HomeMy WebLinkAboutBLD2023-01283 - BLD CD Environmental Health Review - 10/24/2023 'ermit V/, .1ta,,:Id Al i D
„ ,,„ MASON COUNTY F�
COMMUNITY DEVELOPMEN OCI?
SZ� CT242023
�' Permit Assistance Center,Building,Planning 23
BUILDING PERMIT APPLICATION ReCF'VD 61 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:JEFF MILES NAME: z+
MAILING ADDRESS:247 SE WESTON RD MAILING ADDRESS:
CITY:SHELTON STATE:WA ZIP:98584 CITY: STATE: ZIP:
PHONE#1: PHONE: CELL:
PHONE#2: EMAIL
EMAIL: L&I REG# EXP. / / > 2
PRIMARY CONTACT: OWNER❑ CONTRACTOR 0 OTHER 0 m
NAME TREVORGREGORY EMAIL PWWDEVELOPMENTSOGMAILCOM T
MAILING ADDRESS 321 w CLEAR LAKE DR CITY SHELTON STATE WA ZIP 98584 rn
PHONE 3ea49as1oe CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 42135-50-00042 ZONING NA r
LEGAL DESCRIPTION(Abbreviated) CLEAR LAKE TRACTS PCL 22 OF BLA t2137... FIRE DISTRICT
SITE ADDRESS wA CITY SHELTON
DIRECTIONS TO SITE ADDRESS LEFT ON 101 AT CLEAR LAKE DR,SITE ON RIGHT
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM❑
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)RESIDENCE
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 3
HEATED STRUCTURE? YES(Whole Bldg ] YES(Pants)of Bldg)Re NO❑
DESCRIBE WORK NEW SFR
SOUARE FOOTAGE:(proposed)
1ST FLOOR 2322 sq.ft. 2ND FLOOR--LL sq.ft. 3RD FLOOR sq.ft. . BASEMENT sq.ft.
ET
DEC. _sq.ft. COVERED DECK C/I sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE 1055 sq.ft. Attached 0 Detached❑ CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL R LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW 0 EXISTING❑
PLUMBING IN STRUCTURE? YES 0 NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 Na]— EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 3 ✓ TOTAL BEDROOMS 3
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 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)
X 10-16-23
Signature of OWNER(Must be sinned by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH WI" wuFt,) C. 4 ii-b . '514
650 W CLEAR LAKE DR `
SHELTON WA 98584 _ "
PCL 42135-50-00042 \
NEW SFR SITE PLAN :
•UBJECT PROPERTY
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supplemental engineering report The report is in reference
to extended footings and wall heights and potentially will not
be used at all. If used,they will only be applied towards
areas of the foundation where require-which will only be on
the South side of the building footprint.
EH Setbacks
A.) Draintield/Reserve requires 10'setback from footingifoundations
B.)Septic tank(s)requires 5'setback from all footing.'foundations
C.)No foundation/Perimeter Drains within 30ft,downgradient of
DrainfieldiReserve area
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
50ft,down gradient of DrainfieldiReserve area 488.43'
EH APPROVED
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CLEAR LAKE DR.