HomeMy WebLinkAboutBLD2023-01540 - BLD CD Environmental Health Review - 1/3/2024 MASON COUNTY
COMMUNITY DEVELOPMENT
7 2023
Permit AulsGnce Center,Building,Planning
BUILDING PERMIT APPLICATION6 15 W. Alder Street m
)A`, 0 �1014 P TYOWNERMORMATION, CONTRATTORINFORMATION:
R�C�IVED MMAAdd77�CQ FFRRPSS /�4M,C NAME'a MAILING ADDRESS:
CII'Y:13t•r'N' STATE: ZIP: CRY: STATE:_ZB: TTI Z
PHONEa): - - O PHONE: CELL: D
PHONE 92: - EMAIL: r
FMM. PICK FI M •CFw+ L&2 REGp f7 r� fiXP. / /_ = m
NAME Y ' •p DWNeR� WNTBATOIOURO..! 6e�Ei!- en A,).eom
MAIL)NGA ffl B LIIY / SFATE�AI,�2IP D
PHONE OM- zZq-T 640 CELL r
PARCEL INFORMATION:
PARCEL NUMBER(12 Di®I Nuah) L1U 000 aD ZONWO
LEGALDESCRIPTION(ANnwiMM) FBIE �Ta•LT
RTIEADD- 2140 �G p E oote 3o CO'Y 6e1FP'IC
DHtECDONS 1D STIR ADORES 9
BiTMB PBOIFAT WHRHS3W FT OFSLOPE(s)GBEATER THAN I<%: YESD NO SNOW LOAD:�rr
M PROPP.RTY RSSFTOFTmx FOLLOWING: N+nmeaaPbl'
SALTWA'ILF LAKE❑ RIVERA%RBm(0 POND❑ WEDAND(] SEASONAL RUNOFF 0 STREAM❑
TVPF OF WORK: NEW❑ ADDDION4 ALTERATION Q REPAIRS OTHER rI
D30 oP STRacIV''RTTEAArP � I�¢S'•dto(C
MUSE PRDIAR. BI SRASONAL❑ NUMBER CFBIDROONL4_NUMBEROFBATHROOMS �J 9DBM
HEATED9TRUCTURE4 YESM aM1❑ YES(PW.I•/aW❑ NC4 d �RUA>d /y iI
DESCRIBEWOUC ADD M1 d A tr edanl E oo1 ,
TUBE MTCF
OISTPR �
_Wan ll ,OFLOOR 3RDFLOOR MIL BASDO T_rq.R
DICK-� �� fl COVER®DEIX_fq.R SFORAQE fq.ft oTHER K&
GARAGE" ,R ❑ CARPORT y R An 13 lM El
mAiguncrulm How INFORMATION: 4 COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WWTH BEDROOMS BATHS SIRIALNUMBEtt
ENVIRONMENTAL HEALTH:
smA•wcrisHwex souR�: SmmC❑ mwm* 1 NIEWO EK)STWG❑
PLIIMBWGWSTRUCNRE9 YES)( No Ifyes,— WmnAAxga Forty
PBRD.ffiIFRIPOUNDATION DRAWS PROPOSED? YES❑ NO IMSTINGSQ.".. 1370
E%6TING BEDROOMS PROPOSPDBEDR�MS TOFALBBDROOMS
arllElreW�Meil®tlmaWnbbndlr�.eie mlwmelron mm,®un lneslw Pmna mautim AWpAeyrnWllC(Na�Y�/
.piev.edw.l me.nnui i mneoxwmm i mmix mgeremtl i em enmiea m�n.wewmRxmm aomewxu PrPwea Inm
muirea Pmm6gon M1un el u.:sonw Pa+�.mduarq m..w��em nga.a Pama aunweal nPseM w.PoNu m.wn.rw Wu
�gPecwNee,rewasan•nui urelmwmrion Pmr�-�'aw.ae a,a Pngs engmeas q Nmai Crumy amnume eoovaeevneNPm.4
.a.m+a.M:l rW renau anf inspvtion. m:remuyco®om mmne.nmi a.aa i.,on orzgmm�ea cmmvmon�:mw mnm®ino MM1n 1R]
�n or nma�w.00�»<n rs s�ooa mra c.�m q�eoen.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION INACTIVITY OF THIS
PERMIT AP CA 1 0 DAYS OF F LLL CAUSE CODE HE APPLICATION TO BE EXPIRED.(MASON
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DEPARTMENTAL REVIEW APPROVED DATE SERIES DATE TAGFNOTES/CONDIIIONS
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