HomeMy WebLinkAboutBLD2023-01264 - BLD CD Environmental Health Review - 10/18/2023 MASON COUNTY Permit No: B(v-0,93-()nQ-})
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Permit Assistance Center, Building,Planning KEAL 3
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: EMPIRE HOME CONSTRUCTION,LLC NAME:MASON COUNTY EXCAVATING, INC
MAILING ADDRESS:P.O.BOX 241, _ MAILING ADDRESS:30 E WILLCHAR BLVD,
CITY:KELSO STATE:WA ZIP:98626 CITY:SHELTON STATE:WA ZIP: ::584
PHONE#1:LOREN 360-751-1745 PHONE:360-490-3144 CELL: 360-490-31^• Q
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PHONE#2:DAVID 360-751-8062 EMAIL :MASONCOUNTYEXCAVATING@YAHOO.CO �p
EMAIL:LORENDUVALL@GMAIL.COM L&I REG#MASONE915PM E�{p 3 (� �
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER❑ to
NAME DAVID DUVALL EMAIL DAVIDLDUVALL80@GMAIL.COM c�
MAILING ADDRESS PO BOX 241 CITY KELSO STATE WA Zip 986.6
PHONE 360-751-8062 CELL SAME
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 22017-50-00045 ZONING RR
LEGAL DESCRIPTION(Abbreviated) TIMBERLAKE#2 LOT:45 FIRE DISTRICT FD5
SITE ADDRESS 560 E LAKESHORE DR E CITY SHELTON
DIRECTIONS TO SITE ADDRESS Turn right onto E Timber Pkwy,Turn left onto E Lakeshore Drive East
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO 0 SNOW LOAD:30 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER ❑ LAKE ❑ RIVER/CREEK 0 POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW El ADDITION ❑ ALTERATION ❑ REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.)RESIDENTIAL
IS USE: PRIMARY ❑ SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg) Q YES (Pan(s)of Bldg) ❑ NO ❑
DESCRIBE WORK NEW MFH
SQUARE FOOTAGE: (proposed)
1ST FLOOR 1296 sq. ft. 2ND FLOOR sq. ft. 3RD FLOOR sq. ft. BASEMENT sq. ft.
DECK 32 sq.ft. COVERED DECK sq. ft. STORAGE sq. ft. OTHER sq.ft.
GARAGE sq. ft. Attached❑ Detached 0 CARPORT sq. ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE CLAYTON MODEL UNDER PRESSURE YEAR 2023 LENGTH 48FT
WIDTH 27FT BEDROOMS 3 BATHS 2 SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW 0 EXISTING 0
PLUMBING IN STRUCTURE? YES El NO ❑ If yes, attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES ❑ NO0 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
obtainedfission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
--/ - Z 2
3^DI g-(� PLN Approved
L 1��o2- 10/25/2023
Mason County Community Development
.....4... . -
Gavin Scouten
f All Changes Subject to Approval
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,t, . • Arrow Septic Designs
171 E. Vuecrest Dr
Union, WA 98592
(360)898-2255
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Planning Setbacks :
Front: 25' t t I t C Audio-Visual Aia-,�
b t' zo 30 `to
S8'
Rear: 0 1,Q, O C,ea�nout
Rear: 10' �
*all setbacks measured from the. larthest
projection of the building ,T_-m : I t^� rn e- Ca'^-S� 3 O 500 Galion_ Pre-Trash task
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rel- rl,eected ii «?rtiove-k"` � Ksc�
*subject to EH setbacks /� 03NuWater BNR-500 ATU Tank
o e ryy, / S 5.a.1-' 1 000 Galion P urlp Chamber
17tx,>,/GeJ/ t22-8 (-1— CO-7)DCAS O Valve Control Box
EH SETBACKS
A)Drainfield/Reserve requires 10'setback from footing/foundations
B)Septic tank(s)requires 5'setback from all footing/foundations
C)No foundation/perimeter drains within 30'down-gradient of drainfield/
reserve area
D)No cut(s),bank(s)(greater than 5'&over 45 degrees)within 50'
down-gradient of drainfield/reserve area
EH APPROVED
I).Anderson 11/20/2023