HomeMy WebLinkAboutBLD2024-00450 - BLD CD Environmental Health Review - 4/8/2024 MASON COUNTY PerwtNO:�ldi/d.j'N+CWED
F'C0.�1Li V
COMMUNITY DEVELOPMENT APR 08 2024
Permit Assistance Center,Building,Planning
BUILDING PERMIT APPLICATION 615 W. Alder eet
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION:
NAME:TMEY'OR�NN�NI s,w slssgM MANE: LNEDEYIICPRENf
MAIIlNG ADDRESS:"mENuaausw ED MAE.WGADDRESS:loll P.ededom RD
CITY;Reuw STATE:'"" ZIP:NNN C17Y:cN^R"+t" STATE:W" aP:wal Gat
PHONEft PRONE: CELL: aeoaM.aem C+ j v
EMAM:NEvamN^"'"1F°E'tE'waNNn`aD°N 0/L O m
Ply p2: L&I REOlo—e mle" EXP.___ F fz�
O
PRIMARY CONTACT: OWNER❑ CONTRAROR13 OTNBR❑
NAME aueuNwu CiTy
PHONEGADDR855 CITY SPATe_ZIP_
ZIP-
PHONE CELL 0
PARCEL INFORMATION: D Z
PARCELNUM8ER(12Digit Numbs)eel'Unp0130 ZONING if
LFAAL DFBCRH"DON IAbbaeviaW)T 12W YNEMCOFaPetMaETEUR =SM U FIRE DISTRICT = m
SITEADDRESS410ENdaaMwRD CITY°NEL Z
DIRECTIONS TO SIE ADDRESS D
ISTE,PRDTECTWIMIKMItTOFSLOPEE)GREATERTR 14%: YESD NOQ SNOWLOAD:n of r
ISPROPERTYWITIIINNIOFTOFTHEFOUAWDIG: (C".etmdal AWYlm
SALTWATER❑ LAKE❑ RIWR/CREEK❑ POND❑ WETIAND❑ SEASONALRUNOFP❑ STREAM❑
TYPE OF WORK: NEW❑ ADDITION 0 ALTERATION❑ REPAIR❑ OTMER fl
USE OF STRUMM Pealdeaee C+Mea,mmmemwl NCO.�.)RERC61fN1
ISUSE: PR VIARYO SEASONAL NUMBER Of BEDROOMS a NUMSEROFBATHROOMS'
HEATED STIti)C[URE? YES ryadeeNy� YES�v.(e/yateyO NO[3
DESCRIBE WGRRMmeu HEW NNiDRADNREp IXJME
SQUARE FOOTAGE:
IST FLOOR _eq.ft 2ND FLOOR_eq.R 3RD F140R R.ft MSEMENT_R.R.
DECK_sq.R COVEREDDBCK_q.R MEADE R.R OTHER_,q.R
GARAGE_Eq.R Xtmrhd❑ Detached❑ CARPORT_KRM MO DemcOd❑
MAMUFACTLTRFD HOME INFORMATION: '4 COPIES OF THE FLOORPLAN REQUIRED'
MAREaAYTa -- MODELLO"Fvw,Y YEAR' LENITCHee
WIDTHV BEDROOMS BATHSa SERIALNUMBER2
HNVIltONMENTAL HEALTH:
SE'WAGF/SEWER SOURCE: SEPTIC O' SEWER❑ / NEW❑ EXISDNOB
PLllMBWOINSTRUCNRE? YEs[+ NO fjma,attacb lampleta Water AdeOuury Form
PERBMETER/POUNDATION DRAWS PROPOSED? YES[] NOD MSING SO,PT.�
EXISTING BEDROOMS a PROPOSED BEDROOMS a 1/' TOTALBEDROOMS
pWNE0.xluwwMepvv Mtl eutmbYn Nlmaurete IMortnatlon mry rowll In atlro wcM wev rc ARnX nvyXm.AtlmcwleegemsaalMra Iv Ey
aaNb➢e E4vv.1tleaem IXeIlam Me timer ens luMareMerellW 1mmllXeelo none Na Pemalaalo eonre xvM1 eepamanen.l"l
mpmaenpave.repn M1om emat
mMRarypeNp,Ie Wlnpanyeeaea gmawed,m WANE tlt sonc,u*a,,ast ptgab Tadmvnmor Ngel
npreaenleLve,repaeaemc end NB In tone, nprwleeab a,aaalaaM preenemplola 9 of Noadn County ecceantdme1 nwA aeavlaea .1.I
ells a r,W�Na)fm review ells Inapeai. o,a pwm&'.dYon aecomea nullHwle RVMM o�aulaomea wncW ction IsM Wmme�avnlM 1W
69ye rcXdnAnc4on voM la cucgMea Iw B pMde N IPO tleys.
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
COUNTY CODE 14.08.42)
sl0remre dOWNER IM M amtl W1MOWNERI Dab
DEPARE
APPROVED DATE DENIED DATE TAGSJNOTE&OONDITIONS
PLANNFOE MPUBLI 7
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