HomeMy WebLinkAboutBLD2025-00365 - BLD CD Environmental Health Review - 3/27/2025 Permit No: R LDan -6,3366-
>, MASON COUNTY
COMMUNITY DEVELOPMENT RECEIVED Z
Permit Assistance Center,Building,Planning MAR 2 5 2025 C
BUILDING PERMIT APPLICATION 615 W. Alder ee m 0
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: '7
• 9• `Gw• rt.'NAME: N o F( / 14j1 t a NAME: e
MAILING ADDRESS: 141 IA) Sla l(00 1" MAILING ADDRESS: 0
CITY: STATE: ZIP: C a SP/ CITY: STATE: ZIP: ' - `off? >—
PHONE#1: 3!r O 446I- i 2 S 3 PHONE: CELL: O
PHONE#2: 3(,o - f 7v -„ ei 3 EMAIL :
EMAIL: LQ o Cal Ct cr 161 Ls c)'1 L&I REG# EXP. /—
PRIMARY CONTACT: Q / OWNERpt CONTRACTOR❑ OTHER❑ �,
NAME ! c L7/t o 4 f EMAIL /a y 0 la c a. Cc)4/71a/I. c4Y1-,
MAILING ADDRESS CITY STATE ZIP
PHONE CELL 3(e0 -4 vr -ci.,t4/l 3
PARCEL INFORMATION: .9021 a 9 pp�
PARCEL NUMBER(12 Digit Number) —3 I — 516 O O ) ZONING /V<6-
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT 5
SITE ADDRESS 3 -7) i . f l r i`•- CITY <h 2 (h'U -
DIRECTIONS TO SITE ADDRESS Tti!IAAv'i*1.1I Gv eA,,.x t rt c S } }e f
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO* SNOW LOAD:g5 psi
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply):
SALTWATER❑ LAKE 0 RIVER/CREEK❑ POND❑ WETLAND 0 SEASONAL RUNOFF❑ STREAM 0
TYPE OF WORK: NEWX ADDITION 0 ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Residence,Garage,Commercial Bldg•Etc) AP C l 1 e41 Cc.'
IS USE: PRIMARY SEASONAL 0 NUMBER OF BEDROOMS 2, NUMBER OF BATHROOMS ;2._
HEATED STRUCTURE? YES(Whole Bldg) YES(Parils)of Bldg)❑ NO 0
DESCRIBE WORK (J e vV 9...e.5► C-
SQUARE FOOTAGE: (proposed)
1ST FLOOR 7'7., sq.ft. 2ND FLOOR C ) sq.ft. 3RD FLOOR 0 sq.ft. BASEMENT C) sq. ft
* DECK 0 sq.ft. COVERED DECK (') sq.ft. STORAGE 0 sq.ft. OTHER 0 sq. ft.
GARAGE 0 sq.ft. Attached❑ Detached❑ CARPORT C') sq. ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
rcl
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
\' NVIRONMENTAL HEALTH:
• WAGE/SEWER SOURCE: SEPTIC SEWER ❑ / NEW,* EXISTING 0
• PLUMBING IN STRUCTURE? YES ® NO 0 If yes,attach completed Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NOD EXISTING SQ.FT.
EXISTING BEDROOMS _ PROPOSED BEDROOMS TOTAL BEDROOMS 3,_
OWNER acknowtedges 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 owsed.I legalae
Xobtained pertT1i�on from a1 the necessary parties,including any easement holder or parties of interest regarding this project•
raxoconlat ranracarde that lha infrvn�otinn nrnvvtart is arr„rafa snit,wants amnlnuoac of\Aaer.n('n.into oivoee to tha ahrwro Mervihdt rxnnarhi
SITE PLAN revised 4/29/25 *NOT AN APPROVED SEPTIC DESIGN*
Use approved septic design for septic system installation
Hoff/ Hegland
323 E. Pickering Road, Shelton, WA 98584 SCALE: 1" = 30' NORTH
/
Parcel No: 22129-31-90001 RR5 l
184'
i Slope:flat exceptSite
30f 1-7 for NW corner
DrG l�+ tf* —. — which slopes
2llZy r — — h 'r— - — a I.` S to SE.NW
-+ i u, 4 ' ! corner of
Q house maybe
/ c / ! cut+/-4'.
30' - / `fir •,r o I
r N.) ty
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15' easement: ingress/egress, utilities& maint. of water system. i 1,Ah i1
i — — _. . _ --F._.--- -_ EHAPPROVEDI
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Disclaimer: ason County does not require a °_ '• n
survey to obtain a building permit. As a result, site o s 3
plans may not reflect accurate data. It is the IV? �c E a a < o •
applicant's responsibility to comply with setback V\ Q o q Ls
C...) requirements. to' R.3
___ __ N b a A i i 2•� 2
y .�
U O N
i� �� Off_
184' - ``"
30' See AF #594666 w '
Access RR5 Zoning E
Front Yard Setback. 25'. d �i. �i 1'
.15
z �aW
Setbacks: Frontyard 25'. Side & Rearyards 20'. Drainfield 5'. Side& Rear Yard Setbacks. Residential dwelling o d To
05/12/2025 and accessory structures is 20'. v ,rti=-- -2
o,y,!a,y OR 10%width of lot if not more than 100'wide s,�z v Z;�v�
APPROVED b signedby SODU OR approved ADV a m c Iv Y .-8 w e
MASON COUNTY DCD PLANNING Rundy
Runty
SCOTT Ri1E11Y,AICP