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HomeMy WebLinkAboutBLD2024-00963 WAI2024-00034 Retaining Wall - BLD Application - 8/7/2024 lll MASON COUNTY COMMUNITY SERVICES Permmit�O: 2- `4 L� -i U A PERMIT ASSISTANCE CENTER: 1 •BUILDING•PLANNING•PUBLIC HEAL77-i•FIRE MARSHAL RECEIVED ' 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670 ext.352•Fax:(360)427-7798 Phone BeNair.(360)2754467•Phone Elora:(360)482-5269 BUILDING PERMIT APPLICATION AUG 0 7 2024 PROPERTY OWNER INFORMATION: CONTRACTORINFORMA@fb&:W. Alder Street NAME: NAME: E*4M A-}["r. MAILING ADDRESS: MAILING DDRESS: .O CITY: U N(bN S PATE: ZIP: Z CITY:1N U NA STATE: ZIP. PHONE#l: PHONE: CELL: 4 ■fir PHONE 2 R,I EMAIL: OWL44 a&Nfa,(�1j{Lt-C,bp �• ■ EMAIL: (. L&I REG# EXP. PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHERrO NAME EMAIL I MAILING A DRESS CITY STATE ZIP PHONE CELL (�(;�9g PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) ZONING LEGAL DESCRIPTION(Abbreviated) FIRE ISTRIC SITE ADDRESS 110 0. ?j CITY DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that app4) SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW)( ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage.Commerctal Bid&ac.) gW&Ig;1 �' (JJA L,.(' IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES tnoie Bidg)❑ YES(ParffsJofBldg)❑ NQ❑ DESCRIBE WORK (I�'$ CL-Z•• �t CQ# �.rrs(/�j1J(y �F�i� SOUARE FOOTAGE:(propose+existing) 1 ST FLOOR sq.ft 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.& DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft OTHER.. N.ft WA1t U. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached[] MANUFACTURED HOME INFORMATION: �JA *4 COPIES OF THE FLOOR PLAN REQUIRED- MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC-X SEWER❑ / NEW❑ EXISTINGK PLUMBING IN STRUCTURE? YES❑ N(7'J4 /(yes,attach completed Water Adequacy'Form PERIMETER/FOUNDATION 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 permit 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 permit 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 representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and'inspection. This pemtiVapplication becomes null&vold If work or authorized construction Is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY C E 14.08.42) (�4�ol�tT' 'C 29 Zo _ Signature of OWNER(Must be signed by the OWNE Dat DEPARTMENTALREVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES PerFmmi&o: PERMIT ASS/STANCE CENTER: Y7V D •BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL _- 615 W.Alder Street,Shelton,WA 98584 Phone Shelton:(360)427-9670'ext.352•Fax:(360)427-7798 Phone AUG 0 7 2024 Belfair.(360)275-4467•Phone Elmo.•(360)482-5269 BUILDING PERMIT APPLICATION 615 W. Alder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:' NAME: e*W %N44('r, MAILING ADDRESS: MAILING DDRESS: .G1 CTI Y: U N(b}A SPATE: ZIP: Z CITY:11Y U!JA STATE: ZIP. PHONE#1: PHONE: CELL: �� PHONE 2: EMAIL:�_ 6M� O w b r EMAIL: Alh ca-,� I �, L&I REG# EXP. PRIMA Y CONTACT: OWNER❑ CONTRACTOR❑ OTH NAME EMAIL D 116M+ a6 MAILINGA DRESS CI gr— TY STATE ZIP PHONE CELL T,���C� l+�filQ PARCEL INFORMATION: d� PARCEL NUMBER(12 Digit Number) -.1PZS t /60 0 ZONING LEGAL DESCRIPTION(Abbreviated) F-Ate*I LIOT'q FIREPISTRIC SITE ADDRESS )(eO �j� ��[. CITY L414i DIRECTIONS TO SITE ADDRESS trtrere. IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YES[] Nll)!�. IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all char oppty): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEWX ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residences Garage.Commercial Bldg IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTURE? YES(whotemdp)❑ YES(Pori/s]ofBktg)❑ NQ❑ DESCRIBE WORK Ijl§rA .. :L Ve:5KdI4(#J(y WA-44 SQUARE FOOTAGE:(propose+edsthrg) 1ST FLOOR sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft DECK sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER__,©.sq.ft.WA GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: fJA *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTICJ( SEWER❑ / NEW❑ EXISTING) PLUMBING IN STRUCTURE? YES❑ Nt Ifyes,attach completed Water Adequacy Form PERIMETER/FOUNDATION 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 permit 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 permit 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 representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This pemmillapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work Is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY C E 14.08.42) ��•c•► t��o�uT "t �29�Zo 2� Signature of OWNER(Must be signed by the OWNE Dat DEPARTMENTALREVIEW APPROVED DATE DENIED ;DATE '.TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH Boa -o 3 Not to be constructed over property line. t' -F �CTINPORMnION, 08/27/2024 i d PARCEL is 32il2900SOdr �PROPGSEri Rr MIAL ESCRAPTION fABLR.9 APPROVED 6L ' toTG&VACALF-M.ST AO/AMI GP MASON COUNTY DCD PLANNING ALCFRSTAWSG45 S 11N' SCOT{RUE�V,Arep 1 , MHY RRR22255 ff Digitally gg ff FRONT -2 signed SIDE FRONT 4 I • '1� ; -25 j — - -- - �!