HomeMy WebLinkAboutBLD2024-00861 - BLD CD Environmental Health Review - 7/18/2024 BLDZoty e-00861
MASON COUNTY
COMMUNITY DEVELOPMENT JUL 17 2024
.N Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION 615 W. Alder eat
PROPERTY OWNER INFORMATION: CONTRACCOR INFORMATION:
NAME:auaNaxlwlxew4s°x NAME:waoxMueg vwd G.m. tCC
MAILPIGADDRESS:®slLiNt YGR MAILING ADDRESS:3430MmA`EM F ��
CITY:°IaTG" STATE:WA ZIP:man CITY.'ga'^'A'Na STATE WA ZIp:Ie61z t
PHONE41:amaa'4aN PHONE:>�TM�® CELL: aN®raaae
PHONE 42:dial EMAL paaaamA�a vanan J
EMAIL:xbxol.M'csrGlaluGlusGu L&I REG 4NAaaFa—saa .
EXP.05116125
PRIMARY CONTACT: OWNIAQi CONTRACTOR[] OTHER --- z
NAME unavasutpx EMAIL xlulaemamxMcwwraN
MAIUNGADDRESS mELsatal CITY arnsw STATE ZIP. LIJ
PHONE CELL
PARCEL INFORMATION, z Q
P%RCELNUMBER(12Dien NNnba) zxnaaoppopa ZONDlG aaa O LLI
LEGALDESCRIFTION(Abbrevignal a adz4wdmgarRsxsaeRRNac—g FDtEDISTRICTCam"o-adaaa CC
STTEADDRESS ape'^'°arm CRY aa—
DDtECTIONSTOSHEADDRESSmdaxwnMalum nmx mlrtryanxwlauml Tw,vairoamp mxnM mxrlawrp, •z
R MWVN9 Ok.NRNNGXlg110UtA4(VDk WMIM°HWnRNEW MNGM. LU
MS PROJF.CI'�3 nOFSLOPE(S)GREATERT 14%: YTS[] NOD SNOWLOAD:a_ps(
M MOPERTYWITHINMIFTOFTHEFOLLOWBMG: tihctMlabsmly/:
SALTWATER❑ IAKE❑ RIVER/CREEK❑ POND❑ WETI.eWD❑ SEASONALRUNOFi STREAM❑
TYPE OF WGIM, NEW D ADDITION❑ ALTERATION❑ REPAIR❑ OTHER ❑
USEOFSTRUCTURE(Reddasa,G,ege,CuxmnIX t .)!E!�--
ISUSE: PRTMARYD SEASONAL❑ NUMI3EROFBEDROOMSa NUM13BROFBATHROOMS
HEATEDSTRUCTURE? YES/Mang RAy Di YESOWt)geall❑ NO
DESCRIER WORK'°"O""0 awmn'u'a'ca',xm""'°'°'°®^mnc xwe.cv®waao.xxuoe®
SQUARE FOOTAGE:IAmpaaal
ISTFLOOl sq.R 2NDn00R mi 3RDFLOOR_aq.A. BASEMENT K.R.
DECK aq.R. COVERED DWK N.fi. STORAGE 'ft. OTHER sq.R.
GARAGE_aq.R Anal D Damchad❑ CARPORT aq.& AaaehM❑ DetachWo
MANUFACTURED HOME INFORMATION: a4 COPIES OF THE FLOOR PLAN REQ1THUgH!
MAKERFaB'^CCa MODEL�10i YEAR age LENGTH'''
WIDTH-d' BEDROOMS4 BATHS' SERIALNUMEER
ENVIRONMENTAL HEALTH:
SEWAGOSEWFA SOURCE: SEPTIC SEWER❑ / NEW MSI]NG❑
PLUMBINGINSTRUCTURED YESQ NO❑ I/yea,atmch completed Wma Adagmry Form
PERIME(ER)POUNDATI..ON,,yyDEATHS PROMISED? YES NOD MSTING SQ.FT. Mad
EXISIINGBEDROOMS� PROPOSED BEDROOMS 4 TOTAL BEDROOMS'
GW NER acknaMeEpes PrtiuCmbslM IX baavae inKnn&in mry neWl in a elcq vvh atlas pemRrewrerka.PtloaeMedaemam NveM1 Iaq
1111.1e below.I declare Mal l am Me weer ant I NMer declare Nat l am modoc b receive Mile paml and to da to vmM1 as impound I am
obtained Merl M1om all Me rcfcyuy Fal Including any emement M1dderorpames admitted,regarding vab,ploRCL The—arr lapel
repesenlative,represents IM1eI Ne YXamelbn partletl is eavale arb prarAs emgoyca of Meson Lwnry e¢aee bNa above tlesvlbM pmpaM
andabu:luran)letreNer,is aupalbe. r.,pemiil/epplydon Eemmes null&vdd nxvAweulFodxe]amsW a1MnbnNCpmmaN9tl xitlil ta]
Jaya orueoxaleagon wad:S axapaxaee m e pedoa m tM ears.
PROOF CO TINUATION OF WORKO THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
ITAPP C TION 180 A MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.
(MASON
COUNTY CODE 14.08.42) �j
Sp NotOWNER(MUM do SIMMED a
D"XIIIACENTAL REVIEW APPROVED I DATE DENIED DATE TAG&NOTSEnCONOTGONS
BDH.DMGDEPARThfENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLICHEALTH Z -
1
__AN
! - - - - - - - - - - - - - - - §
� ƒ 7
0
3 -0
)
\ `
\ m
| I 00
/ I / K
q+ ! §
ƒ m 9\
/
|( !.! , (\ , 7 \ i ! �
!!,
( ! \ � ) / / ° ° z � |
§
, § ! 0.30
2 2 } / � \30
• - - -- - - -� - - - - - - - - : / r k
. ® {
,a_eaLLC QURAO=NICHOLE WILSTON Pa. �5000003F,,