HomeMy WebLinkAboutBLD2024-00339 - BLD CD Environmental Health Review - 3/18/2024 e 3 Permit NO: 4J�-0033 /
MASON COUNTY RECEIVED
COMMUNITY DEVELOPMENT MAR 12 2024 rn
z
BUILDING PERMIT APPLICATION 15 W. A t = �
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: D z
NAME:Teaa NAME:x.nx LLC
MAILING ADDRESS:roam tact MAI.INGADDRESS:tnt xEiruaelWMMRa
CITY:tea+' STATE:rA ZIP: CITY:1+ STATR WA ZIP: _ r n
PHONE 81: PHONE:— CELL: z
I.anee..n�woeX.mm
PHONE 82: EMAIL: xueixw.emc EXP'._/4 /24
EMAI.:��^°•R+ebee�'a" L&I REGd D
PRIMARY CONTACT: OWNER❑ CONTRACTOR❑ OTHES❑ r
NME EMAIL
MMUNGADDRE&S CELL
CITY SfATB_ZIP
PHONE I
PARCEL INFORMATION: - d
PARCELNUMBER(12Diit Nambr) autut.aemc ZONINGRwe.NM �4 ��j�
LEGALDFSCRIPIWN(Abbreviated) WIp;.WUAaa MluXetdM FIRE DISTRICT W^n Msrn
SITEADDRESS---- p'PYimuye
DIRECTIONS TO SITE ADDRESS
ISTTD:PROJECFWITHIN3Nn OPSLOPE(5)GREATERTHANI4%: YES[] N0[a SNOWLOAD:lL--pat'
ISFROPERTYWITFRN280FTOFTHE:F0LLOWING: (cx tuurm WW:
SALTWATER❑ LAKE❑ MVEETFEEK[] PONE[] WETLAND[] SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW 2i ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USE OF STRUCTURE(Pv,Mmr.Cmaya cmme wramr.6c)Rmwme
IS USE: PRIMkRYEl SEASONAL❑ NUMBEROFBEDROOMS- NUMBEROFBATHROOMSt
HEATED STRUCNREI YES Ma Bw❑ YE3(�,J9w w lil NO O
DESCRIBE WORK a'ea lmswwtmednwnemoreay.wlelozaaw�omlprtw•wmiX
SQUARE FOOTAGE:&"..4
IST FIAORM m.& 2ND FIAOR eq.R 3RD FLOOR RY ft BASEMENT_M.@.
DECE_aq.ft COVEREDDECE_aq.ft STORAGE w.R. OTUER_aq.&
GASAGEMab sq.& AmacA da Decoded❑ CARPORT sq.ft Aawc d❑ Detached❑
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH•
SEWAGIVSEWERSOURCE: SSF-nc El SEWER❑ ( NEw Di METING❑
PLIIMBDNG IN STRUCIUREF YES ID NO❑ Trym,al.M 1,s WmrAdequvry Fo m
PEIt1MET'ESJFOIJNEATION DRAINS PROPOSEJX YER NOD EXISTING SQ.FT.
EXISTING BEDROOMS PROPOSIDBEDROOMS 2 TO'TALBEDROOMS2
pYIER rhnaMeaJee Ntl wdnl.wm N Inrsul6le inlonrelion may n¢uX In a akpwk Drat m pennX revomtion.pdrcx.LSNememmwm Yby
vpnaWeENcw.l aeaw N41vm N.wmr ma M1Anra.aera Nat w MW tete Xaa , aMmao Ne vrA ee%vpmea. baw
manse Prml.xon rcaa dl nre ne�aavY wAm mauamF a.r maanem naaMrrpw-anmma��ebnpN�•Pmiea me amrrbpel
�pmemletive,�gaeeenN NYNelnbimtlun proNaeamalurele ens emme egtyas of Mown Cwn bNeebm eeavibea pmpaly
rld MluaWe(a)Iv mtsr/aiM inepeNen.ThIB prmNepPlluXm Hamm null8 wla X xwk u BYIMizM a�abuaM ie mtwmmrwa WNn tm
eyerXmrenuSm xaA Is waPanaW fre pMoa d 1N ays.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPIJCA ON OF 180 DAYS OF MORE WILL CAUSE THE APPUCATH3 TO R EXPIRED.(MASON
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Sig Jt ter WNER
DEPARTMENTALREVIEW APPROVED DATE DENIED DATE TAGSTIOTESr ONDM1
BURRING DEPARTMENT
PLANNING DEPAR'TAIDNT
EMS MARSHAL
PUBLIC HEALTH
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