HomeMy WebLinkAboutBLD2023-00592 - BLD CD Environmental Health Review - 7/27/2023 �,....AN.,rr. MASON COUNTY R'�_ 1..._I�1 02.5- Db`J OZ
.N.:44:0) COMMUNITY DEVELOPMENT 6 2023
Permit Assistance Center,Building,Planning MAY 2
BUILDING PERMIT APPLICAISNj Alder Street kk7
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I PROPERTY OWNER INFORMATION: ACTOR INFORMATION: JUL 2
NAME: Gale and Canna MAILINGAshbyNAME: �Q'C
ADDRESS: 3454 H 11"Y MAILING ADD• .., RECE/V
CITY:Haiku STATE:HI ZTP:96708
PHONE#1: 360-490-9378PHONE: :`L— ZIP: ED
_ CELL: --
PHONE#2: EMAIL• -- dashby@jottniscott.com ',e,,
EMAIL: gashby7082@gmall.com ' Gil YL 192 K _EXP.j)S-10 / It
PRIMARY CONTACT: OWNER❑ CONTRACTOR Q OTHER❑
NAME David Ashby EMAIL davidashby@johnlscottcom
MAILING ADDRESS CITY STATE ZIP
PHONE CELL -EN R NMEINTAL
( PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 32232-52-19001 ZONING R-2.5 HEALTH
LEGAL DESCRIPTION(Abbreviated)UNION-GRAYS HARBOR&UCRR;BLK 19,L 1-2 FIRE DISTRICT 6
sin ADDRESS Corner of Pt.Townsend and Pine St., (fly Union
DIRECTIONS TO SITE ADDRESS N.on McReavy to left on 5th St Lett on Pt Townsend St.to Pine St Property on SE corner.
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YESQ NO❑ SNOW LOAD:25 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cleat alb Mal apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION 0 REPAIR 0 OTHER (1
USE OF STRUCTURE Mesidoree,Garage.Coaencnial Bldg.Ere.) Residence
1S USE: PRIMARY Q SEASONAL 0 NUMBER OF BEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Rtdg)❑ YES(Pnrr(s/ofBtdgl Q NO❑
DESCRIBE WORK Construct 2 bdrm home on owner's property
SQUARE FOOTAGE_(proposed)
1ST FLOOR_101 sq.ft 2ND FLOOR sq.ft 3RD FLOOR sq.ft. BASEMENT sq.ft
DECK 336 sq.ft COVERED DECK 51 sq.ft STORAGES sq.ft OTHER 155 sq.ft
GARAGE sq.It. Attached 0 Detached 0 CARPORT sq.ft Attached 0 Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
4 ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC Q SEWER 0 / NEW D EXISTING Q
PLUMBING IN STRUCTURE'? YES 9 NO 0 lfyes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES El NOD EXISTING SQ.FT.
EXISTING BEDROOMS_____ _ PROPOSED BEDROOMS_2 TOTAL BEDROOMS 2 _
OWNER admowledges that submission of inaccurate information may result in a stop work order or permit revocation.Atlmowledgement of such Is by
signature below.I declare Nat I arrt the owner and I further declare that I am emitted to receive abs permit and to do the work as proposed.I have
obtained permission horn at the necessary parties,inducing 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 Comfy 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 Oct commenced within 180
days or 8 construction work is suspended for a,aviod of 180 days.
PROOF OF CON NUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APP•CATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
Signature of OWNER be sinned by the OWNER) D
DEPARTMENTAL REVIEW APPROVED DATE DENTED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL _PUBLIC HEALTH et/ 1 H11!3. (-I 1 j j s ctihd s
, 1 _OW 9.09,73--0 0 6Y
08/16/2023
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APPROVED „ ,\ , SPULC1
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MASON COUNTY DCD PLANNING I LC)
SeoT►RUEr?Y ICP r -�_ _ RR2.5 Zoning --
r a' Front Yard Setback. 25'.
Digitally _ _—_ j Side & Rear Yard Setbacks. Resi ential dwelling
sic,rled)?- and accessory structures is 20'.
Scoff Ruedy by j .: OR 10%width of lot if not more t an 100' wide
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R -%.f :-, z • OR approved ADV
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EH APPROVED ' — _ _ __ ____ _,
Rhonda Thompson 09/14/2023 ADV2023-00071- 5' Min— ADV2023-00071- 15' Min
S1 T r ILL�]f' 1 All setbacks are measured from the furthest ;
( '`-) YYYIII projection of the building. ~�_ 1 J'
EH Setbacks I ,
A.) Drainfield/Reserve r wires 10'setback from footing/foundations '
B.)Septic tank(s)requirese 5'setback from all footing/foundations I *-~� �f
C.)No foundation/Perimeter Drains within 30ft,downgradien of
Drainfield/Reserve area .
D.)No Cut Bank(s)(greater than 5ft and over 4Negrees)within
50ft,down gradient of Drainfield/Reserve area
The approval of this project is subject to the recommendations i
and specifications outlined in the-attached geotechntcal report. All ; I ... ( -N.
applicable recommendations aeic�-specifications shall be applied -.--.- • - .-. --- $
to the development on this-site. Any.deviation requires_stamped
written approval from thy registered design professional I . o, -
responsible for the report and may require special inspection by -- - `
same. Structures and/or land modifications (grading, cuts, fills, .
etc.) required in the geotechnical report. may require a separate •
permit.The geotechnical report shall remain attached to the
approved building plans.