HomeMy WebLinkAboutBLD2024-00529 - BLD CD Environmental Health Review - 4/29/2024 MASON COUNTY Permit NO: 1, as -oo�
COMMUNITY DEVELOPMENT C E I VE D
PermitAssistance Center,Building Planning MAR 25 2024
BUILDING PERMIT APPLICATION
er Street
PROPERTY OWNER INFORMATION: CONTILLCFOR INFORMATION:
NAME: RvIij. t Sue ecc AY'q/t NAME A4W4564 16f�s
MAH"NO ADDRESS: O /;pK 62S'D MAILRJG ADD Sox i1Yi m
CRY:F1JiMO.NAS SFAI8:� ZZIP: CRY: iPi-ibN STATE:w& ZIP: Z
PHONE Sl: - - PRONE: w93 0 CUL: C
PHONE 82: - - EMAIL 4+�Tlti R,¢S Iw[@6RwL..4Rn
EMAII.: LAI REGN IN 436 MI B7LP. /_li m O
PRIMARY CONTACT: OWNER[] CONTRALTORM oT [3 Z
NAMEArAaP_ Ira Fe EMAIL
MAR.INGADDPESS ow-STATE-
PHONE CELL M
PARCEL INFORMATION: .P j
PARCELNUMBER(12DiSh Nu .) 32O4-6!D-Om * ZONING
IEGALDESCANTION(Abb.ndd) "IBRARAIL ` . 4L11 T&_ FRBDISTRICT 1j
SREADDRESS!J00 EE. p:oQ kjA n lids DR-E CRY fwlt rJ Q
DIRECTIONS TO SITEADDRESSM R4 T:tV 6N4N A► , Le Fr oA rup aan✓t W
R R6NT nN C P.audma, LLJS ba=s . SM it o.a IiAeIPI'.
BTREPRORiLTWRI@MOn OFSLOPE(S)GREATERTRANI/%: YEEQ 1406SNOWIAAlt
ISPROPRRTY WTTHEV 200 RT OF TBR FOLLOWING: /C.Md.11dmypy):
SALTWATER❑ LAKE[] RIVER/CREEK0 POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NBW❑ ADDITION❑ ALTERATION D REPAIRK OTHER ❑
USEOFSTRUCI'URBpou.raf��Duaam) 6TCA STOQA61E
ISUSE: PRIMARY[] SEASONAL[Rf NUMBEROFEEDROOMS_ _NUMBER OF BATBROOMS_L_
HEATEDSIEUCTURV YES(mwenayff YES( 1Nre41❑ NO❑
DESCRIBE WORK w TR
64UARE FOOTAGE:Orwp®a
IsTFLOORSSG M.& TNDFLOOR q.& 3RDFLOOR q.& BASEMENT_q.R
DECK_q.H COVERID DECK_q.ft STORAGE q.ft OTHER q.&
fi CE q.&AmcM1M D TMar o CARPORT q.ft AttaJxd❑ Dpm O
MANUFACTURED HOME INFORMATION: wa COPIES OF THE FLOOR PLAN REQUIRED*
MARE MODEL YEAR LENGTH
WBYIH BEDROOM$ BATHE SBRW.NUMHBR
ENVIRONMENTAL HEALTH:
SEWAGE)SEWBRSOUR(F: SEPTIC%. SEWER❑ / NEW[] EXISTINGN
PLUmglwow TRIICNRSl YES& NO 4'Jv,aCrcFcw &wdWaraAdrq ,Fry
PYRAIB'IERR/FOUNDATION DRAM PROPOSED? YES❑ NO® E1D5INGS(IFT.
EXISTDJGS®ROOMS_ _ PROPOSED BEDROOMS TYIAL BHDROOMS _
OWREN aY.nwAeA�n WlairCmlWgrollnmraN Inlump'ronm0'rwJtF R WPVMkptlry PxmR mwaLLn.NhnMMOxMdmb6b/
oAAAmi Lmmsaetlera Awlr vn AAowns MI Nenxax@renvlrMarl®tlmmlMORb peimilaMWMNewhnprymN.rIwe
oebmee perm¢eYnn rmm v1 me nacessxry wrAre.ndading am e%unsnnoYlrvamlwnNelea:regardro ms wMarR meomerrckW
rwpemnwere,rwga»,umem.mmnneAw pA.uee l..r<..wm eoa prem..ripgasaM®n ewmr acc„c w uw.be,.d.aeee popsy
uk¢pucnngs)br renew em inyection. iM1ls permNepglrefion eecwnu M 6 wM ewt m eurmnzee fnnstr efan rsm[mmmsuE eBYn tm
aera orrcwnewcnpe wwR uauwarem rw a pmm rt rw eeys.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION, INACFMTY OF THIS
PERM71TA�APP(/JCrATION OF IN DAYS OF MORE WILL CAUSE THE APPLMATION TO BE EXPRRM.WASOM
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SgMuad OWN[R Dab
DKPARTMENTALRR W APPROVED DATE DENIED DATE TA(S?MT'ESPOONDITIONS
HULLOING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHM,
PUBLIC HEALTH
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32104_ w - opw+ EH Setbacks
AI d&nM1el�'neserveregmrasl 'sabacN lrom lamingXwMBtlOM '
C)Wfndahon®quiets Y Drwns on 30M, tirg,Mmrli0n5
C)No IaunEationNenmsiv Drvns wMln 3Cry,OpmArWynl of
BrLLMnWtliesene arse
0)W Cut Bank(G)IAreater Nan 6H aM cve 46 tle0reas)wllhln
EH APPROVED
Rhonda Thompson OW2I2024
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Reserve area
designated by Designer
James Medcalf on ATF
asbuilt5/21/24 /