HomeMy WebLinkAboutCOM2024-00002 - COM CD Environmental Health Review - 1/8/2024 MASON COUNTY Per-HNF:C,0Yn2dA•�J/b)�
} COMMUNITY DEVELOPMENIRE CE I VE D
Permit Assistance Center,Building,Planning JAN 05 2024
BUILDING PERMIT APPLICATION
R W. Alder s
PROPERTYOWNER INFORMATION: CONTRACTOR INFORMATION:
NAPdE:swr Rroaan NmaCwluc MAII.iNG ADDAESS:4T1A NerM.r RDNE NMAIL W: GADDRESS::4M MaR NE
'P
CITY:OMPNe STATE:WA 2IP:8M16 pTy:oturpn STATE:WA ZIP:M36
PHONE#1:M Mml PHONE: CELL:s6�T t L
PHONE 92: EMAIL:nnmPino>yreav - O O
EMAR.:n -Wg@ .- LW REG pBENCOA956D EXP.
PRIMARY CONTAM OWNER CONFRWMREl 0TRES8
NAME"ea — EMAIL t r-Granit94lM Y
MAILINGADDRESS o]06MvaM Re NE CITY°*'." STATE WA ZIPM11 S`
PHONE CELL
C
PARCEL ENFORMATION: (J
PARCELNUMBER(12DigitN=bes)4Tl1291b10W ZONING--
LEGALDPSCRe'HON(Abb..U.d)I'Pva[pntn'yW]2E6&RlLd 17 FDIEDIST-CT
SrTEADDRESS M820NUSFWytM CFTYNmOeWR
DRUiCTiONS TO SD'EADDRES31°ruMyt018rbN MwN,eP Fu tle mxnd Hmemtpap[ny an Or Mlt[Hval Fvnrtl 6W I.r
wdaam.l;
IS THE PROIECI WIT'BDS 300 FT OF S PE(S)GREATER TRAM 14X: YESD NO❑ SNOW IAAD:E—ld
ISPR0PRR1YWITffIN200F7rOFTHEFOLLO%TNG; �111gpyl:
SALTWATER B LAKE❑ RIVERJCREEK❑ PUND 0 WETLAND❑ SEASONAL RUNOFP❑ STREAM❑
TYPE OF WORK: NEWD ADDITION[] ALTERATION❑ REPAIR❑ OTNERR^^D'^Ir[N[m
USE OF STRUCTURE(Aawd•['.m..ya Cwrwn[id ey[6¢JHP;eMI°rN
IS USE: PRMARY Q SEASONAL❑ NUMBER OF BEDROOMS_NUMBER OF BATHROOMS_
HEATED STRUCTURE? YES(W BhW[] NO❑
DESCRIBE WORKre^'^'r°aN[LL'06'W"g.ra rePN[ww'iF rcw[o-umnrMrwvaNYPnYIodpYemv®W
SQUARE FOOTAGE*&,,-4
ISTFLDORMAI R.R. 2NDFLOORM K..R 3RDFLOOR_W.& BASEMENT2IM K.R
DECKI224 R.R COVEREDDEOL_R.tt STORAGE2IM eq.R OTHER K.it
OARAGEO K.RARPched❑ D 1-d❑ CARPORTO aT.R AU.W[I Dl.eW[3
MANpFACTURED HOME INFORMATION: '4 COP16S OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENOTH
wmTH EMROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH: CJ'L "ants + -'mpirD1.[D.
SEWAGESEWER SOURCE: SEPTICO SEWER❑ J NEw❑ EXISTING O _—
PLUMBINGWSTKUCIIRE? YESEI NO0 DPH.a hco.pkla Water Ad,.,Fong
PERAffiTERJFOUNDATION DRAINS PROPOSED? YESD NOo I=rINGS(.".
EXISTINGBEDROOMS PROPOSED Issultum 26 TOTALBEBR —Zf2— bU-
OWNERe mMeaNe9m�[u0.m16&Pnollnamreleinfwmatlonmeyrteulrinaa;cpxaM1weerorprmM1rewmtlan.AgwMe�emenrol[umwby nGq
.grerure haFw.l aaaare ma;l am me arwrer aaa 1 runm.ae[mre;na;1 am enmlea m reaNa mia Palma aaa 10 as me wax H PON[e1.1 naW �1y1�t
oEfeinW Parml[Wnhon[IlrM mmsvry pelves,Inqudng anyeesamm;M1olaermpaNn al lrM1ereA 2peralnp tltle pgecl TheuwrwrclpY
BPrtae^r raPr [ Nrtme in(mnatien Proviaea w eccurale aaa 9ran;s employe[[W Meeon COMy e[csee ro me e[aro aB[mba prcPM1
am s0ucwm(s(s)mr m renewm aaa inaP vm. mi[PcmnrapWnrim m�mm nutawienwawemnarrm mnvammremt mmmanma whin 100
aaa Prn wiww[e[ri wwhe[[.pmaea tar a PanPa a+m aa1x. r,�
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS T"
PERMIT APPLICATION OF ISO DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X �L ( �-2t-
SgrRNre^A OW�R 1Nwt be slarrM by Me OWNERI Oate
DEPARTMENTAL REVIEW APPROVED . DATE DENIED DATE TAGSJNOT'ESICONDIITONS
B=WG DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTfi \ S
\ �
\
. ■ .
* �\ :
( q
!
-
(
Q /` ■ZO