HomeMy WebLinkAboutBLD2023-01069 - BLD CD Environmental Health Review - 9/11/2023 MASON COUNTY COMMUNITY SERVICES Permi(p�]o: �Q10 1
PERMIT ASSISTANCE CENTER: 1 \
.SUIMNG•MANNING•PUBLIC HEALTH.FlIiE MAFSHAL E D
Ii,W.Naer Street,SMXon.WA98W
p .Shsoo, (WYU-16I00FI.111.Fas PI 01]-T]98MOne SEP O l 2023
B4hIr.(360J375406]•Pamre Elmo:M0JM-6?69
40 BUILDING PERMIT APPLICATION615 W.
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: Jn�C.a..r r1�13
NAME:Nm6 cBmnas C.rn NAME: Rpgs /1As�
MAILING ADDRESS:""WMawnIX MAILING ADDRESS: aaCO
CRY:1ms^9G1QW1 STATE:IL ZI,M47 CITY: STATE: ZIP:_
PHONE#I:3AT.ese.Ame PHONE: CELL:
PHONE#2:71S3"3202 EMAIL:
EMAI.:vo-.nrwra.®9mNlmm L&I REG# EXP. /—/— Z
PRIMARY CONTACT: OWNERO CONTRACTOR OTHER
NAME raa'^°"" EMAIL er6e IoR)^
so
MAIMNGAOORE553A69w NeNm Ds CITY uaa.. STATE ZIPe9w]
PHONE ro.mam CBLL nemm
PARCEL INFORMATION:
PARCEL NUMBER(12 Di01[N.W)1231w MIM ZONINGRurs Res 10 roes
LEGAL DESCRIPTION(Abb-16W)"'soP1'aosHurmnsnxosraeae.sweEewe FlRE DISTRICf�Nre°"Rp Fl1°
SUE ADDMS161 NE RHOebpq CITYEi
DIRECTIONS TO SITE ADDRESS Soni Rd m Rkii CL Tom MOM W Nsla.on"fmscawwc. Lu
LSTHEPROJECFWTTHD 3NnOFSLOPE(S)GREATERTHANI6%: YESO NOO SNOWLOAD:u Psl
ISPROPERTYWITHIN200FTOFTHEFOLLOWRIG: Flw m'INmoypby'
SALTWATER❑ LAKE❑ RIVES/ EHSEK❑ POND❑ WETLAND❑ SEASONALRUNO"11 STREAM❑
TYPE OF WORK: NEW O ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(AUlhaoe,exxRa,cnmm..du Neg.Fr.)Rextlanm
ISUSE: PQIMARYO SEASONAL[] NUMBEROFBEDROOMS3 NUMBEROFBATH1SOOMS3
HEATED STRUCTURE? YES M'I caw❑ YES lvaollm"W OO NO❑ _
DESCRIBE WORKs"m°na P:nan mMsxa
SOUARE FOOTAGE_bmmYU
ISTFLOOR !3 sq.ft. 2NDFLOOR_6q.R 31DFLOOR_q�ft BASEMENT_N ft.
'DECK_sq,ft. COVEREDDECK374 aq.ft STORAGE N-ft OTNER_Nft.
GARAGET]S sq.1t ArtdchedRI Dr.W[I CANPGFT ,ft Aot k,dO DemCAedO
MANUFACTURED HOME INFORMATION: r0 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL_YEAR LENGTH
WIDTH BEDROOMS BATHS SERW.NUMBER
ENVIRONMENTAL HEALTH•
SEWAGFISEWERSOURCE: SEPTICO SEWER[I / NEWO EXISTING❑
PLUMBING IN STRUCTURE? YES El NOO Uyed,RdncO rospleud Wwe.Ade9mry Film
pERIMETEWFOUNDATION DRAINS PROPOSED? YESO N E%ISHNG SQ.FT.O✓
EXISTING BEDROOMS O PROPOSBD BEDROOM56 Fe TOTALBEDROOMS3
gVNER xYnvMea¢s IIW sWniOtlpn pl Memeal0 FMmMixl m%rtwX In a p%xaM1 was w ImmN resN.Nlm.Itla11m1Me11MnI°1 Wm kb/
ypaWrt oelow.l aeaare NMI un Ne caner sid ludnsaeNart tlMI am enEueab receive Nis peimnaMWao Me NgkupepxM.lnew
CMain06puimission l lrtaloe.NeInN-m lion pmN6BaisepmreH sp Innisiamplgee50l Magian CwMy Naxssor to N peon—..l.d orf
end ebu Aum(s)for
reex and Inwoot7c . This im�NepFioa ls,Groomes roll 6 wio I can or auNoKM mn0butllm u nor¢mn✓+u6 vMNn 180
loans or I coossuclon mr,i0 wspenaed or.period a Im days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE
EYCADS CAUSE
THE APPLICATION TO BE EXPIRED.(MASON
3pnewroo4OWNERINu61be bnM N OWNERI DeN
DEPARTMENTALREVIEW APPROVED DATE DENIED DATE TAGN OTFSICONDITIONS
BNLDMG DPPARTMENT
PLANNING DEPARTMENT
FBDS MARSHAL
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