HomeMy WebLinkAboutBLD2024-00760 - BLD CD Environmental Health Review - 6/26/2024 MASON COUNTY PeTmttNo: 1110
COMMUNITY DEVELOPMENT CEIVED
Permit Assistance Center,Building.Planning JUN 24 2024
BUILDING PERMIT APPLICATION
615 Ider Street
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:f_e1a2`/ NOL)O f.J1E.T�lI/ NAME:
MAQ.INGADDRESS:27W& AFL) QLDE MAMING ADDRESS:
CTTY:PDUL<R!7 sTATE:WA_ZIP:�fjW CITY: STATE: ZIP:
PHONE#I: / PHONE: CELL:
PHONE#2: 1 EMAIL:
EMAIL: K L&I REG# FU).
PRIMARY CONTACT: OWNERa CONTRACTOR❑ OTHER C� m
NAME EMAIL O%GS 1I OU'l
MAILINGADORES1�2711 r D_D Cin ryli5B0 STATE ZIP O
PHONF ydL% G
PARCEL INFORMATION: vv�A rr11
PARCHLNUMNU(12D:Ot Numbla)�JZ0Z1-tITJ-'�I[Y13. ZD
LP.GAL DPSIRRT[ON(Abbtvm'Yd) yuA[Es>r yu ES2s rt Of "ra D RIOT
DIRECTIONS TO
SITE ADDRESS Nn xIG_HiiW 'gf TO E ACO/c%ITFG m DGTON
)V RwI QI(MII
rufL4 sso px,,—,�ooDw� �T-p/� SSGG Fe' — Nu w�+L rar .
I9 TTSPRO2ECTW'IT�A'300 FT OF SLO E(S)G TER , YFS N0� BNOW LOAO: sf
IS PROPERTYWITT@N 200 FTOFTHEFOLLOWING: la..ctmaor :
SALTWATER❑ LARH❑ R[M/C]UPIC❑ POND❑ WETLAND[] SEASONALRUNC) ❑ SCREAM
TYPE OF WORK: NEW E ADDITION❑ ALTERATION❑ REPAIR D OTHER TI
USE OF STRUCTURE(Resedead ro„Nc ae.) 2E 11 p P.NLL
IS USE: PRBAAAYp SP_4SONA [] NUMIHEROFBEDROOMS NUMBBROFSATHROOMS
HEATED aTRUCTIIRET MP,aSSBNy® YSSmFanl•JMewl❑ NO❑
DHSCRIDEWORK FRLJE 0U—/ HD'*E AJ (P6 W4tALLp9 DA) s_OI
NOW RX
edo 1
ISTFLOOR q.R 2ND11OOR III 3RDFLOOR_N.R BASEMENT q.R
DHIXq.fl. COMEDDECKORF
.ft. STORAGE q.R OTHER q.fl
GARAGE_q.R. Attached❑ Delacl e l❑ CARPORT q.R AU. W❑ Dialectal
MANOFACTU�R,,E�DHOME INFORMATION: 4 COPIES OF THE FLOOR PLAN REQUIRED•
MAKE _&Wj rO'J MODELTE YEA$MIP6 Oil g 06anJ4 LENGTH_
WEDD(l BEDROOMS 3 BATHS Z SERIAL NUMBER
ENVIRONMENTAL HEALTH:
58WAGEISEWFA SOfIRCE: SEPTIC$ SEWER / NEWK EKiSTING❑
PLUMBINGIN STRUCNRE] ME NO❑ Ilyca.attach romFlxad NPaterAdgaary Form
PERIMETER/FOUNDATIONDRAINSPROPOSEDP YES[] NOE MISTINGSOFT.
EXISTING BEDROOMS_ PROPOSEDBEDROOMS ^i TOTALBEDROOMS 3
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lepteaenMNee relpresets Neml me mitt ardor,pAvdM ISceacwrete and t Ilw em M1 adrmp.Nx oMasonx W Imertn ne.rall Mt poial llie veer m Ieael
prams anlHoyees Mon County e «e to enm an
pmgrry
. sauINrelsitor renew ectl I-tee Indon. Thispermioappltration beasnea nullflvokHmmkor authoexea wnstndbnk nd commencetl MM1In 1>t
mya or H mneWcibn xuk al us«atletl for a penal of IN Gaya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
�� • _ COUNTY CODE 10.08.42)
SigneWnaf OWNERQRastlro6laned bvthe OWNERI Date
DEPARTMENTAL REVIEW APPROVED DATE DENdtD DATE TAGSINOTES/CONDDTONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH % f
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