HomeMy WebLinkAboutBLD2022-01570 - BLD CD Environmental Health Review - 12/27/2022 DocuSign Envelope ID:A83D2301-B2CA-48DA-8435-CF6687941875 /j J�
rta�' MASON COUNTY COMMUNITY SERVICES Permit No:6 Le aaaa�0/ 70
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PERMIT ASSISTANCE CENTER:
,y .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEI�
,
j 615 W.Alder Street,Shefon,WA 98584 C`r-rti rn,
/ Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone `�-" " `rI2b
Belfair:(360)275-4467•Phone Elma:(360)482-5269 DEC 2 7 2022 (J
BUILDING PERMIT APPLICATION 6frOii���M E NTAL
615 W. Aber
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATI N:
NAME:Scott and Tamiryn Anders NAME:South Shore Construction HEALTH
MAILING ADDRESS: 1510 Pamela Ct MAILING ADDRESS: PO BOX 963
CITY:Concord STATE: CA ZIP:94520 CITY: Belfair STATE: WA ZIP: 98528
PHONE 41: 925-250-3512 PHONE: 360-2750818 CELL:
PHONE#2: EMAIL: southshoreng q.com
EMAIL: L&I REG nnl1THSC0IFNL EXP. 02/10/24
PRIMARY CONTACT: OWNER❑ CONTRACTORX OTHER El
i NAME EMAIL
MAILING ADDRESS CITY STATE ZIP„
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32124-50-00053 ZONING RR5
LEGAL DESCRIPTION(Abbreviated)EMERALD LAKE DIV 1 TR 53 S 29/191 FIRE DISTRICT
SITE ADDRESS 130 E Peaceful Place CITY Grapeview
DIRECTIONS TO SITE ADDRESS Head North on WA-3 2.7 mi,Turn left onto E Mason Lake Rd 5.0 mi,
Turn right onto E Emerald Lake Dr 0.5 mi,Turn left onto E Peaceful PI 0.1 mi, Destination on left
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOX SNOW LOAD:25#psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ •
TYPE OF WORK: N IN% ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Goruge,Commercial Bldg,Etc.)
IS USE: PRAIARYX SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg)X YES(Pan[s] Bldg)❑ NO❑
DESCRIBE WORK Install new manufactured home for residential use
—
SOUARE FOOTAGE: (reposed)
1ST FLOOR 2006 sq.ft 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE KIT MODEL Pinehurst 2506 YEAR2023 LENGTH68
WIDTH 29 BEDROOMS 3 BATHS 2 SERIAL NUMBER N/A
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING,GI
PLUMBING IN STRUCTURE? YES NO C If yes,attach completed Water Adequacy Form
PERLMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOX EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
OWNER acknowledges that submission of inaccurate information may result in a Sop 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 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
„—P-..bakttg,AftgLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
12/6/2022
—Signature-tit-OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEP.ARTIMENT
FIRE MARSHAL
PUBLIC HEALTH R/et I�Z� W V'J�K�) G�
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RECEIVED
DEC 2 7 2022
615 W. Alder Street
ENVIRONMENTAL
HEALTH
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90L^dv) r),2R O t 5 7 D The destruction or alteration of Fish and Wildlife Habitat
Conservation Area's or their buffers through removal,excavation,
grading.dumping,discharging or filling of any material;clearing; I
shading;intentional burning:vegetation removal(terrestrial.
freshwater,or marine):planting of non-native vegetation that
would alter the character of the FWHCA or buffer;or the
EH Setbacks construction or placement of structures or increasing the
A, OramliekLReserne requires 10'setback born footingJowrdahons structural footprint shall undergo mitigation sequencing and shall
B.j Septic tanks)requires 5'setback from all footin yloundations require a habitat management plan. .
C.)No toundation/Perimeter Drains within 3011.downgradient of �`
Draintrotd Reserve area ^(��-^JJJ
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within / ish
5011.down gradient of DraintieldReserve area
01/23/2023 EH APPROVEDRhonda Thompson 03/0t'202APPROVED
MASON COUNTY DCD PLANNING stream to the S of the
SCOTT RUEDY,A1CP . / property line must maintain 1 q buffer
7 for future development. l
Digitally
Scott Rued
y signed
by Scott
edy
Ruedy
P LOT P LAN 30 FUTURE
GARAGE
NAP of this app-o�al
SCOTT & TAMI AN D E RS I ----1
130 E PEACEFUL PLACE
GRAPEVIEW, WA 98546 150.96' tr.ITI
PARCEL:32124-50-00053
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SCALE: 1 "=30'
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:./ ---29.6'---1
EXISTING
4' x 6' �5'� RESERVE&
LANDINGS DRAINFIELD
—
—25.63'
PROPOSED 68'
ADV2022-00178 10' Min — 'Notcr 29.6' X 68'
MH
EXISTING
DRIVEWAY
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37.14 3'
R5 Zoning
=ront Yard Setback. 25'. •
side & Rear Yard Setbacks. Residential dwelling l 20'
ILend accessory structures is 20'. C/ F ..
JR 10% width of lot if not more than 100' wide 100 78+
JR approved ADV E PEACEFUL PLACE
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