HomeMy WebLinkAboutBLD2023-01181 - BLD CD Environmental Health Review - 10/2/2023 MASON COUNTY Famir : ALWOP3-0I l8l
COMMUNITY DEVELOPMENT RrC'';V7r- z
Permit AMIstance Center, Building,Planning C
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BUILDING PERMIT APPLICATION 7 ZC<.; _
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 615 W. AI 9f S''.-rM Z
NAMffi: ,de, v NAME: 3
MAIL GADD S: r•. INGADDRESS> -
CTIY: 7�w TATE:JaZZ CITY: STATE: ZIP: = m
PHONP RI: % 7//S PHONE: CELL: Z
PHONE#2: - EMAIL: -I
EMAIL L&1 REG N EXP.
PRIMAR ONTACT: OWNER% CONTRACTOR[] OTBRE
NAME % .e EMIMAIUNGADDRESS 'S - CITY ATH ZIP
PHONE CELL
PARCEL INFORMATION:
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PARCEL NUMBER(12 Digit Number) 72/J 65?-0.2,005/ ZONING C' W
LEGAL DPSCRDIION(Abbrevuted) FIRE DIST CT 4� }
SITE
DIRECTIONS TO SITE ADDRESS
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ISTHEPROTECTWITHDi200FTOFSLOPE(S)GREATERTHANIOYe: YES NOH SNOWLOADytpar C
ISPROPERTYWITRDN200FFOFTHKFOLLOWINC: Anseml uv yPtyj:
SALTWATER❑ LAKE❑ RIVER/CREEKQ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW J& ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(eeneeve,C+mee.Coemmbal BHe.Fxf
ISUSE PRIMARY[ SEASONAL[] NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HEATEDSTRUCTURE? YESANweeLWl® YESIPm N-fBlkl❑ NO[]
DESCRIBE WORK
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I ST FL00 y q.ft 2ND FLOORrq.ft. 3RD FLOORsq.ft BASEMENT sq.ft.
DECK_q.ft COVERED DECK eq.ft STORAGE sq.ft. OTHER_sq.ft
GARAGE SQ,ft. Auoahed❑ Deraphd❑ CARPORT sq.ft AaapFed[3 [krachW❑
MANUFACTU
RED HOME��IO�NF�[[O��RMATION: /V/ COPIES OF..�1 THE
E�FLOOR PLAN REQUIRF,D-
MAKEA70nUf4G /'i,*L d6DEIG3Iw�e (d✓L YEARLpp Y LENGTHl
WIDT]l BEDROOMS BATHS SERIAL NUMBER
ENVERONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC SEWER❑ / NEW'% EXISTING[]
PLUMEINGINSTRUC[URE? YESt NO❑ TfPes,aeacA completed Water Adequury Fasm
PERIMETER/FOUNDATION�S PROPOSED? MCI < N( MISTING SQ.FTEXI STING BEDROOMS PROPOSEDBEDROOMS L/ ✓ TOTALBEDROOMS
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PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WALL CAUSE THE APPLICATION TO BE EXPIRED.INASON
COUNTY FADE 16.08.62)
M�OVMER 1Murt Cr elonetl DviM OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIM DATE TACSMOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNDNGDEPARTMENT
PIRb MARRHAL
PUBLIC HBALTH eG
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PLN Approved
pp Planning Setbacks
10/02/2023 Front: 10'
Mason County Community Development PARKWAY BLVD Sides: 7'
Gavin Scouten Rear:20'
All Changes Subject to Approval 'all setbacks measured from the farthest
projection of the building
CC I 'subject to EH setbacks
a ,
FUTURE WATERLINE 'o
tOFf+ FROM ALL
OSS COMPONENTS
_ EH APPROVED
& LINE$ j I Rnana momPz� Ilrovzoza
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1 APPROX. 71
PROPOSED TANKS i FUTURE
NUWATER BNR500 , HOME
1500 PUMP TANK LOCATION `^
C/O
EH Setbacks I 0
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alnlyWFeserve area
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� 10'RLD SEERACK
PRIMARY DRIP AREA
681 SOFT 1414 LN FT I 1
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55_
RESERVE AREA
R „ ' 913 SOFT
AN AEEUILTI WePALL 510NOFF FEE WILL
9E CHARGED ATTINE W INSTALLATION
CUSLOMLK: I RAVE LARSON THIII'I}I: 1LlLIKMI':
PIONEER DIGGING, INC. PAKC0.C:12021-58o2004 "ro . 0.21 2"1 U
MCA .
SEPTIC DESIGNS NDDKr.s&I"VARKWAYRvv R s w nn:tGa^
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