HomeMy WebLinkAboutBLD2024-00612 - BLD CD Environmental Health Review - 5/16/2024 MASON COUNTY Permltblwk%`) ��-OO&R
COMMUNITY DEVELOPIV &I VE 3
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Permit Assistance Center, Building,Planning �tn-
BUILDING PERMIT APPLICATION MAY 16 M4 p
PROPERTY OWNER INFORMATION• CONTRACTORINF I&erStreet
NAME;SHAWN&LISA PERRAULT NAME;NW GREEN CONSTRUCTION,INC.
MAII.ING ADDRESS:1210 NE CARBON BLVD MAILING ADDRESS:261 N HAMILTON RD
CITY:BELFAIR STATE:WA Z[p;98528 CITY;CHEHALIS STATE:WA ZIP:98532
PHONE#1:380-227-8482 PHONE:360-740-0345 C'Fi.T.:
PHONE#2: EMAIL.MECCA®NWGREENNOMES.NET
EMAIL;a zpenau1182®gmeil.cam L&I REG#BWGREGC92205 EXP /_
FT
PRIMARY CONTACT: OWNER❑ CONTRACTOR[3 OTHER❑+
NAME REBECCAMEISIERtNWGREEN CA NSTRU(MON,INC.) BMAIL REBECCA®NWGREENHOMES.NET
MAILING ADDRESS 261 N HAMILTON RD CITY CHENALM STATE�W-AA ZIPI88855322
PHONE 3e0-74D03/5 CELL E IVIRON r•Ia1IAL
PARCEL INFORMATION: HEALTH
PARCELNUMBER(12 Dijat Number) 123315100123 ZONING!5
LEGAL DESCRIPTION(AbbMVieted) BEARDS COVE DN 8 LOT:123 FIRE DISTRICT 2
SITE ADDRESS 1210 NE LARSON BLVD CITY BELFAIR
DIRECTIONS TO SITE ADDRESS Turn M0 after Dairy Ouem Gnll&unlit(on that left);Turn left be stay on WA-300 W;
Turn right onto NE Sand Hill Rd;Turn left onto NE Leon Blvd
IS THE PROJECT W1TEIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO EI SNOW LOAD:25 psP
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Cheri:alr thm arapW:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER n MANuFACT uRED HOME
USE OF STRUCTURE(Residence Gawge,Co— a'Bldg,Eta) SINGLE-FAMILY RESIDENCE
IS USE: PRIMARY❑+ SEASONAL❑ NUMBER OF BEDROOMSZ< 2 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(WMIeBW ❑e YES(Parr(+]afBkW ❑ NO❑
DESCRIBE WORK PLACEMENT OF 27X/8 MANUFACTURED HOME W/DECKS;CONNECT TO EXISTING SEPTIC AND PUBLIC WATER
SQUARE FOOTAGE: (prapae d)
IST FLOOR 1298 sq.ft. 2ND FLOOR sq.fL 3RD FLOOR sq.R. BASEMENT sq.ft.
DECK 32 sq.ft. COVERED DECK sq.R STORAGE aq.ft. OTHER sq.ft.
GARAGE Sq.ft. Attached❑ Detached❑ CARPORT sq. ft. Attached[I Detached❑
MANUFACTURED HOME INFORMATION: 'w4 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE FLEETWOOD MODELPURE 28483U YEAR2024 LENGTH48
W)DTI27 BEDROOMS 3 BATHS 2 SERIAL NUMBERTO BE ASSIGNED
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC❑+ SEWER❑ / NEW❑ EXISTING B
PLUMBING IN STRUCTURE? YES E] NO ❑ If yes, attach completed Water Adequacy Form
pERHAETER/FOUNDATION DRAINS PROPOSED? YES ❑ NOQ EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS'# 2- TOTAL BEDROOMS 1_ Z
OWNER acknovAedges that submission of inaccande Information may result in a stop work order or permit revocation.Acknowledgement of such is
by
signature below.I dada.that I am the owner and I fuller declare that I am entitled to reoelve this penult and to do the work as proposed.I have
obtained permlaslon from all the necessary parties,Including any easement holder or parts"of interest regarding this project The owner or legal
representative.represents that the Information provided Is accurate and grams employees of Mason County access to the above described property
and structure(s)for review and inspection. This permWappllcaMon becomes null&wid 8 work or authorized construction Is not commenced wIMIn 180
APUBLICHEALTH
struction work Is suspended for a period of 180 days.
OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
IT APPLICAT OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASON
/s COUNTY CODE 14.08.42)
.> 4.24.2024
nature of OWNER(M ust be sinned bV the OWNERI Date
ENTAL REVIEW APPROVED DATE DEMED DATE TAGS/NOTES/CONDITIONS
G DEPARTMENTG DEPARTMENTSHALEALTH
EH Setbacks
A.) Dra fill/ a- ¢requires l0'sefback from footinyfountlationa
B.)Septic tanks)requires 5'selbaok Imm all footingMouMatlona
C.)No rouMatioNPenmeter Drains within 3Wt,downgradient of
Dri infiediR serve area
D.)No Cut Banks)(greater than 5n and over 45 degrees)within +/- ap•
50ft,down gnuieirt of DranfirlNR¢serve area ,
� IiI�RNE �hINFIEW
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SUt.Ea (INCH 20
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OwNEh S+V w+v d L ISa l�Ghw u�T PLN SETBACKFront
,;rMhOp1QESS: WC, N6 1 Sides:
SLVD 8':25'
Sides:8'
Pnnc��F 1a3315100 l a 3 A< a' •u Rear:20'
-
-- - - - - -- ---- - ---- ----- 'all setbacks measured from the farthest
Sg> Sp(A51-blades projection of the building
.subject to EH setbacks
PLN Approved
06/13/2024
Mason County Community Development
Gavin Scouter,
All Changes Subject to Approval