HomeMy WebLinkAboutBLD2023-00883 - BLD CD Environmental Health Review - 8/1/2023 PermR No:}' wQoB'8-6
MASON COUNTY RECEIVED
COMMUNITY DEVELOPMENT
Permit mistanceCenh¢Building,Planning JUL 27 2023 BUILDING PERMIT jO`PPLI" Alder Str E}'N
VIRONMENTAL
PROPERTY OWNER INFORMATION: CONTRAC-TTOR INFORMATION: LTH
NAME: V a NAME: des k ILi /6P/9
MAD.INGADDRESS: n MAILING ADDRESS:
CITY: .c+.r�STATE: ZP: 1765 I'S CITY: STATE: Zip: �S
PHONE#1: 3ln "1EN 6YAI PHONE: CELL:163-ZZ. .3 AIG61
PHONE A2: EMAIL: i rw .e•nr
EMAI.: 4e��,n Vara a law.4w L&I REG EXP._/_/ �, , 11p13
PRIMARY CONTACT: OWNER[] CONTMCTOR d OTHER rCF/�f0
NAM�sTaA [c pales EMAIL
MAILINGADDRESS CITY STATE ZIP
PHONE CELL
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Nombm) N1/2�'/y 9d/d/y ZONING
LEGAL DESCRIPTION(Abbire a ) FIRE DISTRICT
SITE ADDRESS CITY
DIRECTIONS TO SITE ADDRESS Cea ea. Lr/_ t!u/ifAreW Yel. /eufl'en i(�o/g oe�(rA f.
IS TBE PROTECT WFI'HIN 3N ff OF SLOPES)GRMTER T I4%: YES[] NO p SNOW LOAD W
ISPROPERTYWITH1N2WFTOFTHEPOLLOWING: ([hmhnllaur.Pal,):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND[] WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERATION[] REPAIR O OTHER n
USE OF STRUCTUREI), I «,caroga ca umaw ems,ac)
ISU RI SE: PMARYQ SEASONAL[] �/ NUMID M EROFBEDROOMS NUBEROFBATHROOMS Z
HEATED STRUCTURE? YES("'.naldyl fi YFS rya,y,)yady[] NO❑
DESCRIBE WORK
SOUARE FOOTAGE:A.vya,M
ISTFLOOR/K5/, K.ft 2NDFLOOR_aq.R 3RDFL0OR_'.R. BASEMEN eq.R
DECK eq.R. COVERED DECK aq.R STORAGE RI.R OTHER p.R
GARAGE 4 ()p.R Attached[] Demchd❑ CARPORT ,A. Attached[] Derv:hed❑
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERUL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWFR SOURCE: SEPTIC SEWER[] / NEWS EXISTING[]
PLUMBINGINSTRUCTURE? Y g NO[] !/3'er.allot*oo Oleled Wahl AdMaary Form
PEJUMETERTOUNDATION DRAINS PROPOSED? YES❑ NO[] EXISTINGSQ.FT.
EXISTING BEDROOMS PROPOSEDBEDROOMS-2— TOTALBEDROOMS 3
OWNER aclvgrNeEpea Vul auCmis4m dlnxcunle InMmeMn mry�aXln a atrp xvhaEx w puma revwtim.MkmxleEpamenl NawAp py
aEM1m¢apmn4bn M1«nillrei Mnacwery paNn IMul+p ary wapnienl MWw>m Ne¢diraerml rll9 mre � 'nah n0��aa11Mw
PnNtle 9�«fib enWiMaes ay acev paled. TM w.nx gnPeM1Y repreaentelna.repeaede MMtlre Flmmetim tl's axurale atl NMaon Ccun btM1e aNw tlescnbel
em annemelalmr reaieq aaa iriepeNan.?nis p«mN�lealbn b..amea nuT a wia nwA«auettnrm Wnn«¢mn is enmam.m.a rm'n iea
aey¢«rccpndmdion wix re wep.mm(«a Petlptlal too a ys.
PROOF IOT,F�CpOyLNITI�pNUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
XON 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON!
COUNTY CODE 14.08,42)
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of OWNER I.. besianetlbRtMOWNERI Dale
DEPARTMENALREVIEW APPROVED DATE DENIED DATE TAGS/NOTESICONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
.. FIRE MARSHAL
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