HomeMy WebLinkAboutBLD2024-01016 - BLD CD Environmental Health Review - 8/21/2024 1JjjjjftL MASON COUNTY COMMUNITY SERVICES Permit Ng: OldLlp
PERMIT ASSISTANCE CENTER:
•818ONG•P MING.G UC HENLTH•FIRE IMRS
fits W.N Smt SleXen,WANS116
Plrow SXMtrm:(3600274870wt 352.F¢(300JGZ)-Mul F 3
PWYr.(380R)SMO).Fhw EMe:( OMU-5289
BUILDING PERMIT APPLICATION �J�d
PROPERTY OWNE6R!INFORMATION: CON TR.IACCIORINFORMATION:
N cG NAME: XLLL KmL NAME: 1 VA V
MAILING ADDRESS: MAR,WG ADDRESS: .+.�
CITY: STATE: ZIP:_ CITY: STSX ZIP: LLLJr
PHONE#1: PHONE: CELL:
PHONE#2: EMAIL: / � .~.I
EMAIL: LAI REG# EXP._/ /_ Z Q
PRIMARY CONTACT: OWNER CONTRALTORIK OTII O W
NAME EMAIL c
MAILINGADDRESS CITY SPATE_ZIP
PHONE CELL
PARCEL INFORMATION: q boqO W
PARCELNUMBER(12 Digit Number) ZW(.rV� ZONING
LEGAL DESCRIPTION(AbbmvieteO FIRE DISTRICT
SITBADDRESS 'I_FO E. PAL. C�An11KuA4 20 CRY �R C-L Am
DIRECTIONS TO SITE ADDRESS
ISTHEPRWJ WTTBINJSSFTOFSLOPE(S)GREATERTHAN14%: YES[] NOY SNOW LOAD:2-5pd
ISPROPERTYWTTIIW2W"OFTREMUOWWG: TM1eSd(i5agyty):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF[I STREAM
TYPE OF WORK: NEWY, ADDITION[] ALTERATION 0 REPAIR❑ OTHER []
USE OF STRUCTURE(Aedmse'.Gunw.Cmww Bl D)
HUSE: PRIMARY❑ SEASONAL NC BEROFBEDRCOMS NUMBEROF¢ATHROOMS_n
HEATED STRUCTURE? �S Bql YES 10TWy❑ N
DESCRBSEWORK -J , [•• �1 ,�(�
SQUARE v
1ST FLOORN 2ND F
LOOR_5q.R JRD FLOOR dq.ft. BASEMENT sq.It,
DECK sq.ft COVERED DECK_p.ft STORAGE ,R OTHER N.ft
GARAGE p.ft A.M d[] Demched[] CARPORT 6q.ft Adm ed[] Ddwhed❑
MANUFA TION: •L COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS NUMBER
ENVIRONMIIs1N LTH:
SEWAGFISEWERSOURCE: SEPDX. SEW2R[] / NEW[] E%IET
PLusual IN STRUCTURE, YESU NO V/ws,,mmrhromplered Water Adegwv Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES[] NO[] EXISTING SQ.FT.
EXISTING BEDROOMS PRO POSED BEDROOMS TOTALBEDROOMS
OWNER akmMetlgw NN udnu&m Ninecunbinlame5m mry iseuXNepop wM atlera pmtll tlon.O hmWeEpemeniMwNl6 X/
.bl.,nure Lelow.I d"nd mall em ,.,lren,l land Eetlue Ntllem end—,unce,c tlld pemYleM to ev.IXk e6 pmpowdl=
p8leineS peimievon M1pm ell lXe necessary peNw,InGWnO mry eewmenl XolBer or pedks Winlu. nyeNmO INsp Qtl ilia wmer or 6W
npresenklw, ,urda Pal OeInr—d—poNd.dbemmle e'd lrud ,,MgesMMeson Ccudle¢ess 1.Ne Teue Eeu,bw prepete
and seudulow form and Inspecn- T.pennW.wli ton ruts null B and ffmo,or suWneeE mnsvurdon Is nd mmmenced and 1W
Ery6 atl m+wuetion unM 15 suspeMed to a period W I80 drys.
PROOF OF NTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT LICATJO�10�.3$D QAVS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(I.UBON
( (/ j ) / COUNTY CODE 14.OBA2)
slgrewrddOWNER[Muet ha ri0netl by Jul DHe
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSMOMSCONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH I Z1l
in »iw+.m w+esa am w pu lep
vo g0k
r van aDom
EH Setbacks
A.) DrainilelNgesene requires l0'selback from footing/foundations
_ B.)Septic tanks)requires 5-setback imm all fooling1foundations
iMt/ SETBACKS C)No foundatioNPenmeter Drains within 30ip downgradient of
Ru0IS) PS Dminiield/Reserve area
D)No Cut Bank(s)(greater than 5ff and over 45 degrees)within
OWN:20 501,down gradient of DrainfielNResene area
Ali
-01 Mol dm masin,red hill 1W gIMM � rmsaa tOunor
"Ja lka,W Iba WIN"
'eulawt W Fq Ma0ntlat
a
I
Ell {V
»wao—mass ez
I LteT / // MModeK i
Will X
t4l refs � 1 O
I 1-T G
Z
H
--F ®RLS1 Q
o
' -..... I yr
O Q i
t I � Ia1a'ph tT
cawm rtala-�,•e= � � I
n W
;z .J
•wren—.� I =
79
n..
EH APPROVED I
Rhonda Thompson 10/01/2024 r4
S �
r TAIY
.am J rxu�aNs
K.T
elel
am, I r
O
I PLN Approved
aerz,naiiial
Mitzi CamremAy lx eGglrrrt l�'E PL:J
m. ,Ir
I nu Cnw-y.�sin,cT x Anoroa