HomeMy WebLinkAboutBLD2023-01491 - BLD CD Environmental Health Review - 12/13/2023 Permit No: PT I 2:Q2-3-o I —I
COMMUNITY DEVELOPMENT RECEIVE �fc�MASON COUNTY
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BUILDING PERMIT APPLICATION 815 W. AkWSWO n'FD
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: Z
NAME t OR&M f NAME:
MAIL DRESS: £ MAILING ADDRESS: =e =
CRY: STATE: ZIP: CITY: STATE: ZIP:
PHONE#1 PHONE: CELL: D Z
PHONE#2: EMAIL:
EMAIL: sarMR \ W&I REG# EXP._/ /_ !:4
PRIMARY CONTACT: OWNER CONTMROR❑ OTHE0.� S m
NAME EMAI Z
MAILING DIE$$ T CITY STATE ZIP '-i
PHONE CELL � � D
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PARCEL INFORMATION: '\�
PARCEL NUMBER(12 Digit NttmbeO e{.2I ��II ZOMNG
LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT
SITE ADDRESS CRY 4
DIRECTIONS TO SITE ADDRE
ISTHEPRO"E WIMM36FTOFSLOPE(S)GREATERTNANI4%: YEEw N0� SNOW LOAD:�yef
ISPROPERTYWITHINIIWFTOFTHEFOLIDWING: T desard,,da)
SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND[] WETLAND❑ SEASONALRUNOFF❑ STREAM[]
TYPE OF WORK: NEWAV ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTTIR6(EesMmae.GrvFe.Cawe Alt Fie)
MUSE: PRIMARY)I SEASONAL[] WIPERMOFREDROOMS a NUMBEROFBATHROOMS__L__
HEATED STRUCNRET YES#ea4lmw❑ YES(Fw/a/glesyA NO 0
DESCRIBE WORK
OSOUUARF FOOTAGE Gwsmadl
ISTPLOORJW94R 2NDFLOOR sq.R 3RDFLOOR sal EASEMENT sal
DECK_..�111 R_ COVERED DECK_aq.R STORAGE sq.R OTHER aq.R
GARAGE_ay�OSQPAuached DeeacM1d❑ CARPORT zq.RAvdshed❑ Deemhed❑
MANUFACTURED HOME INFORMATION e#COPIES OF THE FLOOR PLAN REQUIRED•
MODEL LING
"TH BATHS SERGE NUMBER
ENVMDNMENTAL HEALTH:
SEWAGIUSEWERSOURCE: SEPTIC[] SEWER❑ / NEe EXISTING❑
PLUMBING IN STRUCTURE? YES NO❑ TfWd,anacAcdegdemd WprcrAdegwry Farm
PEKIMETER VOUNDATION DRAINS PROPOSED? YESX NOO WSIING SQ.FT.
EXISTINGBEDROOMS 0 PROPOSED BEDROOMS 2� TOTAL BEDROOMS
GWNFR»naWslpee Mal eubnbYon aIn...Yi venalion mey esask in a slop eve pMr or pmN rnwelbn.HknwNac'nom M isum
elpreWfeMlow.I eetleretM Im des,wmrrW I NMrOetlre Net I M mNled to receive IMa pened and as do me as pwomm Iham
EtBMedpertniasionhom aI1.ttstaWrypYtlw.inW]iap aM.semenesolderor -a.1 Minlem shin,a phis me. TM1eommtrlepel
Ie d aside nestepRemis NM IRA potion. hi poWded is ecwMe end p2nls employees of Mason Lo zed wussr b me east daeMEM ryapeby
ea ew ffasn slbtnnan end InxpetlNn.TNepand of
dap Mmmss null b wltl tivmM or euMonzed wnstruNan k nm rvmmencetl Mtllin 1e0
drys r if vauYu<tlm oaM1 k rMmeOlra prutl o!180 tlays.
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.(MASON
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DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSTIOTFSICONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMINT
FIRE MARSHAL
PUBLIC HEALTH
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