HomeMy WebLinkAboutBLD2024-00329 - BLD CD Environmental Health Review - 3/11/2024 MASON COUNTY PeamMNo°�id2o2 t- alY��j
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistance Center, Building,Planning MAR 11 2024
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:EWUWl Ymia NAME:SInP>on CambeYen
MAIIJNOADDRESS:05W� MAD.INGADDRESS:
CITY:sme STATE-WA ZIP:a CITY: STATE: m
PHONE 01:50% PRONE: CEIA.:
PHONE R2:521 iTdJ EMAIL:SmPinhiMnbcOYelm.mm a m
EMAIL LAI REGO EXP. I Z
PRDIIARY CONTACT: OWNER(] CONTRACTOR[] OTHER[] O f G
NAME n.o Avyr. EMAIL
MAILINGADDRESSa05y� SLATE WA Zlpsa mO
PHONE CELL�'��^ D Z
PARCEL DDWORMATION: ". :;
PARCE1,NUMBER(12DigitN.b.) I aA�1�1 - 5a - 1�0/Y� - ZONING6e'Banaal 2 m
LEGA,DESCRIPTION(AMrrevuted) FRtE DISTRICT "�M"°n O" Z
SIM ADDRESSSI Fm Smbb Cwe CTI'YSMax '�
DU,ECOONSMSTTEADORESS IMyaNOMbEd Pb ig Pa6 Cmm eMgeroNaelna remM On Eeg H«s+ire e�iapexmtl. r
Myn rgM1lon E SouN Intl IXt MMa WpMan E HaNrre YIaN flE$deb wl ebnm E Fdti NM1m noel.4M1on SmMi me Wryb hY 81
IS TER PROJECT WITHIN300"OF SLOPE(S)GREATER THAN 14%: YES[] N00 SNOWLOAD:--�II
ISPROPERTY WITHIN 200 FTOF THE FOLLOWING. pa.aoaa wW:
SALTWATER[] LAKE[] RIVER/CREEKO POND[] WEIT.ANDO SEASONALRUNOFF❑ STREAM[]
TYPE OF WORK: NEW E] ADDITION❑ ALTERATION❑ REPAIR❑ OTHER []
USE OF STRUCTURE(m ..c g..Dewy ee)
LSUSE: PRIMARYQ SEASONAL[] N,,MBEROFBEDROOMS3 NUMBER OFBATHROOMSS
HEATEDSTRUCTURE? YESP BWEI YES�m .)O WD NO[]
DESCRIBE WORKNew ramu«4Pn alrtgaaNa,bmewaM1 a d.ma.a Gaaaa..'nad inM.mMM mdviaaS g.routs mrvebaW
SOUAREOOTS(,w-v Fr+shed.
ISTFLOORISIS aq.ft 2NDFLOOR sq.ft. 3RDFLOOR m.R BASEMENTIM sq.I
DECK N R COV DECK— SF A. STORAGE N.ft. OTHERIIS n.ft.
GARAGI aq.li Anached[] Tklached CARPORT aq.ft. A .hed[] Detached[]
MANUFACTURED HOME INFORMATION: •4 COPIES OF THE FLOOR PLAN REQUIRED'
MODEL LENGTH
BEDROOMS BATHS SERIALM BER
ENVIRONNEE 4TAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC SEWER ( NEW EXISTING
FLUMBINOINSTRUCIURE? YOEI ' NO❑ LP.� a wh completed Wm AdW Form
PERMETERAMJNDATION DRAINS PROPOSED? YES[r NOA-' EXISTBIGSQFT.
EXISTING BEDROOMS PROPOSED BEDROOMS S v— TGTALBEDRODMSS
gYlB.d.'mmg.tlm[whn®on enawvale imolmalon dory r In aSo°wM1«d««Pemrvl maaaon.AdmwMeJgemeM d neh w by
vsj w wm Iaedam Me Iammew randINnneraeaMmatIamen wtoras9 Me vermaaMmdomex *as POMsad.llia+a
veinal PIXmistion rcom au me recesary wnlss.mcwstg am easanerR lwlder«PanlesaimeteA ragaNina mrs vtaea Themm««IGal
:1rePresew mat ma�mo„m�arn°rw�aed sa.,�,�rP°,.,P��a�z°w�a�a,Nk�m.�m�a��t,°T��eaeae„��P�n°w�ian _ .. _
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPUCATION OF 1E0 AYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
cooE taoe.u)
S-pre4ve dD I uidlms nod wtim mNNERI Oie
DEPARTMENTAL REVIEW APPROVED DATE I DEPRED I DATE TAGSRNOTEWCONDITIONS
BUDIN NO DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLICHEALTH
n�
b A/
e i ! IT
\ ! t
� ! m
� ��® � ^ � •
LT
! ! 09
\a 2 CO 01,
11
§ �! ,
§j \
! �2 � -
±
_ . - J ■222