HomeMy WebLinkAboutBLD2024-01260 - BLD CD Environmental Health Review - 10/24/2024 MASON COUNTY Permit N.: 1..W 2U-
COMMUNITY DEVELOPMENT 'E C E I V E D
Permit Assistance Center,Building,Planning OCT 2 3 2024
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTORINFORMATIO9:15 W. Alder Street
NAME: D NARK: d 6U/fW4fCTo^Y7AG-r'r4.Kultwl✓
MAD,M ADDRESS: MAII.IN'0 ADDRESS: G. Ps/c 1 Zo
CITY: 1 L STATE: ) ZIP:d CITY'p'YAfGfA STATE:' w�nPE
PHO #l: - - I PHONE�(*2?Jfe CELL TE tee
PHONE#2: EMAIL: ICi1Le/U 6? N Z
EMAH,: AAA; I . Lt.H^ L&I REO# f%kivH{TB(SRE EXP. 1 /2/tzp L
PRIMARY CONTACT: OWNER CONTRACTOR 91 OTHER
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NAME ❑ EMAR br// 1'12c1[[RfN�m ff T
MAIWNG ADDRfiSS170vp CITY STATE WA M
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PHONE ;%W * LTLL /ut! Z.ML
PARCEL INFORMATION: O
PARCELNUMBER(12 Di®c Number)��.320J.1 -SL'-O/0�' WHING A-/
MGALDESCRIPTION(Abbmistd) /a 4AJ. IIIv6G6 FIRE DISTRICT
SITE ADDRESS N L CITY V jOr r
DIRECTIONS TO SME ADDRESS 6 `�
Dtop, Q
ISTH6PROT6CTWTTR WFTOFSLOPE(S)GREATERTH 14%a YES[] I,C SNOwwg ,.Y?PC
]SPROPERTYWITTUiSEEFTOFTHEFOLLOWING: r[nw afl apy:
SALTWATER[] LAKE[] RIVERC [] POND❑ WETLAND[] SEASONALRUNOFFD STREAM❑
TYPE OF WORK: NEW UK ADDITION❑ ALTERATION❑ REPAIR❑ OTHER 0
USEOFSTRUCTURE(eauea,Co Cwwo BU,Frc.)
ISUSE: PRDgARY❑ SEASONAL❑ NUMBEROFBEDROOtdS -3_MIMBEROFBATHRO0MS `L
lE'ATED STRUCTURE? YES t BWW YES�q ya.W o NOD
DESCRDIEWORK PVAdd,
SQUARE FOOTAGE:aar q
ISTFLOOR6kO eq.A 2N1DF1,OOR sq.R 3RDFLOOR sq.R BASEME K.R
DECK VT2 v .R COVEREDDFCK xi.B. STORAGE sq.R OTHER p.R
GARAGE ,ft. AMchad❑ Demcaed❑ CARPORT rq.R Ar [] Detached❑
MANUFACTURED HOME INFORMATION: `I COPIES OF'THE
'FLOOR PLAN REQUIRED`
MAKE L/t�� MODEL3Nr3—d4 YEARLENGTH
WB)TH 2.h BEDROOMS_ BATHS y SERLU.NUMBEROI�f^V 223—�
ENVIRONMENTAL HEALTH: /
SEWAGTJSEWER SOURCE: SEPTICR SEWER[] / NEW EXISTDIGD
PLIIM INGA'STRUCIURE? YES[] NO[I b5.,mmche,.*tedWanaAdegaary Famr
PERMIETERNOUNDATIONDRAMSPROPOSED? YES❑ NOmI- EMSDNGSQ.". JJ
EXISTINGBEDROOMS PR0P0SEDBEDROOMS—_3-- TOTALBEDROOMS
GWNER eekna.I dedere sIam1,e el"aamre"her
mutt Inas5p neaaays parmR aepLWeapemerA 1r.M Ir Ly
upaemw nelaa.l cease mn i am m.owner are I n�nner eeaere xer I am emNee m rewlw Nle Peaaxeae m mare wx ssrrwmea.l n.w
aa®nea p0rmbaon xmm ee me nec:ssan rarss.Inaueino am cakmcm naaa awnbe norm+N rWerSlp Mle p{eG me awsa lapel
aaeearNuw,wrreeene nn,me mmimama PoMeee�s`mare am prenre aaYgeee n Num Daear eaessmne ebo.e aetuilrM NrPeiy
qr ewff 2(s)mrmAm'eMmepmndee as pamcrfh peon ExnrrAs r'ullawla nxwka.ultnnwemnAuciknkMmmrwu0vAnen1m
awe a E mnmama�won Is waaaaea mr a Penoa n 1 w aew.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. IKACTMTY OF THIS
PERMIT APPLICATION OF 18 AYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY LODE 14.01.42)
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DEPARTMENTAL VIEW APPROVED DATE DENIED, DATE TAGS'NOTES/CONDIMONS
B=INKIDEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBUCHEALTH I'y(
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9,a`140 RAH R P R. o to ad So
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�1 �1 �tti�r_ToN�i�� 4B5$4
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\ sc, Cut behind house must not
exceed 5'. Maximize distance
from reserve DF.
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EH Setbacks
A.) DounXeld/Reserve requires 10'setback from lootingfoundations
B.)Septic dark(s)requires 5'setback from all foatingdoundatlons
C.)No foundation/Perimeter Drains within 301t,downgradient of
Drainfielc/Reserve area
D.)No Cut Banks)(greater than 5il and over 45 degrees)within
50LL down gradient of DrainfiekVReserve area
EH APPROVED
Rhonda Thompson 11/21/2024