HomeMy WebLinkAboutBLD2024-01075 - BLD CD Environmental Health Review - 9/6/2024 MASON COUNTY Permit No: BLD7 o memo' 1
' COMMUNITY DEVELOPMLIT#f EIVED
Permit Assistance Center, Building,Planning SEP
O.y
BUILDING PERMIT APPLICATION 815 W./Uder (`'.a^
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: WA41C r la6c C?h a I:� NAME: r _
MAILING ADDRESS: 6 MAILING AD RESS:
CITY:SI,D4 STATE: ZIP: CITY: STATE: 'ZIP:
PHONE#1: 3L. CIp�S}16i PHONE: CELL:�.�.�m�
PHONE#2:_,`5!(op UAk}3A EMAIL.—
EMAIL: L&I REG# YO /0/ EXP. /
PRIMARY ONTACT: OWNER CONTRACTOR❑ OTHER❑ yI
NAME EMAI
MAILINGADDRESS CITY SFATE'AW ZIP B
PHONES& Llo' ar q LL ;(ppu n'cl,.' 1 1 N
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 6v ZONINGR
LEGAL DESCRIPTION(Abbreviated) 6 c{ 16: A/ WSS�r FIRE DISTRICT [ 6j
STCE ADDRESS W �—Cz C TY S�e+�nrr
D ONS TO SI ADDRESS 9 j e Ly
(7/Y710 A/U( f/wr /o/ t<d//dw w-a bed �r /s�'-/o
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] NCC& SNOW LOADl
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Ckeckd�rharappiyj:
SALTWATER❑ LAKE ❑ RNER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW , ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Rerideacc G vs,,Commercial Bldg,Erc.) / es.0
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(whole Bldg)0— YES(Pan(s)afBldg)❑ NO❑
DESCRIBE WORK
SQUARE FOOTAGE: (proposed)
ISTFLOOR L yGt/ ft. 2NDFLOOR_sq. sq.R 3RD FLOOR sq.ft. BASEMENT sq.ft. 75,
DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq. ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED•
MAKE G u e v de/1 We,[S MODEL(y3 9 t/ YEAE_JW� _LENGTHy��
WIDTH_ BEDROOMS(" BATHS a SERIAL NUMBER C,QST(J y2t*, 062S
ENVIRONMENTAL HEALTH:SEWAGEISEWER SOURCE: SEPTICL7i�[
SEWER❑ / NEWA EXISTING❑
PLUMBING IN STRUCTURE? YES jj NO❑ Ijyes,attach completed Water Adequacy Form
PERIMETERIFOUNDATION DRAINS PROPOSED? YES❑ NO(�- EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWNER acknowledges that submission of Inaccurate information may result In a stop work Order or perm0 revocation.Acknowledgement of such Is by
signature below.I declare that I am the owner and I further declare that I am entitled to receive this pertnit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of Interest regarding this project. The owner or legal
_SCALE
/1" = 50'
we</ EH Setbacks r_--I- T_n
A.) Dralnfieldmeserve requires 10'setback from lootinglountlations 0 25 50
` l G.)No
requires r sefins from all t,cim d radient ns
at
B..)Se tic tar (s)requires 5 Drains within all f dpwngradient of
thenfil.WReserve area
1 D.)No Cut Bank(s)(greater than Sit and over 455 degrees)within
50h,down gradient of DralnfleldlReserve area
NORTH
° EH APPROVED
Rhonda Thompson 10/09/2024
e an flow,
lit fF.e)N<r,-f l..r,k
t/T
fJ r
v:e _
Id
. -r na molt _
?'
133
�l d4 Ilk A
PLN SETBACKS
Front(W):25'
j"1 If
Sides:20'
Rear:20'
all setbacks measured from the farthest
-�ttM1..,, 4 • H projection of the building
rwe rFv i 'subject to EH setbacks
PLN Approved
I, 10/04/2024
9p Mason County Community Development
Gavin Scouten
All Changes Subject to Approval
Disclaimer
Mason County does not require surveys for
building.As a recur,site plans may not reflect
dddl / accurate data.It is the applicant's responsihility
to _ to comply with Setback requirements.