HomeMy WebLinkAboutBLD2024-00173 - BLD CD Environmental Health Review - 2/8/2024 Permit N.:e)t oacQU"Q��/
MASON COUNTY RECEIVED
COMMUNITY DEVELOPMENT
PermftAsa]Plzme Ceram,gullalry,Planning FEB - 8 2024
BUILDING PERMIT APPLICATION
PROPERTY OWNER INFORMATION: CONTRACTOR ITV TTON: Z
NA(E:..DTRESe DEM1Y NAME:KIFERCM51nnU4T0N UC C
MAILAIGADDRESS:175EPHg11P8WEl=PRD MA]LINGADDRESS:1515KREMAY UE
CITY:6HELRCK STATE:WA ZIP:gaSeg CM: STATE:we ZIP:gain, 2
PHONERI:-as6xsl PHONE:--'- CELL: maaa>75ce � Z
PHONE$2:M4W1am EMAIL:DNUOuyIlFacaxsrFucn«r.aRa
EMAD.:MMKBERRYngXl.l-. LBI REG9 KIF£.MM EXP. 3 212024 'J.
Y CONTACT: OWNER❑ CONTMLTOR(] OTHER[I
Cn
NAME GMDEES EMAIL CMNXMK1FBIrOWIIATEl.aPa
MAIWNG ADDRBS51msImE6KKAuraua CDY�^R'+M STATS21Pgm5r
PHONE emror4«P CELL smrK+su
PARCEL INFORMATION:
PARCELNUb1BER(12 Digit Numb«) Y lsaaP42 ZONING
LEGALDESCRIPTION(Abbrevimed) FIRE DISTRICT
SITEADDRESS1mEmUJPe LN.ELDDPRD CITY �C(02��10If
DIRECTIONS TO SITE ADDRESS 'm"r""'"°"rr�'""r"r"""°."°"'"."'o"'."""""'"'°"'."s".`.sr`m`e" O
LERr
N=PROJECTWT M300FPOFSLOPE(S)CREATERT NI4%: YFS[3 NOQ SNOWLOAD:---Psf
IS PROPERTY WITIHN]00 FT OFTHE POLLOWING: 4oa emr aPPyJ.
SALTWATER❑ LAKE❑ RWEWCEEFTC❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW O ADDITION❑ ALTERATION❑ REPAIR.❑ OTHER ❑
USE OF STRUCTURE(2,a �ge.cwu.s.vwlawa.fiK)R[61DENCE
IS USE: PRIMARY O SEASONAL D4., NUhIDEROF BEDROOMS2 NUMBER OF BATIR OOMS g
HEATED STRUC IJRE? YES(wAa.BUW1 YES ryon(,JMN6i1❑ NO❑
DESCRIBE WDRKmaY.gBARNDOMXILM vn1RPNN1EDSfUPlOCMETK RDOFµDT1-11610EWNL PANELS
SQUAREFOOTAGE:I&wP
1STFLDOR1rm s4.R 2NDFLOORWA N.R 3RDFLO0RW sq.ft. BASEMENT WA Sq.R
DECR_N.R COVEREDDECK,M sq.R STORAGE N.ft OTHER_sq.R.
GARAGEwA N.ft. Anached❑ Dem AnI[3 CARPORT N.ft. Attached[] Deaah []
MANUFACTURED HOME INFORMATION: A4 COPIES OF THE FLOORPLAN REQUIRED'
MAKE-MODEL-YEAR LENGTH
WIDTH BEDROOMS BATHS SERW.MIMBER
ENVIRONMENTAL REALTH:
SEWAGE/SEWER SOURCE: SEPTIC0 SEWER / NEWO EXISTING❑
PUMOINGINSTRUCTURER YESO NO❑ IJW,,amach cPnnkwd WmerAdawgy Form
PERMIETERNOUNDATION DRAINS PROPOSED? YES Qi NOD EXISTING SQ.FP. ,Tm
EXISTING BEDROOMS NONE PROPOSED BEDROOMS 1 TOTALBEDROOMS e
gYKER a«n«.xaau ma wemwim mmxwele mmmemn law lawn In e.mP..«x araer«Palm,rewmum.wrmxagememawa lany
eiarary Eelossaeclere Nm erarMOmerwa I d,dagxMRmelIan IWomraYive Inn Penn,ammaanM x«kYgOpaMa.I Nue
omeinee oemiisslon,lain mime necessary Ponies,MNueinD anv ee.emem miaa a Pames M Inmlem rpmalnatw Pgea rneawnr«kPM
repmemmive,reyeaents roar Ne imorm9bn ProNaea'u atu2re se Preens emPlgreea M Mawn Cwny eoxv wNeeW.e aemilM PrM«rY
ana orI-.e)rareview eM iusaa'.11m. ,.In.
ISidam Ee»mea nu118 vca IwwM aeutrm'izeecwauctlm laMmmnwcaa MNF 1W
mye«n on.m.cum w«K is a�wwaea roe a Pease a lea aaas.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLIC TION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNtt CODE 1AOB.82
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R1'MENTAL REVIEW APPROVED DATE DENIED DATE TAGS!NOTESICONDTITONS
ING DEPARTMENT
NING DEPARTMENTARSHALC HEALTH Orr my
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