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HomeMy WebLinkAboutBLD2023-00803 - BLD CD Environmental Health Review - 7/14/2023 Permit No: 1 S2O 9 2'CC,50�I ., ... MASON COUNTY COMMUNITY DEVELOPMENT RECEIVED �,,, / Permit Assistance Center, Building,Planning J U L 14 2023 BUILDING PERMIT APPLICATION t PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:RICK PHILLIPS NAME:T.B.D. MAILING ADDRESS:4111 NE 92nd STREET MAILING ADDRESS: CITY:VANCOUVER STATE:WA ZIP:98668 CITY: STATE: ZIP: PHONE#1:360-607-0719 PHONE: CELL: .� PHONE#2: EMAIL : = EMAIL:rickp4942@gmail.com L&I REG# EXP._I W-C2 PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER 0 _TI K NAME EMAIL �� MAILING ADDRESS CITY STATE ZIP PHONE CELL PARCEL INFORMATION: (— PARCEL NUMBER(12 Digit Number) 421355000025 ZONING RR 2.5 LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT SITE ADDRESS490 W CLEAR LAKE DRIVE CITYSHELTON DIRECTIONS TO SITE ADDRESS NORTH ON HWY 101,LEFT ON W CLEAR LAKE DRIVE,PROPERTY IS ON THE RIGHT 1/2 MILE IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO SNOW LOAD:25 psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE 0 RIVER/CREEK❑ POND ❑ WETLAND ❑ SEASONAL RUNOFF❑ STREAM 0 TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0 USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc)RESIDENCE IS USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS$ NUMBER OF BATHROOMS2 HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Rart(s]of Bldg) 0 NO 0 DESCRIBE WORK BUILDING WITH GARAGE ON LOWER FLOOR AND LIVING SPACE ABOVE GARAGE SQUARE FOOTAGE: (proposed) 1ST FLOOR *0 sq.ft. 2ND FLOOR769 sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE 1500 sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached❑ Detached 0 MA ME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL ,...YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER T ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER 0 / NEW 0 EXISTING❑ PLUMBING IN STRUCTURE? YES 0 NO ❑ If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS ` TOTAL BEDROOMS I 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 .erffI2E.,>L-' 06-27-23 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 co ,�J PUBLIC HEALTH v(Z- 4 t�`�S G1" I_ NCn 33 T•- D R88Eig,1° gel ?co ?,' ' D mr �rr�fa� �K i i i � m -- �Z -�iD co 3 o� r ` �a • C \. �' •�: • • Y .• y\' ' N ; :. CD I . , : : •' 4 ` ' ' F4` sA D le Im rn i' co iii § I ( /,: . . ., \ ym Z r Z8 o s9-, _ L D r� �,., j g� � F. ym vO um m au =g o C7 �../ �., f m '�y < u O Fey 1 I ! 7 2D aI;"g� 0 .m 00 v 13 MI m N t9 O r. Z � Q w m V) o O c. ; $$ Z ' e < 3 's3R n Z x j N O m s §t X M N 8 u, l+H I g =il r � Fr f;I ''l rf OIaag z{ l; I lii_I I1 E o® ,ti I I Fl p v =I=®iI I 11 i� t`IFliy 1�1 i±,'ri 4 1 r i —1 e d 1 ...i:`i. .Icro;I i 1 f :_4 Af I I� ' j�" O O 'I 9� iI - jj Fe i:jl •:Ih I!.,II I': 86 i � r rr�7, y � 0 r 1 � I I {: c , o a t r'.I Ir, +�1.i -:Y • Illlala:llll'I I I-I ;ill I r { In [I] i 'I-1' 4 1. _ :.; r'u Y �� = © 'I I;I i'i1 ,'I�''I i 11/1 � ; qc ok: 6 111 IHII III a& " •Y`Ilk eit p6 ...HM � D� C� IR J }�;app{ I!!)I 1�I 'Fill. I�I I� ::I l�Mi e ✓S 88l o Q F4 192 i. t e I I • Ak • t ;* /otxai 1s''4 , i )YofQ a :? i a a ., 8 , ' !a, , _ l L.. f N'T I&l Site Plan it Elevations I.� "�""r°"... . ._..-_.T� _I ¢ N a 1 Phillips Residence ._ -____ 1 n BNfa IwAixIx 490W clear Lake Dnve x u, tf ' u,p !w c L i X i X Shelt! rn.WA 98584 • g F _.I.. _ I I I • For Rick Phdbps _� B L