HomeMy WebLinkAboutBLD2024-00330 - BLD CD Environmental Health Review - 3/12/2024 PermR No:� 90 -00330
MASON COUNTY 1 C -
COMMUNITY DEVELOPMENT tgpR I 1 2024 z
Pmnn AMl,Ol Centv,,EuiNiay manning <
BUILDING PERMIT APPLICATION 615 W. Alder Skeet = x
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: D O
NAME: NAME:o.mo c««-I—NMMef
MAILING ADDRESS:e111.R1 Road.a m MAILING ADDRESS:23a = ITN
CITY: STATE:NI ZIP... CITY: STATEWA ZH:Mme z
PHONE pI:en-zewul PHONE:amasxum CELL: eoaaznssa
PHONE tQ: EMAIL:m«Pwlalam.l:n— D
EW,IL:nlaaaedm.amm L&I REG NvaclrwFavua EXP.06/14/24
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PRp4ARY CONTACT: OWNERO OOINBACTORp OTHER❑
NAM EMAIL
NAILING ADDRESS 411 WM `faw CPIYrwwaN•W+a.. STATE v 4.u1 3
PHONE CELL waao+ml m 9
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PARCEL INFORMATION:
PARCELNUWER(121A&ii N=Ixa) a3aoaW@10 ZONING Ra m O
LEGAL DESCRIPf10N(AEblavute� aassnPaulavavmaaaR wmgr Rlr+a Mn FBUi DISTRICI"`a""""'""""°a O �
$1TE ADDRESSem ME are...m.n CITY+
DIRECTIONS TO$DE ADDRESS eam«w o..almaamamaas.n ua.ayXm MrA1MIm NarenumaN
LSTBEPROJECTWITRIN3N0 OFSLOPE(S)CREATHR THAN I/%: YIMO NOO SNOWLOAD�
ISFHOPAEW WRBIN20EFTOFTHEFOLLOWBSG: Irewl aaam W*Yl:
SALTWATER❑ LAKE❑ RIVEP/CREEK p POND❑ WETLAND O SEASONAL RUNOFF❑ STREAM O
TYPE OF WORK: NEW p0 ADDITION❑ ALTERATION p MAR p OTNFR p
USE OF STRUCTURE ManN .T,«as c—anno&agw—
MUM: PBDAARYO SEASONALp NUMBER OF SMROOMM a NUMBER OFBATHROOMSX
HEATED STRUCTRE? YES~aW O YFS(Avdy yaYa1❑ NO[]
DESCR®E WORK NBv6aPh Feny
SQUARE FOOTAGE:omwnaag
1STFLOORIem q.B. 2NDFLOORIam q.R 3RDFLOOR q.R. BAMEMENT_q.ft
DECK q.& COVEBEDDECR4I1 q.R. STORAGE q,& OTHEE1. q.R
GARAGE_q.R Auada p Dear AM[I CARPORT_q.R AW6&p Ikmhm13
MANUFACTOREU HOME INFORMATION: e/COPIES OF THE FLOOR PLAN REQUIRED'
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBEF
ENVIRONMENTAL HEALTH:
SEWAGEISEWER SOURCE: SEPTIC El SEWERp / NEW EXImmo
PLUMBING ON SIRUCRME? YES O NO❑ KYe,a map/etetl Wa Adegaary Faml
PER]AM-UMFOUNDATION DRAINS PROPOSED? YESO NO[] BKISDNGSQ.FT.
EXISTING BEDROOMS PROPOSFDBEDROOMM S L� TOTALBEDRCCMSa
OWNFR ecbivwlmpas Inel wdnbebn of iixm+m inl«meYm my'awW F e erop v.M«br«pmmX reuwal'wn.acanvil�gamemdeutll bEr
alaMurt nelow.l tletlere Nw I em Uw vnYr ene I NMereeGYe WI I am emXbe to remlre In4 pmnX ene to eo me xv,F ea pmposee.l Nw
cLleinae P¢miwon Irom all lne nwessery qNm,includ�q Byetwnera�dw«penlre d inlaetl rey�ein9lms P�%en.Tlie wmer ar legal
rapesenmliN,ee)rea«ns tlut Ina IM«Inel✓F PBwpeX'a e¢vRb«tl penb mployeM N Ma6m CwnlY.scess la Ne e0we eesceLeE p�tglly
em slma«ya)ar naw.m ImpxXm.aria peimmwgi®X«Immnea gun a wa ea.«x«auumnzae<onsrewon la na«mmerwm wmm Im
Gaya«X mNrvctlan sxA Y euapenUM M e pa1N d 100 eaya.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERIAD APPLICATION OF 18E DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
X sWNTY CDDE I/AgA2)
3/ii/24
Slgim OWNBR IMM W aminad M aM OWNBR) Dal,
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGSMOTFB/CONDITIONS
BUILDING DUARTMENT
PLANNING DEPAKTMINT
FIRE MARSHAL
PUBLIC HEALTH -
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