HomeMy WebLinkAboutBLD2024-00080 - BLD CD Environmental Health Review - 1/22/2024 MASON COUNTY COMMUNITY SERVICES Permit NE:RLmoa4'DOOSd
a PERMITASSISTANCEydJCHCENTER. RECEIVED m
.E RM PUNNING.PUBLIC XERL I{l.FIRE M4RSXN.
815 W.PMer5Uae45M1alon,WAagi 'z
Prore snamn:pm�a2PSE2a.ae 312.Fm:(y&ya22- icynm JAN 22202;
ears°.(mt77sua1.Pool Ems:(JaNae2azm al
615 W.Alder Street = X
BUILDING PERMIT APPLICATION m O
PROPERTY OWNER INFORMATION CONTRACEOR INFORMATION- D Z
NAME NAME:xaam xom.r -r--I
MAILING ADDRES : SSx SF 4—J_ R( MAILING ADDRESS:11daT®alE '_ m
CRY:SLIA. STATE:W& ZrP,gbrPu CITY:°weog STATE:'NA ZIP:— z
PHONE#1: 60l Skill P14ONE: aTM1s Cl --I
PHONE 02: o Ss EMAIL:°�.mn D
EMAIL: ' !RI REG p xwrvxvFMD EXP. 11/8 /_
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PRIMAR OWNER,a— CONTRACTOR[] OTHER❑
NAME EMAIL_ 1-1, c..ea P/�I
MAILINGADD SS4� SESE/ 7 GITT sN�II,,, STA'('8 ZIP41 Ssy
PHONE b CELL 6d6 7Rt icb
PARCEL INFORMATION:
PARCELNUMBER(12Digit Nambl 77-4�a/— b1—q,i ZONING m Z n
LEGAL DESCRIPTION(Abbrevigi FIRE DISTRICT C! N
SITEADDRESS 533'i SF l4..nd:_ 2d CITY SLe 14,.
DIRECTIONS TO SITE ADDRESS ---------------
N
O N
IS THE PROJECT WITHIN 300"OF SLOPES)GREATER THAN I4l YESO NO SNOW LOAD:ZSpor
IS PROPERTY WITHIN 3(p FT OF THE FOLLOWING: 1['IreR a(nua°P.yl:
SALTWATER❑ LAKE❑ RIVEWCREEKEJ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM D
TYPE OF WORK: NEW RP ADDITION❑ ALTERATION D REPAIR❑ OTHER TT
USE OF STRUCTURE(PxMmce.GaT.Cameaeb/Ly amJ St=R
IS USE: PRIMARY, SEASONAL❑ NUMBEROFBEDROOMS 5 NUMBEROFBATHROQMS 2
HFATEDSTRUCTURE? YESI1Rwbeud❑ YES(Wjq''Nyl NOD
DESCRIBEWORK �w sb.�+.'� w.., S'FR
SQUARE FOOTAGE:D.IPmay
ISTRAORY 42aR.R 2NDFLOOR sal 3RDFLOOR_sy.ft. BASEMENT sq.R
DECK sq.R COVERED DECK id]_sq.ft. STORAGE rq.fl. OTHER sal
GARAGE G7S so,ft. Algall DaradMd❑ CARPORT N.R. Artxhel fWacMd❑
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOORPLAN REQ
UIRED'
MAKE MO TEAR LENG731�
WIDTFf' DEDROOM$ BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAGHSEWER SOURCE: SEPTIC SEWER[I I NEWX EXISTING
PLUMBING IN STRUCTURE? YES NO❑ Tfnd, msaahaampleled Water Adsydy Farm
PERIMETEUTOUNDATION DRAINS PROPOSED? YES NOO DGSTING SQ.FT.
EXISTING BEDROOMS A PROPOSED BEDROOMS 3 TOTALREDROOMS S
GYRIER abnv.MMgmtlW SWmutlon ainpmlale infortnrtan mry multi palry wU.oNpr or pamJlmwtlm.PtlnmNe]yemandfacia uq
slynaumideloat aetlan Mel lamtneourerandl fonM1erExLRMRIYaddra dy,RmiwlM1bperrulanEb OOMewM as plemser! base
obtained!pa,m®sion M1gn all ne newmary Pales,including any eaemaM h.......allim of lr deadt repelalrq Mh pmptl. TM1e ow,Nr or feat
ad,nd andyl IpmMb tl1al NP Inbnnapn grov.'s a—.and yra as employms of Mason Courtly suns to IM1e a.-tlrWlbed anday,
endsWI loyin,ccmiensM inspeclun, r. a.WIAnlNn Eeamae nullflvoM it waM1 oreNM1q¢ad cOnalocTon IsnW commeMsd MMin 18D
idays Ai, on wJM14 SusynUeo bre panod ollW tlaya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IB BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE 14.0El
Slgrogyra IER w baeMnd bu the OWNERI pale
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TACSINOTFSICONDMONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH
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