HomeMy WebLinkAboutCOM2024-00018 - COM CD Environmental Health Review - 4/1/2024 I
MASON COUNTY Pernik No: D
COMMUNITY DEVELOPMENT
AP4 01 2024
BUILDING PERMIT APPLICATION 610 V V. n)uCr .Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:P OFSNELTON NAME:WUYC
MAILINGADDRESS:21IN�WAY MAILING ADDRESS:PO IN (^� !Ta CITY:stIELTON STATE-WA :NMa CfFY:SfELTGN STATAWA jJE:9X3M _ '9A� U_ T
PHONE#1:sewzo-nr PHONE:100-tOBRaaS CHLR.:maaYawB vly
PHONE#2: III.fAII.:MouYKOREmRv®aMAILCGM 0 v
FIvVs)L:BRANDCNPdPCRTOFSRELTON.CCM IAI REG# EXP.—)—� CdA2 '�O��
PRIMARY CONTACT: OWNEREg CONTRACTOR El OTHER❑ FQ G1
NAME—� W EMAIL MOLLWGREWW@GMAILCOM ITT
MAILINGADDRFSSPOB-lm CITY. STATE WA E1P%W4 z
PHONE— CELL
PARCEL INFORMATION: = m
PARCEL NUMBER(12 Di it Nu.b )^2o22mcA0o(1 X ) ZONINOCOMMERCI z
LEGAL DESCRTPTION(AUbI<viatN)------- FIRE 1ISTRIC9RE wSiRICTSS D
SM ADDRESSIS W sNaOERSON WAY C,,,MELTON
DIRECPIONS TO SITE ADDRESS'w"1B1+1O1xm�exmaF.a.y.y.mwr+.axT�wwa�...waw.e.ww.
LRTBEPROIECTW 300FTOFSLOPE(S)GREATKRTHAN14Ye: YESO N00 SNOWLOAD:�
ISPROPERTYWFTH]N200FTOFTHEFOLLOWING: Icy da. ,, ):
SALTWATER❑ LAKE❑ RNER/CREEK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAMD
TYPE OF WORK: NEW EI ADDITION❑ ALTERATION❑ REPAIR❑ OTHER F1
USEOFSTRUCTURE(xmumw GamE.Cux.ertwR Fs)COFPEESTAND
ISUSE: PRIMARYD SEASONAL[] NUMBER OF BEDROOMS[] NIIMBEROFBATHROOMS0
HEATED STRUCTURET YES(Pwda ROB 0 YES ry gy NnW❑ NO[]
DC4CRIBE WORKNEW CONS11tUC11CN OF ptNE-TIIN WFFEE STAND
SQUARE FOOTAGE:
ISTFLOORM eq.ft 2ND FLOOR oq.ft 3RD FLOOR eq.ft BASEMENT sl.&
DECK Xq.ft. COVERED DECK eq.ft STORAGE q.& OTHER_,,ft
GARAGE sq.k dnucAed❑ 1)erarJvd[] CARPORT ,It An D []
MANUFACTURED HOME INFORMATION: •b COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
SEWAOP/SE WIJRCE: SEPTIC❑ SEWER❑ / NEW +[] EIDSTING❑
PLUNIDINGINSFRUCNRE? YESB NO NW.-N camp/ WXN Adegvmy Form
PERIMETERTOUNDATION DRAINS PROPOSED? YES❑ NOO EKISI'INGSQ.FT.
EKISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS
OWLER acknoxba�s XblwEml¢bn d Iremrtale IfRa'matlm may rtsuX In a sbp xak pEefppe�mXsava®tlm,PaAmx'kOgammld eiM 4 Xy
ngreXeB celmv.l aeaare ihai lam me wmar rt— NrMa,aeaere Noel amemme0lo�eceWe inb pemm aM rotlo Ilre vuhmmpgvael.l Imve
Wwenp mlealon M1wn all ma na�ssnry Parties.lnnudne any aaaamam naoar or paNea'd .n mgaNlnq m¢pTfah 1T8 oMWaIpY
mpreaenb45e,rep�esems WI me In(o�ma0on pmn0etl Is artu�ne anE gmnls employees d Maon Cumyacceae b Na eEMa OeeViEM pOpeM1y
aN sNFtuR(s)M Iav19N aM Inscetlbn,ITIS Pe�mNapp6mfion CecOmaB nN B vPN ttBIXk IX euNIXhEO cpasWUM 6 not mmPerceE vAMm 1Ba
Erya w II mnf Wtlnn xqk Is soyvMN br a pHnotl N 180 Ceys.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVRY OF THIS
PERMIT APPLICATION OF IN DAYS OF MORE WILL CAUSE THE APFUCATK)N TO BE EXPIRED.(MASON
CWNiY CODE I&"l)
K 0 311 5/2 0 2 4
n ER(Mort Wnknatl DV 1bg OWNER I Date
D"ARlimmNTA REVIEW APPROVED DATE HD� DATA TAC OTTStCONDITTONS -
BURRING DEPARTMENT
PLANNING DEPARTMENT
F)REMARSHAL
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