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HomeMy WebLinkAboutBLD2024-00302 - BLD CD Environmental Health Review - 4/5/2024 -0 MASON COUNTY COMMUNITY SERVICES Permit No: dt,,O �("I PERMIT ASSISTANCE CENTER: .BUILDING•PLANNING-PUBLIC HE41.M-FIRE MARSHAL RECEIVEDC03M 615 W.Alder Street Shelton,WA 98584 Phone Shahan:(360)427-9670 ext.352•Fax:(360)427-7796 Phone MAR tWORON ME Better:(360)275A467 a Phone Elma:(360)482-5269 A BUILDING PERMIT APPLICrAIAAlder LTH m u PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: ^' o NAME: 1 tep.Qti✓ NAME: Sy rt..- L G MAILING ADDRESS: ), MAILING DRESS: +`� CITY:Slt!A+0a TATE:/ 1�ZIP�R.cR�I CITY:)ni,,odd i_ STATE: aler ?F: PHONE#1: 3Aa-'30-1Z� PHONE:z i ry b CELL: PHONE#2: EMAIL: tn+cb. t�we_i. a hnvu e- r EMAIL: L&.I REG PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAMEGr' EMAIL MAILING ADDRESS CITY Slime!44A ST TE1 — ZIP 98S�/ PHONE 36n•If9•1973 CELL PARCEL INFORMATION: 1 PARCEL NUMBER(12 Digit Nutnber) S`LOVtil- 21_-0o3y6 ZONING I` LEGAL DESCRIPTION(Abbreviatedl)'T}? 33 0G 60VI' LD7'(#AIWAV3 FIRE DISTRICT 4-L SITE ADDRESS 343+ w449e AA1Lya.4r1, I fl✓ C�C wJ�1.-14dn DIRECTIONS TO SITE ADDRESS r"4/-, A4._&+j&C Jk ¢.A =.e 4I✓ Lu.l c- A&"".e f Pike IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOW SNOW LOAD: Del IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check aU datapply): SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM TYPE OF WORK: NEW W ADDFFION❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Rehimer.Garage,CommercfalRldg,DO�tN IS USE: PRIMARY. SEASONAL❑ NUMBER OF BEDROOMS J_ NUMBER OF BATHROOMS La HEATED STRUCTURE? YES(Whole Rldg)8;_ YES(Panfel os B/dg)❑ NO❑ DESCRIBE WORK SOUARE FOOTAGE: (p apood) 1ST FLOOR l 8'L sq.R. 2ND FLOOR sq.ft. 3RD FLOOR - sq.R BASEMENT sq.fL DECK sq.R COVERED DECK sq.ft. STORAGE sq.ft. OTHER-L 00-sq.R GARAGE 't@i_sq.ft. Altachedit_Detached❑ CARPORT sq.ft. Attached❑ Detached❑ IMANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLOOR PLAN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS SERIAL.NUMBER ENVIRONMENTAL HEALTH: i SE'WAGEISEWER SOURCE: SEPTIC 14 SEWER❑ / NEW❑ OUSTING Er I PLUMBING IN STRUCTURE? YES 9- NO❑ , Ifyyes,attach completed Water Adequacy Form PERIMETERTOUNDATION DRAINS PROPOSED? YFS f4� NOS/ EXISTING SQ.FT. EXISTING BEDROOMS PROPOSED BEDROO V TOTAL BED ROOMS OWNER anI nowtedges that submission of Inaccurate information may result in a stop work order or permit revocation.Ada ossedgement of such Is by signature below.I declare that I am Me owner and I further declare that I am emitted to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parses,including any easement holder or panes of Interest regarding this project The owner or legal owaen.apwwms®fna s,mueewn alwxawfnmmauw,mrmawlln.amp�xerewwpma ievomnoeAamaiMatlpmanrwwmtM elpMure Lebw.I tleLvefl,rt l em Ne owcr aM l(uMvtlaclanfhn l am mifltletl b wNelltla pamM1aM b M Mexaxk ae pmpavee.l Mre Wa4,a]prtmlsskmfmm all Ne nec�asery pmlim,Irclutling anyeeeM>s[noltlww pvEes ollnfamsl repaNliplM1ic pmleG The Wmerorlepv rq enmllN,repesa�Nef Pe mfomarvn pwtleileewm@antlprenLS mnploywsWMesan CourryaeevbfFe,vr nneretl Wuni vd sbuWrels)NmAew antl iwpaV:x Tib pnnWeppsEon 6amnes null8uritl BxohoraW Wetl�s4umm is M cwnme vnNin iW days w Mcvns w haus diic Im a plbtl ar IM dam PROOF OFCONTINU FWORKONT ISPERMITISSYMEANSOFINSPECTION. WACTIVITYOFMIS PERMIT APPLI OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON COUNTY CODE 14.09.42) X R notate AOWNERfNuetbs atoned WMe OWNERI Dale ... ._ .,...�,_. ....- . ...- .-.. ., .... 'r^hss iEIbN.eQPUN.TLQ4�' K lrAi ,,: ,.ArZ$Q£F_OT' +D . -:+ I i ':Dpffi" .`ucslt4o BUILDING D)PARTMINI' PIANNINGDEPARTAIRU PBtSMAacae* PUBi2C]' LTB \ \ m ' & &§/! \\ j ® � x4R \§� ® «/ ! / f ) q Ea � ) (p ! \ 2 � ] q / ; §° \ | ¥ § _ § ©'R! ) M.2 (i |(! � 21 Co ! !/ �\ � • - � / \ { g & : . 1'7 / � ! � - — : „z I� = r F (n m T - D W W ID' m cn 31n `m ^� � D _ - oy Q m�T, � WNZ �\ DmZ D o CL n _ TN ^ fn Z Xn' Lo HIZ » p m � m � D zo � Z \ \\ i< \ m p 9 . . -. � am D o ym 0 Om A ; � mu \ \ � \ 0 9 \ mpp m0 m Z m \ \1 \f is A = Zm h! o � 1 " & as3 a � ..• �f a Ail n �` p � s