HomeMy WebLinkAboutBLD2024-00667 - BLD CD Environmental Health Review - 5/30/2024 MASON COUNTY Per1ffItNc,: r Z � 17
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Building,Planning MAY g G 9 LUL�O4
BUILDING PERMIT APPLICATION 615 W.M w SbvM
PROPERTY OWNERINFO MATION• _CONTRACTOR INFORMATION. M
NAME:EMPIRE HOME CONS7"CTON,LLC NAME:MASON COUNTY EXCAVATHU INC Z
MAILING ADDRESS:P.O.BOX mL MAI.WG ADDRBSS:3o E WILI.CHM BLVO,
CTY:I0LsO STATE:WA ZIP ea328 CITY:aHBLTDN STATH:WA 7.IP88s89
PHONE tlI:LOREN 380.)51-1]15
PHONE:38(lefil N CELL: 8 11041H m
PHONE A'?:DAW0380.>61-0id] EMAIL:MA80NLOUNtYEXCAVATN ' Z
®OLIRILCOM O®VAHOO.COM
EMAIL:LORENDWALL L&I REGpMASlNJE815PM EXP.3 1161M_
PRIMARY CONTACT- OWNER p CONTRACTOR❑ OTBM10
NAME = rn
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avid W VAIL EMAIL DAvuxOw
MAILINGADDRESS PO BOX2N1 ALLB000" CCM
PHONE 39LLp812mE CITY n¢so STATE wA ZIP 98883
CELL SWE D
PARCEL INFORMATION- r'
PARCEL NUMBER(12 Digit Number) 2201151-0oU98 TONENG RR
LEGAL DESCRIPTION(Abbmi had) TIMBERLAKE 8a Meo FERe DISTRICT FDS
SITE ADDRESS INO E UK PLACE C[jyaHFLTON AM411
DIRECTIONS TO SITEADDRESS Fdbw WA-3Ne1M EAgeb Rdm EEkR tz-cF ZQ>�
IS THE PROJECT W1 300 FT OF SLOPENS)GREATER TRAN 1X%: YEE0 Noe SNOW LOAD:�ef C
ISPROPERTYWT'EENMITOFTERFOLLOWING: /[aeadl,nmayyj:
SALTWATER❑ LAKE❑ RWER/CREEK❑ POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW p ADDITION❑ ALTERATION❑ REPAR❑ OTHER n
USE OF STRUCTURE(Araidolw,Do oae commaeWeMe,eleJ RESIDENML
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(BQor m i p YES(Pnl+I Ne/4)❑ NO[] —
DESCRIBE WORK NEW MFH
SOUARE FOOTAGE:r,,„amadu
1ST PL00R 1288 N.B. 2ND FLOOR_aq.R 3RD FLOOR_
N.R BASEMENT_N,R
DECK 32 N.1L COVEREDDECK_sq.R STORAGE N.R UTHER_si
GARAGE_wi.R Attached❑ DWacM1ed❑ CARPORT N.ft Attached 0 Demched
MANUFACTURED HOME UJF'ORMATION: 4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE CIAYTON MODEL UNDER PRESSURE y8AR202N LENGTH""
wDDTB2hT BEDROOMS3 BATHS2 SERIAL NUMBER
ENYIRONMF_NTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTICp SEWERO, / NEW EXISTING
PLUMEN`G IN STRUCTURE? YES NO[I Ij3v,atMch mmyletad Winer Adegaery Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES[] NOE EXIST1NGSQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 3 TOTAL BEDROOMS 3 ti--
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NYIeeE perm Woodall, a.ell me necessary Oarliestion ,Ind med la many aesema1- a lam or pvtles aNn m Count,a...
mis arresters
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eM a BCOnamwtbn vM is auapeMetl(ore panty of 168 Ue}z.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLI ION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUHTV CODE 14.08.42)
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Signe4rte R(MualWabned bvL=OWNERI Oete
DEPARTMENT HE APPROVED DATE DENIED DATE TAGS/NOTBS/CONDMC
BUILDING DEPART?.ffiNT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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TBACKS O 3,0o0 Gallon Pump Cham r be
AWN $
rF5 + . C Valve Control Box
Front (SW): 25' � "
Sides 7 "'Y
Rear. �0
EH Setbacks
from
t B.) Septic itarlserve requires l0'setom allfrom foclingndatio Lions
.all setbacks me�St4red from the farthest B.)Septic lank(s)requires 5'setback from all footing/foundalians
ro ection of the building C.) No foundatioNPerimeter Drains within 30ft,downgradient of
P f 9 Drainfield/Reserve area
'subject to EH setbacks D.)No Cut Banks)(greater than 5R and over 45 degrees)within
Soft,dawn gradient of Drainfield/Resewe area
3 ,� = �EH APPROVED
Rhonda Thompson 06/21/2024