HomeMy WebLinkAboutBLD2024-00238 - BLD CD Environmental Health Review - 2/28/2024 w MASON COUNTY COMMUNITY SERVICES Permit No:
PERMIT A SSISTANCE CENTER:
•BUILOING•PLII N G•PUBLIC NFAITLI-"BE
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Bt6 W.Ntlm 50eat 5Mtlan.WA 9858e D 1 "
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BUILDING PERMIT APPLICATION 615 W.Alder Steet = 710
PROPERTY OWNER INFOMATION: CONTRACTOR INFORMATION: p z
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NAME:Mkhael A Nelalle Penn NAME
MAILDJG ADDRESS:23133 NE 10M CI. MARLING ADDRESS:
CITY:Sammemish STATE:WA 7]P:98071 CITY: STATE: ZIP: = IT�I
PHONE#I:<25-aE3deE1 PHONE: CELL: Z
PHONE#2: EMAIL:
EMAIL:mpnpocomg net LAI REG# EXP. / /_ r
PRIMARY CONTACT• OWNS EI CONTRACTOR❑ OTHER❑
NAME EMAIL
MAILTNGADDOSS CITY STATE_ ZIP �M
PHONE CELL—
PARCEL INFORMATION: EB T 82024
PMkCELNUMREEL(12 DN9iI?4B b ) 22132 r41-90033 ZONING RR5
LEGAL DESCRIPIUN(Abb."md) .TR 3-C OF GOVT LOT 3 TR 3 OF SP#25a3 FIRE DISTRICT ECEIVED
SITE ADDRESS2A0 E.DU&Cove RE. CITY SheKon
DIRECCIUNSTOSITEADDRESS �y�
IS TBE PROJECT WITHIN 360 Ff OF SLOP&EI GREATBRTHANU:: YOE) NOD SNOWLOAD:yrym
ISPROPERTYWITHLN ePFT HE OFTFOLLOWING: (@mt ea a+r opPry):
SALTWATER❑ LAKE WVMCREEEK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAMD
TYPE OF WORK: NEW El ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(EmIM Gm ce.iw.u(JNE.Ere.)Re nM
IS USE: PRDIARYEl SEASONAL HUMBEROFBEDRCOMS3 NUMBEROFBATHROOMS<
HEATED STRUCTURE? YES meae elQp D YES(vm.l= WIB410 NO❑
DESCRIBE WORK Remove erW Replace exislilg reI#Cerwe.Boatharse.
SOUAREFOOTAGE:IP,.p 4 Fltitshed
I ST FLOOR 25TT eq.fl. 2ND FLODR_xq.R 3RD FLOOR_eSft BASEMENT2117 1q,R
DECK836 sq.ft. COVEREDDECKIO {.R STORAGE Kqk OTHER__W.R
GARAGESSR sq.B. ATached 0 I)IBBAd❑ CARPORT Pq.R. ABBd D DnachaO
MANUFACTURE➢HOME INFORMATION: 'A COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUXBER
ENVIRONMENTAL HEALTd•
SEWAGEISEWER SOURCE: SEPICa SEW I New El EXISTING
PLUMBINGINSTRUCTURE? YESE1 NOD
lJyc,nrtacN complete!WaTer AQequary Form
PERTMETERffOUNDATION DRAMS PROPOSED? YES® NOD EXISTINGSQ.FT.
EXISTING BEDROOMS 2__...... PROPOSED BEDROOMS 3____ TOTAL BEDROOMS 3
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1 yg ,nw Ctlow.Ie NMl N w.na aM l(uNvrC JI2Nallem nMkebreceiae lM1b ynnilenebMNextMUPry tl.11we
omeieea Permiuio,rrem+n Ne rrmsslry wms,macsre mveaem.m naleer or w�ambreH reymairM ure Preps. TN.wauole+rr a Nyl
represeebNe,rePeserna Nazur ierommva,Pm:em m Ioovae mrtl e•I^b mePlevees erwtssol even e�m rm�w. m wtlPerN
am.mnmda)ta re.m.ele e:Peow1. mie PermwepPt Irl r�.+re.ew E wie m..aG a ewxe:oe cw,mv�ror:s rwt=mmmxee minor tM
aananwesem�m wx'e ewPmtletl roreoenoewtaB wye.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTNITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO Be EXPIRED.(MASON
% / CO fTY BE 14.e8.42)
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RE VIEW APPROVED DATE DENIED DATE TAGSMOTE&CONDIIIONE
TMENTRTMENT
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