HomeMy WebLinkAboutBLD2024-00021 - BLD CD Environmental Health Review - 1/9/2024 MASON COUNTY Permit No:L /GLOLG��ooD a1
CnU K NITY DEVELOPMENT
p�r �kistance Center, Building,Planning jECEIV
ryt BUILDING PERMIT APPLICATION o
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: Q' "J
de treat ,$
NAME: C A)• hha. L` NAME:HIune Homes 1 Qu '/�
MAILING ADDRESS: 3h -s1^ MAILING ADDRESS:ftwsezeDAVEE
CITY: t"te•lr�"I" STATE: 1 ZIP: 9 ff f CITY:PUYA LUP STATE:WA ZIP:go 3
PHONE#1: 360' `I9 -, G PHONE:253-770-220 CELL:
PHONE#2: EMAIL:Pmconswclw^®nulnemma.mm
EMAIL: L&I REG#HIUNH'sa3en EXP. 11 / 8 /25
PRIMARY CON ACT: OWNER CONTRACTOR❑ OTHER❑
NAME t/t-r _71.K..f� 4 EMAIL r1 �3ti+'n� a4 /3�/ PAD 5.--a �l.c--
MAILING ED SS f i R L- L-,- 6-( - r.� CITY STATE ZIP
PHONE CELL 3Gf�- 7%�
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Number) L12333-51 - ba oo N ZONING ff& ^
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT /
SITE ADDRESS S392. Ij �.kt C-1�^�-. CITY
DIRE TIONS TO SITE ADDRESS Ton �bL {�wy !d( -> If`/ r �S n •lcJ nnr/'4 - fcc�
e ask rtk err < < Y
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%: YESO NO❑ SNOW LOAD:_psf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Checkalliharupply):
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM pr
TYPE OF WORK: NEW g ADDITION❑ ALTERATION ❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE,(h/efdenre,Games Coss nermol0*,,&rc) F„11 fisle, 003,'O a e
ISUSE: PRIMARY E SEASONAL ❑ NUMBER OF BEDROOMS ,? NUMBER OF BATHROOMS ;i
HEATED STRUCTURE, YES(While BhIg1 YES(Pawfrjof8fdg)❑ NO❑
DESCRIBEWORK EcJ 1Je`I Asy 6)+ili*[J 7nd$,Iter) :nclr,J;.. we 11 f fir- 1'lwtm y-�
G
SQUARE FOOTAGE: iteepu ed)
1 ST FLOOR ZO'4 I sq.ft. 2ND FLOOR
�' sq.R. 3RD FLOOR sq.ft. BASEMENT sq.ft.
DECK sq.ft. COVERED DECK,,it�sq.ft. STORAGE sq. ft. OTHER sq.ft.
GARAGE��sq.ft. Attached Detached❑ CARPORT sq.ft. Attached❑ Detached❑
MANUFAC A4 COPIES OF THE FLOOR PLAN REQUIRED"
MA MODEL AR LENGTH
DTH BEDROOMS BATHS SERIALN
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER / NEW EXISTING [I
PLUMBING IN STRUCTURE, YES NO❑ lyes, attach completed Water Adequacy Form
UNDATION PERIMETER/FO DRAIIROPOSED, YE NO�Q]. EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSED BEDROOMS ✓ TOTAL BEDROOMS
OWNER acknowledges that submission of inaccurate information may result In a stop work order or Parma revocation.Acknowledgement of such is by
signature below.I declare that I am the owner and I further declare that 1 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 some described property
and structure(s)for review and inspection. This permk/application becomes null 8 void 0 work or authorised construction is not commenced within 180
days or 9 construction work is suspended for a period of 180 days.
PROOF OF CONTINJIATI hOF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APE ICAVI 1= 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14,08,421
X 1 -G � Lj
Signature of OWNER(Must be alined by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE I TAGSINOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH g
` � B
SITE PLANKZ
_ a�a
OPPRM 6r Llx/
nas
/ 1 C y
W
EOI\ --------/-1 Q0 m -
d � / o � d P I
d J I O W
W m
N QO / \ \ / Ycl
5 w
W ry LL7 / / \ w Q d Z06
Vl N N 9 u d
W L / '' $9 i / 11041—LIMF
/HOME TO ixOYE11TY 4" / I1PPR0%11V
LINE LPPNO%1IO R� / / f /
d / / ' /
JI
O � �
U V
,L'%ItlpiNElWr OFON a N
\ i X K \
j
P.NbNE P.. � "_- k O 8
\�� /NO" PN.m\ = F
/ .WNW \\� / y 2EE o
Ln
\ R92 cv 4
Vw
09 _ Q f \� CIO to
IN
�H
yky
b7 N \� Vo
AlNZ.W Za N
� <O1000