HomeMy WebLinkAboutBLD2023-01357 - BLD CD Environmental Health Review - 11/13/2023 PermitNm &{Z2o23 01361 ,
MASON COUNTY RE.CrEME^
COMMUNITY DEVELOPMENT NOV 0 7 2023 Z
Perms MsIMMCe W,SWNIY,IHannlnQ
BUILDING PERMIT APPLICATION 615 W. Alder S4-ee!
PROPERTY OWNER INFORMATION: CONTRACTOR DNFORMATION: F_}I• 0
NAME:wcoALB xuTV NAME:Na Y Z
MAILAIG ADDRESS:m EANfHONY aoAD MAH.ING ADDRESS: r
CT[Y:GRAPEYID STATE:WA 21P:30EH0 CRY: STATE —I
PHONE#L: 890.N$s PHONE: CELL: = m
PHONE#2:03.M.0esa EMAIL: Z
EUAd,WE3T00ASiKQ®LP/E.COM LBGI REG# EST._/�— D
PRIMARY CONTACT: OWNER❑ CONTRAOTOR❑ OTNERD r
NAME r^+awtaa°^ EMAIL ONE0131 lod i-ccm
80EMrtXONYRD CITY'^s"s'a"M STATE WA ZIPQB`+13
MAILING ADDRESS
PHONE CELL
PARCEL INFORMATION: NOV 3 20T3
PARCELMUMBER(12 Di&sNamba)W 21+10L20m ZOMDtGA
LEGALDESCRIPTION(Abbsey,,D NIR Sla Nin NWIRYOF OR WIWEY 3d40 FDIEDISTRICTOENRULMASON REC
SITEADDRESS110EELOAMSR Iw CITYGa yliry
DIRECRONSTOSITEADDRESS"HOamanma.Tnxkwnrmom—_coxr—e 2M:as Tocarnaauara+vv.T
TRAVELSEVERPLHUNDREDFEUMDTANELEPTONME1➢M1ARHOLLOW.FOLLOWTOENDMDTAHE'OTTHWU M
OTBRPRO]ELTWITRW300FTOFSLOPE(S)GREATERTRANI4%: YES[] NOE] SNOWLOAD:!af
ISPROPERTYW NM0FTOFTHE FOLLOWDiC: ICE.aou�nm�Plyl:
SALTWATER❑ LAKE❑ R WENCKEER E POND❑ WETLAND 0+ SEASONALRUNOPP❑ STREAM❑
TYPE OF WORK: NEW Q ADDITION❑ ALTERATION❑ REPAIR❑ OTHER 0
USE OF STRUCTURE(RMWn_se cwawv,14 y)RESIDENCE
IS USE: PRIMARYE] SEASONAL❑ NUMBER OF BEDROOMS=NUMBEROF BATHROOMSTS•15
HEATED STRUCTURE? YES`whore slay 0 YES lPM(t)fBMJII� NO❑
DESCRIBE WORKTO DNLDA NEW HOUSE ON MY P0.0PERTY
SOUARE FFnO���OTAGE•@ryre..e) �7 Adlc� fMt irltj*A 4
ISTFLOOReAAl4' q.R 2NDFLOOR_q.fL 3RDFLOOR_1C^ q,R. BASEAENT?4IL sq.R
DECK_,"' COVERED DECK_K.R ORAGE�_q.R. OTHER_p.R
GARAGE, q.R AstgcFed DewAed❑ CARPORT iq.R. Av WO DWw M❑
MANUFACTURED HOME INFORMATION: •O COP=OF THE FLOOR PLAN REQVIREDe
wA MODEL YEAR LENGTH
W TlI BEDROOMS BATHS SERLV.NITMBER
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC SEWER❑ / NEWD EXISTING❑
PLUMBEJGLNSTIIUCTURE? YRSD NOD lfy augcAco kfed WmeeAdsgeaey Form
PERMETERFOUNDATION DRABJS PROPOSED? YESD NOD EIOSNNGSQ.FT.
MSTWG BEDROOMS PROPOSEDBEDROOMS �J .TOTAL BEDROOMS
ONNER eGrvMMgu IM1Msubm�ion of lnazaraK Inlamalian mey recall in a slop vwk atlxorpermH nwsHm.MknrnNetlpemsnaf wGl6 by
apleWe belwr.l tledare Nal am tlM ovmer enE Nriner Eeclare Nal am entitleE to receive IM1is pBlmttlM to Eo Bie vnrtk as pmpaaed Iuve
.d pem.'asim Imm all Ne receuary penies.Inclutlin0 anY easement MWa�d panics o(inlet�l repeNing Ws pmlecL TM1e owns orPle�ITy
rePpamaOue,repl�enls Nal llre Ntwmallon pmvitlatl'n ecwrele aM gfams employees d Macon CnmOy eases to Pa aWve tlesvibetl
eM wu]ure(altureviewantl inspec4on.TTIs pennwapplina.be[Orn.no&—,i I—..,.0 n..,.don bnN—n.—E whin 1W
Eeya arHcansWc4on vroM1 Is a.y Metl fmapedW 01100 d.M
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTMTYOFTHIS
PERMIT APPLI^ F 180 DAYS Of MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.("SON
�� e�COUNTY CODE 11.00.62)
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DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE -TAGRMOTES/CONDTf10N3 -
BUB,,WODEPARTMENT
PLANNING DEPARTME
FIRE MARSHAL
PUBLIC HEALTH T I
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