HomeMy WebLinkAboutBLD2023-00527 - BLD CD Environmental Health Review - 5/15/2023 (.----0°.-r''_,, • :3?, MASON COUNTY COMMUNITY SERVICES Permit No:�t I(I k ?) ' Llo 2 iPERMIT ASSISTANCE CENTER: EIVED
�� Y+ ••BUILDING••PLANNING•PUBLIC HEALTH•FIRE MARSHAL
[;i hi •6 615 W.Alder Street,Shelton,WA 98584 '
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2.�,�•"•'''+ �� Phone Shelton:(360J427-9670 ext.352•Fax:(360)427-7798 Phone � � 20��
I Beak:(360)275-4467.Phone EIma:(360)482-5269 r
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BUILDING PERMIT APPLICATION 615 W-Aldcr Street •
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: .
NAME:- ;A41Ylcia-3UhKI \\On(6_ NAME: t'_t' 0 (-OnCAfl~(As kC;r1
MAILING ADDRESS: 51 wl �luc,1r.11 n _ MAILING ADDI SS: i..i3-gvl,..-,r Rd,
CITY: STATE: CITY: .,,1`n C= STATEq,`)t l LW:Gi .z, l
PHONE#1: - . — S,Q— PHONE:
PHONE#2: 5-3 '3/�C: 'S-(p C) EMAIL: rn
EMALL: YN C"'5 C-•I Cc ( e 0 Ync"-L'-.the - L&I REG# EXP. / ! I z
PRIMARY CONTACT: OWNER5( CONTRACTOR❑ OTHER❑ 13.
NAME Jv.$1��V'Y\ �C ck AMC 1^Vt., EMAIL
L XI11 MAILING ADDRESS L{t1U ' Cd-TV
C Et_ i e• . STATEu1Ct ZIPCf yEG:; m I 1 J
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PHONE J � m
3._7S -Sc s 3 T
PARCEL INFORMATION: `-'-rz
M ry
PARCEL NUMBER(12 Digit Number) &\� tT "lu-000c i ZONING w . y
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT = r jij
SITE ADDRESS a ,S/ IA) •�\,w� m A 1 ,( A aTY �.\,, ck da
- DIRECTIONS TO SITE ADDRESS
Joll
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO H, SNOW LOAD: psf r
. IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (awckali that apply):
SALTWAI R❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW A ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Resided Garage Commerdal Bldg,Etc) (.- 1CA-fi L' /1'7'4e h,i y n
IS USE: PRIMARY❑ SEASONAL', NUMBER OF BEDROOIv1S NUMBER OF BATHROOMS
HEATED STRUCTURE? YES(iF7/w(e Bldg)0 YES(Pa ls]ofBldg)❑ ENO❑
IB
DESCRE WORK /�"1(iA LLG / t)��.(L A Y(.c"-ice
"I II
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. 011-1ER sq.ft.
GARAGE L`7 sq.ft.Attanhed❑ Detac_h . CARPORT sq.ft.Attached❑ Detached❑
MAl\UFAC _ ON: " *4 COPIES OF THE FLOOR PLAN REQUIRED*
..----I MODEL LENGTH j,-
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
sEWAGE/ rE°SOURCE: CTPTIC7C SEW".❑ i INEW' EXISTING❑
PLUMBING IN STRUCTURE? YES❑ NO Ifyer,nna.•h Ieted Flirter Adequacy Form
PEZ EMMIER FOUNDATION DRAINS PROPOSED? YES❑ NO EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revoovtion.Acknowledgement of such is by
signature below.I decare 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 aC the neressay paw,including any easement holder or parties of interest regarding this project.The owner or legal
representative,represent that the information provided is accurate and grans employees of Mason County access to the above described property
and struclure(s)for review and inspection.This permRlappfcation berxznes nut&void S work or authorized construction is not commenced within 183
days or if consbuchon work is suspended fora period of 183 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PER APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.06.42)
/ �ignature a`OWN ( ust be sinned by Date
i.- ...__...-._,�._, _DFAIXI)_.":.DATE":TAGS/NOTES/ ON'D.TITONS_,
•�F�ARTMNI'AL Ri�rJIYV�- :APPROVED:`�_i DATP.''-:, -• _
BUILDING DEPART *L
PLANNING DEPARTMENT
FIRE MARSHAL /� _ //,�.��/� S f._� ,,�
PUBLIC HEALTH 1 14 7/Zy/7 _t-NIII,T,w- erg •
PLN Approved `y ',,,
P►ar r"�P
pp `',
05/18/2023 to ProPieJ . P t e., biro
Mason County Community Development
Gavin Scouten
All Changes Subject to Approval \� oZ.0 ►a-p:t •Tc t) '54 ea t'o
Planning Setbacks �1 be de Mot;gk,�)
Front: 25' f
Sides: 20' l 3. S e PT i s reell /
Rear: 20'
*all setbacks measured from the farthest \4
projection of the building Li, NpvSe
*subject to EH setbacks
1
t 5, Wet t►
EH SETBACKS 6
A)Drainfield/Reserve requires 10'setback from footing/foundations c 's,
B)Septic tank(s)requires 5'setback from all footing/foundations to
C)No foundation/perimeter drains within 30'down gradient of drainfield// i 1 f CO( C..-a-r PUri"
reserve area Q ,J
D)No cut(s).bank(s)(greater than 5'&over 45 degrees)within 50' /
down gradient of drainfield/reserve area /
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• ? 0fur/1 F:� ��
EH APPROVED :,
04 M� Y' n
D.Andcr<on 07/24/2023 � "V •
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TOPOGRAPHY PROFILE: L{ 1 >' I1 y 9 e r3 I'e o Pe r-7 r
L. 001i:A 9 0ow'7
n„ _n!1 JC2 Direction: Scale: Approval: for office use
Building Permit number: C.0 ' • 9 GQ " Building:
Owner/Applicant: Mont-0 a Date of Planning:
/ application: Env. Health:
Parcel Number: 11 11 ja--/'7 0 ()DOD
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TOPOGRAPHY PROFILE: Lf I J' 15 c) ,e.r' P r o P t r 7 Y
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��� JC2r Direction: Scale: Approval:for office use
Building Permit number: ) c 0 Building:
Owner/Applicant: a a CO Date of Planning:
'! application: Env. Health:
Parcel Number: (!y lq -I`7 J 0 b00Q