HomeMy WebLinkAboutBLD2024-00299 - BLD CD Environmental Health Review - 3/8/2024 Permit No: 51,D A0eR-Q
MASON COUNTY RFCFl�/
COMMUNITY DEVELOPMENT
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615 W. Alder S
BUILDING PERMIT APPLICATION p1
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PROPERTY OWNER INFORMATION: CONTRACIOR INFORMATION:
NAME: NAME:T Taw m
MAILING ADDRESS:j. gLn(hSL,$ --BLVD MAB,ING RESS:•�43:.i38'M�P cF D z
CITY:.,AM-,r 14 _ TATE:V�_ZIP: ...' 1 CILYSAUIb✓ueal STATE:] ZIP:as+szar� r 9
PHONEBl:360 ^440-SL72-. PHONE ICELL: ""I i
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PRIMARY CONTA OWNERP( CONTRACTOR❑ I OTHER D
NAME STn.A.� CITY
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MAIWNGADDRESS('I $MRI IBDI Y CITY s(/iLTet/ STATE-1,1�iiPOAS'AO
PHONES/al CELL
PARCEL IPFORMATION:
PARCELNUMBER(12Di9jt Numbs) ZONING
I.EGALDFSCRB•T[ON(AbbrevimlFIIIE DISTRICT CGNTY�• M
SPIEADDRESS/" FA/ CITY f><EL PWa/
DWX�DNSTO SITE ADpRESS d '<I r� I
TC) Ain I ,,,-,. 1.
MT PROJECTWTT'HBiMnOFSLOPE(S)GREATRRTBANId%: YESD ROM SNOWTAAD:Pm
IB PMATE,YWITIBND FTOFTDEFOLI.OWONO A:bstm wy [
SALIM1VATER❑ LAKE❑ RIVERMREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ AAWE
TYPE OF WORK: NEW E ADDMON❑ ALTERATION❑ REPAIR❑ OTHER M
USEOFSTRUCIURE0aaaa-i,.cmaaawlm*E0 Sin d w Rm,agwez
MUSE: PRIMARYJ1 SEASONAL[] NUMBEROFBEDROOMS NUMB OFBATH WMS I
HEATED STRUCTURE) YES Mb Wei r NO
DFSCRINE WORK AT EW [a+7 NSTB Ti B.J S N4Lf s]T9TY
SOUARE FOOTAGE:
ISTFDORNAS Nl11 ZNDFTAOR_K& 3RDFLOOR_N.fl. BASEMENT p_ft
DBCR aq.ft COVERED DECK Qsq.fl. STORAGE K,& OTHER agft
GARAGE�JJ7 N.ft Aeacbed; DemcAed❑ CARPORT N.fl.Av d❑ DaAwhd❑
MANUFACTURED HOME INFORMATION: 'd COPIES OF THE FLOOR PLAN REQUIRED'
MARE MODEL YEAR LENGTH
WB)TH BEDROOMS BATHS SERIALNUMBER
ENVDtONMENTAL HEALTH:
SEWAOUSEWERSOURCE: SEPTIC[] SEWER) / NEW❑ MSTINGS
PLUMBOIGINSTRUCTUSET YESm NO I] Ijyu,.anacb wim flid Wmo,ldegwcy Foam
PEUMETERIFOUNDATION DRAINS PROPOSEDP YESm ROO EXISTINGSQ.FT.
EXISTINGBEDROOMR PROPOSED BEDROOMS Z TOTALBEDROOMS 7-
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PROOF OF CONTINUATION OF WORK ON THIS PERMR IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE IA.Ue.Q)
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Sijamim OlNNER IMurt W eMeeE by Me OWNERI Deb
DEPARTMENTALRII,IEW APPROVED DATE DEN6D DATE TAGS210'TFS/CONDTI'IONS
BUILDING DEPARTMENT
PLANNOIGDEPARTMENT
FIRE MARSHAL
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