HomeMy WebLinkAboutBLD2025-00678 - BLD CD Environmental Health Review - 6/5/2025 //-----:p,.:. MASON COUNTY Permit No: Rrr0l17C/
COMMUNITY DEVELOPMENT RECEIVED
.,
Permit Assistance Center,Building,Planning SUN 0 3 2025
BUILDING PERMIT APPLICATION 615 W. Aide
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: 16-"Av'y 1,4--117H-e NAME:
MAILING ADDRESS:YBaa k►j pelt, Pte. MAILING ADDRESS: - c\ m
CITY: D/y lak STATE:(.EMI' ZIP: 9 YI? CITY: STATE: ZIP: O t' z
PHONE#I: p M
n_76c�c�S9S PHONE: CELL: n J,
PHONE#2: EMAIL
EMAIL:PII CP �r�ti���r Cna�A L&I REG# EXP._/`/_ p�= g
PRIMARY CONTACT: OWNER% CONTRACTOR 0 OTHER 0 CI " G,
NAME &?1►4 a_)fTI+ EMAIL D
MAILING ADDRESS CITY STATE ZIP
PHONE CELL Z f-76y dS98r —I K
= m
PARCEL INFORMATION: pt Z
C
PARCEL NUMBER(12 Digit Number) 321)2-d7 D'0 03 IG
71 ZONING .tiJ -
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT g D
1 SITE ADDRESS/a 0 A. Z3/eN j e, vv., CITY S'h RA ff)At r
DIRECTIONS TO SITE ADDRESS t.„p,I(L (.400%.4.yiCk-
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YESO NO/ SNOW LOAD:1S psf
IS PROPERTY WrrHIN 200 FT OF THE FOLLOWING: (Check al that apply):
SALTWATER 0 LAKE 0 RIVER/CREEK 0 POND 0 WETLAND 0 SEASONAL RUNOFF 0 STREAM 0
TYPE OF WORK: NEWS ADDITION 0 ALTERATION❑� ,REPAIR❑ OTHER ❑
USE OF STRUCI URE(Residence.Garage.Commrrcial Bldg,Etc.) S t 4t.et tK
IS USE: PRIMARY SEASONAL 0 NUMBER OF BEDROOMS 3 NUMBER OF BATHROOMS 2.,
HEATED STRUCTURE? YES(Whole Bldg)0 YES(Part(:)of8ldg)' NO❑
DESCRIBE WORK 1\J A ( SPX. IN 1 a, LL (-O( 0
SOUARE Fq AGE:(proposed) tJ c)
1ST FLOG qys sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.a.
DECK sq.ft. COVERED DEC II. STORAGE sq.ft. OTHER sq.ft.
GARAG 00 sq.ft. .4ttached,De or CARPORT sq.ft. Attached❑ Detached 0
MANURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEINER SOURCE: SEPTIC* SEWER❑ / NEW)J EXISTING 0
PLUMBING IN STRUCTURE? YE9]-- NO 0 4'.res.attach completed� Water Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YEStl- NOD EXISTING SQ.FT.
EXISTING BEDROOMS 0 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 1 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 proiect The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above descnbed property
and str cture(s)for review and inspection. This permillapprcation becomes null b void if work or authorized construction Is not commenced within 180
clays or if construction work is suspended fora 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)
il
X6-24
Le/3kOZ
Siurfature of OWNER(Must be signed by the OWNER) Date
0 DEPARTMENTAL.REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL 1 �/ �t� ,n ,�
PUBLIC HEALTH 1 "7)i1 fllG-$ 40-eJ1
i 1
1
06/26/2025 RR5 Zoning
• APPROVED Front Yard Setback. 25'.
MASON COUNTY DCD PLANNING, seorf fzuEav,Afep Side & Rear Yard Setbacks. Residential dwelling
r and accessory structures is 20'.
a Digitally OR 10% width of lot if not more than 100' wide
r s.,�by colt OR approved ADV
Ruedy All setbacks are measured from the furthest
Q CO �0 projection of the building.
0 S �~
a EH Setbacks
A.) Drainfield.'Reserve requires 10 setback from footirg,loundations
t B.)Septic tank(s)requires 5'setback from all footingtoundations
0 C.)No foundation/Perimeter Drains within 30ft,downgradienl of
Drainheld.Reserve area
CI)
D.)No Cut Bank(s)(greater thar 5ft and over 45 degrees)within
`7 O II) 50ft.down gradient of Drainfield,Reserve area
E.)Use approved mitigation from section CI-9 of the department of
CS ecology's'Criteria For Sewage Works Desgn."when sewer
transport lines are within 1011 of water supply lines.
CI O
N)(111 ° EH APPROVED
n Rhonda'Thompson 07/03/2025 ;
DRIP R/A 275FJ �C
87 r
88 4j/.'/, 2g0 ��
: , `�.. .41
89 ,% •�'1
� 3 ,.
90 :
�i 0 8
9,1 DRIP RJA(400FT2)
dr
92 C
93
94
95 f� O
I
. MO 9R • e
C? " \\
a.
`,
97 (..---
.S•
•
ADV2025-00065- REAR 15' MIN 1— THIS SITE PLAN DOES NOT -r' w`(1
All setbacks are measured from the furthest DEPICT THE ROOFLINE
projection of the building. /.
V
aoi
h Of Disclaimer:Mason County does not require a
�� survey to obtain a building permit.As a result,site
plans may not reflect accurate data. It is the
ADV2025-00065- SIDE 5' MIN applicant's responsibility to comply with setback
requirements.