HomeMy WebLinkAboutBLD2023-00554 - BLD CD Environmental Health Review - 5/17/2023 �S�q cart N� MASON COUNTY COMMUNITY SERVICES Permit No:0l�2O3.3— o55
s PERMIT ASSISTANCE CENTER:
4 •I I• . .., •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL R E E t v E D
615 W.Alder Street,Shelton,WA 98584
y - - Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone
.w HIT'' yy BeHair(360)275-4467•Phone Elma:(360)482-5269 MAY 7 2023
Off, 1
BUILDING PERMIT APPLICATION
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PROPERTY OWNER INFORMATION: CONTRACT64t JY1F RM" ATIONs reet
NAME:Curtis&Desiree Langston NAME:FUTURE HOME SERVICES �C'1 f
MAILING ADDRESS:7773 McCombs Mill Rd MAILING ADDRESS:PO BOX 2503
CITY:Pinson STATE: AL ZIP: 35126 CITY:GIG HARBOR STATE:WA ZIP:98335 0 O
PHONE#1: 205-215-3890 PHONE:360-900-9777 CELL:
PHONE#2: EMAIL:angie@futurehomesbremerton.com
EMAIL: crlangston56@gmail.com L&I REG#FUTURHS776D0 EXP. 3 /17 /25
PRIMARY CONTACT: OWNER p CONTRACTOR 0 OTHER❑
NAME ANGIE AMIDON STROH EMAIL angie@futurehomesbremerton.com
MAILING ADDRESS PO BOX 2503 CITY GIG HARBOR STATE WA ZIP 98335
PHONE 360-900-9777 CELL ENVIRONMENTAL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 22004-75-00181 ZONING R-5 HEALTH
LEGAL DESCRIPTION(Abbreviated) PCL 2 of BLA#21-22 FIRE DISTRICT
SITE ADDRESS 231 E WILLCHAR BLVD CITY SHELTON
DIRECTIONS TO SITE ADDRESS w.*"ar•rwwo...•rts.b.CMO wgrq Si can•uE anow,.a.q,rt WO E.caaww.
RIGHT ONTO E PHILLIPS LAKE RD,LEFT ONTO E PHILLIPS LAKE LOOP RD,TURN LEFT ONTO E WILLCHAR BLVD
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD:30 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) PRIMARY RESIDENCE
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part Is]of Bldg)0 NO 0
DESCRIBE WORK NEW MANUFACTURED HOME
SQUARE FOOTAGE:(proposed)
1ST FLOOR 1400 sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.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: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE EVERGREEN MODEL 28502E YEAR 2023 LENGTH 50'
WIDTH 28' BEDROOMS 2 BATHS 2 SERIAL NUMBER TBD
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER 0 / NEW 0 EXISTING 0
PLUMBING IN STRUCTURE? YES 0 NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ 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
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
x � .(' WQ/,� usl e i 05 11 2023
Ign ure o O N us a signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL a �,,yi,� �/���
PUBLIC HEALTH DP- 0 f Orne3 Wvdhcon aiete,It
EH SETBACKS
A)Drainfield/Reserve requires 10'setback from footing/foundations EH APPROVED
B)Septic tank(s)requires 5'setback from all footing/foundations
C)No foundation/perimeter drains within 30'down gradient of drainfield'
reserve area D.And.nu. 08'10/2023
D)No cut(s).bank(s)(greater than 5'&over 45 degrees)within 50'
dowmgradient of drainfieldfresere area 50'
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y�, G00 SQ FT 20' 40' 20'
W IELD
REESERVESERVE AREA
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N1 '� / PARCEL 22004-75-00181
X = l)OWNSI'c)U I SPLAti1113LOCKS 231 E.WILLCHAR RLVD
1 \ = RUNOFF DIRECTION FUTURE HOME SERVICES
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