HomeMy WebLinkAboutBLD2024-00223 - BLD CD Environmental Health Review - 2/21/2024 e Permit No; LD
MASON COUNTY
COMMUNITY DEVELOPMENT
PennKAstluEncECmta.IWiINnEHennira FEB 21 202
BUILDING PERMIT APPLICATION 615 W Al .Stfe
PROPERTY OWNER INFORMATION, CONTRACTORINFORMATION. �
NAME:Eem ADRTEnmr NAME'—'
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MAUJNGADDKESS?D4a+.xaFw MAdMG ADDRESS:+D+m T+eaemamN,m 1
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PHONERI:�— PHONE:Earss>aN CELL.
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PRUTARYCONTACT: OWNER❑ CONTRACTOR OTHRE0 ---
NAME EMAIL^.wrRmermm+
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PARCEL INFDRIMATIpN; -- '. D Z
PARCELNUMHER(12DigtNme ) fIIN5.L00.1 ZONINORee '
LEGALDESCRIPTION(A vo )IA'mARDyipA4EFTRQ FIREDISTRK7s = m
SPEADDRESS.ELW . CITYAbe z
DIRECTIONS TO SITE ADDRESS.rn RWv]pwm EIYNYmam MmEllWrewm'a mrid.
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:THE FTOFTHtF0LL0WWG:TERTHAN 14%: YES❑ N(3❑. SNOW IAAD:b
IS PROPERTY WIININ RD ROP THE FOLLOWING: ft'Ananrmrrµl. -
SALTWATER[] LAKE❑i RNER/CREEK❑ POND[] WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑i ADDITION❑ ALTERATION❑ REPAIR❑ OTHER n
USE OF STRUCTURE/.t,. tvr4v,r'o,.r.m✓nuy Fi./A..mur
ISUSE. PWMARYQ SEASONAL[] NUMBEROFBEDEOOMS4 NUMBER OF BATHROOMS4F
REATEDSTRUCTURE? WSmw+'e [] YFS monAldpq/❑ NO[]
DESCRIRE WORKS — .RaN,Nmavefarwe
SQUARE FOOTAGE:N
ISTFLOOR+DE p.R 2NDFLOORUR p.IL 3RDFLDOR__p.A BASEMENT_p.R
DHCK_p.R COVERED DECK+'T!NO. STORAOE�p.A. OTHER_,&
GARAGES p.R Amrhrda lkmrMd❑ CARPORT K.I AtM o Drmrh.d❑
MANUFACTURED HOME ENFORMATION: V COPIES OF THE FLOOR PLAN REQUBED4
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
SLWAGEBkWER SOURCE: SEPTIC❑ SEWER / NEW❑i OUSTMC❑
PLUMBNG M STRUCTURE: YES E) NO❑ !!/.sr.R/arhrmPlrad WRrc Ad, For«
PERIMETERIFOUNDATION DRAMS PROPOSED' ma ❑ EKISONG SQ FT.
EKISTNG BEDROOMS_ PROPOSED BEDROOMS, TOTAL DEDROOMS�
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PROOF OFCONTINUATI N OF WORK ON THIS PERMITIS BY MEANSOF INSPECTION. INACTIVITY OFTHIS
A UCAM0N F 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
A CWHIY CODE+4.0i.Q)
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DEPARTMENTAL W APPROV`ED DATE DENEFD DATE TAGSINOTES'CONDRIONS
BUBO GDEPARTMENT
PIANNMG DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH ( '(}t
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