HomeMy WebLinkAboutBLD2023-00318 - BLD CD Environmental Health Review - 3/21/2023 ' �J,r•"""''''a;t MASON COUNTY COMMUNITY SERVICES Permit No: E�EK �
PERMIT ASSISTANCE CENTER:
111 . •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
. •a 615 W.Alder Street,Shelton,WA 98584 MAR 2 0 2023
rj,f Phone Shelton:(360)427-9670 ext.352••Fax:(360)427-7798 Phone
'�it' vY' Belfair(360)275-4467•Phone Elma:(360)482-5269
'"...24... ,r���� 615 W. Al. • Street
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION•
NAME: Norman&Junell Villines NAME: *
MAILING ADDRESS:1461 W.Hurley Waldrip MAILING ADDRESS:
CITY:Shelton STATE:WA ZIP:38584 CITY: ST• : Z ' 11‘ '-- k->
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PHONE#1:360-427-8519 PHONE: CELL: , Z
PHONE#2: EMAIL: Ilk
EMAIL:Junell@laceycollisloncenter.com L&I REG# EXP. Q_
PRIMARY CONTACT: OWNER❑ CONTRACTOR 0 OTHER 0 7/
NAME sn.w^^^+•. EMAIL shawnyames@yahoo.com m 0
MAILING ADDRESS 800 Yauger Way SW Unit 0303 CITY op'mp• STATE WA Z1P98502 D z
PHONE CELL 253.202.6312 r—•
PARCEL INFORMATION: = (Tl •
PARCEL NUMBER(12 Digit Number)41925-75-00070 ZONING Z
LEGAL DESCRIPTION(Abbreviated SURVEY 12/27 FIRE DISTRICT
SITE ADDRESS 1A61W Hurley Waldrip 61 my Shelton D
DIRECTIONS TO SITE ADDRESS r
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO❑Q SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION 0 REPAIR❑ OTHER Q
USE OF STRUCTURE CommercialJ(Residence.Garage.Commercial Bldg,Etc.) /�
IS USE: PRIMARY l�l SEASONAL 0 NUMBER OF BEDROOMS ,p":"> NUMBER OF BATHROOMS Z
HEATED STRUCTURE? YES(Whole Bldg)[[r.YES(Pan[s)of Bldg) NO❑
DESCRIBE WORK ��1?V)1P�� a C1C C_ ('Pc \D L
SQUARE FOOTAGE:��``� (proposed)
1ST FLOOR P,040sq.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 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKEPalm Harbor MODELAme^can Dream YEAR 2.62-2- LENGTH'S Y' '
WIDTH30 BEDROOMS3 BATHS2 SERIAL NUMBERTBD
ENVIRONMENTAL HEALTH: 11\){1A14 GO 9,1,4 (1V1 1''V 41 Gt-�hl.ct 1
SEWAGE/SEWER SOURCE: SEPTIC D SEWER❑ / NEW 0 EXISTING 0PLUMBING IN STRUCTURE? YES a NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT.
EXISTING BEDROOMS 3 PROPOSED BEDROOMS 71._ 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 if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
—
Ne PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
Q 1 PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X 3-Za-23
�y,� Signature of OWNER(Must be signed by the OWNER) Date
U DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL �1.
PUBLIC HEALTH F1� ,�I/3 !L �'tl 1V`t.' aell24
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'EH APPROVED C� �-
j• •• 1 -- -Rhonda Thompson 06/06/2023 —..-
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- _ . EH Setbacks _ _• . _:.
• A.) grainfield/Reserve requires 10'setback from footing/foundatf _1 � —
I r }} 8.)Septic tank(s)requires 5'setback from all footing/foundatiorts y • •' I ..
• 1- C.)No foundation/Rerimeter Drains within 30ft,downgradient of J - .... ` ��
.1111 Drainfield/Reserve area r 1 1
_ D.)No Cut Bank(s)(greater than 51t and over.5 degrees)within - •- - _ .. . •
..i N 50ft.down gradient of Drainfield/Reserve area _
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EH APPROVED
Rhonda Thompson 06/06/2023
EH Setbacks
A.) Drainfield/Reserve requires 10'setback from footing/foundations •
B.)Septic tank(s)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of
Drainfield/Reserve area
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
1 50ft,down gradient of Drainfield/Reserve area 3
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