• ?.. C ,.. ♦ ' REAR LG $COTI ROedy w b 1 :- ..A , PROPOSE{RESER�4 . ♦ , Qp� p nRw_,rELD1x/Sr :; PROPERn�popEss Scott �,�g �t ''f• . 5• Vr', ,I, 11 ( IN E 3rd STREET.-_ • �, ( , �{ • UNION.WA dSl Ruedy V t S PROPO9EO SE19X�.M I ♦ I , ,� 0 —��.��i ♦♦�♦♦ ,1 LOTSRE Np 10.38 ACRES t116.551.e SO.rT) z! EH APPROVED t . ,♦y. I• �miwsl°^upn`)ni./ '_`'� i, 1 �I Rhonda Thompson 08/27/2024 .. - # .WoM ` 1 = I = No fill over reserve area and no drains in retaining wall • '" I raroETE �, �� I � • '1 iI FAO ♦ _ ( ''� II , 11 LEGM Z F N ______ I I ♦ I 1 1 l� __--__— PRf"RTYEINr SETBYCX U)Q d -p°"n,BE J EF l r ! r' _-._.. corrtf>uRs • m W ( i 11 ! /!i 0 W 0 -- Sf t 4-1lZSFPiC SE1BTGN LL � / EASTNGSULUNG �''...._ THIV STREET ! PROPOSED CONCRETE E EXISTING GRAVEL IXWLwAr Js C4 t 4 A4 SSPIT yRESERVEAREA SM PLAN Disclaimer:Mason County does not require a [€ 81 I.•2YrPALowpWr I••ral lrs2EF *•�'�P n survey to obtain a building permit.As a result,site j plans may not reflect accurate data.It is the s I r•oa o a .a eu applicant's responsibility to comply with setback requirements. a K O rc A � � P IRIS PRINT 1S W,U'PLEASE SCPLE • "AS-R O OR.VM+Cw9 ACCGROINGIY i. MASON COUNTY COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health 415 N 6"Street, Bldg 8, Shelton WA 98584, Shelton; (360)427-9670 ext 400 -.- Belfair: (360)275-4467 ext 400 0.- Elma: (360)482-5269 ext 400 FAX (360)427-7787 Application for Waiver/Appeal Amount Paid: LL Receipt Number: -A Instructions 1. Complete Parts I and 2, No determination can be made until these parts are fully completed. 2. Fees maybe billed for waivers and appeals, based on the Environmental Health Fee Schedule. 3. Submit completed application with attachments to Mason County Public Health for review. PART 1. Applicant/Parcel Identification Name of Applicant_Eeft $ �.11006a Folgom Telephone Mailing Address of Applicant, -'t 6-o S - city io J1 State WA Zip 12-digit Tax Parcel No. A o Site Address 1j 6 Lk Subdivision Name and Lot PART 2: Nature of Waiver/Appeal 11 Contractor Certification Requirements 0 Class B Reduction in Vertical (installer, Pumper, O&M Specialists) if- Separation El Food Sanitation Requirements • Building Permit Review Policies 0 Group B Water System Regulations • Location,WAC 246-272A-0210 0 Water Adequacy Requirements El Holding Tank WAC 246-272A-0240 Cl Enforcement Timelines 0 Mason County Onsite Standards 0 Departmental Determinations 0 Other Description of Waiver/Appeal(include justification, additional material may be attached.): k!1W1'ftV'- 1.5 dVW_A81.Qr= '!Q4 4hOt'K' 0-11ak ZU"Iff .. Mtell',_ _rre.,Am,.,Y Zeva ; Applicant Signature: Z Date: 9-e'9z!y J:12H FDTMS\Waiver-Appeal Mason County Local Revised 1/2=0 17 Page 1 of 2 i PART 3: Public Health Evaluation (Staff Use Only) 1. Type of Determination Required: Type of Onsite Waiver(if applicable) o Appeal Waiver to None required o Class A. ❑ Class B ❑Class C 3 2. Identification of Specific Code/Standard/Determination(include date of determination or latest Code/ Standard revision) \N 3. Nature of Appeal: 4, Hearing Official: 11 Board of Health ❑ Health Officer ❑ Pollution Control hearing Board ❑ Public Health Director C] Certified Contractor Review Board 'environmental Health Manager 5. Mitigating factors:. 6. 1 have received this waiver/appeal request. It is complete and mitigation required by the state and local policy has been submitted. t Staff Signature: '�� Date: PART 4: Determination of the Hearing Official The hearing official has determined that approval of this request will not adversely affect public health and is hereby granted.This decision is based on the following findings and conditions: ❑ The hearing official has determined that approval of this request could potentially adversely effect public health and is hereby denied.This decision is based on the following findings and conditions: Hearing Official Signature: Date: �J �• J;EH Forms\Waiver-Appeal Mason County Local Revised 1/20/2017 Page 2 of