HomeMy WebLinkAboutBLD2023-00604 - BLD CD Environmental Health Review - 5/30/2023 r
•
.:4. p'•
MASON COUNTY COMMUNITY SERVICES Permit Nit: A A - 01 .`� ' PERMIT ASSISTANCE CENTER: �� i._ .
`
•�'.•BUII t),NG•PLANNING•PtiELIC HEALTH•FtRE MARSHAL• •I 1• ^•. Gt'a:Y_Alder Street.Shelton.WA 9$934
`' ✓�,� 4. AY 30 2023
s PAono S1.&G L'(3EtJ)<YT•95TO Ge:332•Fa(369)42T•T:96 Ph.S•M
y7?I Eclair(360275tt6T•Pho w En=13501•t6-•Ss59
^4s_-i0r 'Saw.
�_ - BUILDING PERMIT APPLICATION 4 �6NZ-W ,•Eder Street
OWNERPROPERTY INFORMATION: CONTRACTOR INFORM. (i),:r
. NAME:•� titt ctiay l7 q►� NAME.•.: Lb 1 A, • .• ae •'64.tea
• MMAII-ING ADDRESS:LT t�.engK"tItAxl�C.•5::.1 Q MAILING ADDRESS: . ;. .
CITY:Tc o(flc). STATE:101-1_2f:ci ' 472 CTTY9 Ut.T4‘(•l1.STATE:L`I* %1 7tV-1L1
. PHONE 171: 0�3 ten_tCCFt ' PHON . ' CELL:
PHONE .2: EMAIL. a 1ooi if w YYI k111.411�L ,
EMAli:` (i)(0(11C( i-.11k A r 11_8:1 RE:G,,fit 4-16Y L-I ‘5�+t hXPYCz��.-
PRIMARY CONTACT: OWNER L CONTRACTOR OTHER iT
\i.�1= Jat,...i ��,�'�!ka.`'`� S�}S 4 EMAIL � 5.1E &�14s wi_4L.if+-� P, t
: MAILING ADDRESS •7�)�I(p h�rJ1�1ke_Gt, CITY S:ATEN! ZIP�4�'G-- Z
• PHONE .'fGc C-131-i?l I CELL 3 Cr;-;ci"II 37
•
PARCEL INFORM ATION: _ X
PARCEL\l.:StRER t 1_2 Dian Nunibcrl 171:.'�_ti I1�'L� 7C,NI\t. m 0
LEGAL DESCRIPTION(A4,1,:c,:atcd)Plas ,t,"; +v✓ehrt Short .4?i?0si I FIRE DISTRICT
sin:.ADDRFSs 5 150 r M0.(..n t_AV' J-Dy. 1nj (:FIY.C•lyaw\ IP t.' m
DIRECTIONS TO SITE ADDRESS
IS THEPROJECT RITItIV 300 FT OF 5LOPE1Sl GREATER T11:1X Il:: PISS(_! NO K z•s
IS PROPERTY WITHIN 2041 FT OFTIIE FOLLOWING: 1CA.tiJ:,L!:).
SALTWATER:i LAKE' WVLR'CREEK] PO I)I WETLAND�_.SEASONAL RUNOFF 0 STREA.A1 f
_
TYPE OF WORK: NEW ADDITIOK-1 U.]ALTERATION' ' REPAIR _) OTHER [ r
USE OF STRUCTURE(e..;.r....-.t rw. c.—,.,J 5.6.Esc) G4 fG1cS ,. •
• IS t;SE: PRIMARY a' SEASONAL 1 NUMBER OF BEM H)MIS NUMBER OF Hall(ROOMS
HEATED STRUCTURE? 11:' p-s .•3::�,(-J PF �::,!.1e3L _^ / No
hiN
PESCRIRE WORK .e1)4C i1 Y Cl--4� e J��L' .
