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HomeMy WebLinkAboutBLD2023-00834 - BLD CD Environmental Health Review - 8/1/2023 YA MASON COUNTY pei.mitNt,: I�C1 V 1. LsCOMMUNITY DEVELOPMENT JUL 2 7 2023 � ' Permit Assistance Center, Building,Planning 615 W. Aid,. Street BUILDING PERMIT APPLICATION PROPE TY OWNER INFORMATION: CONTRACTOR INFORMATION: kV NAME: _ NAME: AUG MAIL& A RE : MAILING ADDRESS: U i 2023 CITY: • ' ATE: • _ZIP: 'T.ICITY: STATE: ZIP: PHONE# . r - PHONE: CELL: RECE/ris, PHONE u • EMAIL: EMAIL: L&I REG# EXP._ /___ PRIM RY CO, A •. OWNER'A, CONT CTOR❑ O HER NAME V • EMA MAILIN ES CI STATE ZI i m PHON CELL I _ PARCEL INFORMATION: ` m PARCEL NUMBER(12 Digit Number) 4, ZONING _ LEGAL DF.SCI ' d "' r'. a CITY 4T ! �!Mittr�r' � I� �n 1 ,— ;r i e IS THE PROJECT Wfl'I1LN 300 FT OE SLOPE(S)GREATER.TI N 14%: YES❑ NO'_ SNOW LOA1�� psi IS PROPERTY\VITIIIN 200 FT OF TILE FOLLOW'. A a rmrgr,: SALTWATER l LAKE El ❑ PC 'D 'Pi. LAND[] SEASONAL RUNOFF❑ STREAM 9 TYPE OF WORK: NEW ADDITION❑ ALT'tApOi,❑ REI' IR❑ OTHER [] USE OF STRIJCTUf 1!Rer,.!onv.Gm,sa,cr.rwronmJBfr!}.E',.) _ailIS USE: PRIMAR SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATED STRUCTU _ YES nrh ere 1' s r , 1% o Raj; o DESCRIBE WORK ._ � i�t11uy SOUARE FOOTAGE:,proyua,r, • • 1ST FLOORW1A61 sq.II. 2ND FLOOR a .IL lit 'OR sq. . BA H. E T _ sq.It. DECK ,ft. AVER,D DECK 11// •f, \GE sq. . 0 -. sq.ft. GARAGE <i I , racked❑ Deco lied❑ CARPORT_____N, eq.R. arra Jre<I Detached❑ MANUFA URl� D HOME INFORMATION: .C'OPIES OF IE FLOOR PLAN RF ED• MAKE_{�tae/ MODEL 1/?1 Ci� ULR ( YEA Rb LENGTH W1DTH_(7 ) I3EDROOMS _I BATHS' IALNUMBER ENVIRONMENTAL HEALTH: SEWAGE,SF.WI R SOURCE' SEPTI SE\1.40. r NEW lf\ EXIST1NG PLUMBING IN STRUCTURE? YE.S NO❑ live.. cinch en , rcd IFaren.•Idequacr Fnnn z r PERIMETER FOUNDATION I) AINS PR0POSL•D? YES❑ N EXISTING SQ.F. f01 Lt[ EXISTING BEDROOMS PROPOSED BEDROOMS I TOTAL BEDROOMS ' OWNER acknowledges that submission of Inaccurate Information may resuk in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I em the owner and I further declare that I arc 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 I representative.represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures)for review and inspection. This pormitlappLcatlon becomes null&void Ir work or authorized cons.rucdon Is trot commenced within 180 days or if construction work is suspended for a period d 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PER ON OF 180 DAYS OF MORE WILL CAUSE THE APPLIC TION TO BE EXPIRED.(MASON .�.` COUNTY CODE 14,08.42) , X faR3 ignat e of OWNER(Must be sinned by the OWNER) / Date DEPAR'I'\IENTAL REVIEW APPROVED DATE I.). IED DATE TAGS/NOTESJCONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH D lap op l lA[/o'PUj''1p OGZ�f�'R doiiiik ocn cn =�0 O cn•'� 6L r 0 m 2 w w \---"\ --_________ CD ��z.os' COO 13—Ix cnZ F Z /o Z N\�' \' �\`�` /## m � � m • mac,. \' c. ' �� g �• m C O i 2 .C.. d C T'T 1 � E °, d n ' a 1 T. � tr / �i� to O 0 O N \CD \ 0 xi O ,,I� O 7 0 tZ v d �O z \` C Co •�I R y C N p O`\ 4. .. N O ,•� j.rD iD `C7 -yr m RI ar�D v' /-013.•� In 7 3•cp O `. O' w PC 0 CD VI RP o 3 W \o¢� 00 0 n O rf•O V I Co C D _ _ a d = MARINE VIE. .DR.v, M. 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