HomeMy WebLinkAboutBLD2023-01391 - BLD CD Environmental Health Review - 11/16/2023 MASON COUNTY PEnadil BL412093-LIJ ll
COMMUNITY DEVELOPMENT ' F M
Permit Assistance Center,Building,Planning s C z
BUILDING PERMIT APPLICATION c n =y PROPERTY OWNER INRORMATION; CONTRACTOR INFORMATION: tD O Z
NAME:(NN xalEs ux; NAME:CNN NINES al 7
MAD,AIG ADDRESS:Mn awmw WAVE MAILING ADDRESS:MTE MARTIN WAY.STATE:CITY: m
PHONE#1 IAOF' WA 21P. Ml- CITY:i..nEr STATE:wA ZIP:Made Z
:R6eMWKa __ PHONE:deur•_• CELL: aeuenrzae
PHONE#Z:Mume-rm ENbUL:xcalxgaamMm.mn
EMAa:"c"'®tl"F""°"'^m"' L&I REG#ceHNwaMFO E))(P. 10/03/ E D
PRIMARY CONTACT: OWNER Gi CONTRACTOR Gi MEER
NAME desncKNee. EMAIL NmeasY,ur<m.�
MAILINGADDEESS 8312NANTINwaYE COT E•ar SFATE wA Z[P--
PHONE 36yaly a CELL emmwzn
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) azm!b MKHa ZpNDIG R.Res.arm..
LEGAL DESCRIPTION(AbbadMaW) slc�mml BeemFWS]mnalm:at FIRE DISTRICTS
SITE ADDRESS IM.CEDMDRPIE LN COyaHl
DHtECTIGNS TO SITE ADDRESS Fm E canal IN a,E F.De.m#dengpM wm ad US m cea,an.to YeA
Fm M11IL
IST EPROIELT INSOOFTOFSLOPE(S)OREATERTIIANIS%: YFSD NOG. SNOWLOAD:jL_,a(
is PROPERTY WTININ 200 FT OF TBE FOLLOWING: (Ea�twAWypy):
SALT WATER❑ LAKE❑ RWER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION G REPAAR❑ OTHER
USE OF STRUCTURE(g,Neee, ,le,,ce.a.m,,'no,REEmF
ISUSE: PRIM)lRYD SEASONAL❑ NUMBER OF BEDROOMS. NUMEER OF BATHROOMSg
HEATED STRUCTURE? YES(Xaweamgl G. YES(Penp)geuy G NO G
DEBCRIBE WORKNEW SFN aUUNUFACNRED XOEE
SQUARE FOOTAGE:Sell ep
ISTFLOORaam aI.R ZNDFLOORO Sal 3RDFLOOR0 aq,ft BASEMENT. N.R.
Dl IIO aq.ft COVEREDDECKO aq.ft SMMOEO Ell OTHER. aq.ft
GARAGE. aq.R. Aa/e J,MG Deal CARP. O aq.ft ArtaGedG DeiucArAG
MANUFACTURED ROME INFORMATION: eA COPIES OF THE FLOOR PLAN REQUIRED•
MARE�AUaWry MODEL HEM Loaes NNE SUN YEAROme LENGTH..
WDYTH%e BEDROOMS. BATEV SERW,NUMBERTRO
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEFTICQ SEWERG / NEWQ EXISTMGG
Fumar NG IN STRUCTURE? YES]a NO G fired,lual meepletad Rare Adegxory£mm
PERMEETER/POUNDATION DRAINS PROPOSED? YES G NOO EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS S TOl BEDROOMS
OWNER acFrMa]pae WI even".orhal inla.mand,mry hal In a Shod vM Mer ppn at nnvctlien.MknpNaEgemenl d auCi is Ey
s11—habMow. mtlere Mel lannana.land I NHI.eeedarenal em eMIIeE W—heyanYpwmxendm N.1h..-prodoned ll,ne
obuined dearal nrygn all the nWae,paNeS.lncilany ememenl holder weaned,Oil SeNm9 MO Small.TTeexnl legal
e.pexrvauw,nweeema mn xs InlOrmatim pmNaea is eca,rere na grenle employer.,a aa,on cOumy.mere mme eeo»aeecneed pmpaM
a MUCmrelewdid.'lau aM i n.TNa pemtixapOli�'slion demmv nWl a Wier rcwnk O.aamoeimd mn,o-.clbn®na cvmmCSea eilnm 1eo
a.n erxaammcaon wwK YaWPWdupeaaea lw.p.dddaeeb den.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIWTY OF THIS
PERMIT APPLICATION ISO DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X r/ 10 f13
Slgnamre of OWNER RAW be NSUNd IN INS OWNER) pq
DEPART MENTAL REVIEW APPROVED DATE DENIED DATE TAGSNOTESICONDITIONS
BUIIDDiG DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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RESe�J£ I �r�c-£r.�32DZi-sR- o3o41
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Maas Coo',iy 1 ns ffcJo, 50 i 1 too
T ,;,o 0 �,.em 5WG 2D21- Oo551 •.
23" Sa^dy jW"\.
I Q oil 24°} G�a� lacwn
40.1MvaAY D.G.
t4 6 ¢ 8, 8R �n 'CRE-rJLHEsQS* 0• C.
wr ftt- Aoo 5a Fr
N(Ii 24 X� 9RkvN RES�R E
7 O1 Audio-Visui Alarm
I O2 Cleenout
11 ?each
� 500 Gallon?-_-Trash tank -
DRtOEWA*} ,
20 (3 NuWater BIVR-500 ATU Tank
O1,000 Gallon Pump Chamber
W T-N+
t0.ka• O6 Valve Control Box
�YGfy1'1'i�fl•'�+�'� ^`°''J 1a! t.j i vN j N ft� yd!a '. O/A\
'1'E' oN LYG4'C -ta^KS cwG USetj' "�:!
PPR V D
EH Set backs °`°'°VJON"%
A.) DrainfielNReserve requires 10'setback from footing1foundatlons { Th ✓:xnAB
B.)Septic tank(s)requires S'setback fmm all footing/foundations
3�o C.)No foundation/Perimeter Drains within stiff.downgradient of EH APPROVED
Drainfield/Reserve area
0.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within Rhonda Thompson 02/15/2024
5011,down gradient of Drainfielc/Reserve area