HomeMy WebLinkAboutBLD2024-00853 - BLD CD Environmental Health Review - 7/18/2024 Jjj � UPe ' NO:?)
MASON COUN7DE�VIEELO
RF( B701G EN�����
40 COMMUNITY T lfPermit Assistance Center,Building,Plan
BUILDING PERMIT APPLICATION 615 W. Alder Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
cnd.CpryAt.min EVNe NAME:TM WYllmwiS nP1/>.Irl�lytdl ^I-
NAME: MAILING ADDRESS:v.18 NE1 ,s.
MAILING ADDRESS: STATE: ZIP:
CITY:°"""" STATE:'"" ZIP:8B5�B CITY. em«e.aae CELL:
PHONE#I:DF""6'81658- PHONE:
PHONE#2:
unN.I0o-u968aD EMAIL :•.•°m`^°••"""'"�o"""°".•°"
EMAIL:— "yfi�"°"iieB"""`°"'••'•,war®y.n.e.oan L&I REG#u11 LLIDL4.�1OQ1
P�RIMARY CONTA�CT: OWNER Q+ CONTRACTOR❑ OTHER I�—
MFPtyryMJ tpr 1n71Uli.�WaS /tlrl^' 1-Gr EMAIL
CITY STATE_ ZIP
MAILING ADDRESS CELL
PHONE
PARCEL INFORMATION:
g 929zaasohtsb ZONING RRs
PARCEL NUMBER(12 Digit Number) FIRE DISTRICT
LEGAL DESCRIPTION(Abbreviated) Ta rs of SURVEY ss
CITY aE1FAIR.WA9054e
SITE ADDRESS ore]NE NIAHOWYA RD 9ELFAIR.WA 9-8
DIRECTIONS TO SITE ADDRESS Fmm sbanon,mx.H.ya N.rmr.aW.e.L.nwAsw n g.ayowan In tarot.Ln nlry'.nwAaww,wnt..n Ne xwmsewn Ro.
Ron eanran Or,arM1on NE HUN M.mM.sVYgbr.n MYM'rya Rd
IS THE PROJECT WITHIN 300 FT OF SLOPES)GREATER THAN 14%o YES+ NO ❑ SNOW LOAD:2�sf
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (CheckaV that Vidy):
SALTWATER❑ LAKE❑ RIVER/CREEK(]+ POND ❑ WETLAND❑ SEASONAL RUNOFF[I STREAM Q+
rLFFR
RK: NEW Q ADDITION❑ ALTERATION ❑ REPAIR❑ OTHER ❑
TURE(Residenre.Garage.Conunerclal Bldg,Etc.)sFa NUMBER OF BATHROOMS _
RY ❑ SEASONAL 0+ NUMBER OF BEDROOMS'
CTURE? YES(Whole Bldg) +(] YES(parrlsloJBldg) ❑ NORK NpN°°°°0Au .sro Iw..:mcwa�TAGE: (vropo4�1
1ST FLOOR°W sq. ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.R
s ft. STORAGE sq.ft. OTHER s<I ft.
DECK sq.ft. COVERED DECK al 4 CARPORT aq.ft. Attached❑ Detached❑
GARAGE sq.ft. Attached❑ Detached❑
MANUFACTURED HOME INFORMATION:
"4 COPIES OF THE FLOOR PLAN REQUIRED*
MODEL YEAR LENGTH
MAKE SERIAL NUMBER
WIDTH BEDROOMS BATHS
ENVIRONMENTAL HEALTH: EXISTING p
SEWAGFJSEWER SOURCE: SEPTIC(]+ SEWER
NEW
I attach completed Wafer Adequacy Form
PLUMBING IN STRUCTURE? YES�' NO 'f EXISTING SQ.FT. °
PERIMETER/FOUNDATIONgRAINS PROPOSED? YES�' 2 �❑ TOTAL BEDROOMS ° '�
EXISTING BEDROOMSs PROPOSED BEDROOMS
OWNER acknowledges that submission of inaccurate information may result In a stop rmrk order or permit revocation.Acknowledgement of such is by
signature below.I declare that I am the avatar and I further declare that I am entitled it receive this permit and to do the work a proposed. have
obtained permission
ta all the nedessmy a.m.,that the ormation provided slng any esaament holder or accurate and grants employees of Maees of ton Couerest nty accessarding tothe above des Project The scribed a abed Property
representative
1 so
and structure(s)for review and inspection. This pertniVapplication becomes null avoid if work or authorized construction s not commenced within
days or R construction work is suspended for a period of 180 days.
EANS OF
ON. INACTIVITY OF
PROOF PERMIT APPLICIATIONI OFO 0 DAYS OF MOIRE WILL CAUSE ITHE APPLICATION TO IS
F WORK ON O BE EXPIRED. (MASON
COUNTY CODE 14.08.42)
I'] Weber
signed by Rachel Weber 7/1E/24
X Rachel Weller Date:2024.07.16 OR 2501-01aO' Dale
Signature of OWNER(Moat he aianed by the OWNERI
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT -
PLANNING DEPARTMENT
FIRE MARSHAL - lS
PUBLIC HEALTH
. \
_._
f § y
` D
�
\ l
x /\/I • / § \ \ � :\
! /
J|/\
/
�� E ° f �
6 /| ;
- - -