HomeMy WebLinkAboutBLD2024-00198 - BLD CD Environmental Health Review - 2/20/2024 Permit No:�zid.
MASON COUNTY FEB 13 2024
COMMUNITY DEVELOPMENT
Pegame sIsUnca� wr suIwl^RPIannI^, 615 W. Alder Street
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATTON: CONTRACT OR INFORMATT )N:
NAM&AN¢aR+b' NAME:R�R A n
MABJMADDRPSS:m�m MAEJMADDRESS:>Mawcba.wm Raa �..
CTTY:�Wax STATE:WA ZIP: - CTTY:N.u¢ STATE:WA ZIP: m C
PHONE81:>° - PHONE: CELL: �o+wa m
PHONEn EMAIL
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PRIMARY CONTACT: OWNERO CONTRACTOR[) OTHER[]
NAME—� EHAIL
MAIUNGADDRESS rou Me CDY aw STATE WA W D z
PHONE cff . .r«m
PARCEL INFORMATION:
PARCELNUNMER(1]Di®tN.m ) TAMNGRM S z
LE(3ALDESLTIE'ION(ANxeviwei) MLGWMAmata PMl 981W1 FEUDISTRICf+a z
STIBADDRESS M W LRNRd'"°°°I eR^ CF(Y®izaui D
DIRFCTIONSTOSTLEADDRFSS z^"'a°"^�ma'Rg^� mwumw Mb.zezmrab.��.�zzambuaen nyapra
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M=PROJECTWTTRIN300FTOFSWPE(S)GRFATRRTHAN14%: YES[] NOEL SNOWWO --pd
TSPROPERTY WR�i3W PTOFTRRFOLLOWING: Fwauabrq SALTWAT9R❑ LAKHE] WVH4CREEK[] POND❑ WETLAND[] SEeISONAl RUNOFF❑ STREAM❑
TYPE OF WORK NEW❑ ADDITION❑ ALTERATION❑ REPAIR❑ OTNEt []
USE OF STRUCTURE fwm Cm Camrod W&l )RaR^a itlitlli°r�W¢
ISUSE: PRIIARYEj SEASONAL[] NUMBER0FEEDROOMS3 N(IMBEROFBATHROOMSB
HEATED STRU� YES(Ma.nWy❑ YES(Par(al.ln w if] NO❑
DESCRIBE
SOUARE FOOTAGE:(PWum/
ISTFLOORtere aq.k 3ND FLOORRA aq.ft 3RDFLOORNA aq.11 BASEMENT"^ a ft.
DECK & COVHREDDECK±M R.& STORAGENA K 1 OTHERr aq.ft
GARACB—R.ft Aaa W El Tk W D CARPORT NA "ft A. W[] TM []
MANUFACTURED HOME INFORMATION: , V COPIES OF THE FLOOR PLAN REQUIRFD-
MARE MODEL YEAR LERGDI
WIDTH BEDROOMS BATHS SE NUMBER
ENVIRONMENTAL HEALTH:
SEWAGF/SEWFRSOURCE: SEPTICD FEWER[I / HEW❑ ERISTING0
PU1MB]NGMSTRUCTURES MITI NO❑ {fy -mevrJ�rorm/xad WmnAdeguary Fann
PERIv4TBR/FOUNDATIONDRAIISPROPOSWS YESD NO[] FXISTIHGSQ.FT.
ERISTTNGBEDROOMS PROPOSEDEWROOMS a TOTALREDROOMS a
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¢Ipne411e Mbw.l aetlare M91 em we amer enG I mtlM!aeelere aul l am malba to realty N4 awRxtlbaotlwwdk tl glgY%a.l N're
�m Pxmisslanrv«n eo we.e�«y Paiax Inauamp aay....w.m aolax«Penes wlm¢ren nyxeipws xgaa TRa awwxmPtl
regrsenmM1ve,rape¢sn¢wmwe uammmbn proNa¢a Iz amrem am Prent¢anplryree w Nazon co.q.®nmme eeora aewleza popeM
ma¢trudtaelq H narw Is uwndon. a pmndlffl tim�mmneun6vaaaxwk«auVaau]mlaWman4MaamnxW xitlYnIM
a.y¢wnconmaa«wore Is suspeneea br.Paaoa m+m can
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTI T OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08A2)
R � i3 202a-I
sreRawewOWNER(Muatawawa NR M.OWNFRI D .
DRPARTMENTALR)IEa APPROVED DATE DR DATE TAGSTIOT'FSrCONDTTTONS
BUU.DING DEPARTMENT
PLANNAIGDEPARTM8t1T
FIRE MARSHAL
PUBLIC HEALTH
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