HomeMy WebLinkAboutBLD2024-00261 - BLD CD Environmental Health Review - 3/1/2024 Permit ND: S I,DAog4—emu I
MASON COUNTY
COMMUNITY DEVELOPMENT RECEIVIED Z
Permit Msisana Center,Building,Planning FEB 2 9 2024 <
BUILDING PERMIT APPLICATION = x
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: ^ RI O
NAME:Gaging Dorgan NAME:Tengleeamd cpnNlucmn .p tO VUV
MAILING ADDRESS:gain MAILING ADDRESS:I-E Nqm-,Sky ie m
CITY:Preen STAIE:� CITY:Saemn STATE:Wlk ZIP:0 1�
PHONE#1:-3M'3- PHONE:WO42/8]23 CELT--S7W -a t
PHONE#2: EMAIL:9m11®Mryhecaamrelnxduamm
EMAR.:gthetivmen®gmell.pam L&I BEG#TMGLWMME EXP
PRIMARY CONTACT: OWNER[] CONTRACFORE] OTHER❑
NAME EMAIL�a®la"gl°a°°mm�.oumm.com
MAILING ADDRESS 100 E earl entry or CRY anami STATE WA ZIP Sea"
PHONE 360.427672a CELL 360=9313
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) 22oD]sgglwm ZONING RRS
LEGALDESCRIPTION(Ablm,,iited) Se4l'a"Arq:]tPBr2 FIRE DISTRICT
SITE ADDRESS 1921 E TIMBER-WE WEST DR C,,S,eMM
DIRECIMSTOSITEADDRESE +'3MarE Bdhir,tI9M ApeN Rd LeRMhGaN Sbrt,LCRan TMaeMkea
ISTHEPROJECT�MOn OFSLOPE(s)GREATERTI NI4%: YESCI NO[3 SNOWLOAD:y�psl
ISPROPERTYWITHIN200ITOFTHEFOLIAWING: rL'nee4nrf rh.,r,gµ}):
SALTWATER[] LAKFa RIVER]CREEKQ POND❑ WETLAND❑ SEASONAL RUNOFF[] STREAM13
TYPE OF W ORIC: NEW D ADIA ION Q ALTERATION Q RTPADL D OTHER ❑
USE OF STRUCTURE perdnx anrOr,tomm.,.mtarey em.1 RaMeINe
ISUSE: PRIMAIl SEASONALO NUMBER OF BEDROOM 2 N,,,EROFMTFBLOOM53
HEATED STRUCTURE? YES rytw.aJd&1 E+ YES raarf l Iw4V❑ NO❑
DESCRIBE wORKNewrevkntlal wnsaucnon
SQUARE FOOTAGE:r,, , , F;nisuA
1STFLOOR1248 sq.fl. 2NDFLOOR K.A. 3RD FLOOR aq.R BASENMNf1167 aq.ft.
DECK (I0O Ka COVEREDDECK 2O sq.ft. STORAGE181 aq.ft. OTHER aq.ft.
GARAGE aq.A, A#crhado DWached[3 CARPORT sq.A Mached0 Ddached0
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOORPLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
SEWAGFISEwER SOURCE: SEPTICp SEWER[I t NEW EMSTINGB
PLUMBING M STRUCTURE? YES Q+ NO❑ Jfwut,arfach comFiewd IPahn Adegrran•Farm
PERIMEIERHOUNDATION DRAMS PROPOSED? YES Q NOCI EXISTING SQ.PT.
EXISTING BEDROOMS PROPOSED BEDROOMS a TOTAL BEDROOMS
OWNER atkroMeEgea Net Submission of Ineaturate aMmletbn gay tame In a crop earl,meer or ceank reecmtim.AQrrn4ealemem d auca b py
egreNre Mal I tlecbre Met I am me MoMp are I enter anal tlat I am manned to re—Ink armttem0 M W Me M*as pmtae t.I hate
obteirce armlaabn hcm ell Me rcuasery peNa,IMUEIIq eny eaeemenl Mkx or peraec of iritermt rgertlirq Mh projxL Rn mmm a Iagal
teperomNx,rWearte Melitrt hfmneupn Itta.11ea k mrebaM grenteempoyea at Maem County e¢ae M rile aNw Ewcrl W prvaM
entl cbmMreln)b nvMe eM lnyaction. TM1k amlDaplkalbn Eewma nugflvak dxak aeutlubeE amNudbn YrM canmxcetl wlNh 180
dara a rcmnNmcuan worx Ia auaanaee Mr.cerbd d tao din.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. 1NACTIVRY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE IXPIRED.(MASON
COUNTY CODE 14.08.42)
X q1 y- 02/12/2024
Signowne d OWNER LMNst Ne sMri W tine OWNER) Dale
DEPARTMENTAL REVIEW APPROVED ®DATE DEN DATE TAGSINOTPSICONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL PUBLIC
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PUBLIC HEALTH W 3
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