HomeMy WebLinkAboutBLD2023-01548 - BLD CD Environmental Health Review - 1/3/2024 MASON COUNTY P`rrk iRe.# �c)
COMMUNITY DEVELOPMENT
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Permit Assistance Center,Building,Planning 2023 VD�i.�
BUILDING PERMIT APPLICATIOID 15 W. Alder St JAN O 3 2025
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: RECEIVE()
NAME:———— NAME:°'-"'w°xe--
MAU,INGADDPMS:a°e^--- MAI[.INGADDMS:'1a---
CITY:— STATE:o" ZIP: CITY:°°+' STATE:— ZE:'w"
PHONENL'— PHONE:emannro CELL:
PHONE N2: EMAI.:.N°row.°ro°^Ra^�m^
EMAIL LAI REG N°'^®°1m EXP.09123/_
PRIMARY CONTACT: OWNER❑ cONTRACIORO OTIm1O
NAME Nv ENAB.Px°+'�
M UNGADDRESS STATE
PHONE CI L rm
PARCEL INFORMATION: ENVIRONNIE N TAL
PARCEL NUMBER(12 Digit Naeba) 'v"°a°roei ZONING— WPAR. H
LEGAL DESCRIPTION(Abbevietd) • raxre Mw* usaAa.s-A°s FIRE DISIRICTe
SITEADDPXW3 s°"•iYm
DIRECTIONS TO SITEADDRESS °iYn^""eO1�"'w""^xaes.rwn.a.�pg
.a[euwp s ws wnwr a,mxn nea.¢me wsowe[o.troeM.yymx u,�wxo nrw wewu
18 H MOIgCTWITRIN3IMFTOFSLOPE(S)GREATRRTRAN14X: YESO NOD SNOWLOAD:�—paT
MPROPE.RTY TDRIN21111FIr OFTHEFOLLOWQNC: �CnctanwgPNr:
SALTWATERO LAKES RIVER/ [3 POND❑ wEn.AND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEWO ADDITION❑ ALTERATION(I REPAIR OTHER
USE OF STRUCTURE(irtm Gwga CwiwemblABg w—
ISUSE: PRIMARY❑ SEASONALQ NUMNEROFB®ROOMS' NUMBEROFBATHROOMS
HEATED STRUCTURE? YES(WAYir tW 0 YES fPmrl++/lAN❑ NO❑
DENCBBE WORK'"—
SOUARF FOOTAGE:rwlaW
ISTFLOOR'w eq.fl INDFLOOR=sq.R 3RDFLOOR sq.R BASEMENT sN.B
DECK. q.fl COVEREDDECR"° N-fl STORAGE iiii.ft OTIIDt nq.fl
GARAOE_,.ft. Ar d❑ Damd"[] CARPORT sq.ft Anaj] LkrOd dO
MANUFACTURED HOME INFORMATION: •d COPIES OF THE FLOOR PLAN REQUIRED-
MAKE MODEL YEAR LENGTH
WmTII BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH,
SEWAGEISEWEt SOURCE. SEPTIC❑ SEWER RI / NEW[+ EXISTING[I
PLUMBINGMSTRUCNRE? YESQ NO❑ Ilya auarh wnih,W Weer AEequxyForee
PERD411TELFOUNDATION DRADIS PROPOSED? YES[a NOD MSTING SQ
EOSTINGBE)ROOMS ° PROPOSED BEDROOMS ° TOTAL BEDROOMS °
QMtERSMMMnn NN wanw.mainaa.�reniawr�'wn mor mxnnssmnvv4aa.av�n silo-.xw,waeaemen�mawruq
egme mw.v.i aaeRmr i xm m.�w ana i mnne�e�se mr i an.nu.a romlaw P.r'.ie roa me wox a:v�voxa.i�
amnwe pvmbmnnvn r dw nee..-%aery wmx.mauamv un evrmm naeer or v.ur nBeemtiavamw aw wNev+- me owrer n legs
ieoneeasue.iepv.e ma ma mtmnevon Po.;eeeueoy�ae w�a mw�w enwgen aMnmc ar�rome.eoe aeeoier v�w«h
me enuraralrn'misnaa nwvavm. mi.vemuevvi�uum pecans nur novae ewox aw�monzm mmumm m mi ranmarwewxNn tm
esya a e mnwxiwn won N wamaee rar a Peaoa ar t w aeye.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTWITY OF THIS
PERMIT APPLICATION OF NMI DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EMBED,(MASON
COUNTY CODE 14.06.6])
OVINE?(MuetMalOned Mllr ORMERI DaM
DEPARTMENTAL REVIEW APPROVED DATE DENT® DATE TAGSNOTENCONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL A
PUBLICH EALTH l 1` 4
1
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DRAINAGE DESIGN
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