HomeMy WebLinkAboutBLD2023-01108 - BLD CD Environmental Health Review - 10/5/2023 T % MASON COUNTY COMMUNITY SERVICES - �Pe114nI�Yb. /AL�/ ISO I I D F)
�- PERMITASSISTANCE CENTER: w
BUILDING.PLWNING.F(9OC HEALTH.FIRE MARSHK r-
6,5W.NemSne.tS52.FasAB6664 SEP 5 2023 L
Pnptw snenan:N60N2 7.tat xs2.F..:R60142T5269 Pnane
Bvm n6onT.sueT.PMa.Ena:(6e0Iae2-6z66 W Alder Street O ,n
LL-- A" .
BUILDING PERMIT APPLICATION - +,
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: "Y
NAME:On.Bimpn NAME:~IduaNev%.Nq B6i* Iy ��
MAILING ADDRESS:PO Box 16M MAILING ADDRESS:6M SE Eal.n BW.
CITY:AV,,6ren STATE:WA ZIP 08520 CITY:Beak Ow.iM STATE:Wn ZIP%604
PHONE#1:6810,2406166 PHONE:921.'N4.3602 CETI
PHONE#2: EMAIL:nLsi aMSMARMe.wm
EMAIL.an.smm(u+6omr.wm L&I REG#V.VLR11W1BD EXP.
PRIMARY CONTACT: OWNER❑ _ C0N3R*c7DRv OTHER Li CCD
NAME neniammk.«.ka ew.a EMML.�•+.-+•... - m �1
MAILING ADDRESS 6T SE Eaton find. GTTY6mn.n....n STATE ZIP fieew n G
PHONE 6T4nMdM2 CELL me N
PARCEL INFORMATION: � p
PARCELNUMBER(12Di®t Numb,,) 4226666Od1M ZONTNG11M
LEGAL DESCRIPTION(Abbsevixd) LAKE CUSHMAN W TR 10 FIRE DISTRICT
SITE ADDRESS 241 N Dui3tabimb Or E CITY HOaWPmt
DIRECITONS TO S1TE ADDRESS
ISTREPROJT.CTWITIIM MFTOFSWPE(S)GR TERT'HAN14%: YESD NOTD SNOWLOAD:--1.1
ISPRDPTTRO THI D FT OF' REEKLO MNU R.v IWETL«.pD
SALTWATER❑ LAKE❑ RI.VJER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ SIRF.IM❑
TYPEOF WORK: NEW 35 ADDITION❑ ALTERATION❑ REPAIR❑ OTTER ❑
USEOFSTRUCTII ((u ...Cn .�Bs ex)PIY^rY R�agrm
IS USE: PRIMARY p4 SEASONAL❑ rf NUMBER OF BEDROOM52 NUMBER OF BATHROOMS+
FIATED STRUCTURE? YES(va> a'dMTO YES ryn()gfJosW❑ NO
DMEURE WORK
SOUARE FOOTAGE:NmmtM
IST FLOOR6+6 aq.& 2ND FLOOR WA p.ft. 3RD FLOOR WA M.B BASEMENT WA sq ft
DECK Xg
sq.ft COVERED DECK WA sq.E STORAGE WA sq.ft. OTHER WA R,ft.
GARAGE NIA , ft. ANndmd❑ DesacAM❑ CARPORTWA sq.ft Assrchad❑ DewehM❑
MANUFACTURED HOME INFORMATION:MODUTAR e4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKEY.nxin0.5Nn MODEL E-S YEAR— LENGTH I4•
WIDTTL" BEDROOM52 BATHS SERW.NUMBER
ENVIRONMENTAL HEALTTI:
SEWAGEIBEWER SOURCE: SEPTIC
IC SEWERS / NEWV EXISTING❑
PLIR.IHDJGDi STRUC3URE1 YES% NO❑ mash sred WaeerAdWaoty Form
PERm4TER/FOUNDATION DRAINS PROPOSEDI YEhe NO EXISTING SQ.FT.
EXISTING BEDROOMS 6 PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
UWNEP oasmI pea Mtlsutmi Mea,in.mnale itnerde 0n mry result treed to m wMsterna%ndto oM MknmNnepemeMW nrs,kby
slyneNre Eeimr. eetlxre u.l am Me wm.r.ae IUMer eea.re Nst m.ntltleemrem�e Iks panne end tomue vaunt as a.sE.I Mrs,
nblknae p.mm5:ion rvom ai ue rewsia«pane:.ind.auv arN assan�am n«aer.r v.�es«imereN iep.tmio mk«yea me.omw«iqas,a
i
addsnwant,aso-tnini na Inssantsan ibis peimivapviiutisnamcamanuiillaw0?xxwa«enutl✓xl ewn.burnsnkwl ccmm�m�¢e w Neim
ay.«xwnawaan.art is.�apaaeaa s«.pmim w+w e.ys.
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.(lwBCM
COUNTY CODE 1408.42)
XnT- Aug 9,2023
Sgnaam iM OWNER(Must IseAMnM bvtM OWNER) Data
DEPARTMENTAL REVIEW .APPROVED DATE DMIRD DATE TAGS/NOTESIOONDTIONS
BUILDING DEPARTMENT
PLANNING DEPARTWWI
JJ FIRE MARSHAL
PUEUCHEALTU 0 ib I
. � )
/ 19111§ !
m - - - - ! !
�
_
3
!! J< ;
,
\ \ � ! I � � - - - - - - _ ■�|
�\ /
| ,
■ • , � R � ti |\
w