HomeMy WebLinkAboutBLD2024-000118 - BLD CD Environmental Health Review - 1/31/2024 MASON COUNTY Peril No: BID -601
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center,Building,Planting 1AN 2 9 2024
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROP6ATTY��OVINER 'INFORMATION: CONTR�A,CT�OR INFORMATION: /t
NAME:y/ir TDG'n ✓C NAME: 1'<K�EpY6 •B maa�(
�I�E�O�DRESS: ✓' MAIL)NG ADDRESS:fY O t-I�AJ�A+ f
S ATE: ZIP CITY: L STATE: ZIP: q fbAi
O��#1 O —� PHONE: CELL: /a
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PRIMARY CONTACT: N S,towNER❑ CON�MIML oTNBR T✓ 3
NAME 0f u CH.Oi7.
MMLINGADOno CITY ATH ZIP / '
PHONE CELL / z
PARCEL INFORMATION: // v
PARCELNLMRER(12DiFJJNu ) 30 ' Z�ON_GLiG Ntabolh4xt r¢ 1•
LEGALDESCRIPTION(Abbttvielcd) /CN LK lA D Puaayu ]'RICE }1 �� ...
RADDRPSS 2 EK cTTY
DauSCTONs TOSDDADDREo Pu/z / n ro 2 + +'
D0, +Ur JAN 3 12024
srRoP�ERTY wr�z�aRax�r oFOT�Foo)wm�c ft]NT d�IN l it/: YES13 NO> (SNOw LOAD:�A RECEIVED I
SALTWATERO LASED RIVE!/ Ill POND❑ WETLAND❑ SEASONAL RUNOFF STREAM❑
TYPE OF WORK: NEW ADDITION❑ ALTERAnoN❑ REPAIR❑ OTHER n
DSEOFSTRUCURE mre.a�rs�.u. 841,E ) VI l.l�sl
0 ul, PRDAARY SEASONAL❑ NUMBEROFDEDRODMS NUMREROFBATHROOMSl
HEATED smuLTUREa YES rondo 94y❑ YES rym#ai�aNy'�NO❑
nEscRmEwoRx C`r
SOUAREFOOTAGE:aA.,,anaq
ISTFLOOl 2NDFLOOl 31DFLD0R al BASffi.fETT_ q.8
DECK_ Tq.ft COVERED DEIXJ�S S p.ft STORAGE q.R arIll al
GARAGE p.ft AaacMd Dam 6 CARPORT al Aoac [] Oda [j
MANUFACTDREDHOMEINFORMATION:,If//} 4COPIE9OFTHEFLO0RPLANREQU1REDa
MAKE MODEL YEAR IENOTI
WIDTH BEDROOMS BATHS SERIALNUM9ER
ONMENTAL HEALTH:
SEWAGEISEWERSOURCE: NnTICET SEWER❑ / NEvl,A F.%IST80G❑
PIUMEIMGINS'[R3iCTTIREI YES NO❑ /j a,anacFmgrl Wmo Adequacy Fonn
H�PRRTER/F0uNUA'TIDNDRADNPROPOSEDT YES NOD mGSDNGSO.FP.�
,,,S,,GEEDRCDqS=Nll PROPOSEDBEDRODMS TOTALBEDROOMS
Dal mar�n..mv.adr ae.r wp.nna is ommn.A>w.�.ew"'.mw.wi x q
egnmre.— eaman n,a i.m m.n.nerem ramrardawmn l an.mmmmrul v.mn em roe.m.aox®POPma1.limn
all vmmissm Imm all Me ne-nar,C,n,mCueYi6 any eassnml Wdn Or pal mlmermt rt9W'ina Mre MWea Tie wwsu Ypl
and
reereaa�m maneInrormrtm vrm+d.dk�u ene gnnC amPloyeea muawn canNem.�m m.aemadmnE ll
aamwrurele)fwre„w..m nuaecdon. mie ParmmavWm.mn mmmea nUinw�dnwnor emronzee fa wmm'.miedmmarcm wmnrro
oap or I caul wa s su l—old for a l m 1W da,
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
R LIGATION F 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(NASON
COUNTY CODE 14.00.I2)
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DEPARTMENTAL ixivIl APPROVED DATE I DEN® DATE TAG&NOTES/CONDITIONS
HUD.DING DEPARTMENT
PLANNING DEPARTMENT
j FOIE MARSHAL
PUBLICHEALTH 1kZl 1M.S
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