HomeMy WebLinkAboutBLD20213-01189 - BLD CD Environmental Health Review - 10/5/2023 1 Permit No:�y
MASON COUNTY
COMMUNITY DEVELOPMENT OCT 04 2023
Permlt Asslstul Center,Budiding.PlanNry
BUILDING PERMIT APPLICATION 615 W. Alder Stre
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: 10
01�
NAME:..MIddla .n.r NAME:ane.rend me 1, Q �•
MAILING ADDRESS:1roDpN.ams..m MAILING ADDRESS:1MGmd..edIded
CITY:rad— STATE:WA ZI:OINO CITY:Pan°d'ad STATE:m ZIP: �CE�v
PHONE#1:�'`ae— PHONE:..."" CELL: —a
PHONE#2:2v�2^°4975 EMAIL.masurd'oudmall.dd
EMAIL:m.em.amicam 1.Cm L&I REG#M.637. EXPO OB
m
NAMEPRIMARYsCONTACT: OWNERO CONTMLTORD DTlml❑ n
NAME ""ADDR CITY axd.wiga.amn r
MAILING ADDRESS t°ea°I°'n'°°el"m CITY. STATE rw ZR—
PHONE z','°°'>ne°^x LRLL'e°a'u�'e�we+l
PARCEL INFORMATION:
PARCEL NUMBER(12 Dig¢Number)a22t -Mde d ZONING
LEGAL DESCRITION(ANerevused) TM amnawn FIRE DISTRICT
SITE ADDRESS IOW NE Talmo a River Rd pryTow.
DIRECTIONS TO SITE ADDRESS tumm�rlem».r t
TS THE PR02ELT WITHIN 300 FT OF SIAPE(S)GREATER THAN 14%: YESO NOD SNOW LOAD:iL-jd
ISPROPERTYWrITUN200FTOFTHEFOLLOWUNG: iLl+dallddaamtJ:
SALT WATER❑ LAKE❑ RIVER/CRJEETC❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM
TYPE OF WORK: NEW O ADDITION D ALTERATION❑ REPAIR D omER. IT
USE OF STRUCTURE(RoNma+a Gangs Cw...ulB14s.)Rab -sad—pared.
ISUSE PRIMARYD SEASONAL❑ NUMBEROFBEDROOMSa NUMBER OF BATKU001,4 Z.
HEATED STRUCTURE? YES(WAdaBldd 0 YES(Panla,Wfmdi1❑ NO❑
DESCRIBE WORKP^"'y R°°u.re
SOUARE FOOTAGE:Ijm mad;
ISTFLOORM10 d, lt. 2NDFLOOR aq.fl. 3RDFLOOR sq.ft. BASEMENT 142
DECK? x1.ft COVERID DECK�_aq.R. STORAGE aq.R OTHER sl.ft.
GARAGE¢¢° aq.ft. Alwh.d a Debphed❑ CARPORT sq.ft ARd i dd D Ddbrhed❑
MANUFACTURED HOME INFORMATION: a4 COPIES OF THE FLOOR PLAN REQUIRED*
M w MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
E.NVMLONMENTAL EMAIM&
SEWAGE EWER SOURCE. SEPncp WE 13 1 NEwRI E)DsrTNGD
PLUMBINGWSTRUC]l]RE? YCso NOD 1f aa,adraah-My1du Wumm Ad,.,Fom.
PEREMEMIRiTOUNDATION DRAINS PROPOSED? YEE0 NOD EXISTING SD.FT.0
EXISTING BEDROOMS ° PROPOSED BEDROOMS TOTAL BEDROOMS a V/
gVNER a uumeb°aee Nm dumad-a Femme Menewsm may msull m a mcp wwk oroar ur Funs .MknwANgame e W auU I.by,
y,..del—I deem,Utl I am Me mday.M I NMer cmd—Nat I am smiled to remlva mi,pemm and b de Me same as poeaeef.I lure
owained p9mums amen dime necessary perdes,Indmaug anyememem bodwor Farms dinbM IBg91Nng Mi. eJed, ImmmMeralepM
upa.anletive,represents rnmrm inlomi.tlon prmMetl is amrale aitl gams employesa of Muon Lounry amaa b Ne¢Ewe EewiOe]IaaMV
and ernudde.Imr mnaw and inwe[dan. TMs parmlvappli akn Eamon s null a void nwe daiMmzm munaaudism a net o m usedd ymnln tag
d aormmnew nwp SUWMdmmrapedoddtaodays.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT 13 BY MEANS OF INSPECTION. INACTNITY OF THIS
PERMIT APPLICATION OF 1E0 DA S OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
9120/2023
S .Wre ptOWNI'R IMuM IM siRnM MMe OWNER? Dale
DEPARTMENTAL REV�W APPROVED DATE DENIED DATE TAGSINOTESICONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
I _
I � I
I
I i•
Hqa
35 R t/8 KS
Im v s -.w
g� F
•" F,..n ti
AtF �\\ � �•� I� �/�
D as_. ; t _ � ® 9
I � iillllll -- -
I
32aia- 7b � Uv�90
lsf l �Cn/ �l
r _ =1a• —_
ti
tW
r
i
i
�PJ'-PK.P Su
V x ;
C -I-awr paw' l.�e , E
l 1
7 sn�vo
W
U
U
"t ti
ro
far
it