HomeMy WebLinkAboutBLD2023-00278 - BLD CD Environmental Health Review - 3/9/2023 e o,,vivo'-'1'-`4kv,., MASON COUNTY COMMUNITY SERVICES Permit No:�ICI 2O2j" 66276
' PERMIT ASSISTANCE CENTER: •
. RECEIVED
:. •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
aE. s'�< 615 W.Alder Street,Shelton,WA 98584
-y f ,: Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
fit;' �yy<- Belfair:(360)275-4467-Phone Elma:(360)482-5269 MAR 0 9 2023
BUILDING PERMIT APPLICATION 11��I,,
PROPERTY OWNER INFORMATION: CONTRACTOR INFOItM'" IOIW Alder Street
NAME: LD Ve.ISG N\ %, 01nX•• MI, VY_G NAME: m
MAILING D SS: 2 '� MAILING ADDRESS: Z
CITY: q STATE: ZIP: CITY: STATE: ZIP
PHONE#1: D PHONE: CELL:
PHONE#2: EMAIL: 1 3 = M
EMAIL: (,bUA St•INV,MUYO( O . WY~' L&I REG# .R_^_l� rT1 Q
PRIMARY CONTACT: OWNER CONTRACTOR 0 OTHER❑ `uc� > Z
NAME EMAIL
MAILING ADDRESS CtO
CITY STATE ZIP m
PHONE CELL �L Z
PARCEL INFORMATION: r� ' 1 SO PARCEL NUMBER(12 Digit Number) Ia 2i2 L-t"— , —OfO P-1 ZONING ' ' -5
LEGAL DESCRIPTION(Abbreviated) � 5 1 e �.�Its FIRE DISTRICT oZ r
SITE ADDRESS ?yG hJ� Iw1.+�QVLO✓C' �rE . CITY T/,te14L.,ya.. (7u14
DIRECTIONS TO SITE ADDRESS -11AVIA r V*,ib G Gdi�-c_ 1-I,�VN ✓1�'�}'
G 4'rvf %cop- • W I kk fr to I- V
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: Y' NO❑ SND: psf
IS PROPERTY WITHINir FT OF THE FOLLOWING: (Check all that apply
SALTWATER 0 LAKE RIVER/CREEK 0 POND 0 WETLAND SEASONAL R NOFF❑ STREAI ❑
TYPE OF WORK: NEW'' ADDITION❑ ALTERATION 0 REPAIR, 0 OTHER 0
USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Etc.) Vp tr 4L'�1 1\ !t, le, pill, 'V i"
IS USE: PRIMARY 0 SEASONALkr NUMBER OF BEDROOMS I NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YEESS,(Whole Bldg)❑ YES(Part ft]ofBldg) NO❑ { I-L ` h ow
\
DESCRIBE WORK �'V.t 1 Vs 14,Y l/i • Q {il.-Il 1A i).eS �T (M7 Seri,
I SQUARE FOOTAGE:(proposed)
1ST FLOOR 1)6) I sq.ft. p errCOOR 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 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE 611-VvY MODEL ?eitiIe YEN YEAR fey Z.3 LENGTH
WIDTH 131 3 1I BEDROOMS I BATHS ( SB,RJ\/�IKIITUM ER VI 0
ENVIRONMENTAL HEALTH: 1,J l's CDOt-}OSt,7* �_ _ Jti
"'A'
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW' EXISTING 0 F '
PLUMBING IN STRUCTURE? YES NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NC53e EXISTING SQ.FT.i
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 it 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 AP;LIGATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X "
Signs ure: OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL ,,
PUBLIC HEALTH 5JLI�) C �►- g-Vi--lnA, J ,
Ici ?023-- cots PLN Approved
rPlanning Setbacks 04/24/2023
ront: 25' Mason County Community Development
;ide: 5' (reduced to 10% lot width) Gavin Scouten 1�. •=30.
tear: 20' All Changes Subject to Approval CA
all setbacks measured from the farthest o �g 3o y5 bo
rojection of the building )\ P\o f ?\ate.
subject to EH setbacks `n Q y
N/� 0. 1Q� I����D r `CST O l l 15 l`t "—
3g= .o�keshoYz —
5l.or ,
r
I EH APPROVED
Rhonda Thompson 05/22/2023
II I �Y \_ O, ..t--ktt cs' k \roo S
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i 1 i t-\.r75, ..---y\ --e—C,-giL. '\'''''
il \I --,s-ifk."Ac..- •1;--p \t9--e- , -x --5-., y :....t- 0)S\ &-0
`, „—s -- - b 0 a ;(\.bye,
d 0I • I '`'� Kie
l I ` O Audio-visual Alarm
` I o �! 1r O Cleanout
,\',v\2 ` ,( x O 500 Gallon Pre-Trash Tank
5 to fi O_ LWrt.d f n�j,S
�3• I ii Go`�nCv () ?� NuWater BNR-500 pretreatment Tack
4C v �tr aY2�, 33 I. i - • 1,000 Gallon Pup Chamber
I System Headworks
'i ( 4i $ t• i _ • O Subsurface Drip
keg O VC, ,, gilt 1
Low 1 i , j .� .: T ._.�>
Tr ma's . L� y D' '' °r w" � 'hair �1 1 �3-� 3 of sNOV 17 Eitp., r.%..4
�-- — — 1 I CSf�'rV� uNryEtv'lkij i k. rta.• siO 3 9 ,•;h
i Ar')tr�T� ..:',5.,
PAULA JOY JOHNSON }
_ i Jg�, ( '-•.jl' %%...+$.cte'-«;'nt$IGN :: ,
50' ' y �' EH Setbacks
Op,E v.a,••G A.) Drainfield/Reserve requires 10'setback from fooling%foundations
__ N E L1�KE5� B.)Septic tank(s)requires 5'setback from all footing!foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of
O-f ! ! Drainfield/Reserve area
3 D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
50ft.down gradient of Drainfield/Reserve area