HomeMy WebLinkAboutBLD2024-00340 - BLD CD Environmental Health Review - 4/18/2024 MASON COUNTY PeMitN��: FF�� ROM "
COMMUNITY DEVELOPMENT"EI&5 jXAp
Permit Assistance Center,Building,Planning MAR I22024
BUILDING PERMIT APPLICATION et
PROPERTY OWNRR INFORMATION CONTRACTOR INFORMATION:
NAME:1eea'.NNome UD NAME:rs,se—.
MAILING ADDRESS:+sm MaRhee - MAILING ADDRESS: "She Ill -
CITY.— STATE:WA ZIP m'm CITY *«m+er STATE — ZIP
PHONE#1 gasese�T PHONE aal CELL:
PHONE#2w EMAIL a/eRR«ib�Pnremm A
EMAIL, :r rmpreas all L&I REGN EXPO t1 /_ 4�
PRIMARY CONTACT: OWNERB CONTRACTOR OTHER I] �t
NAME wr m.. - EMAIL*s:WMnmeessenal
M WNGADDRESS sewflost CITY same '" STATE W^ ZIP—,
PHONE CELL
PARCEL INFORMATION:
PARCFLNUMBPR(12 Digit Numb«) m osessam° ZOMNG wPos°^�S �m
LEGAL DESCRRTON(Abbsemmed) NW osuWNw oFeHF rrxouwrm FIRE DISTRICT :° 0 s9
SITE ADDR�SSsee ElaiGNWn.EIeTHryOIOseq -. . .. CITY UHmN -. G j
DIRECTIONSTOSITEADDRES$ MVOxCHusnm MOMOERIEk'M(SfIOFFRq PoaRCMOfiunNxnA-MM tO
If,T g1rOOIDINTG4RY WERfOrtO4 ENCHr1MMEM HFIGHi5IX1:01MT0&16EW11NNCE CN LFfi810EGFR0. r
ISTfIEPROJECFWITHNMn OFMOPR(S)GREATERTHANI4%: YES[] NOD SNOWLOAO:sS_::psf
IR PROPERTY WR EI FRWER F [I PO I) pv`ETLAeO E
SALTWATER D LAKE B RIVFR/OtEEK❑ POND❑ WETLAND B SEASONAL RUNOFF 0 STREAM Q
TYPE OF WORK NEW B ADDTTON EI ALTERATION Q REPAR Q OTIRR FI'
USE OF SIIRUCCURE(s.Y.rn.O�rgaG�mrarde.9¢)P�roERCE
M uSE: PRI.IARYD WA NyLB NUMBEROFBEDROOMsn NUMBER OF BATHROOMS?!':. .
)hTATEDSIRUCTIREI YESrwhmao B YESPeivsr-kWO NOD
_.. .. _
DESCRIBE wORKbsia.esTan'emetE.rrd.Rvp�DENc[WranecworWQEFdwonipuutiWaoovwaearu
NODARR FOOTAGE:
1STF1CCl eq.R 2NDFLOOl sq.& IRDFLOOR so,& BASEMENT sq.ft _
DECK se sqR COVERED OEIX'ss eq.ft STORAGE. sq.ft OTHEl aq.ft
GARAGE_aq.R AAashed[] PetmNedO CARPORT-hat& Aresolhol Deta'hed0
MANUFACTURED HOME INFORMATION: a4 COPIES OF THE FLOORPLAN REQUIRED'
MAKE . . .. ...MODEL ._.... YEAR . . LENGTi'. #
WIDTH BEDROOMS BATHS . SERLALNIIDIDER
ENYMONMENTAL HEALTH:
SEWAGEISEW'FR SOURCE: SEPTIC B WwER Q I NEW B ECIsT Go
PLU. INGINsTRUC'RIRET YESB NOS {rM,mtach aaer sed B'merAdequessy Form
PERRv4TFWFOUNDATION DRAINS PROPOSED? YES B NOD ' EXISTING SQ.no
o
EXISTA'OBEDROOMS:.s.: PROPOSEDBEDROOMS a TOTALBEDROOMS a
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oemmea pemreeon rr«n all me n«oemry panes,muom�any e.eemem rmiaror PAID aimeres remi«rgmi:project The w.oarorepl
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PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MF S OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
n COUNTY CODE 14.0.42)
X e.b.r/Ehprezantnive or Luc Mal 11,2024
sgcf OYRFA 1Mum M MarrE Mtlr OWNERI Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSTIO'TES/CONDITIONS
BUDDING DEPARTFgNT
PLANNING DEPARTM
FILE MARSHAL.
PUBLICHEALTH I Owl
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