HomeMy WebLinkAboutBLD2023-00987 - BLD CD Environmental Health Review - 8/21/2023 OJ(lOG•1' '4 MASON COUNTY COMMUNITY SERVICES Permit No:f/I(� l.�G�J 'CO�,(j
-\PERMIT ASSISTANCE CENTER: RECEIVED
BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL
`�I` p 615 W.Alder Street,Shelton,WA 98584
.. l�� Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone A U G 2 1 2023
o, ._�.M`^,ty Be/air(360)275-4467•Phone Elme:tlxo •til.'i�"
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: — k.—M i A CA le\ NAME:
MAILING .•.•DRESS: 2 MAILING ADDRESS:
•
CITY: S C-. STATE: } ZIP: 9BS28 CITY: STATE: ZIP:
PHONE#I: ' -p :0I — 5-5-12., PHONE: CELL:
PHONE#2: EMAIL:
EMAIL:________________________ L&I REG# EXP._/ / Z
PRIMARY CONTACT: OWNER 0, CONTRACTOR 0 OTHER❑
NAME EMAIL-{� /
••� �/�t vI•ti 6 stir �=Qq 1l'l[�`' ..( +Jvt/1
MAILING ADDRESS Pn CITY ,/�v 2 r STATE (j}A- ZIP =
PHONE CELL ?4 D eo i-c-c3? m O
PARCEL INFORMATION: (� > Z
PARCEL NUMBER(12 Digit Number) 6 zZ 5 —75--00 0 0 ZONING .Q R,5- E
LEGAL DESCRIPTION(Abbreviated) I jE DIS I 2— _ m7
SITE ADDRESS ti'7D tJ r X I er ,1 aA CITY BZ ,r
DIRECTIO TO SITE ADDRESS 14-j 4, 3 1A ( r+ YS4r(cep L .4'2- --1
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESK NO 0 SNOW LOAD.2142--_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE 0 RIVERJCREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW X ADDITION 0 ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Etc) Q 5j1J CA.Le_IS USE: PRIMARY la. SEASONAL 0 NUMBER OF BEDROOMS NUMBER OF BATHROOMS 2 r.i1 j
HEATED STRUCTURE? YES(Whole Bldg)• YES(Fortis]of Bldg)0 •NO❑ 2-4
DESCRIBE WORK In e-AJ 601e_ c_ S1-7 U 4104
SQUARE FOOTAGE: (proposed) // ffn IS.h e.ti
1ST FLOOR`C6'T sq.ft. lat sq.ft. 3RD FLOOR VA-- sq.ft. BASEMENT/C sq.ft. •
DECK sq.ft. COVERED DECK.2,y(e sq.ft. STORAGE sq.ft. OTHER sq.ft.
i GARAGE S'7(sq.ft. Attached% Detached 0 CARPORT N'h sq.ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMATION:NA_ *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES F. NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NO15 EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 2, TOTAL BEDROOMS 2_
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
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 ERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICAT ON OF 180 D S OF WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
OUNTY CODE 14.08.42)
Signal of 0 NE ust be signed by the OWNER) Da/i2
^,2:
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL Q '
PUBLIC HEALTH I�ti3 G(NN�?r-itA,S c.c jl.Cs
The approval of this project is subject to the recommendations
and specifications outlined in the attached geotechnical report. All RR5 Zoning
applicable recommendations and specifications shall be applied -- Front Yard Setback. 25'.
to the development on this site. Any deviation requires stamped Side& Rear Yard Setbacks. Residential dwelling
written approval from the registered design professional and accessory structures is 20'.
responsible for the report and may require special inspection by OR to°-o width of lot if not more than 100'wide
same. Structures and/or land modifications (grading, cuts, fills, OR approved ADV
etc.) required in the geotechnical report, may require a separate I Ili I 1 T
permit. The geotechnical report shall remain attached to the
approved building plans. I I [ I i 1 -1
EH Setbacks 09/18/2023
A.) DrainfieldiReserve requires 10'setback from footing/foundations APPROVED
B.)Septic tank(s)requires 5'setback from all footing/foundations MASON COUNTY DCD PLANNING
C.)No foundation/Perimeter Drains within 30ft,downgradient of SCO1T�u�t/r�'n�
Drainfield/Reserve area l 1 lX
D.)No Cut Bank(s)(greater than 511 and over 45 degrees)within
IO 50ft.down gradient of Drainfield/Reserve area t I I I
VN 1 II
1 Di.itall
zon ready si.i-d
"` 'i EH APPROVED by .cot
Rhonda Thompson 10/25/2023 • •y
fll Alkill1111 ■■■■
y ■■ � II ILLi .IUL1UUUUIuIUSU l
r� ■. tli+l 1� �E lit. MI ■ ( ONN.• -b ,. < ■
(•,/. . 11111 ! ag!4 link allbajlirille '''` ■■■■■■■■■
3 f ■ PIKE i11�li■■■i ka• ■■■ ■
1'1:i/■11 i t . e. MI rillitirfartill! . ■■■
a' MINNIE ..._..• - .. '-. - ...- YE IIIIVJlii.IINIK,, 1111111111 •
j:.ffigail-s. -7' '-• '7---i s. ‘ tool t Pfflaill11111111
1 �r .4r1 • A ...;n] . .. , 'r■■ ■■■■
� ■ �■■ '`!■ '�fi��6� ,met -
,P,ALLIK.,_ - ,..a..-ii.,.did,..11, ...... 1
i ■■psi I P.., .4MM iii, ��� . m 111111115MAIIIM k . --7':_ ML ■■
maimA- \ (-z. - vN
itagorma II.
r i+;" 1 mi. . ■ ■ 1�RY o 9�a Pi MI ■■■
7EMIIIIII IIIIIIINIEVENIE-iitidfilalilliVAINIIIII IIIII
pra1111_ JIMIlii� ■ t ■■�I _ d A■■■ ■
'laic- ■ ��" ai . i�.'S REII AI .:; a .ill__�Ii_
TOPOGRAPHY PROFILE: 1
zf_ Y ,.< { i r
r■_�� f
e"e) Direction: Scale: Approval: for office use
Building Permit number`?'Ii` �L}i---3 J�1- �t'_ ' i re.2.f0 Building:
..--� y Planning:
Owner/Applicant: .1 111 L t r1 ez ( � — ' Date of
application: Env. Health:
parcel Nurr br 'rt:l .o ( ; =;k7 -: C 11f.Q . t� 0 6. ?,1-,-')
['tinted horn Mason County C)MS