HomeMy WebLinkAboutBLD2024-00224 - BLD CD Environmental Health Review - 2/26/2024 Permit K{aytRu 002-2't
MASON COUNTY K C
COMMUNITY DEVELOPMENT FEB 2 12024
Perms[A [Rance Centu,Building,PlaWV
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAbffi".Namm NAME:wewmguc
MATLDIGADDRESS:001F0^ —r MAD.INC ADDRESS:ts1t NBTaNp Mm.mMm Q
CITY:ft .s« STATE:WA ZIP:%W6 CITY:Teary. STATE:M'�ZIP:
PHONE#l:—ao 1- PHONE:deb-- CELL:
PHONE 42: EMAIL:aram..sRoxod.mm
EMAR.:1me.mOn-- L&I REG#rLaRTNNLessw EXP.B /4 Y24 Z
PRIMARY CONTACT: OWNER❑ CONTRACTOR Ui OTHER[] r-I
NAMS xm rm..uc EMAIL a.noagaRo. — = M
M UNGADDRESS 1sT1 reT.rary+M.,.aue Be CITY'+ STATE`"" ZIP— Z
PHONE>g1— CELL
PARCEL INFORMATION:
PARCELNUMBER(13 Digit Nweber) 1231TJglWen ZONINO Bweened
LEGALDESCRIPTION(Abbr wcd) M4CPO.L.4BLYIMYeeNLYHW=8=102 FIRE DISTRICTS
SITE ADDRESS eel E Non By as CITYAar^
DIRECIONSTOSITEADDRFSS Fmm Nwvaga vnmE NM Oy Mubmxedeae
ISTHEPROdECIWITHN'300FTOFSLOPE(S)GREATERTHANI4K: ME NO[] SNOWIAIAD:15�f
LSPROPERTYWITH1N203FTOFTHEFOLL0W1NQ iCa anwrm*):
SALTWATER[] LAKE❑ RIVERICREEKD POND❑ WEH [] SEASONALRUNO"D STREAM❑
TYPE OF WORK: NEW El ADDITION❑ ALTERATION❑ REPAIR❑ OTHER n
USE OF STRUCTURE(wam..v.G—,,C«.mamwemg.E0 Nmae.«
IS USE: PRMARYa SEASONAL NUMBER OF BEDROOMS 2 NUMBER OFBATHROOMS2
HEATEDSTRUCTURE? YES(W ,BHeEl YFS fr«rNTdJa NO[]
DESCRIBEWORKgum OFA.nn�Po.Pa
SOUARE FOOTAGE:[pygm)
ISTFLOOR1ar2 N.ft. 3NDFLOOR sq.ft 3RDFLOOR K.ft BASEMENT aq.IL
DECK_v,.R. COVEIUDDECK_kQ_e, ft STORAGE K.ft OTHER N.R
GARAGE:t sN.R A=&d@e De [] CARPORT nq.ft. Alta [] Deteded❑
MANUFACTURED HOME INFORMATION: -4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGFISEWER SOURCE: sEPTic❑ sEWER❑ I NEW +O EXISTING[I
PLUMBMGMSTEUcuRE? YESO+ NO[I YAP,,POac#cmWktr Winer Ada gForm
PERB+]ETER/FOUNDATION DRAWS PROPOSED? YES Not] EXISTING SQ.FT.
EXISTING BEDROOMS__ FROPOSEDREDROOMS_4�11— TOTALBEDROOMS-2w
owraB aa.mtaang ne auemwron orne�,rm.imomiaum mar rgun n a npp ewrM diner«p.mdnwwem.xx.omaryammr a.ucn Iay
als+nr=eao...l em«.na I.mna omm.oa I wood amaRnel..muuaa ro rerelc�Pmdtma ro apne.ua g propmm.l ro.a
Penn.a pm.iaa�m r�eo rre�ewadr pang.mnuamg enr eaeam«r mid«.r pan�a a�c:«m«avdn2 we prgea. Tne wmer or i yin
ngafendnve,reprea«ro Ilal ne InMmallm pmWaea Is awrele aid prenb emggeea or Maxn(:mnlys�ro Ina a�ve aeamoeE prpMR'
aM avucwMalra mkw arq impmim. mre permN�pIiCBllm eemng nue a vaa n wA uaNaizaa conewtim ie na ammarw Mnln 1aD
eye«rmnanrymm.«ela auepandm tprepanpdalm aya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PE IT APPUC TON F 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.08.42)
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pnature a DIMMER Mw W sioneeDate
DEPARTMENTAL REVIEW APPROVED DATE 1 DEN® I DATE I TAGSINOTESrCONVOTONS
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PLANNING DEPARTMENT
FIRE MARSHAL
PUBLICHEALTH S
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a z� 451 E NORTH BAY RD
.s ALLYN. WA 98524