HomeMy WebLinkAboutBLD2023-00263 - BLD CD Environmental Health Review - 3/7/2023 ENVIRONMENTAL
HEALTH
f<st �t�t MASON COUNTY COMMUNITY SERVICES Permit No:
�Z.�ao a�--OO L(Q )
c PERMIT ASSISTANCE CENTER:
'C .'..• ••BUILDING••PLANNING••PUBLIC HEALTH••FIRE MARSHAL ���'''''''''���
° •!I• 615 W.Alder Street.Shelton,WA 98584 „ i - �.�,,,
?;. S
Phone Shelton:(360)427.9670 ext.352•Fox:(360)427-7798 Phone i•+V
%. �� Bel/air:(360)275-4467.Phone Erna:(360)482-5269
N'1,.flIt5, 11AR - 7 2O2.
BUILDING PERMIT APPLICATION
PROPERTY OWNERA INFORMATION: CONTRACTOR INF JA OMder Street
•
NAME:•.)nhv [\�QY ',5 4s1 NAME: reCt 11..7h✓t (/OnS4t3ccbi
MAILING ADDRESS:I47Q LTra'l> tick MAILING ADDRESS: Po 33Q7' S•'vO
CITY:$e\c'al►�' STATE:W A ZIP:G c/2S CITY: ce STATE:WA- ZIP:4k'$SV9 3
PHONE#I:t/Ob—•Z,2.0 --V42_3 PHONE: (744-4 LL:
PHONE#2: - EMAIL: v t4"L7 L C e574"..ay.\- �v'� r
EMAIL: 7 L&I REG# �.�fie. N LXP.$ 3//71 m o El
coPRIMARY CONTACT: OWNER 0 CONTRACTOR OTHER❑ ��.1 IT1 tv
NAME .Sclwi Z2-t-. t EMAIL r ywL C��_C 0 v> 0 IV
o
MAILING ADDRESS CAt:7 ( O Y 5242 0 CITY[mot C-°-J STATE C. ZIP 5 VP? c.._.)
PHONE•3to0•- 7,4 Z.- CELL
PARCEL INFORMATION:
PARCELNUMBER(12 Digit Number) ZZ2Z3`NI—0 is,o'-fc( ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS )4 Zo lt.Tro,i\S •oci Or CITY Sts-P.:, T
DIRECTIONS TO SITE ADDRESS
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14°/: YES❑ NO NOW LOAD:30osf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE D RIVER/ EEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEW ADDITION 0 ALTERATION❑ REPAIR 0 OTHER ❑
USE OF STRUCTURE(Residence.Garage.Commercial Bldg,Eic.) �7
IS USE: PRIMARY�EASONAL❑ UMBER OF BEDROOMS Z. NUMBER OF BATHROOMS 2.-
HEATED STRUCTURE? YES(Whale Bldg) YES(Parisi of Bldg)0 NO❑
DESCRIBE WORK J J e t..., AA N
SOUARE FOOTAGE:(proposed)
1ST FLOOR. '4( sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK •5Z sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached 0 Detached 0 CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE .-i1.15D;riti.}ip1 MODEL'C]4.C.LAP 2-J\ YEAR'7 2.Z-• LENGTHLEt� (9
WIDTH J'-( BEDROOMS 2 - BATHS 2 SERIAL NUMBER 115 9
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC LJ SEWER❑ / NEW 0 EXISTING V
PLUMBING IN STRUCTURE? YES NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOI!".r. EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 1.— TOTAL BEDROOMS Z
OWNER acknowledges that submission of inaxurate information may result in a stop work order or permit revocation.Acknowledgement of such is by
signature below.I declare that I are 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/applicator becomes null&void if work or authorized construction is not commenced within 180
days or it 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 _ 2---7L�—Z3
ignature of OWNER(Must be signed bV the OWNER) Date
i DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
4 FIRE MARSHAL /� q�y.,., ���(�y� '/�h�
PUBLIC HEALTH //A W IZkrt catY'n►e a+ftl�ur�(r
t_ t 2
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\--_.) os • -•• --(7 ,• -Z.----( —
EH SETBACKS
A)Drainfield/Reserve requires 10'setback from footing/foundations
8)Septic tank(s)requires 5'setback from all footing/foundations j
C)No foundation/perimeter drains within 30'down-gradient of drainfield/ \\\f/j
reserve area
D)No cut(s),bank(s)(greater than 5'&over 45 degrees)within 50'
down-gradient of drainfield/reserve area
EH APPROVED 1
I).A:rl.uun �i C
07/24/2023 `s-(I Rear ^-----..--.--
S• fi
r ` i
,,.
RR5 Zoning E
Front Yard Setback. 25'.
Side & Rear Yard Setbacks. Residential dwelling ..i ILI ' .tq .
and accessory structures is 20'.
OR 10% width of lot if not more than 100' wide (�
OR approved ADV
4 &. --•-\.•
i t_L1 r-'1 I,
0 I IA
5
;��
f
Front A. '"
0 Rear
04/04/2023 .-�,, '
APPROVED
MASON COUNTY PLANNING i os ADV2023-00047 10' Min
SeoTi RUF�v,A�eP \�
Digitally i �\ — — I— I
Sc.41Ruedy signed by Scott `7Q4— Front
Ruedy \
'2N-y0, - `- Z..(0 a
Y \
SC at \`1\ - • All setbacks are measured from the furthest projection of the
building.
10/19/2022 17:13 5037696022 KARSTEN HOMES PAGE 04/04
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