HomeMy WebLinkAboutBLD2023-01456 - BLD Application - 12/8/2023 D?cuSignE Vebpe ID:CBF95B4B-BEIEAF6OBMPEE241AFWAFB
MASON COUNTY
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Centel,Building,Planning UtL U 4 2023
BUILDING PERMIT APPLICATION
PROPERTY OWNER A`FORMATION CONTRACTOR INFORMATION: W AIdeF Street
NA1,ffi- x.JI.F 5:.., senl NAME:�' R 'I.M✓ �L..FC C.„�ka� T
MAWNOADDRESS: ' ii A /TUE/� MAILLNO ADORESS:LSii SrPanrt4cA1 KJ NN.
CRY:4.11 % S.� STATE:y�_ZIP: CRY: OLv $TATEAyp_ZiP:gFsr1L m
PHONE Al: s3�85Y-.!' /bc' PHONE- CELL_kn-F➢'l-/%y-/%y-
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PRIKARVCONTACF: OWNER❑ COxTRADIDR OrxeR�� _
NAME 7C0.1„cT a<A EMAIL d'.so....FAZLJK:J.%uc..��-1..-.L'a� Fry Q
MAILINLAODRE55Yy"+rP Sin.V IY CL 9su CITY N. STATE ern Tsp ,so IT7
PHONE 3tO�T1FO-IRAf CEM > Z
PARCEL INFORMATION: ...�ll :. K
PARCFLNUMBER(12Dipjt NnrtLu) 37 CZI^l h-61038 20NM07 = m
LEGAL DESCRIFTIW(AGMevialei) FIRSDLSTRICT Z
SIIEADDRESS YX Pa,.IR\MLV L_Va CRY
DIRECITONSTOSITEADDRIESS A T/FI 1e8L h 6 PAPK. - 9W e, D
L Q2JR1 CR !V L C„C 'V 2
ISIHE PROJEC[WIiJ 1ei300FF OY SLOT&S)GREATG TNAN N%: MD NOX SNOW LOAD Vc
SSAUTTWATER�RL�O RIVER/CREEKI] WPWNQ WEFLANDO SPASONALRUNOFF❑ STREAM❑ DEC 82013
TYPEDFWORK: NEWjy( ADDmomo Ai. B TiON❑ REPAIR(] oTHERn RECEIV
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[SIRE: PRIMARyR SEASONAL❑ NUAIDEROFBEDR WM _NUMBEROFBATHROOMS_Z__
MEAT6DSTRUOIURv VEsP naRr NOD
DEELRIB6 WORK SEL MAu..FalF..<En /Y a.w6
SQUARE FOOTAGE:q,gnar
ISIFLOOR/17; eq.ft 2NDFLOOR_s R. 3RDF1,00R_,ft. BASEMENT q.ft
DECK s0.R COVERSUDECX_M.IL SIORAOE q.ft OTHER—N.A.
GARAGE_,,.ft. Aa.JMD Der 1] CARPORT K..R ARPFMJ❑ DWWO ,.
MANUFACTURED HOME INFORMATION: <4 COPIES OF THE FLOOR PLAN REQUIRED•
MAKE K.'I• euSF.<� 114n1 MODEL ZO/2 Y ZJ14 LENGIui 44 _
WwTK-z6-t BEDROOMS` .MTHS Z SERUd.NUMBER
ENVHWNMRNTAL HEALTH:
SEWAGFISEWE0.5OlRtCE: SEPTIC SEWER / NEWX EXISTING❑
PLUMBINGINSTRURTIRET YES NOD try< ollocF[agJeiMWaerAdegrmry Fom
PERIMETERIFOUNDATON DRAINS PROPOSED? VNsD Nag RuMNLEQ.FT.�
EXIEITNGBEDNOOMS �� PROPOSED BEDROOMS _/ tOTAL BEDROOMS��
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ay.wn��ao...as a mwmem rora Pa".n a Im a.n
PROOF OF q WINUATON OF RFORK ON THIS PERMR IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 100 DAYS aOF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
°O1L'MBRffcooE taoB.azl 12/1/2023
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DEPARTMENTAL REVIEW APPROVED DATE DENT® TE T fSMOYE4CO xim
BUODIIRi DFPARTNFNT
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RREMARSHAL 1.
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