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HomeMy WebLinkAboutBLD2023-00522 - BLD CD Environmental Health Review - 5/15/2023 ,NOG'PI-14, MASON COUNTY COMMUNITY SERVICES Permit No: 02-3194Z a3--065 ap� i PERMIT ASSISTANCE CENTER:•BUILDING••PLANNING•PUBLIC HEALTH•FIRE MARSHAL RECEIVED F 615 W.Alder Street.Shelton,WA 98584 Phone Shelton.(360)427-9670 ext.352•Fax:(360)427-7798 Phone E N V I R 0 N' i E N TA L Be/aic(360)275-4467•Phone Elma:(360)482-5269 MAY 10 2023 _ ` BUILDING PERMIT APPL T•ION Alder Street HEALTH PROPERTY OWNER INFORMATION: CONTRACTOR IINFORMATION: NAME: 4 NNW wG r- NAME: MAILING ADDRESS: i 1Gt Ji k..ir-j 5-r lJ MAILING ADDRESS: CITY: trtleercio STATE: hti,r4 ZIP:cV• ,3,.Z CITY: STATE: ZIP: PHONE#1: PHONE: CELL: m PHONE#2: - (Q r!2 (n, ) C)' 7 L `7 t: EMAIL: C) EMAIL: L&I REG# EXP._/_/_ rn PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER Eg. rn N NAME ocit YY \ be in. EMAIL k.Dd C e Vs• ..i•C E o 9 YYt}�i ` ry MAILING ADDRESS $A-wte— CITY STATE ZIP CA-) PHONE_ CELL 3(G Q —6 —1 01-1 PARCEL INFORMATION: ' PARCEL NUMBER(12 Digit Number) L I L\ 56 •v�00 9 ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT irt\R.Gpti� SITE ADDRESS . A.16 1.4-1ke. ' I CITY`r f3rVV Lt f4 DIRECTIONS TO SITE ADDRESS IN\ A-sc i '"c"al S.iTe... IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESVI._-NO❑ SNOW LOAD:3s psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check oil that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ - USE OF STRUCTURE(Residence,Garage.Commercial Bldg,Etc) IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(Whole Bldg)❑ YES(Bart(s]ofBldg)❑ NO❑ DESCRIBE WORK SQUARE FOOTAGE:(proposed) 1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ 1 MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* C\U��o �1/ MAKE pl Ar i�,i-t e MODEL © C9' O/✓ YEAR 9O O. . LENGTH 6 t WIDTH .2( 9' BEDROOMS 3 BATHS nZ SERIAL NUMBER1)t'f 4D2?O?0 ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ki SEWER❑ / NEW gi EXISTING PLUMBING IN STRUCTURE? YES NO❑ If yes,attach completed Water Adequacy Form ` PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ N$ EXISTING SQ.FT. 17�a D EXISTING BEDROOMS 3 PROPOSED BEDROOMS 3 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 construct on 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) Signature of 0 NER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL nn�(((�� PUBLIC HEALTH k[, Cah13\tOr3 G�c -,20X 36 N . ��� Ft' d1.oza-3-oosaa, -FA V\vyR ‘.&)A• q 5 S-88 PLN Approved 05/15/2023 Rq-‘„.,,k.` 3?2,I L) -$ 0'C)1'(00`t Mason County Community Development Gavin Scouten All Changes Subject to Approval 1 EH APPROVED Planning Setbacks Rhonda Thompson 06/07/2023 Front:25' North side:5' South side:20' Rear: 10' EH Setbacks tall setbacks measured from the farthest A.)Newbold/Reserve reorereslo'setback horn lootinglloundahons projection of the building 8.)Sep&needs)reneges 5'setback horn all toohnploormdalions 'subject to EH setbacks C.)No(oundalion'Porimeler Drains within 3011.downgraAent of Drainhelddieserve area w• 0.)No Cal Bank(s)(greater than Sit and over 45 degrees)within C� 50Il,down gradient of Dranheld/Reserve area V O / / I A s V ') / 0 QS e ,,i) J 1:-.,,.44. '9€ 1/%1 t•4 / y` h v Vj f . A, A \ f .` r \....Q . , -.--\ L? , ---s^s, s ret‘‘ ,...............;,1 Ii., .c • am \ \.0• ' ks A, 6O ki i t.‘t: a— O wwS