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HomeMy WebLinkAboutBLD2023-01129 - BLD CD Environmental Health Review MASON COUNTY COMMUNITY SERVICES PRrwLN.:rjd?o�.�i-bll�,� PERMRASSISTANCECENTER: -- � .ewLOlxc.PUNMNc.PuauCIIEaLTN•FREMansnat 615 W.ANer30aep Sb .Fax.g5 SEP 20 2023 1 Mme Saett , (96pN3]-06]pe#M.Fu:T0e0Xn- rne Mpe W 8enaar(36pJI]51167•PIrowEM:(36U)IfiL.536B c BUILDING PERMIT APPLICATION 615 W.Alder Street Q � PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:� NAME:G `a&P lame NAME: MAILING ADDRESS: M2M3Rb Aw.9 MAE.INGADDRESS: CITY.Talmaa STATE:wA Z(P:"l" CITY: STATE: ZIP: PHONE kl:26a?aPM PHONE: CELL: z PHONEN2:2a.a7S6aea EMAIL: LLI = _ EMAI.:dan a lljAm.ma L&1 REGN EXP. 1 PRIMARY CONTACT: OWNERe CONTRACTOR[] OTHER O z Q L�^1 NAME a+IwWWM EMNI,dialiftlaniave, (] L u MAHINGADORESSIAMsaRbA S OTTT'+ STATE WA W@ I_I /arT PHONE u1w� CELL RaWaxN aV+L•. i. PARCEL INFORMATION: z PARCELNDMBER(12N*,Numbw)1310ad240108 ZONING rMlentlal ul, LEGAL DESCRDvI'ION(Abbreviated) 1RFASDIE Is1ANDTx taeaRaxlRRi las FIRE DISTRICT 6 o O SITE ADDRESS M6 E.Taaam wane w CITYWaR WA DDIECTWNSTOSITEADDRESS NmxNvlwwba MYn;Ran Gp�wNa loop R4 Ron ETmwnIYgR4Ln5bpagi ICI.�151 _� emmetrtre beaaalae:86o lsmuw em llenemldea rwe IJ U 2 W IS�PROHLCf WTf®IV 300 FT OF SLOPE(S)GREATER THAN IOX: YES NOD SNOW LOAD:�Y LU x L4 PROPERTY WTTHIN Z00 FT OF THR FOLLOWDVG: (Or tmtNm4Ml: SALTwATERO' LAKE❑ RIVERtREEK❑ POND❑ WETLAND❑ SEASONALRUNOPP❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION B ALTERATION B REPATR❑ OTHER rl USE OP STRUCTURE(Rwe.,e.,tA..v.,r.,.�.Imy,&e) .uamoe ISUSE: PRIMARY❑ SBASONALQ NUMBER OF BEDROOMS 2 NUMBEROPBATHRWMS 2 HEATED STRUCTURGP YES(F1WeBWC] YFSoW,].fBW8+ NO❑ DESCRIBE WORK mmennmaeb YiaYmenex eeeaRace SOUARE FOOTAGE:d.ya.9 ISTFLOOR N7 NI.ft 2NDFIDORM Lq.B 3RDFLOOR eq.ft BASEMENT q.ft. DECX M N.E. COVEREDDECE I@ K.ft STORAGE M.L OTHER eq.8 GARAGE WI Nl.ft A,m Ej Dezal CARPORT '.6. Atl a[I DMMad❑ MANUFACTURED HOME INFORMATION: -d COPIES OF THE FLOOR PLAN REQUIRED' MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SOUALNUMBER ENVIRONMENTAL HEALTH: SEWAGUSEWERSOURCE: SEPTIC© SEWER❑ / NEW❑ EXISTINGO PLUMBING IN STRUCTURE' YESD NO[I 1Yaa aRad.,Iatad Wm Ada na,,Fa. PERDr1E]ER/TOUNDATION DRAINS PROPOSED? YES❑ NO® EXISINGSII.". EXISTING BEDROOMS 2 PROPOSEDBEDRODMS a TOTAL BEDROOMS 2 OWIERxbaalae9aamNsuGnlabn ollnamaYa Immma[on nW�uiRh a ekq xwk MarnymRnuvutlm,gQMNea2BnMm0lea[�4 Ey Waftd OaY x.laetlero NMlmNeai, lndWMgeclareeullmemMa]breveNe Mu ann6 aMrotlotlnxwkagma.IMw Wblree pamlabnhgn all tle riaroaery pxlM.lntlueln9 eNn9 TMarcero-bpY repaanmA.e.npnmunmtue inrom.Em pwNea is eu:�rab ra grams emggea m xemn cmlmy ayes w me aboeeavifie6 papeA)• ae.m.a,�gal Tor mx.eoe Inapaauon.Tnalammlveepmtion moasa null a.m e.om or eamonme�sNaoa c om maaearoe wiw.1M d Wa sa mse�raai.mx ba�e•,Pamaerara wim a 1m aya. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PER APPLICATION OF IN DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY COOS 14.0aA2) x BgbiTm�oDINNER(aoof /M7 a[.1 by live nM ER) Dab DEPARTMENTAL RENTEW APPROVED I DATE I DEN® DATE I TAGSWOTESrCONDMONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH 22a . DDEBIF 2#! Dom! | I �QUM !\{ 7 /9/ x ^ \{ COD ! ■ v« »���� . ! m ® a, ����• `I I � � - | ■[I � : t