Loading...
HomeMy WebLinkAboutBLD2023-01173 - BLD CD Environmental Health Review - 10/3/2023 MASON COUNTY COMMUNITY SERVICES Permk No Jjd' � P D ERMINCE CENTER: I BUILDING. .PPLaLANNNING.PUBLIC HEALT 1.FIRE Will 615W.Alaar Bheal.SMNn4WAR5584 SEP 28 te 6mz E�: wB� 2023 BUILDING PERMIT APPLICATION 615 w• Adder Street PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME:."'°",- NAME:— MAMING ADDRESS:na.lwr MAILING ADDRESS: p crI'Y:a.a. .a a STATE:as ZIP:® CITY: STATE: ZIP: r ` o`?2Q1d PHONE#1:"°'ma^ PHONE: CELL: PHONE#2: EMAH,: �E/1/Lr'r L&I REG#ad— EXP. 060 2A PRIMARY CONTACT: OWNERO CONTRACTOR❑ OTHER❑ < NAME emaa, EMAIL MAILINGADDRESS CITY STATE ZIP PHONE CELL M O PARCEL INFORMATION: - D Z PARCELNUMEHR(12Di9[Nlnnbc) ,e"'r°m°m ZONING^''''" S m LEGAL DESCRIPTION(AE6levia0ed) FIRE DISTRICT' z SITE ADDRESS min E_did Not al CITY^Aa DHtECDON&IO S[IBADDR1333 D r ISTHEPROJECr WlTRH11380FPOPSWMS)GREATERTHANI4%: YES[] NO[] SNOWLOAD%0___ d IS PROPERTY WIT'HEN 300 FT OF THE FOLLOWING: (ew wlAN ggryJ: SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑ TYPE OF WORK: NEW 0 ADDrl❑ ALTSEAT[ON❑ REii❑ OTHIBR USE OF STRUCTURE(RaNmee.U,.ca—mil 014,,.)0a ISUSE: PRAMARYD SEASONAL❑ NUMBEROFBEDROOMS4 NOMBEROPBATfEDOMS` HEATED STRUCTURE? YES(RholaFuy[]' YES ryax(a]afeYal❑ ND DESCRIBE WORKa'°An•a""• SOUARE FOOTAGE:@rm al ISTFLOOR1al q.tl. ZED FLOOR-` q.R 3RDFLOOR q.R BASEMENT K.R DECK_q.ft COVEREDDECK ql STORAGE q.8 OTHER K.R GARAGE ad q.R Attached❑ THiadrd[] CARPORT eq.R Anached EI Dem Ad[] MANUFACTURED HOME INFORMATION: a4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOl BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGFISEWER SOURCE: SEPTIC❑ SEWERD / NEWEj EXISTING PLUMBING IN STRUCTURE4 YES Q NO❑ Tfi ,attach a plered WueerAdegaacy Form PERBrtETERUTOUNDATION DRAMS PROPOSED? YES❑ NOE] EXISTINGSQ.FT. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS DINNER kvaleagea Mel fWmeaion of madmanN lnlrydaidi may result in a a lop xoM older or Pallawpe ,Mro almiam 0s YW sbnaNre hom I call that I am IM pwte am 11UNer aeGen Mat I am dMaea b ,,aw Mls palmil eM to do Its a asprcidaaM.I all Cplainaa p'miaaiori M1PT all Me IcewaWry IHrtlw.Imcil airy azement holler a parties M)Meant fgBNing Mb Pokd.Tla cwnar or wall rgaeaenlaNe,lequma,IMl It.iMamnnon ami is adds..gran employees of Mason G nryaddl b Me.Wue Easonal p©ndI aMaWCWlammuNon— sinspeplion TNN pennNapplical'wn Eecwnm null&witl Xwmkor euNovetl mnsOUNon is nq wmmancea vMNn1B0 aew a rcmndmdim.an g aaap.naea rare I>aatl d 18a aaw. 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.(MASON COUNTY CODE 14.08,42) X Signature of OMER(MUM W Will EV INII OWNER) Daft DEPARTMENTAL REVIEW APPROVED aDA� DENIED DATE TAGSPIOTRS/CONDTIIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL ' PUBLICHEALTH C S � � • � G §WB ¥ � or ! § § )0> $ ! )0M \ \00 § $ � ; \ . ! ; � \ | mom ■ � ' ) : r a --- -� ----- �