HomeMy WebLinkAboutBLD2024-01421 - BLD CD Environmental Health Review - 12/4/2024 MASON
SON COUNTY
Permit No: R0ZQQ'?a -61421
COMMUNITY DE LOP
Permit Assistance Center, Building,Planning
BUILDING PERMIT APPLICATION DEC 03 2024
PROPERTY OWNER INFORMATION: CONTRACTOR INFOR3iA'Vy Mer S E
NAME: a ✓ NAME:
MAILING ADDRESS: - 7rHVNE
G ADDRESS: -�— j
CITY- SAG(f/ri SsAT'E:/.vp ZIP:_�S� CITY: STATE:
CELL: 'C+
PHONE#I: -,GB-L4 a'oy7y
PHONE#2:
EMAIL:�I'l,�! %m<$'1 c°gNlrl i t Ca wt L&I REG# EXP. —f
PRIMARY CONTACT: OWNER CONTRACTOR❑ LT�R❑ e9ma:l- Ce{
NAME I R�1 Toe EMAIL IM
MAILINGADDRESS ( 7/ ly �^^'^-° CITY c n STATE Lti0. ZIP S�
PHONE /a0-(ICA - ON7;6: CELL cIA7&e
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 319D 97-7 DO 32 ZONING
LEGAL DESCRIPTION(Abbreviated) Rf 3_8 Svny a(uz TQ Z ds• iN 'fa . 19a 1ZRE DISTRICT
-
SHE ADDRESS 1 "Jl _ E e�:✓uyn 4AYI�- CITY Shct>�
DIRECTIONS TO SITE ADDRESS <lA A4A4 ty la R l/eve La Fh e n Pau[a IA ?-
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO M SNOW LOAD:-psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (cherl df dmtapp(y):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER IT
USE OF STRUCTURE(xeridcict Image,Comme,vdBldg.E.)sns-! � y
IS USE: PRIMARY❑ SEASONAL❑ NUMBER OF BEDROOMS—�_ NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES omkiiw❑ YES(Po gIrt(-1,sr8 ❑ NO❑
DESCRIBEWORK avid lli�oA na�(t a l cSknst o¢t�nyi dGfrie �v bedr®� h
t
SOUARE FOOTAGE: (pnpmr d)
1ST FLOOR sq.ft. 2ND FLOOR sq.R 3RD FLOOR sq.R BASEMENT sq.ft
DECK sq.ft. COVERED DECK sq.fL STORAGE sq.ft. OTHER sq.ft. S
GARAGE 7E S sq.ft Attached❑ Detached❑ CARPORT sq.R Attached❑ Detached❑ Pal
MANUFACTURED HOME INFORMATION: -4 COPIES OF THE FLOOR PLAN REQUH"-
MAKE MODEL - YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER {`
ENVIRONMENTAL HEALTH: 7rbd nufih+ 11d fi9�1_�i10 O SS I t b\I I
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEW❑ EXISTING
PLUMBING IN STRUCTURE? YES O NO❑ IJyes,attach compered Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTING SQ._FT.
EXISTING BEDROOMS Z PROPOSED BEDROOMS�— TOTAL BEDROOMS
OWNER acknowledges Had submission of Inaccurate information may reauH in a stop work order or pemiX reuaation.AtlmoMedgement of such Is by
signature below.I declare that I am the owner and I furlher declare that I am entitled b recalve this pemdt and to do the work as proposed.I have
obtained permission from all the necessary Paellas,including any easement holler or parties of IMareat regarding this project. The owner or legal
mnru¢wnfanw rwnmcwnfa Mal ew inrn,mMinn nmWAM la w'niMw aM mm�rs wmNnvwwc M AMcm rSYinN wnwee 1n Mr aFnvw rlwvnaul mm�wM
6.84 3� 77- 9aaZ,), SIDE
♦ oo�m>
RR5 STANDARD SETBACKS*-Front: 25'
Sides:20'
Rear: 20' �$
4 m u m.c
'unless otherwise stated on the site plan { o 3 - RI
'all setbacks measured from the farthest -projection of the building li"aCJ a Ero " N
M W � O M
'subject to EH setbacks •�) a 3
PLN Approvedqua
12/13/2024 d o.8e N
Mason County Community Development - - I'g j
Gavin Scouten m a s
All Changes Subject to Approval W io d
�d
Disclaimer j]( m
Mason County does not require surveys for Y
building.As a result,site plans may not reflect
accurate data. It is the applicant's responsibility
to comply with setback requirements. P`\�/\l w P-.
"J �pKt L
IF 3r 90L7)?pp 3L
O EH APPROVED
nnoma momosen ivzortoza -V
Reserve in between
existing trenches per
"J original 31bd design
.,� SWG94-01039
/s
1, �C1
.(� ICJ 5 5>� 3 � ��� •
C.
A �
(EXISTING DEVELOPMENT)