HomeMy WebLinkAboutBLD2023-00876 - BLD CD Environmental Health Review - 8/1/2023 Permit No: • 00874
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. .. MASON COUNTY L_-L. V - L `(G�
COMMUNITY DEVELOPMENT ��
• • • Hermit Assistance Center,Building,Planning !U 2 Y '' l
gt'G 0
BUILDING PERMIT APPLICATION •-V. Alder S eet /2023m
PROPERTY OWNER INFORMATION:11"" CONTRACTORR INFORMATION: . �j? C ii/kO '
NAME:r•ir_`14;I ,./ el', t'orr. Air NAME M�I CNk,k AD
NA -n2 clt? I e�ICi,till/'
MAILI G ADtDRESS:30 t• 2ti:•1 L'j gl MAILING AD RESS: �I r bO ;,�i�0d Plu;e IS
CITY: - "C:J STATE:y i ZIP: `1 2 ' CITY: ±t I q �S STATE: YA- ZIP: ed5gy m 0
PHONE#1: a fs ago- 5, ) PHONE: 06 i tCELL > Z
PHONE#2: EMAIL:�s�11tp4, d je1pej".Ir� ,4.1- co,rx r
EMAIL: j ht1 c at 0..;)hd I,:;r L&I REG#�' C 1N 5'0`IS to E 5'1�3 --1
PRIMARY CQNTACTT• / OWNER 0 CONTRACTOR OTHER❑ rn
NAME.�tbi,Q1 .}p ('7n.IZ EMAIL i 11 IAA MAILING ADDRESS . 1 'Qr 0Od PIA CITY 51,e 1 y-►e. STATE AA4 ZIP cjg y ''''i
PHONE _ie-__7_ CELL Simi.,
PARCEL INFORMATION: �1 c
PARCEL NUMBER(12 Digit Number) dtc�I C.3 — 5 0 00 03,7 ZONING •K Rs
LEGAL DESCRIPTION(Abbreviated) Q,�cji; Ul KQ, —rp�j a FIRE DISTRICT 5
SITE ADDRESS 30 F g$,5oi. L. Q CITY °re, • i e +
DIR�CTIONS TO SITE ADDRE$S 3 I LQ ' �^ ( n 62i.n ��a i Lz `4-‘,..,
t $Pi.40, Lake, Kitkd /
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES NOIW SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION 0 ALTERATION 0 REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Fac.)
IS USE: PRIMARY❑ SEASONAL 0 NUMBER OF BEDROOMS I NUMBER OF BATHROOMS I
HEATED STRUCTU ? YES(WhgqleB(dg) ES(ParifsJ of Bldg)❑ NO ElDESCRIBE WORK L.6.Nrek del-0,ate 61 (r,...r y `d$ I-3 t� .M AEU
SQUARE FOOTAGE:(proposed)
1ST FLOOR Lfg0 sq.ft. 2ND FLOOR f)" sq.ft. 3RD FLOOR . sq.ft. BASEMENT -•E' sq.ft.
DECK !er. sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER ..G-' sq.ft.
GARAGE .-( " sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE __ MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:.
SEWAGE/SEWER SOURCE: SEPTIC IX SEWER❑ / NEW❑ EXISTING W
PLUMBING IN STRUCTURE? YES VI NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOW EXISTING SQ.FT.
10
EXISTING BEDROOMS ( PROPOSED BEDROOMS I 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
0 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.
RQOF,QF/CONTt1NUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT(P
AP/'LI ATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
1 r ;'/ / COUNTY CODE 14.08.42)
/ { ! U j 7 r L)
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 11 JC'� _1 f leIh y, C a"61- 4(/l • Ai
BFNSON
'UNCOVER EXISTING 1000 ter,` :, L9 Ep
k
GAL 2- COMP. SEPTIC TANK �- R/, ,
AT TIME OF INSTALLATION
AND INSTALL RISERS TO I if r SEE ALSO ATTACHED
FINISHED GRADE. MAKE SURE I i
i EH APPROVED RISERS AND LIDS ARE 1 I I t I WAIVER APPLICATIC
Rhonda Thompson 09/19/2023 ! I\..._
WATERTIGHT ON BOTH I I i
SEPTIC AND PUMP TANKS. I', i, ! ! p EXISTING
t In OO.I\ I S' WELL
3R5 Zoning /'� I '
:ront Yard Setback.25'. r I
3ide&Rear Yard Setbacks. Residential dwelling � � � i
Ind accessory structures is 20'. 1125+ SOFT-5 BED } I
€(.N.
100'wide I
)R approved
width of lot If not more than RESERVE AREA �\�
)R approved ADV N `; � 6' Min Setback
I (20 X 57) All setbacks are measured from the furthest
D
rojectfon of the building.
EH Setbacks 750+ SOFT 5 BED 1\ m — EXISTING GARAGE
A.) Drainfield/Reserve requires 10'setback from footing/foundations AREAI, I 1
PRIMARY I W/ LEAN-TO
B.)Septic tank(s)requires 5'setback from all foonngAoundanons I�1t.I)!1i4,�i
C.)No foundation/Perimeter Drains within 30ft,downgradient of C20 X �8 1 1111i!ii '1
Oraintield/Reserve area II i
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within Ii II!!;iillllll I FUTURE ADU
Soft,down gradient of Drainfield/Reserve area 0-1 % SLOPE PI1f,! ;
1
. /
09/15/2023 Oln // I
APPROVED PROPOSED TANKS: POSSIBLE SEWER
MASON COUNTY R ,AI PLANNING N V WATE R B N R600
I LINE FROM FUTURE ADU
1500+ PUMP TANK ,. •, ,M:oliii,;,v:00.:..1;:i,SOFTTO WELL`
Digitally Ii OI , : •r signed I 0., ;• 1ScottRuedy by EXISTING 1 ce, - 1 # ;,;Scott --\ ._' _ '
Y` • 'il ^':1WELL �O 00;i1/ , :�Ruedy S ' 3 I :(1 jfJ •n ,:•0, ILqa IN:i; ¢:
APPROX. EXISTING T/LINE I Jig fee
{ =`its
TO BE REUSED EXISTING Sri.
WELL Al V.3
EXISTING SEPTIC& PUMP
TANI<TO BE REUSED �'��``�'`�`�'NEW PUMP &ALARM _.. . EXISTING 3 BEDROOM HOME
—
I RECENTLY INSTALLED I;`
I
BENSON LAKE I APPROX. EDGE OF LAKE
DESIGN NOTES: INSTALLATION DuK ,NiF iI;NOFF/ASRV) -FIE Wtl.t.lifi CFIAP.GCD ITIME.OF INSTALLATION. ANY PR.OPOSED'i Ill 1/CI VIC_:3.,,,'•
S i)NILE 11:D TO SEP11C.COMPONENTS.
"t'SFTdAC.i,.
r'� I•R UF.PAR1h1M1 REVIEWS,DESIGNER NO
T RESFONS; LF:FOR T)C ',OM
CUSTOMER: JENIFER FORRES•IT. SC-ALF:I:50 ' ' -- '"`.
PIONEER. D11Gll N-, NC. PARCEL#:22103-50-00032 TFST HOLE I: TFST HOLE 2: TFST
SEPTIC DESIGNS ADDRESS: 30 E BENSON LAKE DR (}IS OLD FILL 0-45 US 037 r18.44 GLS 45+1120 37+1-
3083 E MASON BENSJN RD. GRAPEVIEW,WA 9854E DESIGNER: ROBERT H.PAYSSE
OFFICE•360.426-1803 FAX•3W-427.2353 DESIGN PAGE SITE PLAN