HomeMy WebLinkAboutBLD2024-01086 - BLD CD Environmental Health Review - 9/6/2024 AAlLw Permit No: 6L.02024 tSlDA
MASON COUNTY
COMMUNITY DEVELOPMENT RECEIVED
09C
Permit Assistance Center, Building,Planning
BUILDING PERMIT APPLICATION SEP 0 5 2024
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATOC
NAME:w-andalamre eeareg NAME:
MAILING ADDRESS:WE...DR MAILING ADDRESS: f
CITY: STATE:WA ZIP:aeue CITY: STATE: ZIP:
PHONE ql:..2a 11. PHONE: CELL:
PHONE N2:Mange:4essn12152 EMAIL : O
EMAIL:° `ad`eayamn.Omn D"we"na"yMm."nnumlen• L&I REG# EXP._! Q
PRIMARY CONTACT: OWNER 0 CONTRACTOR❑ OTHER❑
NAME EMAIL
MAILINGADDRESS CITY STATE_ ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 1"1'500000' ZONING RRE
LEGAL DESCRIPTION(Abbreviated) MDUNTAINamDRESmei AIMINrm41 FIRE DISTRICT
SITE ADDRESS 9D E MO"m"n OR CITY D"a^*"•WA am
DIRECTIONS TO SITE ADDRESS M ea mwv D,Raa a atywle.was Re,R m 9 Rwrwn Ra.Rm a o-..t m wr..lMw we,w,mvamm m.
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 149,16: YES❑ NO 0 SNOW LOAD:`a sf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chmkal)thamPplv):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION 0 ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Rerideare.Garoge,Commercial Bldg,Etc.)saWw sRR
IS USE: PRIMARY ❑ SEASONAL 0 NUMBER OF BEDROOMS° NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Pav(IJ ofBldg)❑ NO❑
DESCRIBE WORK"°"'atldAon W.wan0 SER
SOUARE FOOTAGE: (pngD ad)
IST FLOOR PSB sq.& 2ND FLOOR 49 sq.it. 3RD FLOOR sq.ft. BASEMENT sq. ft.
DECK sq.ft. COVERED DECKle 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*
MAKEWA MODEL YEAR LENGTH
WIDTH -BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGElSEWER SOURCE: SEPTIC 0 SEWER❑ / NEW❑ EXISTING 0
PLUMBING IN STRUCTURE? YES 0 NO❑ Ifyea, attach completed Water Adequacy Form
PERIMETERNOUNDATION DRAINS PROPOSED? YES 0 NO[] EXISTING SQ.FT. straolm
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.1 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 parries,including any easement holder or parties of Interest regarding this project. The overall or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above deson bed property
and structure(s)for review and inspection. This pennf lapplication becomes null 6 void d work or authorized construction is not commenced within 180
days or it 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 CODE 14.08.42)
Rachel Weber Digitally spned by Rachel Weber 9/5/2024
X Date:2024.09.0512:4)a9 one
Signature of OWNER(Must be stand by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED I DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL PUBLIC HEALTH Ig' r
( ! � �
)
Er
2 — _ _
} \ � :..�----�\ �` ) .
) 0 m2
\ ( } E
-
` #!
. _ >
- 9EM \
\ ) E \ ƒ \ �\\ a �
® | ! m `
K « ! ! } # » § ' v _ N
k « @ � � ®�
: \ ¢ 0j | ; � � � ,
Disclaimer:Mason County does not require a 09/17/2024
' survey to obtain a building permit.As a result,she APPROVED
plans may not rellecl accurate data.It is the MASON COUNTY KID PUNNING
ano
applicants responsibility to comply with setback w"Ww"10 EH APPROVEDolnnmes
requirements.
m.mw.Pso^
RR5 Zoning
Front Yam Setback,25,
Side&Rear Vent Setbacks.Resicanbal dwelling
and accessory structures is 20% REC Ell V ED
OR mx width of rot a not more than 100'coda EH Setbacks
OR approved AOV ,l SEP 05 2024
•Ia.Pxdar.I•e:+.seee.wdn.aa...sas.
c�wW:mrvea'nwa�ow..aw xM1 uwnaarm n
w wcxa.uyia+n..a�wawasam..nre. 076 W.Alder 9beat
E OREST W1E
ww�wr.0 \ � naw.r All structures should meet Setbacks
e'MIN-SIDE SETBACKAnn
by
At
i
ao
MpJ�N
e
r'x�u ro, me-am-roman
1.(RItcRIPhW: 1'YJINrAH..T.sl
I Iqy W Ma
Sim PDgCaa: am E M.'WIAm oR
awarsvaw con sw+a
SITE PLAN
KIT
E:l•.30
NoltrR