HomeMy WebLinkAboutBLD2023-01055 - BLD CD Environmental Health Review - 10/5/2023 Parm
MASON COUNTY lt"°: f bJ5
COMMUNITY DEVELOPMENT-
Permit Assistance Center,Building,Planning SEP - 62023
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BUILDING PERMIT APPLICATION '1�f
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: m o
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NAME: SSOX NAME: IIRE XOME SEflVICES LLC IT N
MAMINGADDRESS: mooYam MAILINGADDRESS: mRoaxaa o
CITY: aeEPMR STATE: wA ZIP: a� CITY: ruo NARIfOR STATE: WA ZIP: Ir9$
PHONE#I: 9wt71a-aei9 PHONE: CELL: rn
PHONE#2: EMAIL: an w®wwrelwmlabremerces wa
EMAIL: anNeaket,_a®man..M L&I REG# RurvR51S776M E)(P. LL17 aN
PRIMARY CONTACT: OWNER❑ CONTRACTOR® OTHER❑ �.
NAME .c.0 mu aTsmx EMAIL ®r a ..xa ••---ma.,. rI
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MAILINGADDRESS en eoY -a.,u CITY - STATE 2lFylgy_ y
PHONE .,aenea CELL � z
PARCEL INFORMATION: _ rn
PARCEL NUMBER(12 Digit Number) �00nU ZONING Z
LEGALDESCRIPTION(AMXeviated) TMUYAMVERVAUUrfWaa LDrla FIREDISTRICT D
SITE ADDRESS s.n xc aurw. CITY Texeye r
DIRECTIONS TO SITE ADDBESS
RXUMFMTURXLEROrtOXETAXVYAReE aR,NM RpXr prt0 HE eXOWCRa OR,9nEIa rIXMERIRXr
IS THE PROJECT WITHIN 3U0 FT OF SLOPE(S)GREATER THAN 14%: YES® NOD SNOWLOAD: 25 f
ISPROPERTYWITHIN200FTOFTHEFOLLOWDVG: rCnr<tc/tro e1#)):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND D WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW® ADDITION❑ ALTERATION❑ REPAIR❑ OTHER
USE OF STRUCTURE`Xavfoxa Cage Cass[— tstet arc.) .e
IS USE: PRIMARY® SEASONAL❑ NUMBER OF BEDROOMS_ 2 NUMBER OF BATHRODMS 1
HEATED STRUCTURE? YES twAde&sel® YES mdn(4 eNdj)❑ NO❑
DESCRIBE WORK HOMEMUYT
SQUARE FOOTAGE:&M arm)
ISTFLCOR�M,lk 2NDFLOOR_N.R. 3RDFL0OR rq.ft BASEMENT sq.R
DECK al.ft COVEREDDECK sq.ft STORAGE sq.& ITTHER_aq.ft
GARAGE N.ft. AteachedD Detached❑ CARPORT_,ft. ANachad❑ Tklaahnto
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE 9eBJEg,,E MODEL 9afia3A YEAR awra LENGTH sr
WU)TH sa BEDROOMS_I_ BATHS SEIUAI,NUMBER
ENVHLONMENTAL HEALTH:
SEWAGFISEWM SOURCE: SEPTIC® SEWER I NEW❑ EXISTNG2
PLUMBING N STRUCTURE? YFS® NO❑ Ifs mlach cdonylared Water Adrgs F.
PERIMETEWFOUNDATION DRAINS PROPOSED? YESD NOD MISTNGSQ.FT.
MSTNG BEDROOMS lef PROPOSED BEDROOMS_I TOTAL BEDROOMS_ I
&Vatu xMwNetlpes Melat[2m bn at r and
decess M eroded
r redo Me enrt ndWdon.Pe das O,,osoa.I ha ir9 b/
zpnalure[slow. Eedare Mal am Me wmer entl NrNx tbtlara Mat am entllk0tor�iXe Me pelmil antlbMN¢wrk aspceene llled
obtairstl permuvm M1nm all Vle nemssay pertlas,ntlutlln8 a^Y aewneM Ildaxrcpatlks ollntere9 regaNlnB Nla pmpd. The amerttlepY
anderustuns.ralnesenla Mal Masesnon nvroHEeE laamnateaM oraMs emgryaes NrNson CoUnly eemwN ma aEow aemilseE pcpMy
Wttl atMure(sltoonv*iis InepnJ ap9rmlVelspl0a sMmmeanmlflvaknworkwelnnori:eE mnaWclim la as mmmmcetl wlWn t6o
tlayspn mnNrvtion woA le wryenEetlfwe pesoE d 1B0 tlaya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 100 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
X 08-30�2023
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DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGStNOTESICONDTT10N3
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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