HomeMy WebLinkAboutBLD2023-00942 - BLD CD Environmental Health Review - 8/8/2023 Permit No:'71(1 '20 2''7- 01*1 21
MASON COUNTY
' COMMUNITY DEVELOPMENT RECEIVED
t Permit Assistance Center,Building,Planning
AUG 08 2023
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 615 W. Alder Street
NAME: NAME:
MAILING ADDR S: MAILING ADDRESS:
CITY: STATEI,U(._ ZIP: r. CITY: STATE: ZIP:
PHONE#1: -36CI- SpY I PHONE: CELL:
PHONE#2: EMAIL:
EMAIL: 0 I i�.C�_ L&I REG# EXP._/_/_
PRIMARY CONTACT: OWNER,O-' CONTRACTOR 0 OTHER 0 ` = MI
NAME .S EMAIL 'LI I Q
MAILING ADRESl OW-""-- P ST Et ZI 1 - 2
PHONE �b- to. f CELL C.v
PARCEL INFORMATION: _�mj
PARCEL NUMBER(I2 Digit Number) LI�� CY *a-7
ZONING 40- 12t s_ , •
? LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT ;".1
SITE ADDRESS /)/ N m IF /7t'e-t D1/ CITY 1' -p(,(f0(/ -j-
DIRECTIONS TO SITE ADDRESS ! t.r(7
406 0
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NOS- SNOW LOAD:_psf 92
023
IS PROPERTY WITHIN 200 FT ON'THE FOLLOWING: (Check all Ikea npplr):
SALTWATER❑ LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0 `CF/I/FO
TYPE OF WORK: NEW ADDITION 0 ALTERATION❑ REPAIR 0 OTHER ❑
USE OF S IR UCTURE(Residence.Garage.Commercial Bldg.£rc.)
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS NUMBER OF BATHROOMS j
HEATED STRUCTURE?? _YE^S(Whole Bldg)%` YES(Part[]rlBldg)0 NO 0DESCRIBE WORK Lt1ribfl24-a- 6 A/P.e } C/ i
SOUARE FOOTAGE: (proposed)
1ST FLOOR 5240 sq.ft. 2ND FLOOR 224 U sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK t LiAt sq.ft. COVERED DECK 2.4 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached 0 Detached 0 CARPORT_ _ sq.ft. Attached❑ Detached\
MANUFACTURED OM.E INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
DTH BEDROOMS BATHS SERIAL ..
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER 0 / NEW 0 EXISTINGA •
PLUMBING IN STRUCTURE? YES% NO❑ hives,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES A NCB EXISTING SQ.FT. 69-
EXISTING BEDROOMS 0 PROPOSED BEDROOMS l / 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.1 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 APPL ATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X S 0/ k//.;3
Signature of OWNER(Must be signed by the OWNER) (late
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL ^
PUBLIC HEALTH `p 12, I7.3 (._(: .. .1-jcAr ,, 4
1 6
2 0' a e v v I ) 1 1\1 It1 t Orz)i-t . t 7
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Ai- ''� PLANNING:
1 G'�' ALL SETBACKS ARE MEASURED FROM
THE FURTHEST PROJECTION OF THE
r a` � 21� - BUILDING
r
P�`t� °' �`A PLANNING SETBACKS .
.i; Front: 25'
Si-rofj1'v e, Rear: 10' ADV2023-00120
• Side: 7.5'
*Subject to EH Setbacks
////7\1
�`1 lb' APPROVED
• 4� MASON COUNTY DCD PLANNING
v/'') ro SITE PLAN REQUIRED TO BE ON SITE
/++,v!' �- CHANGES SUBJECT TO APPROVAL
L1 .
By: /44' Date: 09/07/2023
&tee e EH Setbacks
=7?o. . , 1. ( A.) Drainfield/Reserve requires 10'setback from footing/foundations
III B.)Septic tank(s)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of •
Drainfield/Reserve area
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
t11 50ft,down gradient of Drainfield/Reserve area
i
(
ice` c�
t j EH APPROVED
Rhonda Thompson 09/26/2023
Al .. ,
t\/ t-- -1"'v i i k r- t)t:i War
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