HomeMy WebLinkAboutBLD2024-00820 - BLD CD Environmental Health Review - 7/9/2024 PSI No:A
MASON COUNTY
COMMUNITY DEVELOPMENT JUL 09 2024
_ FermRAUlnXce C,SI BUIIdin PI Iry
BUILDING PERMIT APPLICATION 615 W. Alder Str
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION,
NAME:pnwrmd m..wc+i+ NAME:aa.ca+mmrm'uc 1'�n
MAH1NGADDRESS:NI1N.IbAXXrI MAILING ADDRESS:IPMXF mm L O
CITY:ASSIS STATE:a ZIP:wrm CITY:YsIn STATE:w'A ZIP:BXXeI {T
PHONE#I:tamlm 1 PHONE:Nm5- CELL: t
PHONE#2:lSM1 Asset EMAIL:dw®+mlmoXaea+w.
�p' L&I REG#wa ISSSN EXP.11/09Q4 C
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHER[I --- _ —
NAME-- EMAR I.w� m O
MAIUNGAODRE55 D1W VVSm Re OW mww SFATE WA ZOa D Z
PHONE mn>d.en au—
PARCELINFORMATION: _ m
PARCELNUMHER(12Di®t Numb.) Q134I ZONINGRrm.w z
LEGALDESCRTMON(Abbteviffi ) D
SI TE ADDRESS II1t W CNw Wu uilp2t (,(.TygleOm
DIRECTIONS TO SITE ADDRESS Adexmusu I01a.soonnmw.m,p.yNmu.rde.mm.wp...p.p,mm.iy.a,re.p.i r
b'ewu w.xsm ea.ia pa ew w+rkeoi Cn.H rwn ybnu suy
ISTTFEPRORE WlTHIN300FTOFSLOPE(S)GREATERTBAN14:4: YESD NOO SNOWLOAD:_Pal
ISPR0PERTYWnIBN200FFOFTBEFOLLOWBVG: rc'mkai w,t,,
SALTWATER❑ LAKE[] RIVER/CREEK0 POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAMQ
TYPE OF WORK: NEW 0 ADDITION❑ ALTERATION❑ REPAIR 0 OTBE R FI
USE OF STRUCWRE(mawe�,aS,,,C�Bldg cxJ pmaNv
IS USE: PRIMARYO SEASONAL❑ NUMBER OF BEDROOMS 9 NUMBEROFBATEEGOMS2
HEALED STRUCTURE? YES fN BkW 0 YES fre,#=J swp❑ NO
DESCR®E WORKue.elnye remlMnm.wet
SOUARE FOOTAGE:0+am.•dl
ISTFLOI N.R. 2NDFL0OR N.A. 3RDFLOOR N.R BASEMENT aq.A
DBCK_N.R COOEREDDEIX.al& ft STORAGE N.R OTHER _q,R
GARAGEmO N.R Almched 0 DSm [] CARPORT N.ft. Aaaphed❑ DC-wD
MANUFACTURED H
AN FACTUREDH ME INFORMATIO •4 COPIES OFTHE FLOOR PLAN REQUIRED-
MODE L YEAR LINGTH
BEDROOMS BATH$ SERIAL
ENVIRONMENTAL HEALTH:
SEWAGFISEWER SOURCE: SEPDCO SEWER❑ / NEWO EXISTING I]
PLUMINGDNSTRUCFURE? YESO NOO tlyn,mmnccmeplmdWawAISS Form
PEIUMETERTOUNDATION DRAINS PROPOSED? m0 NOD MMNGSQ.FI.
EXISTING BEDROOMS a PROPOSED BEDROOMS B TOTALBEDROOMS_0
ONNERala dges InelaWmWbn mFxwrela Inlcnnation mayrmuX Inaslop v2h wtic wpgmH re✓o;aron,Mknw.mepamenlmsutlila Ey
wmSIBmlue Eebn.IEetlere lnmlml ma vma melNMd eetlaeinglmenlMkN to re A¢Nk pamlleMpep NaxeRmprepoW Iftai
eapermistimlranaXma n ,c —SPelPMMd ISS enyrzWdm ,Sa Pwe sda l,anCl my Xds Polacl. The vesw a legal
repreeeme0.re.regeeenla met ure mmm�ml.o vroNaea l:acme me Brai�emwo'feeea Nre.oe cmmy—were more nem pmwM
.ad eweurelsl ra m.;m.ane Insvenlm.inla PsxmlamvX®Xm Xermrn null s vao X wn m minuizee croswmm le nd cwammrse wmbt let
eap arcmnwaaem wn la.,avemeo a.veem a tm eaye.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMWITMPLICATIONOF180 DAYS OF MO WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
CODE 14.NI
X
sipMWma ER Dare
DEPARTMENTAL RRVDRV APPROVED DATE DEN® DATE TAGSMOMSCONDFFIONS
BUIDINGDEPARTTIINT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
! \ TDQOF BANK GAL-e V 50
i
/
y Site Plan
8� PHILIP* r.)wNNNANGELILLQ
S>�' p3- 7aace�#t2135 5D'0OO45_
s/ KfiX W C Ehk LmE D&
Lor 21
'NOT AN APPROVED SEPTIC DESIGN'
Uu,pro. a.ptic dear for arotrc ayamm watallatiai
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EH SETBACKS
A)Drainfield/Reserve requires 10'setback from footing/foundstions
B)Septic tanks)requires S'setback from all footing/foundations
Q No foundation/perimeter drains within 30'down-gradient of droiMield
reserve area EH�APPROVEO
D)No ,bank(s)(greater than 5' over 45 degrees)within SO' V
down-gradient of dro ese infieltl/rrve area mnaaoza �yJ