HomeMy WebLinkAboutBLD2023-01493 - BLD CD Environmental Health Review - 12/15/2023 MASON COUNTY COMMUNITY SERVICES ERI�T 'a -OW3
PERMIT ASSISTANCE CENTER: f�CIJ��LTIT��VVV
.BUILOING.GIANNING.PUBIIC XEALIN.NRE M9R5NrLL
e's W Q74670 e E bn,WARM DEC 12 2023
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BNIpr(xalYrsauN•PnwN BYm:(3hallBhS}69 m
BUILDING PERMIT APPLICATIgh5 W. Alder Street Z
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: x
ME# NA : •#NB 1/T CramwEU NAME: O
MAILING ADDRESS1 i i MAILING ADDRESS Pez
C 10Y_Ie/�oN STATE: IYA_Z :JEIJF CITY: STATE: ZIP:
PHONE#1: 3�60- 19-3901 PHONE: CELL:
PHONE#2: EMAIL: X m
EMAI,: :I•C/OM L&I REG# ESP._/ / Z
PRIMARY CONTACT: OWNERE CONTRACTOR[] OTHER
♦ NAME q ,'-•ntA! from urpll EMAIL f%l+sn OT_r_I1 .9;wB:1•Con n
MMUNGADDRESS -fill SE FA:II ,S ad CRY SA�Ifc., STATE L-A UPf458i r
PHONE 3(0-CIO-34O/ CELL 0',
PARCEL INFORMATION:
• PARCELNUMBER(I2DIp1NUmbes) 320357600220 ZONING AR5 Off,
LEGAL DESCRITON(A66rtyu1M) FIREDISTRICT °k
♦ SITEADDRFSS 111) SE Fhdfips Aomd cITY SNelfan 'tTr
DIRECTIONS TO SITE ADDRESS Odw`f �tlnn an AsA1Bu
OMEPRO/ECTWITHINIEEFTOFSLOPWS)GREATERTHANICX: YESQ NO NI SNOWLOAD:
ISPROPERTYWITHIN2NFTOFTHEFOLLOWENG: TM1erN dllene'oFAYI T`
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW , ADDITION❑ ALTERATION❑ REPAIR❑ OT1 R r_1\
USE OF STRUCTURE IXwN ,,Cmgc Cwwvw18I&.Et/� I TYF fID E ANL,I
IS USE: MUMARY,2"SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS
HFATEDSTRUCI`URE? YES:;1k4 YES ryms/.] "[] NOD
DESCFU EWORK CJ2f UO 1F1E. wi'F" 1-IOmE'
R PO TAGE:Pmmse4
IST FLOOR I sq.ft 2ND FLOOR q.ft 3RD FLOORq.ft BASEMENTq.ft
DECK ,& COVEREDDBCK N.R STORAGE p.R. OTHER p.&
GARAGE—sq.R. .fNnched❑ Drwled❑ .CARPORT , & Abated❑ Duaahed❑
MANUFACTURED
))HOME INFORMATION: a4 COPIES OF THE FLOOR PLAN REQUIRED'
0 MAKE f•it NOMetlu�'/1CY3 tT^MODELl-AAlwrsf 2501 YEAR202'f LENGTH_
WIDTH Z6;Jr BEDROOMS SAME 2. SERA[, I IBER TBs J
ENVIRONMENTAL HEALTH:
SEWAG]PSEWER SOURCE: SEPTIC SEWBR❑ / NEW)d EXISTING❑
PLUAIDMG DN STRUCTURE? Zn NOS lf) ,,much annoceaW rAdegemy Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YESD NOX EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS_ TOTAL BEDROOMS
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slBnaWre Eebw.l Xatlere 1�1I em Ne wmee eM I Nnnee Mc4n Mel I aT MNMO b IMNw Mie pvmX W b XOMe vane¢popoeed I Nw
MleineG pertnbam fiom eY Me mcessery pNc,intluGinO eny eeaemenl MEwa pe2e¢allnlwan reBbXtlO MW pgecl Tlie camel>lepel
leple¢enla0w.npinnm Mel Ce Inblmenon pvNEeE la acru 2le and gnMa elrylgee9WNeson Lounlyelse Ip Me BOJw Eeeo1EM popeR)
ma mffmmtg reNex is iuwandW Tu¢pmmlBal BDc on Lerume¢nNlawiEsxwkuauMomea mn9trumun'm MCOmmerKBa viWn tW
mys mn�M1swmonwm i¢¢nwenX.c tme wnoamle0 e.y¢.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
C NTY CODE 1h.08.63) //�/�023
nNu RI MUM M•Tone by Me DWNER) TP Deb
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TACSINOTF.&CONDTOONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH 7
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