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HomeMy WebLinkAboutBLD2023-00147 - BLD CD Environmental Health Review - 9/26/2023 1 Permit No: Eli) c9 -0/147 ._.. .. MASON COUNTY _C F!V.':r� COMMUNITY DEVELOPMENT SEP 2 5 2023 rn Permit Assistance Center,Building,Planning z BUILDING PERMIT APPLICATION 615 W. Alder Street < XI PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: I O NAME: pail- 470/i TJ II' PL` NAME: C.14414 ( 6 UD&✓IL/3AG, > 2 MAILING ADDRESS: T2'r,g l7x 78 MAILING ADDRESS: CITYyng- f7/L-jcSTATE: WA- ZIP:98Gfle CITY: STATE: ZIP: Xm PHONE#1: -6S0 PHONE: JELL; fed_�S�L 2 PHONE#2: EMAIL: :W ( Ouq<e1hic_C,L' /hg! EMAIL: @ L&I REG# EXP. // D PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHE 1�7 i I, r NAME Fl. d S. Pt EMAIL ‘I 11 e ✓✓1 S 01,54 br/C/t�/CG-f•e-on MAILING ADDRESS KO cA 7co fg CITY e�i}p� STATE 4.4-- ZIP 9 _/4- PHONE (4 2— CELL /V' PARCEL INFORMATION: // PARCEL NUMBER(12 Digit Number) 2-2-6 2 3^ is"- ODQ /L ZONING LEGAL DESCRIPTION(Abbreviated) I jt-4 `OF s Li g-VF S 6 IRE DISTRICT _ 5 �.SS� SITE ADDRESS 7/ �/06OL.i'IYC 5Fi�c// M (/ CITY s L77/U DIRECTIONS TO SITE ADDRESS IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO X. SNOW LOAD:01-5 psf !1 IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all thal apply): SALTWATER LAKE 0 RIVER/CREEK 0 POND 0 WETLAND❑ SEASONAL RUNOFF 0 STREAM❑ EP 1 6`1013 TYPE OF WORK: NEW ADDITION 0 ALTERATIION 0 REPAIR 0 y�OTHER ❑, / R�C�IVr USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.) r.J!t f'r( /,Vr1�iSD 4-(4,, di f (1.� `D IS USE: PRIMARY 0 SEASONAL NUMBER OF BEDROOMS fl NUMBER OF BATHROOMS / HEATED STRUCTURE? YES(Whole Bldg) YES(Pari[s]of Bldg)0 NO 0 DESCRIBE WORK 2Cl5'R- lz '- / '/ Oo/n ifygaVE SQUARE FOOTAGE: (proposed) 1ST FLOOR `LO© sq.ft. 2ND FLOOR 1,g� sq.ft. 3RD FLOOR sq.ft. BASEMENT -- sq.ft. DECK b sq.ft. COVERED DECK sq.ft. STORAGE — sq.ft. OTHER ----"sq.ft. GARAGE d sq.ft. Attached 0 Detached CARPORT --•••—• sq.ft. Attached 0 Detached 0 MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC Ef SEWER 0 / NEW❑ EXISTING PLUMBING IN STRUCTURE? YES-g NO❑ Ifyes,attach con ted Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YES,[ N EXISTING SQ.FT. EXISTING BEDROOMS 0 ' PROPOSED BEDROOMS C) TOTAL BEDROOMS__ OWNER acknowledges that submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT PPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON _--COUNTY CODE 14.08.42) _._______ q/i, nat re o OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL te/�"V� ' PUBLIC HEALTH clewr W1 &V'UAS a I r \% �% /—� =' _ a Ia :I .r'‘-- — v- '-\ Of. ill: k . 1 '''0 i 111- .1. - ''.. .\-t.." '-- '' I { ‘-K. ,..,,,-.. .. . z . _ ..,,,I.,,fiv,.. -- .,( : , . : r ( . / / ‘' i % " • — 4k* "6 --;— "x01 1........ I ,....... .........1,,-1 U'l , ,. Lyir.:„..7T._,/.....____A._.._ 4 f\NI__ --- II'. li 5^ I I:. i ij � aj I \ r \ 'f 1 '� _ a , j I , ' I \\ 4r I , �;� \ I l : / /j.; —'a I II j� - �Ij I I,,\ 1 • \, l I I —I_ I 1 \ 1 I I 1j, � 1 II ,,,, `� ,I \ \ \\ i' ` \ \i\I i I \I j I 4 I \ — N . \ \ , \: i �N 1 \�\� , I `� �\N'` .. • NN,IN Nis N. ,.... , •-.. „...... \,) \ , -..,\ \ • \I, /, _ I�` I I : � "- ` \ ( j ,__--- 1 • S.— �� \/ , — S I N 1 I `- \ I —� _g n i m r o r Y : As u i ;£ 14 g ;lg_ —_ia ie1 Y _ VI ' -i � ax r a3 § s 6 o Z I it $ UI i E TEMPLE RESIDENCE !ILL�a�s. li 671EWOODLANDBEACHLANE ARCHITECT i\iil 4I b SHELTON WA 98584 ---^• 1