HomeMy WebLinkAboutBLD2023-00660 - BLD CD Environmental Health Review - 5/25/2023 1
MASON COUNTY Permit No:3t.Doa3-ob�60_
COMMUNITY DEVELOPMENT
ENVIRONM-ENTAL
` ' Permit Assistance Center, Building,Planning H EAL}hT
BUILDING PERMIT APPLICATION • tf t D
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
��++ 'r,;�aY 2 5 2023
NAME:Z&\1W\ I(b W) LLC k NAME: c)tyl IXC_I'C. ' c41 0
G ADDRESS:'P.). Q,W 11"-Ng MAILING ADDRESS: ,der r Street
CTTY: b(j(`.if(f STADIA_ZIP: W (11,4 CITY: 1 r STATE:I,/Pt ZIP>�$3
PHONE#1 gbh•�2G,— PHO - ''— C
PHONE 2: EMAIL: t L 3(o (L 1 'C
EMAIL '\ ��2lXll�V1'n 9I'l WA 6 L&I REO# ' r EXPQ- / 2_9
PRIMARY CONTAC • `_ OWNER❑ CONTRACTORS[, OTHER❑
NAME Ok SD Y.\ EMAIL I `C6 r`Y!
MAILING DRESS �,t tt[7 / rind 5 a CITY ) • (WOW?'STATFjZG1_ZIP GI
PHONE C--,A—�1. J— Z o y CELL 2M
PARCEL INFORMATION: L�L11J
PARCEL NUMBER(12 Digit Numbest 0,1g 6 j - 0 DO(O'- ZOAsTRNG (�7 JUL 2 7 2023
LEGAL DESCRIPTION( breviated�tf`ftl(� ��j �{ � 1 j?( �I}TIRE DISTRICT
SITE ADDRESS 5t t CITY _RECEIVED
DIRECTIONS TO STI'E RES 1 Otto' o On ,A. a -e ) )tl 0(AJ
�1 o( .� to �� t�t cY Pt b+. t OL. Q d f i -t-.
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NON SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW IST ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence;Garage,Commercial Bldg.Etc f R C.5 i kQ,1,cc_ ,_,
IS USE: PRIMARY Ki SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATED STRUCTURE?
� YES(WholeBldg)4 YES(Parris)of Bldg)❑ NO
RE
DESCRIBE WORK Tell S l al n D (YAM)c-OtQ- t� kortQ
SQUARE FOOTAGE:(proposed)
1ST FLOOR! )`i b sq.ft. 2ND FLOOR sq.II3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK Id- t' sq_R. COVERED DECK sq.ft. STORAGE sq.R OTHER sq.ft-
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE C. MODEL DR1Yt`Feiy t' YEAR '2Q ;4.3 LENGTH
WIDTH BEDROOMS AZ BATHS SERIAL NUMBER t d 9
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING$
PLUMBING IN STRUCTURE? YES 'J NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOO EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS___‘,.1,-' TOTAL BEDROOMS
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 rerxive 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 pruier.L 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)
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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 r� h ,,�� f (�
PUBLIC HEALTH '6I I3/ 3 CC# gt tilf' �c
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is ) ;,. c:.1
•nt' ianning.Setbacks ----- Si -------1:3
Front: 25'
North Side: 5' (ADV2023-00099)
South Side: 20' Deck must be supported by
Rear: 15' (ADV2023-00099) pier pads due to proximity of
*all setbacks measured from the farthest reserve drainfield.
projection of the building
`subject to EH setbacks EH Setbacks
A.) Drainfield/Reserve requires 10'setback from tooting/foundations
B.)Septiclank(s)requires setback from all tooting/foundations
PLN Approved C.)No foundation/Perimeter Drains within 301f,downgradient of
Draintield/Reserve
area
07/26/2023 V 1 D.)No Cut Bank(s)(greater than 5tt and over 45 degrees)within gradient down of Draintiekt/Reserve area
Mason County Community Development_
Gavin Scouten
All Changes Subject to Approval EH APPROVED
T / Rhonda Thompson 09/13/2023
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