HomeMy WebLinkAboutBLD2025-00625 - BLD CD Environmental Health Review - 5/22/2025 . , •
_ .. MASON COUNTY Permit No: BLOZO2S- 00(025
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ITY DEVELOPMEN�rEC E1V ED
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MAY 21 2025
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATI6155 W. Alder S 'eet
NAME:EMPIRE HOME CONSTRUCTION,LLC NAME:MASON COUNTY EXCAVATING,INC
MAILING ADDRESS:P.O.BOX 241, MAILING ADDRESS:30 E WILLCHAR BLVD,
CITY:KELSO STATE:WA ZIP:98626 CITY:SHELTON STATE:WA ZIP:98584 .
PHONE#I:
LOREN 360-751-1745 PHONE:360-490-3144 CELL: 360-490-3144
PHONE#2:DAVID 360-751-8062 EMAIL;MASONCOUNTYEXCAVATING@YAHOO.COMrill"...
EMAIL:LORENDUVALL@GMAIL.COM L&I REG if MASONE915PM EXP. 3 /1 8/2 L
PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER❑ '' D
NAME DAVID DUVALL EMAIL DAVIDLDUVALL80@GMAIL.COM X r
PO BOX 241 CITY KELSO STATE WA ZIP 98626 : t tv I ''
MAILING ADDRESS NJt
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PHONE 360-751-8062 CELL SAME t i
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PARCEL INFORMATION: `4,--'
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PARCEL NUMBER(12 Digit Number) 32021-55-01013 ZONING RR
LEGAL DESCRIPTION(Abbreviated) SHORECREST TERRACE 2ND ADD BLK:1 LOT:13
FIRE DISTRICT FD5 1
SITE ADDRESS
111 E ASH WOOD LANE CITY SHELTON
DIRECTIONS TO SITE ADDRESS Follow WA-3 N/SE Olympic Hwy S,E Agate Rd and E Crestview Dr to E Ashwood Ln
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESD NO Q SNOW LOAD:30 psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM❑
TYPE OF WORK: NEW Q ADDITION❑ ALTERATION 0 REPAIR 0 OTHER 0
USE OF STRUCTURE(Residence.Garage.Commercial Bldg,Etc.)RESIDENTIAL
IS USE: PRIMARY 0 SEASONAL❑ NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2
HEATED STRUCTURE? YES(Whole Bldg)I] YES(Parris)of Bldg)❑ NO 0
DESCRIBE WORK NEW MFH
SQUARE FOOTAGE:(proposed)
1ST FLOOR 1367 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 0 Detached 0 CARPORT sq.ft. Attached❑ Detached 0
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE
CLAYTON MODEL JOHNNY B GOODE YEAR 2025 LENGTH 52FT
WIDTH 27FT BEDROOMS 3 BATHS 2 SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC 0 SEWER❑ / NEW 0 EXISTING 0
PLUMBING IN STRUCTURE? YES El NO❑ If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES 0 NOD EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS 3 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 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 ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE W CODE CAUSE 8.2E APPLICATION TO BE EXPIRED.(MASON
COUNTY
X Date
Signature of OWNER(Must be signed by the OWNER)
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL Obhe !1 (- 1
PUBLIC HEALTH
06/17/2025
APPROVED n
MASON COUNTY DCD PLANNING RR5 Zoning g�02_0).,S - OOo2S
COSTI NEBV,AICP Front Yard Setback. 25'.
Side& Rear Yard Setbacks. Residential dwelling
Digitally and accessory structures is 20'. RECEIVED
signed OR 10%width of lot if not more than 100'wide
`°n`°o°Y by OR approved ADV
Sc
ott
MAY 21 2025
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t 1 615 W.Alder Street
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ADV2025-00062- SIDE 5' MIN
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All setbacks are measured from the furthest
projection of tie building.
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, EH Setbacks
\ r D am i A.) Drainfield/Reserve requires 2-10.setback from footing/foundations
------ B.)Septic tank(s)requires 5'setback from all footing/foundations
1 / / — ,\/ -., C.)No foundation/Perimeter Drains within 30ft,downgradient of
Drainfield/Reserve area
�^ _ �s� D.)No Cut Bank(s)(greater than 5ft and over 45 degrees)within
— :- AJ''"``^'DL •- "\�' 50ft,down gradient of Drainfield/Reserve area
='�,! c p 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
-i Rhonda Thompson 06/18/2025