HomeMy WebLinkAboutBLD2024-00228 - BLD CD Environmental Health Review - 2/22/2024 t 4 ,. MASON COUNTY Permit No: B(.D2-04-oUaga
4./I, _ ,, COMMUNITY DEVELOPMENTRECENED Z
Permit Assistance Center, Building,Planning FEB 2 2 202
BUILDING PERMIT APPLICATION 615 W.Alder Street = X
m 0
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: > Z
NAME:Dustin Theoharis NAME:Lexar Homes
MAILING ADDRESS:2073 East Scorpio Place MAILING ADDRESS:92 ala Square Place = rn
CITY:Chandler STATE:AZ ZIP:85249 CITY:Port Townsend STATE: WA ZIP:98368 2
PHONE#1:253-335-1283 PHONE:360-302-6275 CELL: _i
PHONE#2: EMAIL:haikensaIexarhomes.com D
EMAIL:dtranel2(a�gmail.com L&I REG#LEXARH*842C4 EXP. 022424 �—
PRIMARY CONTACT: OWNER❑ CONTRACTOR]tf OTHER❑ T
NAME Heidi Aikens EMAIL haikens(@..lexarhomes.com
MAILING ADDRESS 92 Kala Square Place CITY Port Townsenc STATE WA ZIP 98368
PHONE 360-302-6275 CELL
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PARCEL INFORMATION:
PARCEL NUMBER(I2 Digit Number) 322205003050 ZONING RR5
LEGAL DESCRIPTION(Abbreviated) Great Bend waterfront tracts blk3 tr 38 E FIRE DISTRICT North Mason R
SITE ADDRESS 17131 NE North Shore Rd CITY Tahuya
DIRECTIONS TO SITE ADDRESS WA-3 S to WA-300W continue onto NE North Shore Rd
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESEI NO 0 SNOW LOAD:as psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER LAKE❑ RIVER/CREEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION 0 REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence.Garage.Commercrul Bldg.Etc.)Single Family Residence
IS USE: PRIMARY Iii SEASONAL 0 NUMBER OF BEDROOMS 1 NUMBER OF BATHROOMS 2.5 i
HEATED STRUCTURE? YES(whole Bldg)0 YES(Panic)of Bldg)a NO❑
DESCRIBE WORK Single Family Residence will be using the existing well and septic
1
SQUARE FOOTAGE:(proposed) •
1ST FLOOR844 sq.ft. 2ND FLOOR431 sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK 374 sq.ft. COVERED DECK 16 sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE 390 sq.ft. Attached Detached 0 CARPORT sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC® SEWER 0 i NEW❑ EXISTING Er
PLUMBING IN STRUCTURE? YES 14 NO❑ If yes.attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES I$ NOD EXISTING SQ.FT. N/A
EXISTING BEDROOMS_0 PROPOSED BEDROOMS 1 TOTAL BEDROOMS 1
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 permit/applicahon 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 CODE 14.08.42) f
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Signature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH 2/Pr 9( C'412
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8/14/24,10:06 AM SWG Application/As-Built
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. F) MASON COUNTY
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l" jijA#0,11--/--- Ab.a(Z-- CA X/A1--- ..
Entry Properties
.ngs Public Sewer Water Supply L >M
io. of Bathrooms � Basement hr. Septic Tank `i� Modified 5/25/20
%A;...4.1_ Lot Size i 4:03:21
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' Moderate 6X Poor None • 1.
ik space or on separate sheet indicating the followin : Created 5/24/20
l location of'houee on lot and indicate minimum and aximum 11:51:1(
ensions of lot and all buildings. •1
and sewage disposal system in relation to streams, akes, wells,
underground tanks, water supply lines and easeme ts. Template
lulling depth, area, porosity and amount plus location of drains.
I on•rif tS 1pR % -f(Htt y -4, Land Records
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) I C �✓ go' �' 3 Fields
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! !e /I Category SWG
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RA1L5•r , Doc Applical
✓ 1 .1.,5,e.-- Type As-Built
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i____� RTS 32220
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--- i [A� Parcel 3222051
1 Number
,\AL?
Archive 1030
Box
. \L 4, ! LegacylD 78633
CURE d Lam DATE}
00 R apt No. 6S-70 By c 4,- -4-- .1. I
Not Approved By kS
Date aitarian •v /
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https://dms.masoncountywa.gov/LWDocView.aspx?id=227780&dbid=0&repo=mason I'I