HomeMy WebLinkAboutBLD2023-00524 - BLD CD Environmental Health Review - 5/11/2023 r /1n
Permit No: id•L-U2��' OO 2,-{
MASON COUNTY
0.,. _
COMMUNITY DEVELOPMENT RECEIVED
- '-' Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION MAY 1 1 2023
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 615 W. Al ier Street
NAME:Gage Bailey NAME:Hiline Homes
MAILING ADDRESS:7271 W Shelton Matlock Rd. MAILING ADDRESS:
CITY:Shelton STATE:t^a ZIP:95554 _ CITY: STATE: ZIP:_
PHONE#I:360.463-9294 PHONE: CELL: J
PHONE#2:360-701.7864 EMAIL:
EMAIL: L&I REG# EXP. i_/ I",
PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑ Z T
NAME 0 e a.dey EMAIL ggbailey73@gmail.com .i
MAILING ADDRESS 7271 W Shelton Matlock Rd CITY she^oo STATE WA ZIP98584
PHONE CELL Jd-463-9294
PARCEL INFORMATION: O W
PARCEL NUMBER(12 Digit Number)520045100005 ZONING Rural 5 Acres CC
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT MCFD#12
SITE ADDRESS330 W Nahwatzel Beach Dr CITY Shelton
DIRECTIONS TO SITE ADDRESS From Shdbo h.ad w„i o.She".rrrdoch Rd for 12.5 mi..loin rghr oo N.h...u.1 ee.:s,D.nwh,ue down rood fora m+es dk properly
will be on the right hand side
IS THE PROJECT WITIUN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NO❑ SNOW LOAD:35 psi , ,4 ,
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM■ , J3
TYPE OF WORK: NEW El ADDITION 0 ALTERATION 0 REPAIR❑ OTHER ❑ 'rr( ./` 4,,
ci
USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Etc.)Residence (4`0
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS j^ NUMBER OF BATHROOMS 1
HEATED STRUCTURE? YES(Whole Bldg), YES(Pants]of Bld,gSt NO❑
DESCRIBE WORK New construction
SQUARE FOOTAGE:(proposed)
1ST FLOOR875 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK72 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGES sq.ft. Attached❑' Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH: I�`._ -K 0�J��
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER 0 / NEW 0 EXISTING 0 i y D v
-, PLUMBING IN STRUCTURE? YES 0 NO❑ Ifyes,attach completed Water Adequacy Form V v 1/
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOD EXISTING SQ.FT.
0 EXISTING BEDROOMS PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
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.
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
Signature of 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 J,,6 iwhi ) 0.11N-6,*\14 4104
PLN Approved
05/16/2023
Mason County Community Development . ' -51 ,,
Gavin Scouten
All Changes Subject to Approval ,- - r t I ,'
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PlanningSetbacks `�® 1
Front: 25' 1 .0 7; " s • r'F
Sides: 10' (10% lot width @ build location) �i \
Rear: 20' - t
*all setbacks measured from the farthest '" -50`~ n
r+ �sto EH Setbacks
projection of the building A,)Drainheld/Reserve requires 10'setback from looting/foundations
l building r. El.)Septic lank(s)requires 5'setback from all footingdoundations
"subject to EH setbacl s� C.)No foundation/Penmeter Drams within 30n,downgradient of
//�y DrainfieWAeserve area
1CO , ` D.)No Cut Bar O)(greater than 5ft and over 45 degrees)wrtnm
l/..may—� 1,0 �,� 5011.down gradient of Drainheld/Reserve area
in:f - 0c
!J i?EEH APPROVED
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f if Rhonda Thompson 06/?J?0?3
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