streams.
I t I APPROVED
A I MASON COUNTY DCD PLANNING
SITE PLAN REQUIRED TO BE ON SITE
„,..------ CHANGES SUBJECT TO APPROVAL
_/- Malissa Paulsen 06/27/2022
6)____. _ _ _ _ _ —e
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APPROX. 330'