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HomeMy WebLinkAboutBLD2023-00207 - BLD CD Environmental Health Review - 2/22/2023 s i MASON COUNTY COMMUNITY SERVICES Permit No: ael4 tctq , D PERMIT ASSISTANCE CENTER: `: ,.. •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL r` `� Itt 615 W.Alder Street,Shelton,WA 98584 / "' !r t. FEB 2 2 2023 ,�' c�,yy r)? Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone I�l , 1j;'-'-''V S Belfair(360)275-4467•Phone Elma:(360)482-5269 V BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: v� rn NAME: r TOrv1 S NAME: 5�WI C ed12-', CO►'1S 1 v U m MAIL AD SS: I(30 'Y.( KtIti4kt_ mAILIN AD RESS:'�30C) W C/O /l Py r J C CITY: I STATE:(4.V}' ZIP: 9 CITY: 6 VI. STATE: c 7 PHONE#1: '3 (o O ?/O i ,c(c f PHONE: 012V. ` = PHONE#2: EMAIL: (-(C(C C.l� l$ 7— (vltcl /•CO«- D Z EMAIL: d C:)tC -'h V oe(OivtCej f,I'i tL&I REG# C $10CC�38-)�1EXP. l/(o/ Zq PRIMARY CONVACT: OWNER❑ CONTRACTOR OTHER❑ )) NAME "t-Q{IL`ls / EMAIL I�c{i c1 .e-v& '6 Z ,,,,, I t GOu1. MAILINGADDRESS � C-I o 0 -vs( e2t,IkIU\ L/CITYJrhF I*8-1 STATEWA-- ZIP = M P E 4 CELL PARCEL INFORMATION: D PARCEL NUMBER(12 Digit Number)_ 6 Z O(Z-• 2-1 ~ 0 b OZd ZONING r LEGAL DESCRIPTION(Abbreviated) n,-_ / n FIRE DISTRICT / Z- SITE ADDRESS I&U W �I It la CY`e c,l' CITY i- DIRECTIONS TO SITEAADDRE S O �I/I --fi'� IAA r ) le - l Q.A. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOg SNOW LOAD: psi IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW W ADDITION 0 ALTERATION�^ 0 REPAIR❑ OTHER 0 USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) 5 T I n IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS �` HEATED STRUCTURE? YES(WholeBldg)N YES(Parr(s]ofBldg)0 NO 0 DESCRIBE WORK SOUARE FOOTAGE:(proposed) 1ST FLOOR )-lei(1 sq.ft. 2ND FLOOR QQ sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK U sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE Ge(5Oq•ft. Attached p Detached❑ CARPORT sq.ft. Attached 0 Detached❑ 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 0 / NEWNr EXISTING❑ PLUMBING IN STRUCTURE? YESIC NO 0 If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 Ni/"*' EXISTING SQ.FT. EXISTING BEDROOMS 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 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 CONTIN ATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERM! PPLIC IONQF=180 DAYS OF MORE WILL CAUSE.42)THE APPLICATION TO BE EXPIRED.(MASON ( COUNTY CODE 14.08 X / a ‘A A -22 ignature of WNER(Mu signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL / PUBLIC HEALTH 8A It lQ(2 3 Cot Ot "IS R'd et( , PLN Approved Front: 25' running 5etnacKs '04/20/2023 .�� ��` Sides: 2 ' Mason County Community Development 3 Rear: 20' All Chang s ubject Gavin S 'all setbacks measured from th farthest ect to Approval t projection of the building *subject to EH setbacks 1 \ :-. : --4',=17:3 ....:•...-1••••:'"•0,'"*.4.1 O. \ 1-777•1 t-:s. "., ' r'.s.," .. .-.:• .. ..: i --Cv.:::-..fj;„...).. "'.- . . ,...... ,..„-p•:, '\'''j 1 \-. . t i 1 k I I t &)° \ ,i '\1\: Shoe , 04E G© ni f ; av it's 5►hrn • a I 1 ! 1 _ i 10' mt 41 F t i �� o ri /o ter- l npvs�d . _cc‘ 'I \ trvtw01 1 f ,�O \ I 1 1 1 (; tt • ' 1 • t�v`� t( i 1d Zd2 - LO1lir —1 ; eo' r__ ' Audio-Visual Alarn t _ 5��� �" u 0 2 50 -� `Oo ;i ( Cleanout ��bv�\tifl O3 1200 Gallon Septic Tank rs q '" 2-Compartment with \r v � \ f�� , r7t Effluent Filter '10 ... '4 PumpChamber �� l0��12'21 O0 ; O4 1000 Gallon rar kgO O Valve Control Box EH SETBACKS A)Drainfield/Reserve requires 10'setback from footing/foundations B)Septic tank(s)requires S'setback from all footing/foundations C)No foundation/perimeter drains within 30'down-gradient of drainfield/ reserve area D)No cut(s),banks)(greater than 5'&over 45 degrees)within 50' down-gradient of drainfield/reserve area EH APPROVED D.Anders:m 04/27/2023