HomeMy WebLinkAboutBLD2023-01259 - BLD CD Environmental Health Review - 11/22/2023 MASON COUNTY PermiENo: -019.,J9
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COMMUNITY DEVELOPMENT ' F(;E I V E D
Permit Aesrefance4nler.Buil4PLPhrim ,
BUILDING PERMIT APPLICATION OCT 17 2023
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PROPERTY OWNER INFORMATION: CONTRACT RINP Qr reef
NAME Joint Danp an a cor t
n Npunn(Em0 NAME: r'
MAII.INOADDRR55:5DDt NE t&P st Q
MAILWG ADDRESS:
CITY:lake Fort Perk STATE:WA ZIP:NIM CITY: STATE: ffi: m
PHONEIH:20h.eal PHONE: CELL:
PHONE p2:ALa.an.sieo EMAIL:
EMAIL:dnlnBunn®�mr+avnm I.&I REGA EXP. / )
PRULIRY CONTACT: OWNERO CONTIMCTOR[] OTHER ---
NAME++ Pm EMAIL TooDneen®mmmnnet R1 C)
MA1LUHGADDRESS5D01NEl&PSR COYuarm pain STATE WA ZIPS&55 r
PHONE mumm CELL e.aaRlmY
PARCEL INFORMATION: = z
PARCELNU M(12DigitN=m )=2451DW21 j CkRRS
LEGALDESCRIPTION(Abbrtvietta) FFEDTSTWLTa
SITEADDRESS21 SE CMmeI Pdm Rasa Q,l.Yyly�, r
DIRECTIONS TO SITE ADDRESS On SE A %Feel all SeI ml Pont Rot afti W Pc honraerM
ET MOIECTWPFHIN3N"OFMOPE(S)GREATERTBANI4W: YES[] NOD SNOW LOAD:__Paf
E MOPBRTY WITI@ "D0 OFTBEFOULO G: ry wino brgwW:
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONALRUNOl STREAM[]
TYPE OF WORK: NEW[]+ ADDITION❑ ALTERATION❑ REPAIR❑ OTIIHR in
USE OF STRUCTURE(Ammma,ca• co,Mwwauy P.,)Penaima
IS USE: PRIMARY SEASONAL[]+ NUMBEROFBEOROOMSS NUMBEROFBATHROOMSDA
HEATED STRUCTUEEI YES Iwnaia tl y❑ YES t/oo[sle RNy1❑ NO[I —
DESCRIBE WORK.Bma rmu ImNenub home
SOHARE FOOTAGE:1P•,aaall
ISTFLOORlN sq.R 2NDFLOOl sq.R 3RDFLOORaq.R BASEMENT—al
DEIX sq.fl COVEREDDECR�1—pIfts STORAGE aq.R OTHER_eq.B.
GARAGES Sq.R Athtmhad l) Oeahoh;d❑ CARPORT eq.&Axachab DnochM[]
MANUFACTURED ROME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
W DTH BEDROOMS BATHS SEIUALNUADLER
ENVIRONMENTAL HEALTH:
SEWAGIESBWERSOURCE: SEPTIC[]+ SEWER❑ I NEW[]' EXISTING❑
PLUMBING RI STRUCT11RE1 YES❑ NOD Iff c.otwc5 eomplend WwerAdegmryForm
PHIUM!TERIFOUNOATIONDRANSPROPOSED9 YES E NO[] E%ISIBiG Sp,FT.
EXLSTING BEDROOMS PROPOSIDBEDROOMS TOTALBIDROOMS
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owm.a Pmmlaslni men all am rem>a.ey pnmea,inaaanp anv.esemem nomarm papas m�a�reel.eearaire Pre P:gaa me ow�erm laps
sn ureNnw.e)fiam 4a rdtmPo#cna .
ek nparmea laam+rem ens e•en6 emP�%'aas or Meson coungaauab Noamaa�iom popeM
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PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIl OF THIS
PERMIT APPLICATION OF•LSD DAYS OF MORE VALL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.1111
x 9/9/23
SI mof OWNER(Nast be s�sretl bulM1e OWNERI Date
DFPARTM]SNTALREVIEW APPROVED DATE I DENIED DATE I TAGS OTES/CONDTCIDNS
BUIDINGDEPARTMENT
PLANNING DEPARTMENT
PIRG MARSHAL
PUBLICHEALTH
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