HomeMy WebLinkAboutCOM2025-00037 - COM CD Environmental Health Review - 4/30/2025 tirltwrl.
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MASON COUNTY Permit No.
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' COMMUNITY DEVELOPMENT
. Permit Assistance Center, Building,Planning APR 2 5 2025
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Central Mason Fire NAME:Domingo Sevilla
MAILING ADDRESS:6011 East Agate Road MAILING ADDRESS:195 Keasling RD
CITY:Shelton STATE:WA ZIP:98584 CITY:Chehalia STATE:WA ZIP:99532
PHONE#1:360-229-8730 PHONE:360-790-9410 CELL: 360-584-7707
PHONE#2:3 SO— 7 -E,—5533 EMAII,:domingojsevilla@gmail.com m n
EMAIL:jzipperer@cmfe.org •L&I REG#SEVILDJ000PS EXP, 10312027 n c�-- G c
PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER 0 r�
NAME Washingotn Home Center EMAIL josh.kaiser@washhome.com v
MAILING ADDRESS 61 SE Ryan Road CITY Shelton STATE WA ZIP 98584
PHONE 360-427-6667 CELL 360-791-3209
PARCEL INFORMATION: ��
PARCEL NUMBER(12 Digit Number) at)173jj1t r-O/D ZONING le'R-5
LEGAL DESCRIPTION(Abbreviated)T 1 1f 5E Sc,....) FIRE DISTRICT 5
SITE ADDRESS 6011 East Agate Road CITY Shelton
{DIRECTIONS TO SITE ADDRESS 1v,(/�, ' +0 rd
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO ki, SNOW LOAD:2�sf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Chec colt that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEW 0 ADDITION 0 ALTERATION 0 REPAIR❑ OTHER 0
USE OF STRUCTURE(Residence.Garage,Commercial Bldg,Etc.)
IS USE: PRIMARY 0 SEASONAL 0 NUMBER OF BEDROOMS 2 _ NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES mole Bldg)El YES(Part[s]of Bldg)0 NO 0 I . -
DESCRIBE WORK Manufactured Home Project - (_C1lLo Li(O ./(j)l eit ll f `"ii.c..�,t- c
SOUARE FOOTAGE:(proposed) i1�
1ST FLOOR 1174 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.
GARAGE sq.ft. Attached❑ Detached 0 CARPORT sq.ft. Attached 0 Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE Kit Custom Home MODEL Pinehurst 2501 YEAR 2025 LENGTH 44'
WIDTH 26'8' BEDROOMS 2 BATHS 2 SERIAL NUMBER TBD
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC El SEWER❑ / N›<6 EXISTING13
PLUMBING IN STRUCTURE? YES 0 NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT.
EXISTING BEDROOMS 0 PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
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/application 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 0 IS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION 1�AY MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X - c1- S
S. natur NER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH 1� rj(q(7 C;I/ 17w5 ' 'I1) a
Disclaimer: Mason County does not require a
1� survey to obtain a building permit. As a result, site
�� DOD O ?j plans may not reflect accurate data. It is the
a••licant's ressonsibilit to com•I with setback
05/08/2025 requirements.
APPROVED
MASON COUNTY DCD PLANNING
SCOTT RUEDY,AICP
Current Trees on Property
Digitally
spa signed
by Scott
Ruedy
ON
(
co
Reserve
Drain Field Drain Field •
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r-y��s��`9
see' Current Fire Station
.31.11R'.
Current Water Line from Timberlakes
EH Setbacks
A.) Drainfield/Reserve requires 10'setback from footing/foundations
B.)Septic tank(s)requires 5'setback from all footing/foundations
SecondaryEmergency Egress for Timberlakes C.)No foundation/Perimeter Drains within 30ft,downgradient of
9 Y 9 Drainfield/Reserve area
D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
50ft,down gradient of Drainfield/Reserve area
E.)Use approved mitigation from section C1-9 of the department of
ecology's"Criteria For Sewage Works Design,"when sewer
transport lines are within 10ft of water supply lines.
EH APPROVED
Rhonda Thompson 05/19/2025
Pro
N 6011 E Agate Rd RR5 Zoning
Shelton, WA 98584 E Agate Road Front Yard Setback. 25'.
� Parcel:;2.0/-7- 311� 6 o j 0 Side & Rear Yard Setbacks. Residential dwelling
and accessory structures is 20'.
OR 10%width of lot if not more than 100'wide
OR approved ADV