HomeMy WebLinkAboutBLD2025-00249 - BLD CD Environmental Health Review - 3/5/2025 Permit No: I� � G," 06)14 1
\ MASON COUNTY
) COMMUNITY DEVELOPMENT
Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: gL(Z!4 kSFEE� • NAME: 1:1�
MAILING ADDRESS•. O t O g-r re 2os. 2 . -MAILING ADDRESS:
CITY: (?j A — STATE:v..i ' ZiP:c 5Z� • ' ITY: STATE: ZIP:
PHONE#1: 3(p0 — S c4 S — 59 3 PHONE: CELL:
PHONE#2: (-e Q - c-{Co 3vr.40, 5 2- EMAIL: cl‘
EMAIL: (5(4e(2 •&tkt( •Cpet-t L&I REG# EXP. / /_
PRIMARY CONTACT: OWNER CONTRACTOR❑ OT ER❑ `
NAME c C Fs es-0 EMAIL �(_- I. �'5 Pt 612-1 EY (2 -' '- •
MAILING ADDRESS ('tt5(D G s r- Ia'f` ( C CITY c3 Er' STATE CO I!c- ZIP qe S ZS
PHONE CELL 5 -'7 S 9 3
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 222. I— 5 bbOne, ZONING
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS (10L0 E S—r- WN I elk-0 CITY 6 tiL..
DIRECTIONS TO SITE ADDRESS 3 AA k L S c7 t..l < ' i. € �o -C t)Cp se-.-0 th.( ()E A(�
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YE5 NO 0 SNOW LOAD: psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWLNG: /Check all that apply):
SALTWATER 0 LAKE❑ RIVER/CREEK❑ POND 0 WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW)E1 ADDITION❑ ALTERATION❑ •REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence.Garage.Commercial Bldg.Etc.) R.ee,(otF.3*1 A L 0-a M
IS USE: PRIMARY IBI, SEASONAL❑ NUMBER OF BEDROOMS Z NUMBER OF BATHROOMS 2.
HEATED STRUCTURE? YES(Whole Bldg) YES iPan(sJ of Bldg)0 NO❑
DESCRIBE WORK
SQUARE FOOTAGE:(proposed)
1ST FLOOR_I/Kt sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK_B sq.ft. STORAGE sq.ft. OTHER sq.ft.
GARAGE sq.ft. Attached Ex Detached❑ CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
W TH BEDROOMS BATHS SE
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC, SEWER❑ ( NEW❑ EXISTING pt
PLUMBING IN STRUCTURE? YES NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES litNOD EXISTING SQ.FT. 0
EXISTING BEDROOMS (-A LPROPOSED BEDROOMS . TOTAL BEDROOMS 3
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 ovmer 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 permiUappication 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)
X cssrCfe 3/z7/2c
Signature of OWNER( ust be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT ,11...2.0214.WO I%7-q;�� .p)✓L(I
FIRE MARSHAL �T i J
PUBLIC HEALTH 510115
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Glsdaimer.Mason County does not require a I 1 051 C
survey to obtain a building permit.As a result.s to 50 t i
plans may not reflect accurate data.It Is theII
C�] Ii
aPLA quire a responsibility to comply onto setback �/
requirements. I
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ADU2024-00013
S e-E Act Si-, i 0 r(0ZT F T ExisTiNC� 1
-i, 1000. I I-f o u5e
I., 1 BDega
l 430414 I
rJ7 71 FENCE r
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SCI<I III = ZZ� 1 SCPT1C eyI
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1 0 EA3EMENTS n 2 I.
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EH SETBACKS SWG2025-00192+
A)Drainfirld/Reserve rc5.res 10'setback from Inoung;•oundauom
B)Septic tank(s)requires 5'setback from all looting/foundations
C)No loundatiorcfperimeler drams within 30'dewn'gradrent of dranek.-i;' - /
rtserve area
D)No cubs).banks)(greater than &$' over 45 degrees/within SO' I 1 / l
dowmgradient o1 draintieW/rwma area
E)Sewer transport line may only be within le'of a water supply fine it n mGL `transport -
approved b/the local health officer and the fine is tonstmcted IAW sect r.
...A.-
CI 9 o1 the DoE'coteda For Sewage Works Design'.
t
EH APPROVED --41-1. t
u....Ito,. 05.30,2025
1 I ser1
.a ..15I (11ciuCii.)
I
RR5 Zoning
Front Yard Setback.25'.
Side&Rear Yard Setbacks.Residential dwelling
and accessory structures is 20'. SIDE 10% = 10' MIN
OR 10%width of lot if not more than 100'wide
OR approved ADV Al setbacks arc menewed from the furthest
pro carbon of the tutting.
03/04/2025 i
APPROVED f
�/
MASON COUNTY DCD PLANNING '9'T
seOT1 WEINAICP