HomeMy WebLinkAboutBLD2024-00354 - BLD CD Environmental Health Review - 5/14/2024 ld 20 06,0 Zl
® MASON COUNTY COMMUNITY SERVICES Permit No: i •, �_ —�'
PERNfT ASSIS TANCE CENTER:
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SUILLYNG.PLANNING•P UC HEALTH.FIRE WRSHPI "r o,SW.A v5 N,SM .WA9BN R•
Phone Shoto 13W)m9 70@e 352-Fw 96U 2 MSP - 3
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MAK 1422
BUILDING PERMIT APPLICATION n
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,.! PROPERTY OWNER INFORMATION: CONTRACCORLINFO I ery, rn
\ D NAME: CA NAME; aLtO/ Gr'
MAIl,IN AD RESS: MAIlANCt AD SS: o
CRY: ci TATE: ZAP: CITY: 71L STATE:
PHONE,aI: 0 . I• PHONE: 0/
PHONE a2: EMAIL: /`IG(C JP+tS62CA OWG
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N V P NTA OWNER❑ CONTRACTOR ppTH R❑ r�AA'
\ CC�� NAM MA E EI
2 L LK UQq 6 AT a COra�"'f'.
.lJ MAIUNGA DRESS OO C STATE
3 1 PHONE CEL
NPARCEL INFORMATION: �l'/ "'�
Q PARCELNUMIBER(12Di®t Number) I 7t) - q — 00030 ZONING
N LEGAL DESCRIPTION(AbbavieRd)
3 STTEAGGM / CRY h l�a1
.� D O_NI SITE ADDRESS
ppQ 0 F'I O
r> IS THE PRO]ELT WI'1'HN'3o0 FT OF SLOPE(S)GREATER TRAM Ie%: ❑ NOW SNOW IAAD:_Pal
��CCTT WPROPERTYWTTffENNm Fi OFTKEFOLLOWENG: S: eon,ogytl NO
`Lj SALTWAM0 LAKE❑ RIVERMMEK❑ POND❑ VlE1T.AND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEw R ADDITION❑ ALTERATION❑ REPAIR❑ OMH ERR n
USE OF STRUCTURE Px ,,ram=.Cw A neeroBI¢.5) / DI.0
ISUSE: PRD. RY❑ SEASONAL❑ NUMBEROFBE IWI Z NUMBEROFBATHROOMS Z
REATMSTRUCTURE? YFS(NeIe B'oWw YES( 1 BNgI NO❑
DESCRD3E WORK AI? W IZOO C /❑iD U
SOUARE F��•.O��OnnTAGE:onverad)
IST FLOOR�p.ft INDFLOOR_s;IL 31U) L R p.it BASEhh1ENN[ p.R
DECK .ft. COVEREDDECK !yy p.ft STORAGE p.ft OitIDt p.ft
GARAGE p.ft. Alacw[] Dmocw[l CARPORT p.ft AmChed❑ Demehed❑
MANUFACR7RED HOME INFORMATION: '/COPIES OF THE FLOOR PLAN REQUIRED'
YEAR LENGTH
TFI B®ROOMS BATNS
ENVIRONMENTAL HEALTH:
SEWAGE/SEWERSOURCE: SEPTIC SEWER❑ I NEWTX EXISTING❑
PLUMBINGINSTRUCTURE? YESX NO❑ (f,,00 -d Wmer Ade maq Fork
PERME:TERIFOUNDATI0S PROPOSED? YESv NO❑ EKISTING SO.FT.
XI ESTINGBEDROOM PROPOSEDBEDROOMS Z TOTAL BEDROOMS_
OWNER vkrallo,ee oiel fudnhslon d-acuone Inlw .min renA in a Sap' —on Neo*rewalb.A.h oQe—✓wtlis11'
spneha9 Mee.I Eedane Iliad am ke mne r ant I nxI "oe NM I on eTNaOb--Mb punk end b Eo Ne—ae pmpaaed 11NM
oMdMW pemrstiau M1om a111.recessary pa000 lncluahg any ea5emem ocho.or aoo,dint a r,,monp tltia ougG The vemer or
.eYumaalel,er review..e nepeCipn.M pe Napplloon,oneensnull&—d tivok auonme Ponseucom L[p�¢mnertzE ninth I
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PRO$1FQF CONT ON OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
P,ERMR APP ATI OF 1S0 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
L CWNTYCODE 110E.{3) dA / �//
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NER(Mug be e'o,ba W tlM OWNERI I Deb
ERARTMENTAL REVEW APPROVED DATE DENIED DATE TAGST'OTESICONDTTIONS
BUIIDENG DEPARTMENT
PLANNING DEPARTMENT'
FIRE MARSHAL
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