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BLD2023-01352 - BLD CD Environmental Health Review - 11/13/2023
MASON COUNTY Permit No: r DJJS COMMUNITY DEVELOPMENT ' ""� IVY:D m Permit Assistance Center,Building,Planning NOV 0 7 2023 C BUILDING PERMIT APPLICATION 615 W. AIdeT$trees M PROPERTY//OWNER INFORMATION: CONTRACTOR INFORMATION: NAME'R6(P+ [,, /li C IN 5 NAME: LIB O WT A- r-i w MAU.IITOADDRESS: L ro MAILING ADDRESS: L 1/1 hfa ✓/ i+4= m CITY a.- STATP: ZtP.9 $y CITY:(_¢ STATE: ZIP: PHO 41 Y/./;, 79/�- 97L'3 PHOIJE:3ln-yJG-CELL: �+ PHONEN2: ' 7. Y EMAIL: EMALI -n./D�/d OL.[6LN L&I REGB EXP. /_/_ r PRE Y ONTACT: OWNER CONTRACTOR❑ OTHER[]NAME w < Z r( .< EMAIL -n (,eO iM MAILING ADDRESS L5,4—I SY G A CITP STATE ZIP LLT�LL PHON CELL 7 L0 qa,*RL 2 NOV 13 PARCEL INFORMATION: / G `n / ..,,((,, 2023 PARCELNUSUBER(12DiVINmnu«)_'7/1DY� %G - 0000� ZONBG // - Te>:,E'it RECEIVED LEGALDESCRIPTION(Abk,nvarel) fi ®il,K'S ( W /rf FIRE DISTRICT STTEADDREss S-/ 5F N,/L, c,. _ CTTY MBNr�-rn, D TIONS TO SITE ADDRESS S,o-a- "A fJ/ 4ef t g,tf, to (' ( e ! MT PROJECTWTTIDN300FTOFSLOPE(S)GREATERTRANI4%: YES[] N016 SNOWIAAD:�70 I MPROPERTYWTTBB+ 2WO OFTREFOLIAWDIG: IC ' 0�m+rl: ty SALTWATER[] LAKE❑ RIVER/CREEK❑ PONCE] WETLAND[] SEASONAI.RUNOFF❑ STREAM❑ TYPE OF W ORK: NEW® ADDITION❑ ALTERATION❑ REPAIR❑ OTHER TR USE OF STRUCilIRE/xmra.ee,rm,og<,Cumrslrlag.Frf rt PS �^P-tll++��� MUSE: PRRAARY$i SEASONAL❑ NUMBEROFBEDROOMS V NUMBEROFBATHROOMS Z III HEATED STRUCTURE?O? �� (R'm Aw a YES ryrn/.INex§1 NO❑ / DESCRIBE WORK /fit'-Hnbyc Z /JIrY /XE.b 1/! W(RPf/4 k+-)IL( h C SOUARE FOOTAGE:b�a� IST FLOOR_,-.''_sr,.ft ZND FLOOR sr,.ft. 3RD FTAOR sq.it BASEMENT N.R + DECK sr,.ft COVERED DECK sr,.R STORAGE Sl.ft. OTHER sq.R GARAGE sr,.it AaacAed❑ IX W[] CARPORT el.ft Aa a[] Detached❑ MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED' MAKE CI4.ti Ta'k, MODEL�bRLY160/1VI YEAR. zy LENGTH GO WIDTH BEDROOMS BATHS u2 SERA.NUMBER ENVIRONMENTAL HEALTH: SEWAGUSEWERSOURCE: SEPTTCw SEWER❑ I NEW EMSTRNGX ,P 1,,,r PLUMBRNGBSTRUCTURE? Mjj NO[I IjyM,w hma lered III Ade Form PERIMETEN/FOUNDATTON DRAINS PROPOSED? YES❑ N0,Z EXISTING SQ.FT. EXISTING BEDROOMS PROPOSEDBEDROOMS —'-2 TOTALBEDROOMs� OXNER Ykv.Nen3es PaI suMreelan ol'mameate Inloimation mry muX in a slm vnR wEerwp¢mi1�evY'dWR MAiwAe6aementdwM ie Ey op nw xbx. namrmm ¢mmaownerana mnna,eacbre Net m dirw r¢wie�Nap Tram mmm¢weaes Permner. legal oNa,,,aw nloncman Ile�e,neaaan PaNea.doo, amws ginnaemor Pemea mEI�zresemi�c mia Pyea. maaw�aror leeai �ep�azenbRw,revreaema ua�ue inroimarwn P�¢+GeO is ew,ale miE 0�"anls amgryaea w Mason cmnN¢¢wsa¢to Ne aoo a eewleee PmPeb M Nutlue(¢)b nsiew enE Inayetlbn. lnis peimNavplk¢tion Exmme¢+ull6 witl q vwk aauV9rIZaE mnrhuNm¢M wmmeneen In iBY Erya w Rmnilnblon vcM1 is wspen0en M a pnW N 1806rys. PR OF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIV OF THIS (TAP ICATION OF 180 AYS O ORE WILL CAUSE THE APPLICATION TO BE UPIRED.(MASON `. COUNTY CODE 14.0q.42) X / SpnaW tOWI M a Intl M INER OMe DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSINOTES/CONDITIONS BUILDING DEPARTMENT PLANNINGDEPARTMENT FTRE MARSHALIf PUBLIC HEALTH T W R 0 ° W J Z s 0 m � E �i � 7 f xL i V3 j �N TA LU NI d E '` el - 5 Will Foe W F IN > —n Q u>p8 o s a IL O m o 7.._-7 V f E s } (4)3exZ5' Pftlrl At D- F- T tgc*&$ C. C; O.G. wri' - 1eo ' �vv�Tvc..aar5 5F cegsc r t>R S'j. St.Pt Q 4 rY Ywb/C t— fb / 5' min from foundation — y to drainfield and reserve n 11Qi V`rCc j WA G u u So 40 -.I Dzftt4RCrc 'PLOT fLRN o" �AS6lt£dT �*,CEI-4=3I 104-5io' 00001 11 �� EH APPROVED Rhonda Thompson 12/15/2023 )R�K } Ro81N i-I AMS+ I� � 5 P1 SE H OLL�J AcE i OAutho-Visual Aiaim 5 tit f� I-To N , wA g8 s8f © Cleo gut EH setbacks © 120o Gallon Septic Tank Al Drainfield/Reserve requires 5'setback from footingdoundanOrs; 2-Compa=mt with with WAI2023-00120 EYQLLQRi A11ier B.)Septic tanks)requires 5'setback from all looting/foundations with WAI N/A- C.)No loundation/Rerimeter Drains within 30ft,downgradient of O 1000 Gallon Pump Charrlber Drainfield/Reserve area D.)No Cut Banks)(greater than 5ft and over 45 degrees)within O Valce Control Bar 501 down gradient of Dralnfleld/Reserve area © G Id `}a+k- -Fe Lc raw>osd i o� deco.,�«liistaw ad Arrow Septic Designs M E.Vuer_rest Cr ® O18 1 SR rv.wbi k-. 4e be Usirn,WA 98592 j yaw,eued I2:' X4T inowle ' A bo ...r A ..a..l /.. ✓< .., .-_..t r !_ .. -,,1011iiiiii .l_. . /_L' L 4i.rnari..{'.L# r% elI*-