HomeMy WebLinkAboutBLD2024-00105 - BLD CD Environmental Health Review - 1/31/2024 Permit No:7�[ ^ J
• MASON COUNTY
COMMUNITY DEVELOPMENT JAN 24 2024
PmmitA isbnceQnl dBuildln4Plannlry 615 W. Ald
BUILDING PERMIT APPLICATION 7JAN
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PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:a "` Rv ,61 / 11014NAME: [-i- NAI.�: K�f1 G1 Cs M G DRESS If M WGAD S: VED CITY: L STATE: =3s-t� CITY: STA :
PHONE#L - - PHONE, �CELL:
PHONE#2: _ PMAL: U Cn m �m(.•(Cn M
EMAIL kin M L&I REG# EMP.
P ACT: 0AER CONT Mllt❑ OiNER a<
NAME - EMAIL rVAT + c.
MAILINGA R SS CITY STATE ZIP
PHONE ' CELL • _ - i M O
PARCEL INFORMATION: nn >
PARCEL NUMBER(12 Di®t Number) S-2 o;�I S ti()U D I() TANING P = m
LEGALDESCRITTION(Abbreviated) FIRE DISTRICT
SITEADDRESS L) E 7' Y1 z
DIRECTIONS TO SHE ADDRPS$ G O i [' 1y
.II Ye c rigo,
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ISTHEPROJE WJT 300FTOFSLOPE(S)GREATERT 14%: ME] NOC7 SNOW LOAD: ad
IS PROPERTY WITBIN J00 FF OF]IJE FOLLOWING: (awtdl,Au ygyJ: /'
SALTWATER[] LAKE❑ RIVER/CREEK❑ POND❑. WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION Q ALTERATION,f REPAIR❑ OTHER rl
USE OF STRUCTURE(w,iemu,rveee umwercalNdy ReJ �PSib`Yn rP
BUSE: PRIMARY SEASONAL❑ pp NUMBEROFBEDROOMS NUMB^EROFBATRROOMS�y�
HEATED STRU 1 YE$(mrm.RNtl oy YES lPe+ralwAMd O ND is c O F V/G DESCRIBE WORK � G (!i IF}U
SQUARE FOOTAGE,[o,q„✓1 �1 CLJ1C(C(.�(�
1ST PLOOAy�y'1 eq.ft JND PLODR ?()p.R. 3RD FLWR s,& BASEMENT q.R.
DP eq.ft COVERED DECK Xq.A STORAGE R.It OTHER Xq.IS.
GARAOE p.A. Aaai0 pei CARPORT a,& AaachM[I DeaddiD
MANUFAC RMATION: *O COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODH
BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL REALiR:
SEWAGE/SEWERSOURCE: SEPTIC SEWERS / NEW❑ IDDSTDIG�
PLUMBINGTNSTRUCPURH? YES NOS /fyu,atmrAcompTemd Water Adequary Poem
PER@FTER/FOUNDATION DRAINS PROPOSED? YESQ NOg, MISYINGS(i.FT.
EXISTING BEDROOMS PROPoSEDHEDROOMS� T(TTALBEDROOMS___Q
su,neINNER ackav I dedatlul I amImIXI and
inlormaXm nlayI onina¢loprud wntryers re I.ri.eptlmmNM}nrenlIX aMYby
olraii reEelay.lattars lnellem the owrerenalNMa� any RMem em ontitlaotorxnw Nla per onariato aotbxvh e¢Pc¢¢al.11are
morinao ative, epr hem all 1pa nxeasary wontingei as any easement d ensder o,paNes of lson C rlty ,to de MK.a b TM wnwim legal
and idna ellve.repeesar ss Nat Ow Iector,on pmvNao Ia liccurzle and gems employees of Mason County ems9 W.eMw oxcnON gcgeny
dayaovclurecsl mrre son,isa Inaprrated raarod of ppligmn Mcanaa nWlarelo ilwoM1 erauNen:eo wnswclbnanattmmanreE rANM 180
days or XConmremm�.Dn I¢sa¢pnN.d m,a p.xod a teB my¢.
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 E)(PIRED.(MASON
COUNTY CODE 14.08A3),1
SIPIeWreN ER(Mual ba ahlmd brlM OWNER? D01e
DEP"7rN[ENTAL REVIEW APPROVED DATE DENED DATE TAGSMOTESICONDIPIONS
BUILDING DEPARTMENT
PLANMNG DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH L�
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