SQUARE FOOTAGE:.:+n;ou••,•.,,,.;,
IST FLOOR N.R. INI)FLOOR 14.3,fl. IIRD FLOOR N.A. BASEMENT xl.II.
DECK w.it COVERED DECK Sq.R. STORAGE sq.ft. OTHER sop.it. '
GA RAGE aI(iD Sq..ft. .4naei,eJ 7 Ocf.:rhrdkr CARPORT sq.CL .4:rr:n.,!(u± hi'w ;it [
MANUFACTURED HOME INFORMATION: '4 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE. 11UDI7I. YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
1
ENV!RONMEN TA(.IIEALTII:
S1:WAGEJSEWER SOURCE: SEPTIC k SEWER_1 / NEW ii EXISTINtIXt '
tnn
pie (fret-.at:ucil g;(ercJ(Ji«cr.4r::quu_r Fc.m:
PLUMBING IN STRUCTURE? YES j NO
PERIMETEIVFOL\UATJON DRAINS PROPOSED? YF_S: —02' EXts-ru.G SQ.FT.
EXISTING F)GDROOMS- PROPOSED BEDROOMS_- -. TC)TAL BEDROOMS _--_ -._.._. •
OWNER aekna•/eerjes teat subm et na�fe mL-manor-may result ina a a stop weer o.r permit rwontor.l.� s..riJed,j CAI CI SUM su by...
:ryaaaue bela¢1 Ocnare rat I an tee oweer oral Ikea*:e.rdsy dst I en sntHed to waive this porrn and won Inc won.as prmtzod.t hove
i o0anec x'maseen tram ad the mcessory parties..ds -'. r.+y easwmevt Weer to Pwscs d interest,esarB.o tbs oro i.d.The owlet or Ireyal
reareserewi e.rearen:s ttrx Ore ntter:ta::cn pro..ed rs a_-urre x.e grans erndoyees a Masan Coast.;scr t to ete aaa.e descebee par4ert•y
• orC strockags)1G review one irapeGion.This Pernierappreaton trsemes rad&vac a writ a aurhonzee scnz vduon is net cowmeoscd',robin 180 t
idays ee d cent ubion wan;rL sta.venOtsd to a pemod ee 12O aye i
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APP TION F 180 DAYS OF MORE WILL CAUSE THE APPUCATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42) �E
X /l <`�'� s -/ .> -
/ S�re of OWNER(Must be sinned by the OWNER) Date
DEPARTMEN-TAI.REVIEW APPROVED D VIE - DENIES) DATE I lAGS+NOTESJCONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT I l I----------
PIKE:MARSHAI I I
PUBLIC HEALTH I 7/Ski I cog't'I/p
iyiefi
Al •
O O a' (I) �1 ;0e ..
j70_ C2- 0 1 _ - - _
Q
n O •
-, o (D
m i
_ ,
Qno �cQ _ W ��e
S
D o a) mEr JP 70 G. Er)
2 kii ct
C% ill
D cp a) . - el -I - . 1 - 9-z--E,'---——
(n Cn M F c t?c a 3. _
O0 u" .,--z 8-..2-,,D . x 3 , ic
N.) x O ° av v_ D
O v � NaFE s v s (N
(�� 1^L o W VVV <D 3 C.„, T
CD i N N�. C CA r
al.N N H CD Wi sir
0 a) 'x'1
. 7.
S
CC g as goad D)
C' < y �=_�' 7' 1
CD �U- a 8 3 U)
CD = us n
: °6 O
I 1r/ F .mc K
"f ‘ ? p8Q
y
P o
N W
�g 0 _O
Ls
"' C7 to
ooD o --
ci
7<7 N
N
` ` �� co `` `Q (: � 0 < IV Q,
- -� i -d D U1
4
a t z w
CD cp
0 Z. -D
• 9., o' O
z n r
r 1
8-7 ai
r
O
_ N
S
9/� ,4 l�ol�h 0o a)
_az
N
D-
(D
cn