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HomeMy WebLinkAboutBLD2023-00891 - BLD CD Environmental Health Review - 8/10/2023 MASON COUNTY COMMUNITY SERVIC C I�i�1gc Oir-•�J gOa)-OW R?I 7. `•• .PERMIT ASSISTANCE CENTER: C V L Lr 11 i .•BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 6 6 1 . F it 615 W.Alder Street,Shelton,WA 98584 ys' (360)427-9670 (360)427-7798MAY 2 5 2023 EN'✓I f?0N Phone Shelton: e�tf 352-Fizz Phone �� ..:',. .. __, �;/ Betfair% .(360)275-4467•Phone Elma:(360)482-5269 ) E N BUILDING PERMIT APPL dr NAlder Street 11, HE PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:t 4� NAME.eJ 1-�r\C 7)kg 1\1 W L.Cs NAME:Q1ifrt0.C\Q= C.OY1S- rv(' ! l0r., MAIL� , G ADDRESS: 7 tO (nj G MAILING ADDRESS: • 1 cl(? /)C i V sE 0 CITY'i'Or:Or�j STATE:L h1R ZIP ]�(_,,(p CITY:PO(4. 0( STATE: f AZIP: ► ,to • i )n,3 PHONE#1: d, -' 1G- Tv)(� PHONE:o,,3-a„.),5-no ttLL: Cc�, PHONE#2: EMAIL: i nn o.C, e c.o r\ S-t-Y U�S Ai o n 3 c tc6to An EMAIL:cl.\fi r,S�Y1 ,) Tle,nik\Af�t��n11U ;.N AC,. "tAi REG#9I,KN8ibILPIEXP.L4 /N/`,6 .4 PRIMARY CONTACT: OWNER❑ CONTRACTORS,. OTHER❑ NAME O xe(_ Y\(NSCTI.N EMAI}(pinral.1"�O,,CO3ns C- i Ua.(13(p (� , 1 .CoY'en MAILING ADDRESS 3\ \Aar-6% (Li\ SF CITYC0c Ofr i'N d STATE\,, J`i:1, ZIP (O PHONE93 2,- 22-5- 2-9ln CELL S(k ' PARCEL INFORMATION: 9 n p n i PARCEL NUMBER(12 Digit Number) 104—5�k O Q° C� ZONING �``-S`(���"�,\(' �5 LEGAL DESCRIPTION(Abbreviat d) r I r I V`'S; cj c-LlDdn 1QKe.FIRE DISTRICT k SITE ADDRESS l tO fI ^•T" Y\Q b-n C.O.L DIRFCTIQ'sm"_.,-cADDI W 0' 0r C e IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOK SNOW LOAD: usf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cheek all that apply): SALTWATER 0 LAKE❑ RIVER/CREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF 0 STREAM❑ TYPE OF WORK: NEW R ADDITION 0 ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE idence.Garage.Cvmmersia!Bldg.Etc.) Re S 1(1(Rrs Q )C_Q/ IS USE: PRIMARYEI SEASONAL❑ NUMBER OF BEDROOMS -j NUMBER OF BATHROOMS HEATED STRUCTURE? YES.(,•who/eBldg)g YES(Perris]of Bldg)❑ 1 NO❑ DESCRIBE WORK ��S l-Cx\\ alit A) 1Y1c ucTAk-AUCi ok \Aa , SQUARE FOOTAGE:(proposed) O 1ST FL R 14 1 q le.q.ft. 2ND FLOOR it. .S P't sq.ft. 3RD FLOOR Ks 1 f\ sq.ft BASEMENT sq.R DECK, j lie .iq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached 0 Detached 0 MANUFACTURED HOME INFORMATION: 1 ( *4 COPIES OF� HHTEFLOOR PLAN REQUIRED* CA C�.1,5/COn MODEL SrV\OL k C7 YEAR cla3 LENGTH 5i w I WIDTHot 1 BEDROOMS 3 BATHS -. SERIAL NUMBERA �ej ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW; EXISTING❑ PLUMBING IN STRUCTURE? YESgf NO❑ If yes,attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOE( EXISTING SQ.Fr. 0 f H ��(( EXISTING BEDROOMS I"l I5c PROPOSED BEDROOMS J TOTAL BEDROOMS J 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 0 � Iis (2b2 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 1 61113173 C Ct4Lh4tolk, o f tYlk.,( cC -3\t"IuLi -- 0%-', - °w1 bLoaca3 -ovefet Planning Setbacks S Co-kQ_ ( . 20 Front: 25' Side: 8' Rear: 20' PLN Approved *all setbacks measured from the farthest pp projection of the building �_�- 08/21/2023 *subject to EH setbacks 1 _ Mason County Community Development C\OGavin Scouten V `� All Changes Subject to Approval %\� EH Setbacks A.) Drainheld/Reserve requires 10'setback from looting/foundations f 8.)Septic tanks)requires 5'setback from all fookng•loundations J C.)No IoundahoniPerimeter Drains within 30tt,downgradient of — Drainlield/Reserve area I k�U 0.)No Cut Bank(s)(greater than 59 and over 45 degrees)within 50f1,down gradient of Drainfiekf/Reserve area � � ,A, . EH APPROVED Rhonda Thompson 09/13/2023 I 1 4 i k6UOr /f �! - � ._. _ Ali i 1 1 } 1 i ) ''''N --SV- Ci 0 1 �� ,�� Il \ N ,. j\L \ �G i � z ' ') 1 \ Luxtie-r -r____ — SE FUCnSi6k Av e ., 6 LOao -apgg1 . . ENVIRONMENTAL TEMPO COLLECTION RECEIVED HEALTH SHOUT 55TMP28563BH MAY 2 5 2023 26-8" x 56'-0" APPROX 1,493 SQ. FT 615 W. Alder Street EMI IIrsrCFI ssr Mir Mir -- 'r- D • M' U i t min©= lPINE w■ ... e• �.... 1 irMl'1�►: i ■ �Nimmos s- 1 ENi 171r R.: C IIIIUUIllhiiirduI1L " ); I .... 12 MID I VYING MOM =COM 3 �Dy 2 - OY 1LC IIIssr sum sa• ss• ssr dl 149A s2r .J� tS £6fI XOHddV „0-,99 x w9-,R H8S95'97dw1,gg (LIONS NOId f 1'I00 OTAN II