HomeMy WebLinkAboutBLD2023-01179 - BLD CD Environmental Health Review - 10/3/2023 MASON COUNTY COMMUNITY SERVICES PeL-mit N. V�/A IGZy1•���
PERMIT ASSISTANCE CENTER.
LICH.StjfRECEIVED
1 PERMIT
ASSI T N CE EKTV.FIRE M4R5NAL
616 W.Kbr6lreei,ShYut WAatWe
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BUILDING PERMIT APPLICATION
Stre
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: GCT O 3 2 9
NAME:®ow.new NAME:c.elmvGem�maeolm.vamaxwramnml+c 023
MAI,INGADDMS:eataswslftl s MAIANGADDRESS P.QPm1We RECEIVEp
CITY:RaeG STATE:We ZIP:eems CITY:� STATE:a ZIP:essas
PHONE#1'.ua 1s 1- PHONE:ssseeeale CEIA,: 2Ma1W2st
PHONE#2'. EMAIL m
FMAD.:emeeeemo.,m+r L8:I REG#IRTEoxceavl EXP. 0021124 z
PRIMARY CONTACT: OWNER❑ WHIRAOWRB OTHER]• G
NAME� Ga ft EMAIL aa1+ Iw NA�w mom T
MAILINGADDRESS Pmeaelree CITY xwe�m STATE wN ZIP— 2
PHONE aar CELL D z
PARCEL INFORMATION:
PARCEL NIIMEER02 Digit Numbv) avuslalgs2 ZONING RM = m
LEGALDESCIUPTION(AbbseviasW) LMRCLI$NMMNISEKXtL0T2 FIRE DISTRICT z
SITE ADDRESS 20 N NOoo WCK CT CITy xmmcen J
DIRECIIONSTOSITEADDRESSF.om anNmn,Lon N.lnke LUNmen Re.Lmpwmwe wy,Rm NiWwrywW,RmNMawln Nei 0.. �>l
Rm Bawa G.RmVRW PM Wey r
E=PROJ WTTHBVMn OFSTAPE(S)GREATERTH 14%; ME] NOD SNOWLOAD:ss,psf
ESPROPERTY FT OF 1'IIL IN ICYNae lDty):
SALTWATER ]LASED V [) I'ONDD WETLAND SEASONAL RUNOFF[] STREAM❑
TYPE OF WORK: NEW❑ ADDITION D ALTERATION❑ REI"❑ OTHER T]
USE OF STRUCTURE(P.wae.ae.ec c�BW# ) 'a"'ea
ISUSE: PRIMARYD SEASONAL❑ NIBIBEROFBEDROOMS 2 NUMBER OF BATHROOMS 2
HEATED STRUCTUREp YES lwsmrt RN E] YES rym fgeiiW❑ NO❑
DESCRIBEWORK a2wxWamde Gwy ,Mmasssweae.2em..eaewa
SOUARE FOOTAGE:m ,4
ISTFLOOR_888_sgft. 2NDF R, sq.R 3RDPLOOA_sq.R BASEMENT N.ft
DECK_sq.ft COVEREDDECK_216_s,.11 STORAGE aq.R OTHER sq.ft
GARAGE_sq.ft AfewW❑ DesadLN❑ CARPORT sq.ft AaacMd❑ DeadW[]
MANUFACTURED HONE INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALN11MBER
ENVIRONMENTAL HEALTH:
SEWAGESEWER SOURCE: SEPIICO SEWER❑ I NEW EXISTING[]+
PI.UhIDING W STRUCTURL. Me NO S (Irea aaaah aompIalad WwrAda vd,Fosm
PERIDR?TERIPDUNDATION/D�RAINS PROPOSED? VESD NO[] EXLSTINGSQ.n.. NIM
EXISTINGBEDROOMS_(L PROPOSED BEDROOMS 2 TOTAL BEDROOMS 2
sigh eel—,I epeamtlwtI=ve d lnm IMMercalbn ea rI wal eneGotx ove Nepemh anclW on.Odn as
dtrcaedltmmbb/
Gteema Eehx.l amere nG i we me amw wm I mnnmaeaere mG I we eanaea m reca.an:e cem�n we m sonmw'wL.:taceeea.I w.e
pmamee cemi�ssloelmm ae me�eaessan pmag,meaa�t aroemm�mn naew or ceAea aelerew regemmt oas mgea Tne pvmGmmtel
a d ste.m(stf re w m me Ne ttnameuen tmNaea Is.¢uxb.na green emtleyees mmesOn eaumy.¢easm ure sem.aeeoieee tmtwry
ana ,ffmnsllwrewD*ismspeNon. rltieedod lWdaon elranes nwawlaswoM1 or aumr^zM mnsWGonuMarmmanroewMlnt90
aan«a�avaalw�weM1 m s�steaaea 1m a teasa a tw aeya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(IMSON
COUNTY CODE 14.08A2)
RR u�X " n�%EM,ee1 r�n.emltl biyr tfM1e OWN ER)
ate
DEPARTMENTALREVIEW APPROVED DATE DENIED DATE TAGSNOTESICONDITIONS
BIALDING DEPARTMENT
PLANNING DEPARTMENT
FHtE MARSHAL
PUBLIC HEALTH S�
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