HomeMy WebLinkAboutBLD2024-00441 - BLD CD Environmental Health Review - 3/14/2024 AIM
MASON COUNTY Permit No: l/lAo - y 1
COMMUNITY DEVELOPMENT EIVED
Permit Assistance Center,Building,Planning MAR 14 2024
BUILDING PERMIT APPLICATION Bit
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:Dmoene Mlrnenel'" NAME:
MAILING ADDRESS:30ElikkeM1oR MAILING ADDRESS:
CITY:aneXm STATRWA ZIP: CITY: STATE:
PHONE 41 M02W3885 PHONE: CELL: fT
PHONE#2:360�701-3851 EMAIL:
EMAIL:wvrearidn0®gnm.mar L&IREGW EXP. c.•
t
PRIMARY CONTACT: owxEap roxrRAcroa❑ OTHER❑ n O
NAME STATE
ce ADD EMAIL MY a0@ remI3Bmll m J
MAILING ADDRfiS530E PkhaYNR UTY awe STATe WA EIQF4r�
PHONE CELL lsaealr IO 1..a
PARCEL INFORMATION:
PARCEL NUMBER(12 Digit Nuraber)2201D504003 ZANMGRRS '= m
LEGAL DESCRIPTION(Abbevu4dl Tkaelwa Xi rm 33a M DPC 110i FUSE DISTRICTS L
SCIEADDRESSMEPktaral LTTYSheOm
DIRECTIONS TO SITE ADDRESS xrrme.peumr.roelxaw. mare..amewsagmrw.maa.waR !'
r
V MEPROJ WRHINa00FTOFSIAPE(S)GREATHRTHANI4%: YES(] NOD SNOWLOAD:—_,s(
VPROPERTYWITIIIN2M FTOFTHE FOLLOWING: Cluentallearoppo
SALTWATER❑ IAI E RIVER/CRMK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION o+ REPAIR[I OTHER Tl
USE OF STRUCTURE(Rwdara,Genres,Caaetwelwas@,Eal Grape
ISUSE: PRIMARY❑ SEASONALE] NUMBER OF BEDROOMS 0 NUMBEROFBATHROOMS I
HEATEDSTRUCTURE? YESlrvnoxsNgl❑ MiTheplodi NOO
DESCRIBE WORKworw wnnsk a eddlrq.walw Xemmpnl erA aaaw w Imlee wn NXmmrhSrq wrtw.
SOUARE FOOTAGE:Fool
ISTFLOOR sq.ft. 2NDFLCOR_sal 3RDFLOOR_hsl BASEMENT_sI
DECK fai COVEREDDECK_sq.R STORAGE—dal OTHER rq.ft.
GARAGE_so.R Attached❑ DemdM❑ CARPORT sq.R Aum&d❑ perished❑
MANUFACTURED HOME INFORMATION: aA COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAG&SEWER SOURCE: SEPTIC0 SEWER NEW EXSTING[a
PLUMBDiGINSURUCTURIl YFS0 NOS $yea,nkpph complied Wmer Adegkary Form
PERIMETER/FOUNDATION DRAINS PROPOSED? YES NOD EXISTING SQ.FT. Zeal
EXISTINGBEDROOMS O PROPOSEDBEDROOMS a TOTAL BEDROOMS 0
OWNER"'a"oe n IM fuknkabn otlnaawek Mmnalm mry nsuX N e acq vnR oNera pemY rtwallm.NkmMMwmeMdsutli a Ly
sipneWm[elow.l Cetlert her! ear NewareranE NrlFar tleGare Nel learentitledearmar lnia permitermenna th-6 aspmpaaN.I new
Weemn palNpanhom all the raiser,pares,Inords,any easement holder orpanies areal alarninp this senior IDe mmerorlewl
lepMehY4M,reandenk NN the in canal pmnded a acarram,am grants employees at Mason County aaess to the shave descnted property,
atl eVrWYle(s1NreNexand invetlbn, Tres pernshappBadoe becomes null ar yed XwnM1 or euNonaed consW[lion Is net warrants,MRn I113
6ys wMans6uctim vorM ee auapended fa a paW of IB0 days.
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
COUNTY CODE 14.011.43)
XGl Payne °pineraosidn's-rar"yataideassuraliffilialit 2/12I2024
SgneWra of OWNER(Muat be atoned by Ed,OWNER) Data
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSWCTES/CONDITIONS
BUILDING DEPARTMENT
PIANNDNG DEPARTMENT
FIRE MARSHAL t
PUBLIC HEa1TH ( C g
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