HomeMy WebLinkAboutBLD2024-00467 - BLD CD Environmental Health Review - 4/12/2024 1 MASON COUNTY Peemit Ne: y� I T I
COMMUNITY DEVELOPMENT RECEIV n
Permit Assistance Center,Building,Planning APR 092024 C
BUILDING PERMIT APPLICATION 15 W. Alder SOeZ
O
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME(• A NAME: rn
MAIL ADDRESS MAILING ADDRESS: = Z
CITY: rJ STA Z@: CITY: STATTi: ZIP:
PHONE#I:_4gQ= — -- PHONE: CELL: D
PHEMAIL:E#2: EMAIL: r
J= M LAI REG# EXP._) '9A�
PRIMARY CONTACT: OWNERg CONTRACTOR[] OMER❑
NAMEinse EMAIL -
MAILINGADDRESS CITY STATB ZI
PHONE CELL '•ICr,- =
PARCEL INFORMATION:
PARCEL.NUMBER(IS Digit Numbr) —SO -in I ay_ZOMNG ;
LEGAL UESCAIPTLON(Abbrevald) ��Z FIRE 15711
SITE ADDRESS O CITY
DIRE HIS TO I EADDRESS C
A id ph
ISTBEPROJECTWITHW30EFTOFSWPE(S)GREATERTHANI<%: YESO NO® SNOWI1-1, sf
will
ISPROPERTYWITHINM"OFTHEFOLLOWING: tc'ti«Jmwypyl.
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW$ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER
USEOFSTRUCTURE(Raddhods,andg,Camosma 4¢.Ee) Sadh1 fd,f PyAa cr I r-
IS USE: PRIMARY SEASONAL } NUMBER OF BEDROOMSB
HEATEDSTRUCTURE1 YESIMESSI YES )e)q&IJy❑ NO❑ /rS .1
DESCRIBE WORKS' O T OCO VeJJ 1
SOUAREFOOTAGE:Mwm•0
ISTFLOOR sq.ft INDFLOOR sq.ft. 3RDFLOOR ad.ft. BASEMENT aq.R
DECK- _eqI COVEREDDECK_sq.ft STORAGE sq.k OTHER N.R
GARAGE_sq.ft Anached❑ Darac#ad❑ CARPORT aq.R. Atached❑ Deraphad❑
MANUFACTURED HOME INFORMATION: eX COPIES OF THE FLOOR PLAN REQUIRED•
f LOOR
MAKE LY ITS MODEL VEARZpZ_4/_LENGTH TaS�
WIDTH_BEDROOMS_ BATHS _SERW.NUMBER
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEP1I SEWER❑ I NEWS EMSTINGd
PLUMBING W STRUCTUREY YES N NO❑ if,,,urmeA rorapered Wale,Adegrucy Farm�q�J
PERIMETER)FOUNDATION DRAWS PROPOSED? YES ['❑ NO[' EXISTING LNG SQ.FT. 392
EMSTNG BEDROOMS_J_ PROPOSED BEDROOMS_ TOTALBEDROOMS_L_
Cgmass x*nWi romans Mat
N Nr and
nllR Fhas and n mry recall Ina Sop Tom dEx ttpmYl and
W M Me
Tdnorl MP03 W dwN Y Xy
LpneWra wand irmoreign MXewmertas fu.dl Eetlere Mir M ddmoder bides NisremiteMbEa Neojed smint ae Somaretl. Lew
c61YneE peimisslwham ell Na m,euary paNKomoons acanyeasementts amlorealer Nss"Crmg varra Xns pmlatl. mtimermlepY
repatanouigrtrsone. s11MNesagam impr.-N IsesorraleaMpramsll& bdgs or Mass"CWedamassbNesnowmmen EIX inn
Y'q rputlurelaj MrreMew enX inepectlon. ibis permNaprliunon Eewmes rrull6 wtiE XvnM1 or autlwNetl mnsbutlion b nd rommenW wMln 180
EBJB IX X Wnrhum0�NVM1 Ls 5uspen4etl hf B penoE at 1B0 tley6.
PROOF OF CONTINUATIOA OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
P MR APPLI TION DAYS OF MORE WALL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.011
X
SgneN MOWNER(Mort be llotuE bribe OWNERI Date
EPARTMENTAL REVIEW APPROVED DATE I DENIED DATE I TAGS)NOTES20NDIDONS
BUILDING DEPARTMENT
PLANNNG DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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� --'— EH APPROVED
' I Rhonda Thompson 05/29/2024
PRC)FiLjF: EH Setbacks
A.) Drainfield/Resewe requires 10'setback from footingRoundations
B.)Septic tanks)requires 5'setback from all footing/foundations
C.)No foundation/Perimeter Drains within 31 downgraoient of
Drainfield/Reserve area
D.)No Cut Banks)(greater Man Sit and over 05 degrees)within
50e,down gradient of Drainneld/Reserve area
Prmh number
or/AmBrA WY OI:
Nwnber. k IggR/.l'N�IN:
ENVIRONMENTAL
HEALTH
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YIIS 2e16 2M
3o3E 'CEO IIEE 2460%0
fl{@T 5 OIMS Wro N. F. 0
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FULL
QUEEN L /^\\
e $ I IIil30iE
ze60 zR60 2e60
2et6 2116 24I6
pl6 3016
Park Models rowaeo rvon-con s11ms 1 name o m-soio v —Iz. B
;0K YOWZ YD /MON oxr. 111112111 BB WU:.OLL
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