HomeMy WebLinkAboutBLD2023-00687 - BLD CD Environmental Health Review - 6/20/2023 •
, (;,;;'77.-17-'''\:1.1 MASON COUNTY COMMUNITY SERVICE E,-„PE- pig 7
117
PERMIT ASSISTANCE CENTER: t� V
,..„.. mil , ,,,.., .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
615 W.Alder Street,Shelton,WA 98584 JUN 2 0 2023
- Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
); 1: Beffair:(360)275-4467•Phone Elma:(360)482-5269 615 W. Alder Street
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFOkiv
ENVIR Q N,��EN TAL
NAME:Tracy& Renee West NAME: H EALTH
MAILING ADDRESS:PO Box 1173 MAILING ADDRESS:
CITY:Shelton STATE:WA ZIP:98584 CITY: STATE: ZIP:
PHONE#1:(360)701-0411 PHONE: CELL:
PHONE#2:(360)229-0638 EMAIL :
EMAIL:trwest61@gmall.com L&I REG# EXP. / /
PRIMARY CONTACT: OWNER El CONTRACTOR 0 OTHER❑
NAME Tracy West EMAIL ttwest61@gmail.com
MAILING ADDRESS PO Box 1173 CIZy Shelton STATE WA ZIP 98584
PHONE(360)701-0411 CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number)31912-22-90051 ZONING Residential
LEGAL DESCRIPTION(Abbreviated) Lot:2 of SP#1806(R)AF#529743&1/2 INT IN T.L. FIRE DISTRICT 44
SITE ADDRESS 470 SE SELLS DR. CI 'yShelton
DIRECTIONS TO SITE ADDRESS From Lynch Rd.MP 4 take 2nd Sells Dr.for approximately 1500-feet driveway on left side.
Follow for 250-feet turn left on to ro e
p pnY•
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NO 0 SNOW LOAD:25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK ❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF ❑ STREAM 0
TYPE OF WORK: NEW 9 ADDITION 0 ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) Residence
IS USE: PRIMARY 9 SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg) 0 YES(Part[s]ofBldg) 9 NO 0
DESCRIBE WORK
SQUARE FOOTAGE: (proposed)
1ST FLOOR 1409 sq. ft. 2ND FLOOR sq. ft. 3RD FLOOR sq.ft. BASEMENT sq. ft.
DECK504 sq. ft. COVERED DECK504 sq. ft. STORAGE sq. ft. OTHER sq. ft.
GARAGE 497 sq.ft. Attached 0 Detached❑ CARPORT sq. ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE NA MODEL NA YEAR NA LENGTH NA
WIDTH NA BEDROOMS NA BATHS NA SERIAL NUMBER NA
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER ❑ / NEW 0 EXISTING 0
PLUMBING IN STRUCTURE? YES 9 NO ❑ If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT.
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
PER IT APPLICAT ON OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
re
0o COUNTY CODE 14.08.42)
Si of OWNER(Must be signed by the OWNER) A--
/
Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH cd h d i-(',oil Ooi(Wet
e7LA 62-3 oOCpe 7
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PLN Approved
�i 5 :t o 10 \ 06/26/2023
a ,t \ Mason County Community Development
Gavin Scouten
All Changes Subject to Approval
EH APPROVED
Rhonda Thompson 07 07/2023
pip- . \ Q \ EH Setbacks
A.) Drainfield/Reserve requires 10'setback from footing/foundations
• 8.)Septic lank(s)requires 5'setback from all footing/foundations
; 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
1 50ft,down gradient of Drainfield/Reserve area
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Planning Setbacks
c--X r S Ti`I 1- Front: 25'
Side: 20'
' GA/A I! Rear: 20'
• ,\\ *all setbacks measured from the farthest
projection of the building
j ci, I \\WC-�.l..t^ O� y" *subject to EH setbacks
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