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HomeMy WebLinkAboutBLD2023-00424 - BLD CD Environmental Health Review - 6/6/2023 MASON COUNTY Permit No: — 00q , COMMUNITY DEVELOPMI '.N t"' Permit Assistance Center, Building,Planning APR 19 2023 BUILDING PERMIT APPLICATION Rider street PROPERTY OWNER INFORMAT/ION: CONTRACTOR INFORM�'IiAw NAME: Corn i-tSI�oi Qi1 li1ro qq NAME: O W N'E'e MAILINGADDRESS:113 E fniavi QtjG ' • 4 MAILING ADDRESS: ENVIRONMENTAL CITY: Union STATE:W A ZIP:et t 5cl2 CITY: STATE: ZIP: PHONE#1:01,004/�,V 1Qq(o Abt qat1 PHONE: CELL: PHONE#2:(3to )4105-1Ar11 CM'V)ivl EMAIL: EMAIL: acrairrrataratVQ1nOO.(DM L&I REG# EXP. / /_ PRIMARY CONTACT: OWNER® CONTRACTOR❑ OTHER 01 NAME {\bi A11 Crti° EMAIL GrACC5LrcIto1���Ia1'\oO.CQM ` - MAILING ADDRESS j ja_E. 1 y 10 n tdG1.Q V CITY lini0I s STATE WA ZIP CI Y5iq`L 10 .PHONE (140)4 iO-?Al. CELL SAm-e n PARCEL INFORMATION: G w� PARCEL NUMBER(12 Digit Number) 321 O(p-15- aO 1(D2 ZONING 9.ts,atm 1 N t O LEGAL DESCRIPTION(Abbreviated) LQT $ Of- sto 4 pJo tc>r nil FIRE DISTRICT (p SITE ADDRESS 133 E 1A In too RI GI !!e. it- CITY \A n t 0 n DIIZ .CTIONS TO SITE ADDRESS O V o y glae 24.'Cu.rn Le ar1to 01ravQ-\ YJL1 A{ktV' bb� rter.s1Acle:�83"41�-1rt.t. IS THE)PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESD NO* SNOW LOAD:20 psi IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cheek all that apply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND 5 SEASONAL RUNOFF❑ STREAM I§ TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ®LUSt4-'`4AA1.&L USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) tct hG'xe_ T iota At IS USE: PRIMARY• SEASONAL❑ NUMBER OF BEDROOMS 7. NUMBER OF BATHROOMS 2- HEATED STRUCTURE? YES(Whole Bldg)II YES(Part[r]of Bldg.)❑ NO❑ DESCRIBE WORK Used( MF hurtle oiN Stab F.wv1 ,-k-on SQUARE FOOTAGE:(proposed) 1ST FLOOR(;,t) sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR _ sq.ft. BASEMENT sq.ft. DECK (04 sq.ft. COVERED DECK , _sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT WV t sq.ft. Attached❑ Detached IN MANUFACTURED HOMEINFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE 5 L\ N� MODELL GXIN r_VTO NI YEAR 2001 LENGTH 9�r WIDTH �.1 ' BEDROOMS a- BATHS SERIAL NUMBERZTOII'814b" P N3 ENVIRONMENTAL HEALTH: J SEWAGE/SEWER SOURCE: SEPTIC 1 SEWER❑ / NEW j1Q EXISTING C PLUMBING IN STRUCTURE? YES a NO❑ If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO EXISTING SQ.FT. EXISTING BEDROOMS 2-• 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 permrt/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 41' ►k• B' Dt e Sign.i re of OWNER(Must II signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL { t, r� �,f� PUBLIC HEALTH '�C J ��'r (A14,`!'V A)) �!`�K-{A.8 SCALLoV' D' . p 25 z5 166. `�(�‘ 15 0' b M Sz-r 2LAN AND �S £AvJE1t_ St tZ • &DR-6 ttNi kbl6atLC . ppc,E.L#32106-15- clot toy. • 1 R .E LI NToN IZTOt ' .v In ®�R---ES IgL _-T 2 EE • M !****:\ Ct- • S I• Key: E NO' WeiLAN'o 1 3Ur'F' R 0 Audio-Visual Alarm OS 11 .9 • e Cleanout I'n /'A StormwvCle+r O3 1200 Gallon Septic Tank w un-off pc,1/4-th 2-Compartment with Effluent Filter 15' ev,i-01NG SET6PVc- • 20• O 1000 Gallon Pump Chamber 3d t t ® O Valve Control Box 2'I k 5� ' 'o ® . PRoPoSED 2%. ' MgiJu,�Ac�inaED BCC.�--c 3� EH Setbacks A.) Drainfield/Reserve requires 10'setback from footing/foundations !: • B.)Septic tank(s)requires 5'setback from all footing/foundations Il 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 P �i. 50ft,down gradient of Drainfield/Reserve area House=l • t '`°"'` 1 �i !� back Q © ‘ (5/ ✓'X � 1' V-��M p \ .A E \ ``\\ —t R N ‘ E\..o • T K E. NC1 -{E5 @ 5'oc . D \ \`�e '" \\\ \\\\ 2,ESE, R-V E. zp EH APPROVED \r \� \ Rhonda Thompson 06/08/2023 'ra:AwscoP*R v4R 4y Witil". _ 12.cu,s, 3d s h - t. uTtl.IT`( art d t„aad I;AsatF r 105;1 N O IC) Li., [ jO c / ,i'--. a \ t 7 t® Ljj cr, CD - ! ° C.) a o It ' v tO 00 pO [ Z [It i--.\ \ o f v10 vat f-- i -- v .b e 2 2 U 2 . r: i td LC__i_.) 1 A \ d G i l� Y W tP O U 1