HomeMy WebLinkAboutBLD2023-01433 - BLD CD Environmental Health Review - 11/30/2023 MASON COUNTY RE
COMMUNITY DEVELOPMENT NOV 28 2023 N
PrmftA latarce CMM,AUIMIMMannin# O`
BUILDING PERMIT APPLIg4'fIdA1, Alder " .- '''Q�c d�I01�
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME: Mo.\i'nCad 4sh�9ht NAME:
MAILDIGADDRESS: 1% \ X— MAILING ADDRESS:
CITY:Wttft, STATE:W a. ZIP, CITY: STATE: ZIP:
PH0NE#1: 25 -7ZS• ISuL PHONE: CELL: _, O
PHONE#2: EMAIL:
EMAIL: /'n..kkVAt\9ti�\\\ yeaw0p-Lan L&IREG# EXP._/_/_ y z
A OWNER pF CONTRA—R�y OTBBB❑
NAME s44kr.1 \\: hY EMAIL fl'I
MMWNGADDR65 \cR N ClW Val STATE •`a DP
PNONEz Z` CELL
PARCEL INFORMATION: p D
PARCELNUMBElt(12Di9it Ne ) �Z3363�J0\CSO�i ` ZONING r
LEGAL DESCRIPTION(ALdeviaudl FUZE DISTRICT
=ADDRESS (LID NL Se\-\Z OY Qn e-\4�\r
DUIECTIONSTOSMADDRESS \-\ CY6G r 1l'i2p+Y
6N\ r, iAz 0I,we, v \M h Y
IS'FNEPROIECIWOHIN300FFOFSLOMS)GNEATERTBANI4%t NOD SNOW LOAD:_,d
ISPROPERTYWITKft4 00FFOFTREFOLLOWING: Mamldl/ qd.U:
SALTWATER❑ LAID O RIVER/CR a POND❑ WETLAND❑ SEASONALRUNO"[] STREAM❑
TYPE OF WORK: NEW Cql�AtX)MON❑ ALTERATIOND REPAIR❑ oT n
usEOFSIRUCIURE/AaaAma.GMw.[�®w.,r"*.) ye S" c^6
MUSE: PRIMARY&'SEASONALD NUMBEROFBMROOMS-3--NUMBEROFBATHROOMSZ
HEATED STRUCTURE? YES~Wa1❑ YES(Aagal4AW I' NO
DESCRBEwoRK P4ew SfR
SOUARE FOOTAGE:&,a
ISIFLODRZII5 K.ft 2NDFLOOR p.ft. 3RDFLODR aq.ft BASEMENT sq.ft.
DECKJyP-_�a ,q.R COVERED,.D/ECR�.R STORAGE ,.R OTHERaq.ft
GARAGE_ayQ_1.1L Mm Red p De di [] CARPORT a(.R Atl.c 6 IXlarW E]
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQURPEIP
MAIM MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS sER1ALNUMBER
F.NVIRONMIrNT LIMAITR: �/
SEWAGE/SEWERSOURCE: SEPTICLy sEW 0 / NEW Q EXISTING❑
PLUMBING I STRUCTURE? YEs EK NOD lfjaa.ameA anaP4xd RalerAdeyuary Fwtm
PERIBTER/FOUNDATTON DRAINS PROPOSED? YES❑ NOW mrITHGSQFT.
DOSTINGHEDRDOME PAOPDSEDHFDROOMS 1-
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. IMCTMn OF THIS
PERMIT APPLICATION OF 130 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.0A.42)
X
SIOnaMed OWNER IMraI Ee alvrH MIM OWNERI Dale
V
ENTAL REVIEW APPROVED DATE DENIED DATE TACSNNOTESICONDITIONS
DEPARTMENTG DEPARTMENTSHALHEALTH I✓ILZ
o' o�'v ar0 10
"metlrta� l .fiyfi_
uRmm� __:
cr
G
$a a
' 1
m �t� ZZP
x o r
...
� > w.. 3
M
0
G_