HomeMy WebLinkAboutBLD2022-01477 - BLD CD Environmental Health Review - 11/21/2022 (2) K.•i.,
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MASON COUNTY COMMUNITY SERVIC Pi i7 2O&2—( )/ 77
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PERMIT ASSISTANCE CENTER: E `I
A. •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL /1�
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` 615 W.Alder Street,Shelton,WA 98584 NO't 1 �orl� \ f
__r' :,� Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
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Belfair(360)275-4467•Phone Elma:(360)482-5269
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BUILDING PERMIT APPLk1400610der Stree1E Nil 1 RO N lit�NTAL
4 PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: HEAL-I.t u,
NAME0CG' ry�-�,Scr,�j Weber NAME: Ip _ tfnvrces Trnc -
MAILING A19DRES:S d/ C. Cron r 5�-Rol • MAILING AADDRESS:,2-72O so.,Tsr.
CITY:41 ly n STATE:Wet "IP:q 8,ran CITY:Ta[ama, STATE: (J)a ZIP:eifyp9
PHONE#1:160-al`)- Gr(7o9— PHONE:a5j-9 ,-6S),,,ICELL:
PHONE#2:360-;1-1 -116(o EMAIL: i.tst;w'.►ectAky homes i nC.CCM
EMAIL: f r'uJ hr,CD 9 rvta,1•Corbel L&I REG#REALM ft F1't C N EXP.6 a?//c/clif
PRIMARY CONTACT: OWNER S CONTRACTOR❑ OTHER 0
NAME,r5rP9or9or ,5a11u we & EMAIL r'i W1nre9 1 MCI-4 )
MAILINGADD-RESSS7r G. Vorlc2 L'S� R� CITY Ail STATE Wei, ZIp c1_q{
PHONE 36O-al4 - 6��a CELL 3F4/7-�Iq- '7R' Pr
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) /aa 3 a-i0 -Q0.Q7/ ZONING RSJ
LEGAL DESCRIPTION(Abbreviated)TR7A•G•L•a EK EJ047-81LC.• FIRE DISTRICT ,5
SITE ADDRESS .1 E. Ciro 1t. hM S+ Ra CITY A-{41
DIRECTIONS TO SITE ADDRESS Frcwi S'teA ion•- Hwy 3 -fo Gt (tr-u 4.4A)loop R. -i-tarot r` i+
-4DlleitO 9rc 13 e A) -1-n Cron€4u 's+ Rt1 4-4 n lef'f, fnL{e_ne4 lccKCorphlvcWwa kkoA at.cti,r<c1 ercios 11t f'k-c-t-
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES '. NO❑ SNOW LOAD:... 5 pst
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER LAKE 0 RIVER/CREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW/ADDITION❑ ALTERATION 0 REPAIR❑ OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) S F R.
IS USE: PRIMARY SEASONAL 0 NUMBER OF BEDROOMS oL NUMBER OF BATHROOMS oZ
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Parris]of Bldg)," NO 0
DESCRIBE WORK f E AJ :51e✓
SOUARE FOOTAGE:(proposed)
•1ST FLOORI608q.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK _sq.ft. COVERED DECK 7sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE 1.00 sq.ft. Attached L3(Detached 0 CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQU *
MA „MO EL YE - LEN
WIDTH OMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC] SEWER❑ / N EW(Eir EXISTING❑
PLUMBING IN STRUCTURE? YES/' NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 N 3 EXISTING SQ.FT.
EXISTING BEDROOMS `./ PROPOSED BEDROOMS ;TOTAL BEDROOMS --
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 APPLICA� TIIO OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
) .1 c7- Ck./ COUNTY CODE 14.08.42)
X . 4, / _.-- // /: /77 ...-;:\)�.
Signal a of NER(Must be signed by the OWNER) ate
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL _
PUBLIC HEALTH '41 \-i f- 3 C� -1-k1(• S
EH Setbacks -
A.) DramfieldiReserve requires 10'setback from footing/foundations
B.)Septic tank(s)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of
Drainfield/Reserve area
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
50ft,down gradient of Drainfield/Reserve area --/)�
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EH APPROVED '
Rhonda Thompson 01/23/2023
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Al,setbacks are measured from the furthest protection of 7 r,' L ovt5it•r uc.''i�o s �'" _ �; _ —
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ADV2022-00164 10' Min ' ^
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' "hf14 Gallon t're-Treat ii !OTC - o^t'S ' '\ % -�
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r t uWairr 13NR-5(10 ATt! Tank 1 ' \°
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../ ,,000 G:►ll<�n t'ttmtt C'ttantbrr
`k> Valve Control Liox •0. 3 f :i
RR5 Zoning _t '4n .,` ',,., '' .� ' 31 '7+
Dighei�y Front Yard Setback. 25'. +`-•!-- ‘.'�` t F r
by Side & Rear Yard Setbacks. Residential dwelling �, • ` ;; ,y
Ruedy �-, �.r , 1 < s
and accessory structures is 20'. - 3 j
OR 10%width of lot if not more than 100'wide /19 ,..`t i .►•fti ':
APPROVED OR approved ADV
MASON COUNTY DCD PLANNING i Y
SCOTT RUEQY,AICP . .01/23/2023