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HomeMy WebLinkAboutBLD2023-00499 - BLD CD Environmental Health Review - 5/3/2023 77-�� s Permit No:(LLQ aO 3-o 9n�-/ 1 MASON COUNTY l __ COMMUNITY DEVELOPME cEivEo MAY Permit Assistance Center,Building,Planning _ 3 2023 ENVIRONMENTAL BUILDING PERMIT APPLICATION Alder S PROPERTY OWNER INFORMATION: CONTRACTOR INFORM TIONtreat E• NAME:Notnes-.bw¢ wo-v2_1,4,-Y1Or 4 h 1A St-(ix. NAME:4-1Om es W'IIADcuP I northwest-in G MAILING ADDRESS (6(TX SIaS MAILING ADDRESS: Pb 16 5b$ CITY:,' uri TATE: ZIP: Cl3t302 CITY:�yt,tXw t STATE:LJ1� ZIP:Gigs 72 PHONE#1: 2pb 2/ ijCI 5 11`1 R J PHONE: CELL: S •51<-I• 3cl IS PHONE#2:Qs 3 Sly 3cim CNIecNc„--‘ EMAIL: '''I EMAIL:mt,gO..n9At.),"k'S ex)C5rhoLii. COIYIL&TREG OYytSVYVT19 Z- EXPO3!ZEL/, PRIMARY CONTACT: OWNER Ig CONTRACTOR 0 OTHER❑ NAME «JVP0.- • EMAIL i",JYc_C.,IL$-Q.&e EDY s h.COtrrl MAILING ADDRESS PO 3 5(Q CITY I3 STATE A 19 ZIP 1 3 24 PHONE�(� 2z9 44lir S II CELL ?, 3lt•I 3 IS Y1+��a PARCEL INFORMATION: 7 PARCEL NUMBER(12 Digit Number) 1'(,3 3 c: Sy O00 2� ZONING LEGAL DESCRIPTION(Abbreviated)LO - 24 TS e(I f-ca% COUe_. V1Q:1 FIRE DISTRICT SITE ADDRESS —lb\\ ► C 4rs LC, r i CITY •Q,).c� DIRECTIONS TO SITE ADD)EvU ( 1t1,l1 T-p I_0 N.vr +0 L -U a L 11e�,r 1,4�u_ `t t y l Lod cr, YI F. .S lit j l e s L air e v13 " "_I n }-. IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER TITAN 14%: YES❑ NO„,13'..SNOW LOAD: psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all dratepply): SALTWATER❑ LAKE 0 RIVER/CREEK 0 POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM 0 TYPE OF WORK: NEW ADDITION❑ ALTERATION❑1 REPAIR❑ OTHER ❑ I USE OF STRUCTURE(Residence.Garage.Commercial Bldg,Etc.) n vac,C} SF. 2 IS USE: PRIMARY,Er SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2 t 6 HEATED STRUCTURE? YES(whole Bldg),Ice YES(Part/riot Bldg)0 NO❑ DESCRIBE WORK S ' )1 i 4- I oo((p IcLr1 N I O e E 31Ded 2 Sl �h 2 0a r f SQUARE FOOTAGE:(prrusJ) 1ST FLOOR -tb sq.ft. 2ND FLOOR S 70 sq.R 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK h�sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. )' GARAGE`0J sq.ft. Attached 6 Detached 0 CARPORT sq.ft. Attached 0 Detached 0 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 Ca/ SEWER❑ / NEW% EXISTING 0 PLUMBING IN STRUCTURE? YES, NO❑ If ces,attach completed Water Adequacy Fore, . PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS 3 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 arm 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 r1 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) 5/110093 Sign re of OWN R(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL __yam t PUBLIC HEALTH je 617,(717� C co -5 d C 6U • ... bLOXi423- 00c-: t9 • �,��� �o( s L N 11_ zo� • N� SCALD 30 t t 0 20 way r g.Y'Sr`"9 Bog ►NG 17 pr;veway J ? EIS 12330-5M " 00 0 N ou.. 0 L \ )'orct Garage 2() Fro e0 S f d 1 0' . 3 5R o sL pcc ©. T C: V/ .L D - , s 1 o1. I k...) T — , 1 ~ o _gyp,, LS w( 5• x — c10 M f)A C . Poc, -e- 0 0. o N P..tCt1-00 ' k9. _ _ ... _ i 5Y. SoM£ cotA9AcT or 3 SLo1'E C. A-2: E Setbacks (3) 3'x5-- '' Pc2-IMP`g, A.) Drainfield/Reserve r-•uires 10'setback from footing/foundations ` �N l �� �� �{I B.)Septic tank(s)require. 5'setback from all footing/foundations w`T ��51 C.)No foundation/Perim:er Drains within 30ff,downgradient of ® q' 0 b. l Drainfield/Reserve area ����� i D.)No Cut Bank(s)(grea-r than 5ft and over 45 degrees)within � 1 50ft,down gradient of Dr infield/Reserve area 0 EH APPROVED 'kb') Rhonda Thompson 06l26,2023 0 Audio-Visual Alarmrit,...„"A N irAl.. 3 Cleanou 15' ' =`• Gallon Septic Tank ...r. 51^o34g .. ,Y., O3 2-Co G went with .<. • PAULA JOY JOHNSON •. 2-Comp �`L'iCffig ib �iGAtf'l, Effluent Filter S`;� I�i - 0 1000 Gallon Pump Chamber 7 `S 2.,rj �4? 0 Valve Control Box