HomeMy WebLinkAboutBLD2023-01195 - BLD CD Environmental Health Review - 10/5/2023 MASON COUNTY Permit".: RLn,'Mg1Z-01195
COMMUNITY DEVELOPMENTRECENFE i m
Permit Assistance Center,Building,Planning OCT 042023 Z
BUILDING PERMIT APPLICATION 134510,
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: uifE m 0
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NAME:KIM VAN HOOVER NAME:FUTURE HOME SERVICES D Z
MARWG ADDRESS:PO BOX 2210 MAILING ADDRESS:PO BOX 2503 E I T.CH'Y:BEIFAIR STATE:WA y:GIG H
ZIP:98529 CHARBOR STATEMA ZIP:08935 = m
PHONE#]960.99D8654 PHONE:3 IXO-BnT CELL: Z
PHONE#2: EMAIL:angNOhaurehomesbmmadn.m ara
EMAIL:kind van5rovertR9mall.mm L&I REG#FUTURHSTT6DO EXp. 3. /17./25 D
PRIMARY CONTACT: OWNER❑ CONTRACTORS OTHERS r
NAME ANGIEAMIWN STROH EMAIL Boole®Murebanabreawrton.com
MAILING ADDRESS PO BOX 2503 CHTGK H%NSOR STATE WA 21P00335
PHONE CELL
O
PARCEL INFORMATION: M r-D
PARCEL NUMBER(12 DigirNwaba)1251&19-00000 2pMNp a (�
LEGAL DESCRIPTION(AbbreWmW)S N 114 OF NE 114 S16 T21N R1 W FIRE DISTRICT M 6s
SITE ADDRESS 372 NE FROG POND LANE CITY BELFAIR T N
DIRECTIONS TO SITE ADDRESS PLEASE SEE MAP O o
ISTHE PROJECT WITHIN 300"OF SLOPES)GREATER THAN 14%: YES[] NOS SNOWLOAD:15
IS PROPERTY WITHIN 200 FT OFTHE FOLLOWING: 2Ma+mi rsm yNlO.
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND[] WEILAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION[] ALTERATION❑ REPAIR[] OTHER DIREPLACEMENT
USE OF STRUCTURE(,.aane,,6amse.eommemlm&dA£e)PRIMARY RESIDENCE
IS USE: PRIMARY S SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES fwFa'aal F B YES rymr()yaey❑ NO❑
DESCRIBE WORK REPLACEMEM MANUFACTURED HOME
SOUARE FOOTAGE:deepmaa/
IST FLOOR 173E 6q.ft. 2ND FLOOR_N,ft. 3RD FLOOR_,ft. RASENIHNT
DECK N.A. COVERED DECK sq.ft. STORAGE xl.ft. OTHER A.ft
GARAGE_, ft AmM d[] Detached[3 CARPDRT sq.ft. A.Aad[] Detached❑
MANUFACTURED HOME INFORMATION: a4 COPIES OF THE FLOOR PLAN REQUIRED•
MAKEEAGIE MODEL 20664.E YEAR M23 LENGTH 66'
WIDTH Ph' BEDROOMS 3 BATHS 2 SERIAL NUMBER TED
ENVIRONMENTAL HEALTH:
SEWAGESEWER SOURCE: SEPTIC SEWER❑ I NEW[] ExTSTBNGEl
PLllNIDMGIN STRICTURE? YES[]+ NO ffP %each compheted Faer Ad,.,Form
PERIMEPE10OU14DATION DRAINS PROPOSED? YES[] NOR EXISTING SO,FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3
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npewreativam arreav Nei N¢iamon. npmviGeE I6 ecwrah ann pi�d%empbyee6dMe6on C^unrya®es to Me aWw tlesmEM gcperry
aM 60Wure(allarevbxan0 in6pxYm. TNs p¢mINP[pll®Yon Oewrne6 nuY 8 rW MxalkorauNer¢ee an9rvctim i6 nolwmmerrcatl„iNin 100
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PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 100 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.00.42)
x kill 1//Vi�IJQj^ 10-02-2023
Slgna U Mus[ nedbNtbe OWNEH Care,
DEPARTMENTAL REVIEW APPROVED I DATE DENIED DATE I TAGSRNOTESICONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH M n Z
NOT TO SCALE B�� J 011°15
EH APPROVED
Bhmda Thhun n01117=24
EH Setbacks opicry
A.) DminhelNReserve requires la'aelbeck ream looalpnoumalmns `9Gy/,'�C
a)sepia lanklsl requbes 5'sMbad hom all leoliridoudai
0)No IauMeUONPer'owtor Drains wXMn salt,otw rgradiism of
DrainXelNReserve sea
D.)No Cut Bangs)(greater Man 5h ano over 45 distress)within �C
50h,down grai M DreinfiekVReserve area
1
60'
6 � �
QOSy}1, �Qat•
Planning Setbacks ¢�°�Y�e�`s�
Front:25'
Sides:20'
Rear:20'
'all setbacks measured from the farthest ?
projection of the building
'subject to EH setbacks /
PLN Approved O
10/26pr
Mason Couny community Development
Gavin scout.,
At Charges sublets to Approval
i
EXISTING 100
POWE WELL
1334'+-
N FUTURE HOME SERVICES
(360)900-9777
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W` E x-DOWNSPOUT
RUNOFF SPLASDIRECTION
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_quruofFDlkscnoN 372 NE FROGPOND LANE
s 12316-13-00000
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