HomeMy WebLinkAboutBLD2023-00173 - BLD CD Environmental Health Review - 2/13/2023 ��,.9t`'`'.'.1-1,. MASON COUNTY COMMUNITY SERVICES \L.i-P � w 0017
PERMIT ASSISTANCE CENTER: t ,,•I • LI d,f
-t-rigil Ft •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 77-
`. a
ti o615 W.Alder Street,Shelton,WA 98584 �=�� j3 Ll,��'L�3 ���GPhone Shelton:(360)427-9670 ext.352••Fax:(360)427-7798 Phone //
-(i)
Belfair.(360)275.467•Phone Elma:(360)482-5269 (l
' lo, nSON Alder Stre(8 NV ON M E N TA L
BUILDING PERMIT APPLIC PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: H EAL IT
H
NAME: 6:/f/l y t 1)4NN 4 C.oi1I 8P NAME: A T/st GL G
MAILING ADDRESS:703/ ce ,42c4D/,4 J -1 MAILING ADDRESS: WO/ {�,4eil1 Alvt S£
CITY:S�F1£G¢o/4 STATE: IL'4- ZIP: ,4j CITY:d%i�r*A>. STATE: /,'4 ZIP:.7. 5T5
PHONE#1: 36 O- /O/'O/7/ G PHONE:'t.OW MU CELL:3360 23r'72eJ '
PHONE#2: 340-q4)/-DO77 1) EMAIL: G,}.' y- /)Eri 4y6 ..A.4,4i/-6....Di"1
EMAIL: L&I REG II b -i/Z4 L-ie%7�13r EXP. 3/.? /23
PRIMARY CONTACT: OWNER 0 CONTRACTOR OTHER❑
NAME ��/24f /A6T2Ay EMAIL
MAILING ADDRESS CITY STATE ZIP
PHONE CELL 00- 2 3qi- 7zs8-
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 2 - )2 S 7 U DO 2 ' ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS 70 3/ S-f: ?i7 ,Q b i4 //c7 CITY scfq 6 L Z,)
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD: pst
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK 0 POND❑ WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEW' ADDITION❑ ALTERATION� 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Etc.) /C/1 7' -iQ'-
IS USE: PRIMARY IVSEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS ?-
HEATED STRUCTURE? YES(Whole Bldg) YES(Part(s)of 81dg)❑ NO 0
DESCRIBE WORK /463 '/lI t &Ait/ /CriS 6/Oici C
SQUARE FOOTAGE:(proposed)
1ST FLOOR 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 0 Detached 0 CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: �*4 COPIES OF THE FLOOR PLAN REQUIRED*/
MAKE .52 C !
//;(/g- MODEL S4l 7 �d 2`' YEAR 2�l ..3 LENGTH Y/S/
WIDTH "24 BEDROOMS 3 BATHS Z SERIAL NUMBER 7-3 D
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC I/11 SEWER 0 / NEW Ie EXISTING 0
PLUMBING IN STRUCTURE? YES NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO / EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 0
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 APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x
/-'3/-23
igna a of OWNER ust be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL / i t 5 1��IfL.,I
PUBLIC HEALTH I)f ?/13 ( e `rind fy1C,
a� A
tt�� F
Q ~PC1lLin7
�m.r r— n..a
asp
O LU
o �0 L'� w w3 2 zz
Nm N
O W o - __ M -a -—
Q CC } . � Q U ^ Q Z <
o N A z = o w
O Q L.L.
W �/
c� O z
CQ � . � W
Z I z
V •
K O O� in . ,.,
. _
O W - Z
wZ � Z I
0
coUJ I
m
d
•
W I. ��
'o
.: ' ,—I I- 0 I
•
• t_____ i..- '
'O .
i 1 m
[ J Ji ce
O
' W a o
Z._.' ❑ r '' CD N
* -W $ LL Z N
J - 1 _� fY m
1 -1,-- ---1 g o
1
=r=� �^
`
f
N r ��
I i \.
Q ✓�
m _r I ' 1----
• N
_ 3
0_07 Q 1
•- _�
• - 0 oo �
O _ r--- N= c �.'-�
ce �'I I . ila o z o
co
w 1 oc
on ,
r> .a giW ■ pi Aga iqo a .. , ,,..,
u t
•
•
�- O
a m =
1w
ws-,sz o z
O —T— J
CO
t
N oc N
W
u
V..1
• ,4,: MIzoo =• mN o E _v, u,.,
DO
Ill'r\s.._ ••••,...
-14
Es
V?v ZOa
FQ
O m`a�<E ZS
4 I .,
'L
_...�. ... . _ - 1 r� �► 'fir r
__6- APPROVED Y,
a.
.r.. MASON COUNTY DCD PLANNINGTA a
SITE PLAN REQUIRED TO BE ON SITE v, SQ01(1
CHANGESGE SUBJECT TO APPROVAL 2 0 ✓ 'r
By:
"w —":--- Date: 03/22/2023 ° ZPitifiC S�
K
7:3-) V
.c -V\ Vt0 ,.-- 'g'is---"I'------7-1
I'-.20' . \,
' \7 N
fri,
, (GI
r I,,
W �� -1 20
1 )
/ 1 R/11/EC l
&ARy a-01Ru,'lA eo#iiieg fi r1//,{1.6;=
7031 Si 4rec?tprA PS b. 'ivz:: - —3
/ ,.
TP 242 s a5 �`Oc)o20
i /
PLANNING: , `
ALL SETBACKS ARE MEASURED FROM `
THE FURTHEST PROJECTION OF THE / / r
BUILDING VM0
r
PLANNING SETBACKS ICI' `/ 1
Fron:: 25' , / 1
Rear and Side: 20' �:� / 5r
•Subjf ct to EH Setbacks J(
o ' l
i
,
,
---- -_________ t 1 ii
.„2„.
S A Q )4 e/
+�, iYty
•
g"(Dmam � �
E.
•
P am
T�
•
m Z m -0
a co ct, '
•
vN Cl) Cco AD
m �Z
o -I ZO�Z
nT 0
•
0
•
1-.\
GG)
v- . VZi . .
m
•
•
•
•
o v
•
•
•
R'/ 1i . _ f K1
oa
m Z ��
m
\ 13
g, o i
t_, , .. 1 m \ m Ti .Z7
m0
„ — �- 13
6 0 0
D
r •0' S� Qe u�U} co,a � �. w m i
a - s. •
•
•
•
r \ 0.. .• =tea i ' M1`.
i•:- +moo ,. O nvios>
cam c- = ' • cc '�
c I
I
Y
r W
ag ill
�. �_ ...
e-
•
d m 2d gad m
=
_ 2. H
a
•
oN
m t4- -1
13 dg ViEw
3 ' D
•
,
•
•
o w_d o-a n
•
•
v
w 1111
/ .
z_,ei,,ii‘(ZI/...„S'S), ,.
....s-•__._____k)0__.___•.,N‘iN,_.A.„_-._
___ 6_
o ...o
0
;" w y
93
vs
cXC)
03
v(1 t'� L v