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HomeMy WebLinkAboutBLD2023-01047 - BLD CD Environmental Health Review - 9/1/2023 _,....,I • MASON COUNTY Permit No: U O -o 10ti--7 4 COMMUNITY DEVELOPMENT RECEIVED m i' Permit Assistance Center, Building,Planning C EI" D 2023 BUILDING PERMIT APPUCATION CI li = .l 61 1N. Alder Str+> Z PROPERTY OWNER Il�IFORMATION:I I CONTRACTOR INFORMATION: NAME: r1'Gj/1iCilsGO T`(� UYi.ZULLZ- NAME: ��VY\ 2NeL� i 3' MAILIN AD• S: 13 J VJq Cr]+U I MAILING ADDRES : /�`i R pit.iu CITY: S\(I STA E:U„I ZIP:c/i_It__ I CITY: 0tvnl V I.L STATE: jir IV ZIP: r Cr 27/ : z rn �.�r PHONE#1: PHONE E �2(tO 2 PHONE#2: I EMAIL:-y w'JeS. iV►[1t C��'V` -.-4 • EMAIL: O i . .1 yL.&I REG# ✓ EXP. 7 / i - LE �t�- ©� ' LSL1'LI PRIMARY CONTACT: OWNER ONTRACTOR❑ OT ❑ Mal �� _ a-NAME 7.—SCQ 0• GOY'► y te4- EMAIL olnz , . , SEP 0 12023 MAILING ADDRESS V ' C r lit STATE V Z ZIP"it. a PHONE CELL �3GC 63 3G t"t PARCEL INFORMATION: RECEIVED PARCEL NUMBER(12 Digit Number) 3 190 —q i -0 0030_ZONING LEGAL DESCRIPTION Abbreviated) : • -; •�• -00, FIRE ItISTRI• SITE ADDRESS UMW: CITY • • DIRECTIONS TO SITE ADDRESS A A •'1 � r,. .. Cl 4,Y.v c R_S ro es , . . n w., ih L 1 i US 0 1 tn9 IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO SNOW LOAD:30 psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Dux*all that apply): SALTWATER❑ LAKE❑ RIVERICREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW g ADDITION❑ ALTERATION❑^Ip REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence.Gear.Connnrrriai Bldg.Etc.) / e5 1'✓-l.r! C IS USE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS � . HEATED STRUCTURE? YES(Wrote Bldg/%`-' YES(Particigriid) N DESCRIBE WORK 5 CA' 0Q ci.. RMAO t `-at.%IA n❑ VI OM f SQUARE FOOTAGE:(proposed! t � 1ST FLOORieO9 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❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* x MAKE i 4" MODEL CO Ide.2LeUCc/ YEAR I Ci a 7 LENGTH T 6 WIDTH az BEDROOMS _7 BATHS - SERIAL NUMBER (C`;✓ 2Z ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW, EXISTING❑ PLUMBING IN STRUCTURE? YE" NO❑ If yes,attach completed Water Adequacy Form • PERIMETER'FOUNDATION DRAINS PROPOSED? YES❑ NO[�f EXISTING SQ.FT. EXISTING BEDROOMS 3 PROPOSED BEDROOMS 5 TOTAL BEDROOM OWNER acknos+ledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowl men;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 it work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. i l 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) Signature of OWNS (Must be sinned by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH ‘piZi 1011,173 L0(4• (AA Cd204 guy-A.9-3 0/047 ••--- 4 f oz"E. 2;4 97 EH Setbacks P L N (i\ A.) Draintield/Reserve requires 10'setback from footing/foundations Approved B.)Septic tank(s)requires 5'setback from all Icotinglfoundations 09/05/2023 C.)No foundation/Perimeter Drains within 3011,downgradient of Mason County Community Development Draintiel .� D.)No Cuutt area Bank(s) anks)(greater than 51t and over 45 degrees)within Gavin Scouten \ 50h,down gradient of Drainheld/Reserve area All Changes Subject to Approval 1 EH APPROVED F t-ULr.J 'ts�r�Tlati Planning Setbacks tit Rhonda Thompson ,0/02.2023 Front: 25' 3 1. Side: 20' L_cjT C , t Rear:20' . N *all setbacks measured from the farthest projection of the building V_L 'subject to EH setbacks @ j\ \ Pa(�A'r5 i>Ot EASZAEA)T SGA°_&. l = Lv \ \\ �cls-r)N� Zs - 30l s.rt \ \\\ \ ;.....o-r D \ `• \\ L.'0 tti/ \14) � k • � \ 6t^'Ec..-r,on) i- \ . \ r • r=t- - \ • • \\ E-Ajs-' 4.,T I v,.J \ , • . \ , \\ • \ _ rv4 Pli j\ ti (J 1-I0ME— QtK. POPS. -+ , • l tok \ +r: ff 3 PO C Pt �, w u ci b12EGrrOA) 1 ::w o0 \t, M t ReG"r; 1 t,� ,�r t 1 v, 1--S S E P fit. `6 i-1 LC - j+Si4 GE 2'+48'l T • x Yj\J 6 S° S91 4—b ,_ 34-1 o N 843°4-8 L -"E.) (53 4PP .. .'."" "...\ gia Flo g * C� y1 fl r r • s ir CD so 0 c) .5 111 8 c 1,-- 1 l "IC _..- -4- .,. )7_, I Fi B